 Well, hello everybody. Welcome to another edition of Dr. Jill Live. You know, you can find me on YouTube and all of our past episodes are on iTunes, Stitcher, wherever you listen to podcasts. I'm super excited about a guest today, Dr. Vincent Pedre. And we have been running in the same circles, have known each other for a long time. And we have a mutual passion for the gut. And I know many of you listening have had your own journeys with the gut. We both treat a lot of gut issues. So today, I'm super excited to share number one, his new book, but also hopefully some really practical information and tips. Let me go in and introduce him and we will dive right in. Dr. Vincent Pedre is medical director of the Pedre Integrative Health and founder of Dr. Pedre Wellness, CEO and founder of Happy Gut Life, and has worked as a nutraceutical consultant and spokesperson from Nature MD. He's also a functional medicine certified practitioner with a concierge practice in New York City since 2004. He believes the gut is the gateway to excellent wellness. As the bestselling author of Happy Gut, the cleansing program to help you lose weight, gain energy and eliminate pain, featuring his proprietary blueprint for healing the gut, the gut care program. He's helped thousands around the world to resolve their gut related health issues. His newest book, which we're going to dive into today, The Gut Smart Protocol, a 14 day personalized gut healing plan based on the Gut Smart Quiz, is the culmination of years of research and clinical experience in functional gut health. Dr. Pedre, so happy to have you here. Thank you so much for joining me today. Wow, that was a mouthful. Yeah. So I love to start with story and clearly you are well versed in the gut. You're a gut expert. This is your second book. The first one was amazing. I can't wait to read this one, but let's go way back. How did you get into medicine and then how did you get to be the gut expert? Oh, jeez. I mean, I feel like there's more than one storyline to explain that. The first storyline starts when I'm a child and I can just remember having a diet that was very devoid of vegetables. I hated salads. I basically was eating mostly carbs, rice, bread, pasta. And I just remember nights by the bathroom in tears with severe constipation, trying to go and I couldn't go. And this is probably like I'm seven, eight, nine years old. And then sometime after that, I must have just gotten an upper respiratory infection and went to the doctor. They gave me an antibiotic. Then a few months later, I got sick again, and I got another antibiotic. And then six months later, I went to the doctor again, because I was sick. I had a sore throat or and it just kept happening over and over and over. So I when I look back and I was thinking, well, how many rounds of antibiotics was I from the age of 10 to 19? And it's 20 plus. Wow. And of course, like every teenager, I was eating a typical kind of an American diet, like cereal with milk in the morning. You know, I grew up with those commercials, milk does the body good. So I was having sandwiches. I was having bread every day, every single day. My mom would pick me up at school. And I was already hungry. I was starving. I was probably eating like 3000 calories a day plus. And we would stop. I don't remember if it was Burger King or McDonald's, but we would stop at one of one or the other. And I would get a milkshake vanilla milkshake on the way home. And then dinner was probably, you know, sometimes it was pasta with with cheese, like baked ziti, lots of bread, ice cream for dessert. And little did I know that all of this was poisoning me. And it was weakening my immune system. And they would take me I was first chubby when I was a kid and then went through my growth spur got super skinny. And actually had to put up with a lot of body shaming as a teenager because I was underweight. And I was eating over 3000 calories a day and I could not put on a pound. And I can look back now and I understand you. I had been on so many antibiotics. My gut had become leaky. I had leaky gut. I had gluten sensitivity. And I couldn't absorb my nutrients. And so I couldn't build muscle. It didn't matter what I did. Right. No, I didn't know how to get out of this vicious cycle. And eventually, you know, I went to college and in college, I was in these dining halls where you could eat all you could want. Yeah. And so my my intake of gluten and dairy increased. And I think back now, like I came home from college my first year and I thought I looked the healthiest I had ever looked. My face was puffier. I had filled in a bit. But if you looked at me closely, it was kind of like that puffiness that you get when your body's retaining extra water. Yes. And it's that doughy face that my friend, Nigma Talib, she came up with like different face types. And she says there's like the gluten face, the wheat face. And it's kind of like Pillsbury Doughboy. Your face is kind of round and puffy. And that's how I looked. But I thought, wow, I finally gained weight. I'm healthy. But I wasn't healthy. I was still getting sick a lot. And that was part of my motivation for, you know, aside from my passion for science and for helping people, part of my motivation for becoming a doctor was to figure out how do I not get sick? Yeah, I was