Dr Nirala Jacobi:

Welcome, SIBO doctor practitioners. If you have an elderly parent or grandparent or you're getting up there in years yourself, you may want to listen to today's topic, which is the aging gut. My esteemed guest today is really an elder herself in our naturopathic profession. For almost 40 years, Dr. Sally LaMont has been a licensed naturopathic doctor and acupuncturist, as well as an educator and a cook, and she sees patients at her Marin Natural Medicine Clinic in Larkspur, California. She focuses on healthy aging, digestive issues, metabolic and hormonal imbalances, pre-diabetes, and dementia. She's created drsallyskitchen.com for her patients and the public to share strategies and recipes to beat chronic disease using food as medicine. Such a great idea and such a great time, and I'm so happy to have Sally on our podcast today. So, welcome, Dr. Sally.

Dr Sally LaMont:

Thank you so much. It's a pleasure to join you today, Nirala.

Dr Nirala Jacobi:

Wonderful. So, let's dive right in to the aging gut, but really, I wanted to ask you first how you sort of gravitated towards this topic, healthy aging, which is really, you are... I mean, sadly, we are not filming because you are just such a glowing picture of healthy aging, and how did you get into this?

Dr Sally LaMont:

That's a good question. I think partly, it's just the drift of time. I myself have just turned 67, but I am not buying that I'm old. I think that old is in our heads. And while aging occurs, there is so much we can do to roll back the clock and reduce the detrimental effects of time. I think I probably got into it because I have watched the chronic disease epidemic really ravage, first, the United States, and then we shared our formula with the world. And we have now got six in 10 Americans have at least one chronic disease, heart disease, diabetes, cancer, dementia, chronic kidney and lung problems, and 40% of us have two or more, and that's a pattern that's being replicated throughout the world.

Dr Sally LaMont:

And I know that food is medicine and I know that the way we eat is what promotes the aging process. It amplifies the processes that are just going to occur with time. And so to really tackle the chronic disease epidemic, I guess I decided to lump those chronic diseases all together and make the focus on rolling back the factors that contribute to chronic disease so we can really wipe them out as a whole, and in the process, age more healthfully.

Dr Nirala Jacobi:

Mm. Yeah, so just a small goal you have then in terms of wiping out chronic illness. That's awesome. But let's kind of talk about, I understand that those chronic diseases also have an impact on digestive health, but in terms of if somebody is relatively healthy, what can we expect as we age? What are the changes that we can expect to see in terms of digestion?

Dr Sally LaMont:

Yes. So, like every organ system, its function tends to decline or slow naturally as we age. And one of the prime manifestations is reduce intestinal motility that, not only peristalsis, but the migrating motor complex tends to slow, and a lot of that is due to the way we eat and live. So we'll come back and talk about each of these, this reduced motility is certainly one of the manifestations of aging on the gut.

Dr Sally LaMont:

The other, a second one, is a reduction in what I call the chemical barriers, the output of hydrochloric acid, pancreatic enzymes and bile. And of course, with the loss of those chemical barriers comes SIBO, which occurs at a rate of around 15% in seniors as opposed to around 6% or so, according to the literature in other adults, the over 65, there is an increased reduction in these. Enzymes, we'll talk about that. And then, ultimately, a reduction in the function of the immune system, or what's called immunosenescence, or the aging of the immune system, which is really important now since 70% of our immune system is clustered around the digestive tract.

Dr Sally LaMont:

So as we move through these three kind of aspects of the declining function of the gut, I'll make reference to their relationship to the current pandemic we're in because there's an interplay there.

Dr Nirala Jacobi:

Mm. I think that'll be really, a really fascinating topic to discuss. So, getting back to this slowdown of motility, one of the things that we know also happens is a rise of methane as we age. And so we don't really know if maybe large intestinal motility is impaired with the rise of methane, but then now, you're also saying that they are these other factors that sort of naturally occur. And I wonder, other than aging, is there a purpose to slowing things down or as you age in that regard?

