Living a Life in Balance - PODCAST
Founder & CEO of THE BALANCE RehabClinic | Book Author & Podcast Host of "Living a Life in Balance" | Global Expert in Mental Health & Wellbeing
I lead one of the world’s most exclusive mental health and addiction treatment brands, helping global leaders, creatives, and high-net-worth individuals find deep healing and personal transformation. Through my podcast, I explore the intersection of psychology, purpose, and wellbeing.
This Podcast is dedicated to meaningful conversations about mental health, well-being, and the challenges we face today. It is part of my ongoing commitment to supporting people in navigating complex emotional and psychological struggles. Through open discussions with leading experts in the industry, I aim to break down barriers, challenge misconceptions, and offer valuable insights that can make a real difference.
https://balancerehabclinic.com
Living a Life in Balance - PODCAST
Silent INFLAMMATION Epidemic: Unpacking Gut–Brain Connection in IBS, Autoimmunity & Mental Health
Fernanda Lima Sento Sé, Clinical Dietitian and Nutritionist at The Balance RehabClinic, shares her powerful journey of healing and how food, lifestyle, and mindful choices can transform our relationship with the body. From a health crisis that sparked her anti-inflammatory path to years of studying nutrition, she explores the deep connection between what we eat, how we live, and how we feel, highlighting the profound impact of inflammation and gut health on overall well-being through the lens of functional medicine.
In this episode, Fernanda opens up about her early medical struggles, the role of genetics and environment, and how nutrition became both a tool for recovery and a lifelong mission. With a grounded and compassionate approach, she reflects on the influence of processed foods, stress, hydration, and cultural habits, while offering insights into the microbiome, toxins, and the delicate gut-brain connection.
🔗 Tune in for a real conversation on the small, sustainable shifts that can create lasting wellness.
About Fernanda: Rooted in both science and lived experience, Fernanda integrates research on microbiome diversity, epigenetics, and lifestyle medicine into her work. Through education and personalized guidance, she helps others navigate complex health challenges while cultivating balance, vitality, and long-term resilience.
00:00:00 – Fernanda’s Health Crisis & the Start of Her Anti-Inflammatory Journey
00:01:23 – Episode Overview: Inflammation, Gut Health & Functional Nutrition
00:02:42 – A Healthy Childhood, Medical Struggles & Early Nutrition Curiosity
00:08:10 – Allergies, Autoimmunity & the Role of Environment and Diet
00:09:57 – Genetics, Epigenetics & Lifestyle Choices
00:12:41 – Choosing Nutrition: University Crisis & Transformational Diet Changes
00:15:52 – Developing Protocols & Learning from Scleroderma
00:18:45 – Functional Medicine & Precision Nutrition Influence
00:19:43 – Understanding Inflammation: Acute, Chronic & Silent
00:23:07 – Recognizing Inflammation: Physical Symptoms & Root Causes
00:26:40 – Water, Hydration & the Inflammation Connection
00:31:03 – Hydration Habits, Soft Drinks & Cultural Shifts
00:36:33 – Processed Foods, Stress, Sleep & Gut Health
00:38:58 – Toxins, Microbiome Diversity & Immune Resilience
00:41:54 – Microbiome Development: Birth, Breastfeeding & Early Life
00:44:15 – Chemical Exposure, Beauty Trends & Traditional Practices
00:48:33 – Macronutrients: Proteins, Carbs, and the Pitfalls of Diet Trends
00:51:03 – Keto, Elimination Diets & the Importance of Personalization
00:56:56 – Stress, Individualized Diets & When to Refer to Psychologists
01:03:29 – Local, Seasonal Eating & Practical Travel Tips
01:15:11 – Fruits, Juicing & the Truth About Sugar Detoxes
01:20:58 – IBS, Microbiome, and Digestive Resilience
01:33:16 – Fecal Transplants, Microbiome Therapy & Mental Health Links
01:40:49 – Gut-Brain Axis: Stress, Diaphragm & Physical Gut Tension
01:43:18 – Gut Health Assessment: Stool Testing & Scientific Limits
01:51:39 – Treating IBS, Histamine Intolerance & Leaky Gut Protocols
02:06:41 – Supplement Strategy: When, Why & What to Use
02:14:49 – Fernanda’s Daily Habits & Final Wellness Advice
For further mental health information and support, visit The Balance RehabClinic website: https://balancerehabclinic.com/
Follow Fernanda Lima Sento Sé:
https://www.linkedin.com/in/fernanda-lima-sento-se/
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https://www.linkedin.com/in/abdullahboulad/
https://www.instagram.com/abdullahboulad/
You can order Abdullah’s book, ‘Living A Life In Balance’, here: https://www.amazon.com/stores/author/...