constantly, constantly searching. And it wasn't until accidentally because this and I got to say I grew up in a household where my dad was a bit obsessed with food. So back in the 80s, he did a food allergy test and actually put up on the refrigerator. And we thought as kids, this is ridiculous. Wow. He had like a food, a list of like 20 some foods that he could not eat because he had reacted to them on a blood test. He took a bunch of supplements. He would eat raw garlic every day. He was way ahead of his time, wasn't he? Actually chew the garlic. And here I am as a child, you know, you're growing up, but you're thinking this is ridiculous. Telling me that I should be eating greens. And, you know, one night I got sent to my room because I refused to eat the salad. And he's like, well, if you're not going to eat the salad, you're not having dinner. Go to your room. And that night, my mother and my grandmother, once my dad was asleep, came to my room and guess what they brought me? A bowl of ice cream. I was going to cast ice cream. I was like, oh my goodness. I didn't have dinner. And then they brought me a bowl of ice cream. Wow. Unbelievable. You are talking about so many themes, though, that are common to childhood, like the food as a reward. And like, we don't know any better than our children. So whatever our family of origin eats as a norm. And like this, even I bet after schools like this, oh, we get to go get a milkshake. So it's just like idea that like we get attached to food even as far as the emotions that we experience as children. And pizza. And it's strange because we weren't a family that went and ate fast food. So even though I got a milkshake at these restaurants, I never ordered like rarely was I ordering french fries, hamburger. That wasn't my thing. But there was pizza. Yeah. And then a lot of our food was actually cooked at home, but we ate a lot of bread, a lot of milk, a lot of ice cream, a lot of butter. And I had no idea that these things were a problem because you think, well, this is the way everybody eats. Why would this be wrong for me? But then I got into medical school. And I think because of the imprint of the way my dad has been, even though as a child, you kind of rejected it. This is crazy. I mean, because not only that, but at one point he put a he put a paper up and it had a skull and crossbones at the top. And then it had a list of all the fast food restaurants where we should not be eating. Wow. And that of course, you know, included Burger King McDonald's, Pizza Hut, all those things. And he was telling us, these foods are bad for you. These are processed food. So so but even though we were rejecting it and we as kids thought it was funny, it was filtering in at some level, it was filtering in. And when I got into medical school, I just I couldn't sit and eat cereal with milk for breakfast because I had to be at class by eight in the morning. I'd wake up, brush out the door. So my eating pattern changed. I started, I discovered fats. I discovered that fat is not bad for you. Yeah. Because again, I was a child raised in the 80s. Oh, yeah, well, fat, everything, right? Cookies and thinking that fat is evil. I had two older sisters and my oldest sister was always trying to lose weight and fat is bad and don't eat fat. And and suddenly I discovered weight. Avocados are good for you. Olive oil is good for you. So I started incorporating those and my dairy consumption dropped. And then I noticed, wait a second, I'm not getting sick like I used to. Wow. And so here I am in medical school, not being taught any nutrition, but also being super observant of ourselves because we, you know, when you're in medical school, you're you're like your guinea pig. Exactly. And and I thought, OK, there's something here, there must be something about dairy that doesn't agree with my system. And yet I didn't fully understand. I still would have pizza on occasion. I still would have cheese on occasion. But still, my overall dairy consumption had dropped. Yeah. And I noticed that my immune system was stronger than it had ever been. The doctors, when I was a kid, were telling my parents, oh, he needs a multivitamin that's going to make his immune system stronger. They gave me these big horse pills. And did they work? No. Because you couldn't absorb. Couldn't absorb. Wow. Gosh, thank you so much for sharing that because I think a lot of people can relate on so many levels of our families of origins. We just think that's the norm. And then we're like, wait a second. And even in the very seven-year-old you, and given as a child, it's very similar. Many antibiotics, gut was never super healthy. And we have like whatever either loose stools or constipation, we think that's the norm, right? And until they come to a doctor like you or I or a natural practitioner, this is, wait, you actually are supposed to have a normal formed bowel movement every single day, maybe twice a day. And so many who even today are shocked in their 40s or 50s, like that it's not normal to have a bowel movement twice a week, right? So this is powerful stuff because we assume whatever our physiology is, that's normal. And fortunately now it's easier to talk about, but a lot of times people aren't talking about gut function and bowel health. Not at all. And when I was in medical school