Dr Sally LaMont:

Well, I don't think of it that way. I think of it as a functional loss that is really brought on by the way we eat and live. As we age, one of the aspects of motility that occurs is increased incidents of helicobacter pylori infection, and that contribute to chronic atrophic gastritis. And the glands in the stomach just stop making acid. They kind of wither and shrink our atrophy, which we know predisposes us to SIBO. And with the loss of that chemical barrier, we see malabsorption of B12, which leads to fatigue, and it's one of the most common symptoms as we age. We see a loss of absorption of minerals, which, as you know, are best absorbed in an acidic environment, and leads to bone density and osteoporosis over time. Certainly, leads to SIBO and the methane predominant, like you said, the loss of that chemical barrier leads to C. difficile, which is deadly to seniors, and a risk in community acquired pneumonia.

Dr Sally LaMont:

Now, I want to just move right in to this loss of the chemical barriers that occurs because so many Americans, and I know people around the world are starting to do this too, and that is use proton pump inhibitors, the omeprazole. Omeprazole, as you know, is a class of drugs that reduces stomach acid output by 99%, so this is things like Nexium, Prilosec, Prevacid. They have a black box warning on them that says don't use more than 14 days. And yet those are... that black box warning is routinely ignored. And a study came out just last month that found that the long-term twice daily use of these proton pump inhibitors doubles the odds of testing positive for COVID-19, even after taking into account a whole range of sociodemographic and lifestyle and clinical barriers.

Dr Sally LaMont:

So, we need and expect that acid barrier to be there. Because every time we swallow, billions of incoming organisms are supposed to take an acid bath where they're rendered harmless and their numbers reduced. But the problem we have today in the U.S. and internationally is the rising use of these drugs, really removing that chemical barrier. And so I think that's part of the reason we can get an overgrowth of bacteria in the small intestine. Even the alkalinizing enzymes from the pancreas, that all contributes if we don't have the acid coming in, in the place, we're going to have an increased overgrowth of bacteria.

Dr Nirala Jacobi:

Mm. So, we talk a lot about proton pump inhibitors on this show and exactly what you just mentioned that this black box warning is routinely ignored, and just want to remind listeners that it does increase fracture risk and the risk of osteoporosis and so forth, so absorption of minerals and the whole host of issues that comes along with all of that. And it's probably one of the most common medicines that we see in practice that people are taking routinely, especially in the elderly, and it's just sort of this casual medicine that they're taking.

Dr Nirala Jacobi:

So I think it's a really important topic to consider because very often, I'll use bitters to kind of wean people off of it, and sometimes, if it is really an atrophic situation where hydrochloric acid has been reduced, then bitters are so helpful with the symptomatic relief, but if there is some sort of floppy lower esophageal sphincter issue, then it becomes a little less effective with bitters. But anyways, I wonder what your experience with that is, with just taking people off of PPIs that come in to your practice that have been on it for a long time.

Dr Sally LaMont:

Well, it can be challenging. I mean, I am always amazed that some people then go right off of a PPI and have no problem, but many people do. They struggle and decide to stay on it. So, the way I approach it is to do a very slow wean. And whatever dose they're on, I begin lowering it in intervals until they get down to the lowest dose of the PPI. And then I switch them over to the H2 blockers and let them do that for a little while, which reduces slightly [crosstalk 00:13:18]...

Dr Nirala Jacobi:

Yeah. And Zantac's just been pulled off the market too. So, yeah.

Dr Sally LaMont:

Wait. I didn't hear that.

Dr Nirala Jacobi:

Yeah. Well, in Australia, you can't get Zantac. I'm not sure about America, but yeah, there was also some issue with Tagamet and H2 blockers. So...

Dr Sally LaMont:

Oh, interesting. Well, that tool may go away, but it's a stepping stone down off. It turns out that melatonin is a really helpful agent in, I believe it helps to improve the tone of that lower esophageal sphincter, and you probably know, you may know more about that than I, but it's one of the tools I've used successfully.

Dr Nirala Jacobi:

That's great. I mean, it's great to kind of have all of the different suggestions out there. And melatonin, so you use melatonin to tighten up the LES if people have sort of a reflux esophagitis or so?