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Fernanda Lima Sento Sé 00:00:00 I kept going in and out of hospital. Even though we had a very healthy lifestyle. I think somewhere inside me I knew there was something more that could be done. I got a food poisoning the next day. My body was full on. I've never had an allergic reaction like that. And she gave me a. Now what? I see a very basic protocol of an anti-inflammatory diet. But back then that was the protocol. It was mind blowing how my health improved.
Abdullah Boulad 00:00:30 What are we doing to promote inflammation in our bodies?
Fernanda Lima Sento Sé 00:00:35 A lot of stuff. It's. The list is really long. We're not getting enough sleep. Yeah. Until very recently, it wasn't even published that a woman needs to sleep more than men. Now they're asking, why are there more women without immune conditions than men? So one of the big factors is stress and sleep.
Abdullah Boulad 00:00:56 Emotional regulation.
Fernanda Lima Sento Sé 00:00:57 Emotional Regulation.
Abdullah Boulad 00:00:59 I like the idea. If I surround myself with happy people, I might be happy from the inside out. Yeah.
Fernanda Lima Sento Sé 00:01:07 Supplements should never substitute the food or the source, because the way it comes naturally is the best way we can absorb it. I don't want patients to be dependent on me forever. I want to help them have tools to manage their condition.
Abdullah Boulad 00:01:23 Welcome to the Living a Life in Balance podcast. My name is Abdullah Bullard. I'm the founder and CEO of the Balance Rehab Clinic. My guest today is Fernanda Lima Santos, a clinical dietician, researcher and expert in gut health and inflammation. In this episode, we dive into the deep connection between what we eat and how we feel physically, mentally, and emotionally. Fernanda shares her personal journey from growing up in a family of dancers and athletes to pursuing nutrition as a science after a health crisis during university led her to discover the power of food as medicine. We explore how inflammation affects the body and brain. The rise in autoimmune conditions, and why our modern diets filled with highly processed foods are contributing to anxiety, depression, and chronic illnesses. Fernanda breaks down the foundations of an anti-inflammatory diet, the importance of the microbiome, and how to read the signs your body is sending you, including through something as simple as analyzing your stool.
Abdullah Boulad 00:02:33 I hope you will enjoy. Fernanda. What motivated you to do what you do today?
Fernanda Lima Sento Sé 00:02:42 I think probably my parents. My parents were professional dancers, and my mom before that was a professional athlete. So healthy lifestyle was was just how we lived at home. It's how I grew up. So probably that's the first seed that was planted.
Abdullah Boulad 00:03:01 As the answer is you. How do you live your life? In a healthy way?
Fernanda Lima Sento Sé 00:03:07 at home, we just had a very healthy. We eat a lot of fruits. We had a lot of water. Very healthy lifestyle. My brother and I grew up doing a lot of exercise and physical activity, and spent a lot of time outdoors and at the beach and. Yeah, and just what my parents considered late 80s a healthy diet. And they just kept doing it. I think that's their that's been their lifestyle. And they transmitted that to us. And then throughout the years, I became more and more interested on the impact of nutrition and health. And I myself became an athlete, semi-professional local team here in Mallorca as a gymnast.
Fernanda Lima Sento Sé 00:03:49 And they were very on top of us on our weight. And I saw some of my colleagues trying to lose weight in the wrong way. Others will just snack sweets. And I was just like, oh, I just snack fruit or a small sandwich? It was always quite healthy compared to the rest of people around me. And that just kept my my interest. And when the time came, I said, think I want to study medicine or nutrition or something to do with health, but probably something to do with health and food, because I was always very passionate about food. Both of my parents studied physical education. My mom, started doing a postgraduate in nutrition, but then she got, hired by this company to tour around the world as a dancer. So she stopped that. So I think that probably it's something I took in so much at home. I just thought it was very interesting. And, I was also a kid that was always sick. I had asthma, I had allergies, I kept going in and out of hospital.