over 20 years ago, I honestly thought that this was the unpredictability of my gut. And by then I had more of an IBS-like diagnosis and more not constipated, but more on the loose stool side. And you just never knew if I went out and ate with my friends, I had no idea. One day I don't feel so great. Another day I'm okay. And you don't know what is it that you ate, but you didn't know how to filter down and really analyze everything? Like what were the ingredients in the food that you ate? Was there any cream? Was there cheese? Was there butter? Like there's so many little details that you don't think about that could be affecting you. And I know you and me as functional medical sleuths we're always like filtering down to the detail of what is happening with our patients and why are they presenting the way they're presenting? Because there's always a hidden detail that no one's thought about. Absolutely. And one thing I want to frame you mentioned, I think you and I know IBS and what it really means medically. Let's talk a little bit about that because I think I've read the statistic one in three visits to a primary doctor are related to IBS. So it's super common. I bet our listeners out there, many of them have been told they have IBS. And you and I know there's a deeper root as far as causes, right? It tells a little bit about how is the diagnosis of IBS made? And then why might that be not the ending point? Because there's something else going on, right? Yeah, I mean, this is this is kind of like looking at the looking at the body top down versus inside out and Western medicine with a lot of things. It gives a series of symptoms a name and then says, Oh, we've diagnosed it now. But all you've done is you've taken a constellation of symptoms and you've now grouped them into one name. And you say, Well, this is the diagnosis or use the Rome criteria that, you know, if you you eat and then you have to run to the bathroom immediately and the number of bowel movements that you're having per day, that that's IBS. But there's IBSD, there's IBSC. So there's IBS with diarrhea, irritable bowel syndrome with diarrhea or IBS with constipation. And I just want to mention that, you know, the estimates vary, but up to 11% of people worldwide have IBS. And there's eight billion people in the world. So that's 896 million people over the entire world that suffer from something that has potentially reversible causes. Yes. Hey, everybody, I just stopped by to let you know that my new book, Unexpected, Finding Resilience through Functional Medicine, Science and Faith is now available for order wherever you purchase books. In this book, I share my own journey of overcoming life-threatening illness and the tools and tips and tricks and hope and resilience I found along the way. This book includes practical advice for things like cancer and Crohn's disease and other autoimmune conditions, infections like Lyme or Epstein Bar and mold and biotoxin related illness. What I really hope is that as you read this book, you find transformational wisdom for health and healing. If you want to get your own copy, stop by readunexpected.com. There you can also collect your free bonuses. So grab your copy today and begin your own transformational journey through functional medicine in finding resilience. Reversible causes. Yes. Yes. And again, in your book, I know you talk about these things that let's go on to like, what could, what else could be going on? I was like with you, the dairy thing for me, gluten growing up was toxic. I didn't know it. And I actually got diagnosed with Crohn's N-Celiac and have cured myself through diet. I remember one of my guests neurologist 20 years ago said, you have Crohn's disease. And I said, can I do anything with diet? Because I was clueless back then. We're not taught a lot about nutrition in medical school. And he, without pausing, he's like, Jill, diet has nothing to do with it. Now you and I know better. I mean, that's like crazy, right? And now the data shows that the science actually has come up to date with that. Can you believe? I feel like, you know, I, look, I don't want to bash doctors, but I sometimes feel like doctors just put their common sense hat. They just hung it up on the door. And because I remember when I was in training, PPI's were becoming a big thing. And, and I went to, I was friends with the, one of the first chiefs of gastroenterology at Mount Sinai, one of the, the leading centers, gastroenterology in the country. And he became the chief GI fellow. And so presumptively very smart guy. And I told him, you know, I, I'm just been thinking about this. If we evolved to have stomach acid, why is it okay to take a PPI that changes that? You know, because we're, we're changing physiology that we've evolved over hundreds of years to have this low stomach acid. Because back then they were starting to say, well, PPI is everybody should be on a PPI. If you have acid reflux, just take a PPI. And I was thinking, there's got to be some effect. There's got to be some side effect from changing that stomach pH. And years later, we found out it interferes with calcium absorption, iron absorption. It leads to osteoporosis increases the risk for pneumonia and increases the risk for C. diff colitis. So, and yet we were just thinking, these medications are