Dr Sally LaMont:

Yes, and because it's such a common problem. But there's so much work to do with the diet. I mean, getting people off of the standard American diet. And I know I'm speaking to you in Australia, but unfortunately, I know we've...

Dr Nirala Jacobi:

It's the same here, yeah.

Dr Sally LaMont:

Yeah, we've spread the refined and processed bad fats, bad proteins, and refined and processed carbs around the world. It is, in my mind, a natural thing for the body to reject that kind of food, and it's going to try to get it back out that closest exist, which is right back up the way it came. To me, reflux esophagitis and GERD is almost a natural consequence of eating food that doesn't belong in there in the first place. So, moving people towards a whole foods diet and away from excess alcohol, carbonated beverages, which, their bubbles just force that lower esophageal sphincter open, and having them eat smaller, more frequent meals. And then doing things like reclining at less of an angle than flat, but instead, having a pillow under their back. And that's something you see a lot of seniors benefit from. So, those are some of the examples.

Dr Sally LaMont:

And when I want to use a range of natural therapies here, I love the resin gum Mastika. I use a product called Mastika, but I believe it comes from the pistachio tree in Greece, I think it's Pistacia lentiscus, but it helps to kill H. Pylori and reduce GERD and esophageal reflux. And it's a really helpful agent because unlike some of the other things, like DGL can help, deglycyrrhizinated licorice, has some fibers in it that can contribute to the overgrowth of bacteria. So, I don't see that happening with Mastika.

Dr Nirala Jacobi:

Interesting. Okay, great. Moving on to, so let's move down from the stomach into the small intestine and some of the issues that you mentioned that can frequently occur with aging, such as... I mean, we'll talk about the villi, right, the villi. Do you see any... I mean, it's kind of rhetorical question because we do see it. We do see people need more enzymes and more digestive support as they age. And as you pointed out, typically, when people have had either poor diets, or I find, a lot of stress, right? So, throughout their whole life, if they've been really stressed out, then digestion has been compromised a lot. And so those are the people that often require more support for all processes of digestion, really. But what are your approaches there?

Dr Sally LaMont:

Specifically in helping with small intestinal function?

Dr Nirala Jacobi:

Yeah, and just digestion in general. When you have somebody who has, not just SIBO, because we're really talking about aging digestion.

Dr Sally LaMont:

Right. Well, replacing enzymes, as paradoxical as that might sound, given these acid blocking drugs. As you know, often, giving people pancreatic enzymes, giving people an enzyme mix that include some ox bile to help produce bile, emulsify fats, enzyme supplementation can make a huge difference. And I think another important aspect of what we see lost as we age is that drift towards intestinal hyperpermeability or leaky gut. And when we have a continuous influx of microbes and partially undigested food molecules and toxins going across that lining, we're getting a constant stimulation of the immune system.

Dr Sally LaMont:

There's something called immunosenescence, and that's the aging of the immune system and it plays a real role since 70% of our immune cells are clustered in and around the digestive tract. When I was in naturopathic medical school decades ago, we still called it the Peyer's patches, and they were that little odd group of lymph nodes clustered around the epithelial lining of the small intestine, and now it's called the MALT, or the mucosal associated lymphoid tissue. So, this is where our immune system differentiates between friend or foe, and it helps us develop either tolerance or tags a molecule for destruction.

Dr Sally LaMont:

So one of my big goals in seeing people as they age that have irritable bowel or probable SIBO is to assess whether or not they do have leaky gut with a stool test looking at zonulin, and teach them how to treat their inner skin as well as they may want to be treating their outer skin. I mean, people get so caught up in all of these antiaging things they can do for their face without giving a second thought to the mucosal surfaces. So I want to help them pamper that inner skin with the right phytonutrient-rich vegetables and fruits to a degree that they can handle it, taking FODMAPs into account, using things like glucosamine and zinc carnosine, which is wonderful for helping heal leaky gut and reducing the cytokine production right there at the gut lining.