Fernanda Lima Sento Sé 00:04:54 Even though we had a very healthy lifestyle. So I think somewhere inside of me, I knew there was something more that could be done to improve, and it was there. This willingness to know more.
Abdullah Boulad 00:05:07 When did you discover, like the situation when your asthma and allergies are what did help you there? Was there any nutrition side which was helping you or in Spain?
Fernanda Lima Sento Sé 00:05:20 Not really. in Spain, nutrition is quite recent. So I graduated 15 years ago and I was 10th promotion. So it's only really existed for 25 years. But when we. My family's Brazilian, I'm originally Brazilian. When we went back to Brazil, we used to encounter with these different doctors or health care professionals that had a different perspective from what we were getting here in Spain. And one of the doctors Hawes gave some tips like, don't drink milk, which I naturally disliked, so that was easy. Eat more fruits and more vegetables, which was also easy because we did it at home and and some water. And then he started talking about dairy.
Fernanda Lima Sento Sé 00:06:05 So we started removing some dairy from the day to day and, small changes. But I still had this, this big allergy reactions. It wasn't until I was an adult that I understood why my body was reacting, how it was reacting.
Abdullah Boulad 00:06:22 Was this a health professional, a doctor in in. Yeah, in Brazil.
Fernanda Lima Sento Sé 00:06:25 It was a doctor in Brazil. Yeah. And, he was specialized in Chinese medicine, and, he was linking, the consumption of some food to the generation of more mucus in your respiratory system. Yeah. And, this was still is a thing that people talk about a lot, but now with modern, medicine and research. You know, it's not so much about what you eat is the quality of your gut microbiome. So it goes a bit more into that direction. But he was, it helped. It relieved a lot of my symptoms, but it was triggered due to allergy. So something was there in my immune system that wasn't very, very right. Or functioning. not in such an alert mode where it's, creating an excessive effect.
Fernanda Lima Sento Sé 00:07:18 So I would have, like severe asthma, for example, a lot during the winters.
Abdullah Boulad 00:07:24 I understand at that time you didn't realize where this, has been coming from, how to treat it. But the eagerness to to understand yourself and and what could, could help. But when we look at, around, around the world, like, asthma or any type of allergies, are increasing? Yes. And more and more people are suffering from allergies. And now we are in this time of the year where you can you can hear the people around when you walk around the streets like, suffering, suffering. Yeah. where is this coming from? And why are more and more people increasingly, suffer from allergies?
Fernanda Lima Sento Sé 00:08:10 So allergy is a physiological reaction to protect our system. That's a foreign substance or or thing we could say, because pollen is a thing that comes and triggers your immune system, and the response of your immune immune system is modulated by several things. And the biggest proportion of it that modulates it is nutrients.
Fernanda Lima Sento Sé 00:08:40 And that's what feeds how our immune system responds. So I've been having this theory for many years. I'm not alone in this theory as well. how we've been eating has a direct impact on how our body responds towards our immune system. Because basically, if you have an anti-inflammatory diet, which is a concept that's been changing throughout the last 2 to 3 decades, an anti-inflammatory diet will help your body have less of an acute response. So it's like a mosquito can bite you. You can. Some people will just have that little red dot, and some other people will have a huge inflammation and it will be really red. And that's because that person's reaction and buildup of histamine is much higher than other individuals. and that's modulated. One of the things is food, but can be stress. It can be sleep, it can be it's a multifactorial effect.
Abdullah Boulad 00:09:42 And you think this affect how we individually react to our environment is this. Is this more genetic or epigenetic related, like this lifestyle and the food we are eating? As you mentioned.
Fernanda Lima Sento Sé 00:09:57 There's two things. There's the genetic part. So some allergies and some tendencies to be allergic is a genetic factor. So it's inherited from your parents. But then the way you respond it's an epigenetic. So you have the fact that you will react to a substance. for example, let's say pollen, which is the most common one, you will react to pollen. How you react to it is an epigenetic circumstance where how you manage your life has an impact on how your body responds.