benign. And they happen to be the second most common medication prescribed worldwide. And you and I know it's indicated for 14 days, which may be appropriate at times, obviously. It's not indicated for five, 10, 20 years. No. And how many of those patients I would, I would see that would come see me after they've they've been working with a gastroenterologist for years. And it's almost like they forget, like every time they need to refill, they just refill the medication over and over. So then it's five years down the road, and no one has asked the question, why are you still on this medication? Yeah. So let's go, I mean, get smart. It's coming out. Either ask you listen to this or in a few days, what is your protocol? How do we kind of dive in? Because so many people, we talked about IBS 11%. I said one in three visits, either way, it's a large, large percentage of people suffering, but gut in general. And the bigger thing is that when your gut doesn't feel well, you feel foggy, you don't feel you can't function. So it's not just the gut. It affects every other system. So let's talk a little about gut smart protocol. What does this look like? What are people going to find in the book as far as how they can heal? The big part, I mean, first of all, I go through the science, but I try to make it as simple as possible for everybody to understand because there's, there's so much new research coming out about the microbiome and how it affects us, but also really cool research about what is the right diet for our gut? And actually, as I was writing the book, Stanford University had just completed a study where they had divided the group of people. It ended up being about 18 people per arm. So it wasn't a big study. So we've got to call that out. It was not a big study. And they didn't use a control group. They had a fiber rich group versus a fermented food, high fermented foods. So the one group, they had them eat a, they had them increase their fiber intake. And they went from about an average of 20 grams, but most of them were a little bit lower than that. And they raised it to 42 grams per day on average. The other group, they said, okay, we're going to increase your fermented foods. We're going to go from, they were averaging about 0.4 cups per day. And they went up to anywhere between four and six cups. It sounds like a lot, but a lot of it was being, they were, they were drinking vegetable, brine drinks to get that, that amount and, and eating yogurt. And so, you know, they looked at these two groups and they wanted to look at what happens to gut microbiome. What happens to microbial diversity? What happens to 19 inflammatory markers? So looking at things, not just C-reactive protein, but also looking at cellular activation, like cytokine activation, intracellular activation. What happens if you're on a high fiber diet versus a high fermented foods diet? So they ramped them up for four weeks. And then they did a steady state for six weeks during which they were at the high intervention dose. And then they had a washout period. And they did pre and post stool PCR testing. And, you know, in functional medicine, we talk about what's, what's healthy for the body, eat the rainbow, eat a lot of fiber that's going to the fiber has prebiotics, those prebiotics help your bacteria create all these wonderful postbiotic anti-inflammatory nutrients that are so important for our health. And so I was reading the study and thinking that, you know, I was like, who's going to win here, the fiber rich or the fermented foods group? And honestly, I think they should have had another group. They should have a control group where they didn't have a dietary intervention, but they didn't do that. And it wasn't the fiber rich group that created greater microbial diversity. Wow. It was actually the fermented foods group that showed an increase in microbial diversity and a drop in 19 inflammatory markers. Wow. That's what's powerful, right? Because we know this. That is powerful because what you said at the beginning that the gut, like when your gut is off, you're feeling it all over your body. Well, your gut is also command central for your immune system. So if you can dial down your immune system and lower your inflammation through the gut, then you're affecting your entire body. What was interesting though is they decided, well, what is really happening in the fiber group? So they realized that the fiber group could be divided into three groups. A low microbial diversity group, a middle and a high. And then they looked at where there are any different effects in these groups. And they found that the group with the highest microbial diversity that was on the high fiber diet showed a drop in inflammatory markers. Whereas the low microbial diversity group, even though they were on a high fiber diet, actually showed an increase in immune activation. Wow. So I like to say that that microbial diversity is the holy grail. Yes. It's what we're seeking. But on top of that, what I've realized working with gut patients for now over a decade is that you can't just take any gut patient and tell them increase your fiber, start having fermented foods. Because what if they have histamine issues? What if they've got bacterial overgrowth? So what I did is I filtered it down and I created a quiz. And with