Dr Sally LaMont:

Something else that I want to help them do is to stimulate secretory IgA secretion, and so taking some Saccharomyces boulardii perhaps, if that's appropriate. I don't know how you think that fits into SIBO, but maybe even using something like colostrum, or the SBI Protect serum bovine immunoglobulin, really helps to down regulate inflammation there at the gut lining and build up secretory IgA, and give their immune system a fighting chance so that we're not just sitting ducks when a condition like this COVID-19 comes along. There's some thought that if we have poor chemical barriers and increased intestinal hyperpermeability, that virus can embed itself in the digestive tract where it can spread quickly through the bloodstream to the entire body to cause problems.

Dr Sally LaMont:

So to me, knowing the problem that so many seniors have being particularly prone to the worst outcomes of COVID-19, tightening up those intestinal tight junctions, healing leaky gut and improving their chemical barriers overall is going to let them heal and stay well longer, and be less susceptible to a range of gut infections.

Dr Nirala Jacobi:

Mm. Yeah, I think that's... especially the serum bovine immunoglobulins, I think that was sort of a bit of a game changer when they arrived. And just for those of you who are listening who are unfamiliar with this, basically, used to be IV only, right, these kinds of immunoglobulins that were used also for conditions like mast cell activation syndrome and severe immune deficiency, I think it was used, and just really got inflammation. And they've made it into capsule forms. It's sort of similar to colostrum, but not really, and that it comes from the serum of cows rather than from the milk of cows.

Dr Nirala Jacobi:

So, it can be tolerated... I mean, it depends on how you feel about using something like that, but it's pretty well tolerated, and I've seen some pretty amazing turnarounds in people that have chronic leaky gut and chronic immunodeficiency. And I think it was a really good mention for those that are in that position and that are dealing with COVID-19 hotspots or whatever, it might be a good thing to add in besides these other nutrients, like vitamin D and zinc and those kinds of nutrients. And one other word I want to say, probably the most common condition that I see in my sort of older patients is constipation, right?

Dr Nirala Jacobi:

I mean, almost, well, I wouldn't say everyone, but most people are struggling. Well, they're coming to see me so it is a selection bias of seeing me for condition, but it is sometimes, for years, they have been really constipated and I just wanted to mention this connection with bile, because you brought up bile, and what is, I think ox bile or improving bile flow, if the constipation isn't due to SIBO or methane dominance, or what we call IMO now, or intestinal methanogen overgrowth, really considering bile and obviously, also looking at the diet for obvious culprits there in terms of really lack of fiber, if it's not SIBO and things like that, but would you say that's what you see mostly as well in terms of digestive problems?

Dr Sally LaMont:

I agree, yeah. It's part of that loss of motility. And there are things that we can still do with seniors that might even have SIBO, and that's to do something like drink ginger tea after each meal. A cup of ginger tea three times a day, feels good, tastes good, and is a pro motility agent. I'm also fond of herbal bitters. And you can use just the kind that you might put in a cocktail, but Iberogast, I believe that's a German product, isn't it?

Dr Nirala Jacobi:

Yeah. Iberogast is, I mean, definitely, it's more of a motility agent rather than... we use bitters naturopathically to try to increase digestive juices, and I haven't seen Iberogast be as effective with that, but I do use it, I do recommend it a lot for different conditions. But I find bitters incredibly effective for definitely more also for constipation, not so much for diarrhea. But bitters are... I mean, people have heard me say them in almost every podcast. So, I won't go into it, but the recipe is out there that I use. I usually use Oregon grape, [inaudible 00:26:53], dandelion and Baikal skullcap, just those four herbs and it's so amazing, the beneficial effects. Especially, I use it almost always when somebody is constipated. I just find it really helpful for that also.