Abdullah Boulad 00:10:33 I'm not a genetics expert by far, but when I think about it, we we we consider genetics as something like suffix. X. This has been always the case and this is our genetics. But genetics can also evolve over time like the epigenetics of our ancestors affect our genetics. So the way they have been living, the environment they have been living in, the what they have been eating has been affecting. So genetics can be also something like generational epigenetic process.
Fernanda Lima Sento Sé 00:11:07 And you yourself can change your own genetics by your lifestyle.
Fernanda Lima Sento Sé 00:11:11 If you continuously live in a situation where you are in stress, in alert mode, you don't have a balanced diet. You just eat on whatever you find and you don't sleep well. You're highly exposed to screens and blue light. You don't expose yourself to nature. The list goes on. If you don't use a products that don't have a or that have artificial sense that have microplastics. All of these factors can impact your genetics directly or indirectly, depending on the volume that you're exposed to. But they all have an impact. But this is only something that we very recently know. When I was studying in university, the view was genetics was a fixed thing 15 years ago. Now genetics o genetics can modify. We can change our genetics. We can. Because if we continuously have this response then it's kind of like stays with you. You modify it and then you pass it on to the next generation. And then it's harder to go back and make it not work like that.
Abdullah Boulad 00:12:25 Or we'll get deeper into that.
Abdullah Boulad 00:12:28 but maybe back to, to to the moment where you decided you want to study and how did you get into it? What have you done and what were your further studies.
Fernanda Lima Sento Sé 00:12:41 So I went into nutrition, human nutrition and dietetics with the view that I wanted to link it with sports performance because I was I was doing sports every day. It was a big part of my life. I was training from 2 to 4 or five hours, depending on the day, and it was a big, a big thing. And I said, oh, I can do this. And, my dad has a close friend who's like an uncle to me. He was a professional athlete, and he was like, sure, if you get into that, I'll help you get in a good place in this world of nutrition and sports. And I was like, easy. And on my second year of, of my bachelor's degree, I got a food poisoning from a pizza with, it had shrimps. I'll remember forever. It had shrimps.
Fernanda Lima Sento Sé 00:13:38 I was sitting with some good friends that came from Mallorca to Barcelona to visit, and the next day my body was full on. I've never had an allergic reaction like that, but previous to that I did have several asthma crisis and feeling very tired and lethargic and this foggy brain and I didn't really know what was going on, why I was feeling like that. And then with this histamine, poisoning, it's called when you eat seafood. That's not right. You can have this histamine intoxication, which is very close to an athletic shock. So by the time I got to the E.R., they rushed me through. It was full on season of the flu. Public hospital in Barcelona is super busy, and they're like, oh, going, this girl needs to get checked immediately. And my teacher the next day was like, hey, why are you missing so much classes? And I pulled my top up and I said, look, I've had this massive allergic reaction and I don't know why. And she's like, but you've been skipping more.
Fernanda Lima Sento Sé 00:14:49 And I said, yeah, I've had asthma, I've had sinusitis, rhinitis. I have been feeling quite low and sick and I don't know what to do. She's like, let me help you. And she gave me a now what? I see a very basic protocol of an anti-inflammatory diet. But back then that was the protocol. And she said to it very, very strict for one month. And while we'll check, we'll I'll check on you every two weeks. And I felt so much better. It was mind blowing how my health improved that I was after three months. I was like, wow, I'm not feeling tired. I have much more energy. I was like, what can I do to make this keep going? You know, Is it just this or is this more. And then I said, I want to help others. A little fact that I didn't mention I have an autoimmune condition. It's called scleroderma. I'm very lucky. I have it only on my skin. So I'm one of the lucky ones with an autoimmune condition.
Fernanda Lima Sento Sé 00:15:52 So that also contributed to that foggy brain and the fatigue and feeling very tired. And with the anti-inflammatory diet, all of that kind of disappeared. And I had my checkup with my list, and she was like, what did you do? Your response to allergens are much lower. And I said, oh, I did an anti-inflammatory diet about six months. And she looked at me and she was like, really? Is that it? And I was like, yeah, that's that's it. I changed the way I'm eating. I'm sleeping better, I'm resting better. I'm focused on. I've always done sports and drank water and eat vegetables. But there was a few things to modify that really did the change, which was consuming less meat. Coming from a Brazilian family, it's a big deal. And, I stopped eating processed foods because until I was in university, I didn't realize that on my day to day I was eating processed foods. So I was eating sandwich breads every morning, and I was like, oh, that's going out and sweeteners on my coffee.