this quiz in my book, I differentiate people into three categories, severe, moderate or mild. And depending on your category, I basically guide you on how is it that you can eat at this point to start healing your gut so we can get you into those lower categories, but without eating things that are going to be harsh on your gut. So if you're a severe category, you can't have fermented foods. Your gut isn't ready for it. Yeah. Your body isn't ready. So we need to we need to actually coax some healing to happen before we can get to that stage. And that's part of kind of the pivot of the GutSmart protocol is first taking a quiz, you find out what your GutSmart score is. It gives you a gut type. And it's really just recognizing that there's no one size fits all when it comes to gut patients, that there's actually a lot of individuality in the way that people experience their gut health issues. And if you have more severe issues or moderate issues or you're high on the moderate scale, you're not going to be able to eat the same as someone who only has mild issues. I love that. And from a very personal level, because when I was 26 right after cancer, I got the Crohn's and then I helped, I really healed myself from Crohn's by looking at the microbial, but I have always had a histamine issues. And it's so interesting. I love that you're addressing this because many, many patients, mass selectivation, histamine issues, and everybody else, this is do bone broth, do fermented foods and vegetables. Those are wonderful as you saw in the studies, but when you're in that place, you can't, I know personally I couldn't start there. Now I'm a healthier and I could, but it's profound that you're talking about that because so many of my patients do have histamine issues and they're like, why don't I feel good with bone, the bone broth diet, right? Or why don't I feel good with kimchi and sauerkraut. So I love that you're talking about this because I think it's so, so critical because histamine and mass selectivation is bigger than ever in many of our patients. And it's so important for, you know, because we have, we have all these, like we have such a democratization, let's say of information now because of the internet, but the problem with the democratization of this information is sometimes the oversimplification as well. Yes, right. We come up with all these things and like, you know, this study came out and it's saying, well, fermented foods are going to lower your inflammation. So you might think, well, I need to go out there and eat more, more ferments, but that's not right for everyone. And, and really what I wanted this book to do is to give a voice to those people and see them and make them feel heard that, yeah, that you are different at this point. Your body is behaving differently. And this is the way that you need to treat yourself in terms of food, in terms of mindset relaxation in order to get your body into a healing state. So, so powerful. I am such a fan because again, I see that in clinic where people have been told, and like you said online, there's like, oh, this guy should fix everybody or this day, there's no one size fits all, which is what you're saying in the book. Gosh, I would love to stay here, but I want to talk about gut brain connection because we know there's such a powerful connection here. Tell us about how is the gut and brain connected? How, why do people have brain fog and stuff when they have gut disorders? And how can we actually address that connection? There are several ways to look at this. So first of all, the gut and the brain are connected through a very long nerve, the biggest cranial nerve, the cranial nerve number 10, vagus nerve, that goes all the way from the brainstem down on both sides of the neck, right along where the vocal canal is. And into and innervates all of the internal organs. And it's super important because the vagus nerve is kind of like it's, it's taking an inventory of what's happening in the periphery and it's sending signals back up to the brain. And so the vagus have these nerve endings all along the gut lining that have receptors like five HT receptors that get stimulated by serotonin that's being produced by either your entero enteroendocrine cells, but also by the gut microbiome. So in a sense, your gut microbiome is speaking to your brain through your vagus nerve. And when it sends that signal up and there's more that it's like 70 to 80% of the fibers and vagus nerve are pointing up to the brain. It releases neurotransmitters like GABA, which help kind of regulate and GABA tells everybody to be quiet, you know, it's a soothing neurotransmitter. In the other direction, there's something called vagal tone. So for anybody who's old enough to remember old phones and when we had, you know, wired telephones that had a dial tone, you remember when you were a kid, you picked up the phone and then you didn't hear the dial tone. You're like, Oh no, the phone is dead. Well, your vagus nerve also needs a dial tone. And it's sending a signal from the brain down to your gut. And that signal does a number of things. It regulates the production of the acid in your stomach, secretion of digestive enzymes. It helps actually control partly the permeability of your gut and also gut motility and getting things to the the rhythmic