Dr Sally LaMont:

Yeah, yeah. And then doing things like turmeric and artichoke, even, which work on the liver and help bile production, can make a difference. 5-HTP is often included in some of these pro motility agents. That precursor to serotonin affects bowel motility, and we just have to be careful if they're on an SSRI antidepressant that they don't get too much and go into the serotonin syndrome, but I personally have never seen that happen. But 5-HTP is one of the pro motility agents that I use. And then, of course, there's magnesium, which is the simplest way to [crosstalk 00:27:59]-

Dr Nirala Jacobi:

Welcome back to the SIBO Doctor Podcast. Let's jump right back into it.

Dr Sally LaMont:

... and since it's the most common mineral deficiency, as you know, just putting a little powdered magnesium citrate into water at bedtime can help people prone to constipation, which is more common as we age, wake up to a daily bowel movement and you just really have to titrate that to bowel tolerance, of course, too much and things swing the other way, but somewhere in the realm of a teaspoon. I mean, I've had so many seniors say that single thing, putting magnesium into my body changed my life. I can now go everyday. And of course, it helps lower blood pressure and helps them relax and sleep, multiple positive benefits.

Dr Nirala Jacobi:

Very good. Can you talk a bit more about your cooking show, Dr. Sally's Kitchen? I know when you launched it, it was just such a great concept. And what do you teach people, other than healthy eating, do you have specific conditions that you cook for? Tell us more about this.

Dr Sally LaMont:

Okay. Well, so I created Dr. Sally's Kitchen as a vehicle to educate people about the healing power of food, and really to help them reclaim their energy and vitality and prevent chronic disease. So, I blog every week or two and in fact, put out a really good post just a couple of weeks ago about this issue of heartburn and antacids, PPIs and COVID-19. So the website is W-W-W, drsallyskitchen, and it's D-R, sallyskitchen dot com, and Dr. Jacobi will have it in the show notes, but there's a blog post and then I am increasingly doing cooking videos on things like Facebook live and putting them up on YouTube, and I'm teaching classes now, digital courses on using food as medicine to roll back chronic diseases, strengthen immunity. I'm doing one starting next month, in fact, and it's going to be called the Healthy Immune Reset, because everyone's kind of looking at how can they tune up their system, their immune system, and reduce their risk of getting a range of viral infections.

Dr Sally LaMont:

So, that's going to feature some live discussions, Q&A and cooking videos, so I can teach people how to use the diet that I find generally to be the most loved, easy to do, and it's the Mediterranean diet. That, across the board, is associated with the reduced risk and incidence of heart disease and diabetes and cancer and dementia. And so I am on my website and in my courses sharing recipes that draw from the Mediterranean, but that bring in wonderful phytonutrient-rich spices from Asia, like ginger and turmeric. And I do red lentil dahl and a Thai coconut chicken soup. And so I'm excited about this upcoming course and I invite everyone to come and take a look at the website. I'll have a link to more information about the course, which will be starting at the end of September. And I'll be repeating this course again in January because obviously, this bug ain't going away and it's going to take a while. And...

Dr Nirala Jacobi:

Mm, and if it's not this bug, something else. I mean, it is a changing world in many ways. In terms of with climate change, there's now all sorts of other concerns about superbugs and all that. But getting back, first of all, I'm so happy to hear this amazing resource that you've created with this Dr. Sally's Kitchen and I think it's going to be really popular for people to really reclaim their own health. And I wondered about how much you've included aspects of the blue zones, which, of course, are the ultimate sort of proof of healthy aging, these hotspots in the world where people routinely live to be over 100 years old and what they all shared in common is that they have 80% plant-based diet as the basis of their diet and using meat as a condiment, and I think the Mediterranean diet is really a good example of that. So, do you sort of include some of those aspects?

Dr Sally LaMont:

I do, and I'm glad you mentioned it. Yeah, the Mediterranean diet is just, it's kind of the keynote of those blue zones. But what they all have in common is, as you said, a plant-based diet. They are phytonutrient-rich, colorful array of vegetables and fruits, nuts, seeds, grains and beans, and I call it a modified Mediterranean diet because I pretty much want to have people switch out the wheat for other gluten-free grains since we know that exposure to gluten and gliadin can trigger zonulin, promote just transient, but when reading it three times a day, kind of turns into constant leaky gut. So, I'm voting for a modified Mediterranean diet.