Fernanda Lima Sento Sé 00:17:03 That also left. I swapped it for the green tea. Little changes ate more fish and that just, yeah, took some probiotics, which back then was very basic, only some strains and that's it and helped a lot eight fermented foods and that was basically it. And it really, really made a huge improvement. And then I said, I want to help others feel how I feel. And I think I have a tool that I can use to help individuals without immune conditions and chronic allergies. And it's something that no one's talking about. And I went crazy researching online. And I did my thesis for my bachelor's degree on on on scleroderma nutrition. I did a whole. I created a whole protocol. I contacted universities around the world, like, what do you guys do? What are you working on? How do you react? And they were like, are you calling from Spain? There was no LinkedIn. There was internet. It was very basic. Yes. So it was really hard to find the information about a lot of stuff.
Fernanda Lima Sento Sé 00:18:13 You just had a few papers that were published and, and telephone numbers from universities that you could reach out. So I called Mayo Clinic. Now I laugh how how naive I was when calling the big institutions around the globe like asking.
Abdullah Boulad 00:18:30 But this was your eager to learn and to understand and and for sure, it was an amazing moment when you realized, yeah, it's nutrition which is making a big change and not medication maybe you have had before.
Fernanda Lima Sento Sé 00:18:45 Exactly. And I discovered several doctors from the US talking about precision nutrition and functional medicine nowadays are big names internationally. But they inspired my journey in nutrition, and I remember finding a web page from this clinic in California, and all these doctors were in this clinic and they were having yearly gatherings with other health care professionals. And I looked at the prices, you know, still in uni, super like no money. And I was like, there's no way I can afford this. It's like $120,000 for a long weekend. I can't afford this. But they were publishing videos shortly And they had blogs and I was reading.
Fernanda Lima Sento Sé 00:19:32 Then I started looking at their papers that they were publishing and that that was that was the beginning of, of my journey in nutrition and now to immune conditions.
Abdullah Boulad 00:19:43 Yes. How do you explain inflammation in our body? What is it exactly? Where does it come up manifest in our bodies?
Fernanda Lima Sento Sé 00:19:53 It can manifest in many ways. So you have different types of inflammation. You have the acute one, which is when you hurt yourself and it's swollen. That's acute one. And then you have the silent chronic inflammation which is the one that feeds on stress, lack of sleep, cortisol, simple sugars, saturated fats. Try to visualize a, a bucket that you have these little drops and it slowly fills up. So it's just a very slow, silent process that you don't feel that is happening. And then suddenly the bucket starts overflowing and you're getting chronic headaches, chronic joint pains, bloating nearly every day. You don't. Your rest is not restorative. You feel like you haven't rested after asleep, and then little things start becoming big.
Fernanda Lima Sento Sé 00:20:52 You feel your mental health, thoughts not being so good. It starts degrading. You're easily more stressed, so the stress gets bigger and suddenly you get it's spring and you have an allergy. And instead of just having an itchy nose, it's a full blown up allergy reaction. So that's the silent one, the one that slowly comes. And then at some point, what's meant to be a small reaction becomes a big reaction. And then with individuals without immune conditions. Basically, the silent inflammation just makes your symptoms be more acute or more chronic. So if you have an autoimmune let's talk about the one I have scleroderma. one of the one of the symptoms you can have is chronic fatigue. You can have joint pain. You can have dry skin. so in my case, I was feeling the foggy brain, the tiredness, the bloating as well, and heavy digestion. And, slowly, all of those symptoms improved. so it's not a dramatic change, but if you live with this on a daily basis, when you experience months of zero chronic fatigue, zero bloating is zero foggy brain, you're you feel like you're in a.
Fernanda Lima Sento Sé 00:22:23 Your life has been on another level. You've gained quality of life.
Abdullah Boulad 00:22:27 It is one of the biggest underlying causes for so many other health conditions. Mental and physical.
Fernanda Lima Sento Sé 00:22:35 Mental and physical health. And.