contractions of the intestines. So that's coming downstream as well. So it's really, it's a beautiful system because it's working in both directions. And then there are the seroso like the things that can that travel through the blood that can affect the brain. And we always say, you know, if you have a leaky gut barrier, if you have a leaky gut, then you're going to have a leaky blood blood brain barrier. And then if you have a dysbiosis and leaky gut and you've got yeast overgrowth, you've got mycotoxins being produced in that gut, those mycotoxins are going to get to your brain and they're going to cause mental fog. They're going to cause confusion. They're going to cause memory problems. And I know that's one of your big specialties and what you deal with. So the interconnections are so important. The cool thing is, is that it gives you multiple avenues for healing the gut. And I talk about that in my book because I think a lot of people when, when they think about gut healing, we're thinking about what you can do with a diet, what types of supplements to take. And then the last thing on the table and a lot of times it gets pushed off is mind body connection, mindfulness, meditation, relaxation techniques, ways to activate the vagus nerve, to activate vagal tone. And for anybody listening, you know, this, you know, abstract concept of vagal tone, what is it? Well, when your vagal tone is low, you're going to get things like your stomach's going to feel like when you eat, like food just sits like a rock in your stomach. It's going to feel like food isn't moving down. But low vagal tone is associated with acid reflux. It's also associated with constipation, but also with mental health. Low vagal tone is associated with depression, with anxiety, like being in the wrong vagal tone is going to have mental health issues. So as part of my gut smart protocol, I have a whole section in the book where I explain what the vagus nerve is. I talk about the research behind that, how meditation can actually even affect the way the gut microbiome is functioning and the type of bacteria that tend to predominate in there. And then give people instructions on how to breathe using deep diaphragmatic breathing, breathwork, meditations for the gut that then can improve not only digestion, but also, you know, your whole body because it's the downstream effect from that. You can't absorb and assimilate if you're not in a relaxed state where when your vagus is firing and you're relaxed, what it's telling your body is, I'm safe. You can heal now. Yeah. And you can take it in nutrients. Like you said in so many of us on the go, even in my clinic, I'm guilty between patients like on the go grabbing food, right? While I'm standing, I don't even sit down sometimes. And again, I'm a confession here. But like so important to sit down and you and like, so I love the other section in the book on the vagus nerve because that's one of the biggest questions nowadays is what do we do on the vagus nerve? Patients are starting to realize it's powerful, but I think there's still a mystery about what do we do? Do you have any practical like tips we talked a little bit about, but obviously breathing meditation, what what few practical things could we leave people with with to deal with the vagus? And it's in your book. I mean, I mean, first, I think it's very important to learn how to breathe. Because every time I'm with a patient and I ask them, can you can you take a deep breath for me? This is what they do. Yeah. And their belly is like tucked in. And I'm like, you're not really oxygenating yourself that way. And I and then what I do is I have them lie back, put one hand on their chest and another hand on their belly. And I have them lie down, bend their knees because when you bend your knees, you relax your belly muscles. So it's easier. And then I say, okay, take that breath again. I want you to feel where your hands go when you take that breath. And usually they'll they'll they'll still repeat that chest breath, so that the this hand will rise and the other hand will barely rise. And then I asked them, which hand went up when up first, or which hand moved, which hand didn't move. And usually it's it's the chest, not the other one. And they say, well, let's reverse that. Let's breathe into the belly hand first. And then the chest hand lasts. So you start by filling in the bottom of the lungs, and you end at the top. And then as you exhale, you reverse that process. And now you're learning how to do deep deep dive for mag breathing. And then you can and then so I did that the other day with a patient, I had them lie down. And then it's easier when you're lying down. And then I said, okay, now that you understand the dynamic, because I think for a lot of people, a lot of it is, you know, they're kinetic kinesthetic learners. So experiencing it in your own body makes so much sense. It's so important. And and even just experiencing the shift that happens, you know, and I've been doing breath work and meditation since I was 21 years old. So right before I went to medical school, actually as a solution for the reason I almost didn't go to medical school, because I was afraid of needles. And I passed out every time I had my blood drawn, I had a shot. I was cold sweat, heart racing, then the room would