Dr Sally LaMont:

But beyond that, yes, all of those blue zones, also, they do, as you said, incorporate small amounts of meat. It's not like you can never have it, or fish, or chicken, or even wine. It just isn't the foundation of the meal like it is in our more Westernized countries. And the other things I love about the blue zone is the way in which people eat. So it isn't all about the food, it's the community. It's the connection. It's the fact that they live in... almost all blue zones have a hilly terrain, so it's easy to think of Greece as one of those spots because if you've ever been there, you know you do a lot of hill climbing. And so when you live in an environment where 90-year-olds are trudging up and down the stairs to go visit their neighbors for their evening meal, you automatically have exercise built into the lifestyle. It isn't some torture that you have to drag yourself off to do. It's a way of life.

Dr Sally LaMont:

And they rest. They don't work like we do in, certainly, America where we have 50, 60-hour work weeks. They know to take a siesta. They know to prioritize family, community, connection, and self-care in a way that we have not embraced, but I do hope that... I hope and pray that this pandemic is the catalyst for us to wake up to the opportunity that we have to build health in ourselves instead of just being like sitting ducks waiting for something to strike us. That's just a kind of uninformed way of perceiving. I think self-care's kind of gotten a bad rep for being indulgent, but it isn't when we're talking about the way we eat and the way we move our bodies and how well we manage stress and the kind of connections we maintain. I believe...

Dr Nirala Jacobi:

I was just having a thought about how I think that there is a lot more awareness, of course, about self-care simply because people are sort of disillusioned a lot with the way that modern medicine has treated them or treated their loved ones. And this whole empowerment of taking your health into your own hands can sometimes lead down the road of kind of also extreme views or extreme behaviors, do you know what I mean? Sometimes, people take it sort of really to the extreme in terms of their diets. And that can also mean being really worried and anxious about their diets. Anyways, I just had that thought of that I think there is a lot more awareness in general about health and disease and people wanting to really help themselves.

Dr Nirala Jacobi:

And my question to you was, or is, let's say somebody's listening and they have an elderly parent who has some digestive issues and they know their diet isn't the greatest, what kind of things would you suggest to them, just simple, easy things to start with that might really start to empower also some of these older people to kind of regain some of their digestive health?

Dr Sally LaMont:

Mm-hmm (affirmative). Well, one thing I would encourage them to offer their loved one, and I mentioned it earlier but I think it's really important, is something like ginger tea. It settles their stomach. A lot of older people, especially as they get into their 80s or 90s and their digestion is really compromised, they live with kind of low grade nausea and their appetite is poor. So ginger, a lemon ginger tea can kind of settle their stomach, wake up their digestion, give them a flavor that's pleasant and might help them eat. I would suggest they offer their family members pureed soups and smoothies because unfortunately, as people age, their dentition, their oral health is poor and they might not be able to chew the veggies that we would want them to have, but if you puree them, they can get them down.

Dr Sally LaMont:

On drsallyskitchen.com, I have a few different soups that are pureed, and I would encourage you to take a look at those because they're flavorful, they've got a good balance of carbohydrate, protein and fat, and delicious. And so that would be, I would say, pureed soups, and doing smoothies with a really high quality protein powder, and then putting berries and a little bit of banana for the potassium, and a handful of greens in. That's something that people tolerate well and it's a good way to build strength so that it's easier to think about eating more.

Dr Sally LaMont:

And I would certainly say cooked, steamed vegetables rather than trying to consume so many raw vegetables. It's just really harder for seniors to do. And I would put brassica vegetables, or the cruciferous vegetables to tolerance in there. Now I know that those are higher FODMAPs, and if they had a raging case of SIBO, we wouldn't want to do too much, but the sulforaphane and the sulfur containing amino acids and broccoli activate that Nrf2, compound that down regulates the genes that promote inflammation and really serve the body so beautifully. So, just small amounts, a quarter of a cup can make a huge difference, but of course, steamed, with a little lemon and a little sea salt can kind of wake up the taste buds.