Abdullah Boulad 00:22:37 But people may not be realising that it's an element they should look at. And that diet could could help with that. So I'm just thinking how can we how can we give more information or understanding what is what is inflammation and how to to tackle it. even though we don't, we don't know because a lot of people would have, would have inflammation.
Fernanda Lima Sento Sé 00:23:07 They're trying to create estimates of numbers. And it's very hard because it's so silent. Then there's some people just get used to some of the symptoms. So slightly headaches like joint to pain slightly takes longer to recover from working out, for example, because you can go to the gym. But if your diet is poor gym, let's say it's one seventh of the impact of of gaining health. And then diet is one. It's a five out of seven.
Fernanda Lima Sento Sé 00:23:43 So diet has a big role on how our body responds to other aspects of sleeping and resting. But diet is really important because if you exercise but you don't have the good diet, your body can't recover right correctly and on a daily basis it's the same, sleeping. If people sleep and they wake up every single day. Oh. I'm tired. Oh, I didn't rest. Well, I think I need more hours, and they're having reasonable amount of hours, seven, eight, nine hours of sleep. I still feel really tired. That could be one sign. Bloating. Bloating is now the the trending topic on on social media and a lot of people talking about their feeling bloated, feeling heavy but not. But they eat clean and healthy. Why is it? It's because they're having probably stressed us contributing to this silent inflammation.
Abdullah Boulad 00:24:40 Yes.
Fernanda Lima Sento Sé 00:24:41 So little. Little habits are necessary to modify, to modify, to improve those symptoms. but I think most people don't really realize when they have a trigger or they have a big symptom, so suddenly they develop a digestive disorder or chronic migraines, and that's when they want to have a change.
Fernanda Lima Sento Sé 00:25:06 But if you do it before, it will be much easier and you will have less impact on your body.
Abdullah Boulad 00:25:11 So you mentioned, let's say, inflammation in the gut. where else in the body could like an inflammation manifest or usually would be visible visible.
Fernanda Lima Sento Sé 00:25:23 The skin is a very easy one. women more than men. So. Liquid retention is one of those symptoms. A skin that reacts a lot. Like if something scratches you, it gets red immediately. Pimples. Adult acne. When you have a reasonable, healthy lifestyle, that could be one of the giveaways. tension in your jaw. Tension in your joints. Pretty sure colleagues that work with, manual therapies like a physiotherapist and all, still could agree. You can see the stiffness on people's body when they don't, when they have a lot of inflammation. So that could be one of the things. Yeah.
Abdullah Boulad 00:26:04 So you're saying like, tension in my jaw is like an inflammatory process.
Fernanda Lima Sento Sé 00:26:09 It's a physical tension and that causes inflammation here. So at some point your muscles don't have the ability to relax properly.
Fernanda Lima Sento Sé 00:26:20 Yes, because you hold to some tension and stress. Then you're creating a chronic inflammation and then it stays there.
Abdullah Boulad 00:26:27 Yes.
Fernanda Lima Sento Sé 00:26:28 And then usually people at nighttime is when they feel it more when they're doing the, the grinding their teeth.
Abdullah Boulad 00:26:34 What are we doing to promote inflammation in our bodies?
Fernanda Lima Sento Sé 00:26:40 A lot of stuff. It's the list is really long. But, when it comes to diet, is not not drinking enough water. It's number one mistake that most dietitians see in the practice. People are not aware that we need to hydrate ourselves. So we need a good quality of water and a regular intake.
Abdullah Boulad 00:27:06 What is a good quality? I mean, what is the difference between the quality water and not.
Fernanda Lima Sento Sé 00:27:11 So we need mineral water. And if it's naturally mineral it's better than synthetically manufactured. Tap water, for example, has a lot of chlorine in it, so people are trying to remove the chlorine. If you live in a place like Mallorca, we have a little bit of hard water. Other places in the world that do so as well.
Fernanda Lima Sento Sé 00:27:34 So we try to remove that hard water, but by removing it we remove also some other minerals that are essential for hydration. And then we go to like basic. We have to go back to when we were in school and we're studying osmosis and how it works. And if we don't have enough minerals, the water will be dragged towards the area where there's highest concentration of minerals. So the water that we take needs to have some minerals.