turn dark and I was out. And I started researching why is this happening to me. And that led me to breath work meditation. So I was doing this with a patient the other day. And then I had them sit up and I said, okay, now you're sitting, I want you to repeat that breath. Now it's a little bit harder when you're sitting because now there's more pressure in your lower abdomen. So it takes a little more challenging to take that diaphragmatic breath. Once you get to the peak of your breath and you're going to exhale, now I'm going to have you hum instead. So you're going to take a deep breath in. And on the out, you're going to go and it's going to do two things. It's going to prolong your exhalation. It's going to it makes it a little bit harder to exhale. So it's going to make you exhale for longer, which is one of the things we want. We want the exhalation to be twice as long as the inhale. Second, that vibration is going to activate your vagus nerve. And I tell people, okay, that, you know, people hear meditation breath work. No, I can't like sitting for 30 minutes. And I tell them, you know, just take your phone, take your smartphone and set the timer for as long as you think you can do it at first. You know, if it's two minutes, it's two minutes, try it, go to five minutes. And I just want you to breathe and hum and just do it until the timer goes off. And I bet you by the time the timer goes off, you are so shifted internally that either you feel a complete change in your state, or you're going to feel so good that you're not going to want to stop and you're going to go for another couple of minutes, maybe you'll go for another five minutes. Wow, that is so practical. I mean, I've been in this realm and meditation vagus nerve work, but that little tip is Pearl that's priceless because so practical anyone can do it. And even if you're not a meditation expert, it's doable. It's achievable. Thank you for going through the details and even because patients as they're listening could do that practice. I think that's so powerful. So so powerful and so important. It's amazing how so the patient that I was with the other day, he's a dad, two kids at home, they're like four and six busy life commuting into the city back home stressful job as a lawyer. And we were talking about how when he eats, he feels like the food doesn't digest. And so, you know, like, like, like you, like if like any functional medicine practitioner, I got really curious and I said, well, paint the picture for me. What is your dinner time like? What do you do? And he's like, well, I might just get home from work. We're trying to get the kids rallied to sit down. Sometimes my wife and I are just eating in the kitchen. We don't even sit down. Sometimes I'll get a call from a client and they start eating. And then when the call finishes, I'll sit down and I'm just and I was like, you're not, you're not creating a nervous system transition for yourself to give your body the signal that it's ready to shift and digest and assimilate. And so I took him through this breathwork exercise and said, well, how do you feel now? It's like, wow, I feel different. I said, well, you need to think about this because you when you finish a client call, it's like you're going 60 miles per hour and now you're going to sit and eat dinner at 60 miles per hour. Your body is not in a state where it can absorb and assimilate and digest. So you've got to help your biological system make that transition. We're not computers that can go from one task to the next to the next like that. We have to respect our biology. Yeah, gosh, so many key issues that you've brought up, the personalization of the guy, the gut quiz that people can find out where they are in the spectrum and where to start, the Vegas and the gut ring connection. What would be the one thing you'd most like to see the reader take away if they read your book? Like what is the main kind of takeaway of the whole program? That's such a such a great question. I mean, we covered a lot of pieces of that. I think it's important for people to realize that yes, diet is important. Yes, sometimes figuring out what supplements to take. If you take a probiotic, that's all important. But you can't out diet and you can out supplement a stressed out lifestyle. Brilliant, brilliant. And we all need to hear that. That is brilliant. Dr. Federer, where can people find the quiz, your book, all the information that we talked about today? If they go to gutsmartprotocol.com, they'll be able to find the book. I've got some pre-order bonuses for them. And if they want to just dip their toes in the pool, they can also download a free chapter and check out what the book is about and then decide if they want to pre-order. Obviously, I think this is going to be a great help, not just for for patients and listeners, but also as a tool for other practitioners to use with their patients. I absolutely agree with you. And thank you again for taking your time to come on the show for sharing your knowledge. And I hope if you're listening, you will go and give us the website one more time. It's gutsmartprotocol.com, G-U-T smart protocol.com. Perfect. And they can learn everything about the book there. Fantastic. Thank you again, Dr. Vincent for being on the show. Oh, my pleasure. Thanks for having me.