Dr Sally LaMont:

And another simple thing that's really important, and it's inherent in the Italian lifestyle, is to take an after-dinner walk. Just getting up out of that chair and walking for 15 minutes after each meal. It's a great way to promote intestinal motility, but also wake up the brain and burn off some calories. And it's something that the Italians have always done. It's an inherent part of their lifestyle, particularly in the evening. And then going back to what you said in the morning... or in the morning, when we started this, your morning, is to reduce stress when we're eating, and that includes turning off the television and...

Dr Nirala Jacobi:

Especially these days. Honestly, it's just too much to handle most days anymore, isn't it?

Dr Sally LaMont:

It is. And the average American sits and watches TV while they eat. I don't know if you've adopted that terrible behavior over in Australia, but I want to encourage us all, even if we are alone. If we are a single person, always put a flower on your table, even if you just pick it out off of a garden on the street. Light a little candle at dinner time. Sit and take a minute to think about where your food came from, to thank the earth and all the hands who touched it. That kind of relaxation allows those digestive enzymes to start to follow, which improved absorption and improves motility, and reduces the likelihood of SIBO and constipation.

Dr Nirala Jacobi:

Mm. I love that.

Dr Sally LaMont:

And I think I...

Dr Nirala Jacobi:

Yeah, I love that.

Dr Sally LaMont:

Yeah. It's true. It's true. And just relax and really focus on food, chewing your food really well because it does not help when food is gulped, and that's actually one of the benefits of having a puree or a soup for someone who's got some impaired digestion, just to let them have a sip and swish it around in their mouth so that the enzymes and their saliva start to break it down, and then the digestion ensues so much better when we're not eating quickly, on the run.

Dr Nirala Jacobi:

Mm. Such great, great suggestion. I think the soups are fantastic. I think the ginger tea... I know we'll going to get some questions about what about diluting digestive juices if you drink a cup of tea after meals, but my response to that would be just don't make it a whole cup of tea. Do you actually use... how do you make your ginger tea? Do you use ginger powder, or fresh ginger, or a teabag? How do you prepare?

Dr Sally LaMont:

All of the above.

Dr Nirala Jacobi:

It'll all work. It'll all work.

Dr Sally LaMont:

Yeah. Yeah. There's some wonderful brands of pre-made teas that you can just soak a teabag in. And I'm not suggesting that you drink a big glass of water after a meal, but rather, sip a cup of ginger tea. And they're very different. First of all, you're not going to guzzle a hot cup of tea. It's going to take 15 minutes to drink that as opposed to drinking eight or 12, 16 ounces or what is that? A half a liter of water? That would definitely could compromise digestive enzymes being able to fully interact with the food and break it down. But I feel like sipping a cup of something like ginger tea is really useful.

Dr Nirala Jacobi:

Gosh, so many great suggestions. If you're listening to this and you want to find out more about Dr. Sally, again, all the information will be in the show notes. Gosh, this has been so informative. And really appreciate your expertise in this matter and your, yeah, your really extensive experience in this. So, any other last minute pearls or suggestions for those that are listening?

Dr Sally LaMont:

Hmm. I'm honestly such a huge advocate of cooking that I would say one of the things that you might do with that senior in your life is get into the kitchen with them and put together a simple soup. Take an active role in food prep. Maybe go make a big pot of soup on a weekend together and freeze it so that they have access to food when you're not there that's really going to be healthy and good for them. I just think we need to, as part of taking our healthcare into our own hands, we need to learn to feed ourselves right. Food is medicine. And learning to cook for ourselves is one of the most empowering things that we can do and it has lifelong benefits.

Dr Nirala Jacobi:

Thank you so much, Sally. It's been such a pleasure to have you on the show today. And I'm sure our paths will cross again in, hopefully, not too distant future where travel is allowed again and we can actually meet up at one of these conferences again.

Dr Sally LaMont:

I hope so. It was such a pleasure to talk with you and I just wish you all the best, good health to yourself and to your community there.

Dr Nirala Jacobi:

Thank you so much, Sally. You take care too.