Abdullah Boulad 00:28:02 Tap water is not the healthiest water. We would we would drink. I heard there are different ways. Water. They are water from the mountains or water from from the ground? Yes. Are there differences or there regional differences? What makes a quality better than others.
Fernanda Lima Sento Sé 00:28:22 Does geographical differences. very significant, but they're both good qualities of water. Just depends where you live. One could be more accessible than the other. And then some places you're going to just have to drink tap water or bottled water. And tap water could be decent quality, but not the best.
Fernanda Lima Sento Sé 00:28:44 The basis you need to drink water.
Abdullah Boulad 00:28:47 Yes you have. You have to. That's that's what we consist the most.
Fernanda Lima Sento Sé 00:28:51 Exactly. That's exactly. That's what we consist the most of. And, a lot of the people are depriving themselves from the water intake. So I will just go to the very, very basic where you need to be hydrated.
Abdullah Boulad 00:29:03 I mean, when we drink water, you go to the supermarket, maybe most people around the world, they buy their water. in plastic bottles. And so we know it's a big topic as well. out out there like microplastic and where this comes from, especially if like, say plastic bottle water, stand in the sun for hours and they what, what what's your thought around and recommendations around, buying, getting water transported.
Fernanda Lima Sento Sé 00:29:36 It's a big topic now. It's very trendy for the last couple of years, I think. it's tricky because not everyone can afford water that comes in a glass bottle. So it's hard when, when you work helping people to say this is black and white.
Fernanda Lima Sento Sé 00:29:58 Now we're in a situation where we need to lie a bit in the grey area. Ideally, glass bottles are better to carry water around or metal bottles. But the industry commercialized them in plastic. The majority of the water comes commercialized in plastic. People needs to have an access to it. So until we don't, until the industry doesn't change their model. Not drinking water is, is worse for your health than drinking water from a plastic bottle.
Abdullah Boulad 00:30:36 Okay.
Fernanda Lima Sento Sé 00:30:37 Yes, I think it's. You need to drink water. And if you can, from a glass or or a metal bottle, that would be ideal. If you can't, then it's a little bit of a gray area. Not ideal though. People think it's not that, a big issue, but I'm pretty sure nine out of ten of my patients drink less than a liter of water a day.
Abdullah Boulad 00:31:03 How can we change the habit around drinking water? I mean, there are the apps that they remind you and all these things, and we run through the day maybe stressed, distracted, from one thing to another.
Abdullah Boulad 00:31:17 We eat, but we forget to drink. You shouldn't drink while you eat. So there are so many rules you need to take care of at the end. you don't know anymore when to drink.
Fernanda Lima Sento Sé 00:31:30 So, soft drinks has taking over the space where water was. And, and alcohol consumption as well. So both are there where water should be most of the times. let's go back to anthropology. Alcohol. Alcoholic beverages were at some point created so we could have a safe source of hydration. Because not it was not always available to drink from a healthy source of water. So that was a way of hydration. And that's what they believed. Nowadays we have harsher alcoholic beverages, which actually dehydrate us. And so for me it's also coffee. Coffee is another one. Coffee has taken over. People feel tired. Oh, I'm feeling a bit tired. And instead of having the immediate response, I'm going to have a glass of water. They have a coffee with just the reverse. The complete opposite effect that we want.
Fernanda Lima Sento Sé 00:32:43 Instead of rehydrating us, it dehydrates us. So you get the little kick of cortisol, adrenaline kick. You feel energized for two hours, and then it drops, and then it really drops and you feel really, really exhausted. So I think water has been removed of the of the site and the other beverages have taken place.
Abdullah Boulad 00:33:09 So we need to get back to just having having more habits around drinking water. Yeah. What would I do? For example, when I stand up in the morning, I drink my glass or two as much as possible in water. Add some lemons into it. because I understand it, it activates my, my, my whole digestive system. And it helps me to, to regain. Does it have the same effect later on in the day as well? When we drink water, let's say, because you mentioned when you're tired. should I drink a glass of water? Does it help? To some degree.
Fernanda Lima Sento Sé 00:33:45 If you're feeling very tired, if you're having, like, a foggy brain, it's the first signs of dehydration.
Fernanda Lima Sento Sé 00:33:51 Dry lips. it's another sign. Headache. It's a very slight headache that starts here. The sign of dehydration. So we our body gives us, like, little signs. That's signaling to us, hey, you're dehydrated. But we live in a society, in the modern society where we're very disconnected from our from our physiological responses, and we don't know how to interpret them very well. A lot of people feel like, oh, I'm tired. I need to eat something. Sometimes thirst is mistaken for hunger. Yes.
Abdullah Boulad 00:34:30 We got into the water topic because of the inflammation. So if we drink a lot of water, this helps the body to to reduce the inflammation. In what way?
Fernanda Lima Sento Sé 00:34:41 So we're mostly made out of water. And water is a mixed part of physiological let's say equations. So metabolic reactions in our body and without the water we're putting our body into more stress. So if we're lacking water our body is stressed out because it I can't get the water. It needs to work harder to get H2O to do those metabolic reactions, and that creates more cortisol in your system and that creates more inflammation in your system.
Fernanda Lima Sento Sé 00:35:15 But if you're correctly hydrated, your body doesn't need to work so hard. That's one part. And then the other part is it's transports nutrients and help us eliminate what we don't need as well. Through the urine, but also through our feces. So if we don't have enough water in our system, the stools stay in our intestines in a large intestines for longer than it's needed, especially in the colon area. So your body just says, oh, you're not drinking water, so you're not going to the bathroom. The stools are staying here, and we're going to extract as much water as we can out of it, because it's a source of the fecal policies, the main source of one of the main sources of water. It gets reabsorbed and it just stays there. And then you get this other effect, you get constipated and you get bloated. And and it's when you have severe constipation, it can cause other issues. So then you have another chain of factors that could possibly happen just because we're not drinking water.
Abdullah Boulad 00:36:19 I'll definitely start to drink more water. What else are we doing in our lives in our in today's society, which is, like supporting the inflammations, chronic inflammations.
Fernanda Lima Sento Sé 00:36:33 So I'm going to start with the basics, which is not eating enough fruits and vegetables. That's another thing we see a lot and relying a lot on processed foods and drinks. That's the big, the big factors that could promote into the silent inflammation or the chronic inflammation.
Abdullah Boulad 00:36:55 What about stress?
Fernanda Lima Sento Sé 00:36:56 Stress is a big one. emotional regulation is directly linked with stress. And for those who don't know yet, now it's everywhere, but our gut and our brain are physically connected by the vagus nerve. But it's also indirectly connected by how our hormones and our metab and our metabolism work. So if we don't have a good diet, we are affecting how our brain manages our emotions and stress. And the other way around, if we don't manage our stress and our emotions very well, that's going to affect our digestive system and that's going to affect how we absorb nutrients.
Fernanda Lima Sento Sé 00:37:41 So it's a cycle. We're not getting enough sleep. Yeah, it's a big, big part of our health, which we're not addressing properly. And individuals are not sleeping enough. Until very recently, it wasn't even published that a woman needs to sleep more than men.
Abdullah Boulad 00:38:01 Yeah, okay. And why? Why is that so?
Fernanda Lima Sento Sé 00:38:05 Because we have on a hormonal cycle that that has a variation, a very drastic one. So it needs more rest, especially when there's an administration period. Okay. Also, because women bought the woman's brain can actually multitask much more than male brain in some aspects.
Abdullah Boulad 00:38:25 I can confirm that.
Fernanda Lima Sento Sé 00:38:27 The ones that have kids can can really see it very clearly. Like mom, mom brains are another level of brain function when it comes to the evening. They need to be able to recover. And now they're trying to link this. I know there's many studies going on where they're trying to link this with autoimmune conditions. Because now they're asking why are there more women without immune conditions than men.
Fernanda Lima Sento Sé 00:38:54 So one of the big factors is stress and sleep.
Abdullah Boulad 00:38:57 Emotional regulation.
Fernanda Lima Sento Sé 00:38:58 Emotional regulation. And then how? We are exposed to chemicals. Woman. They die. Their hair. They use nail varnish. They use makeup. They're more exposed to cleaning products than men in general. Yeah. And majority. So all this chemical exposure also has an impact. And with food. Also, one of the things that I find fascinating that I've only recently discovered is we are in a society where food comes from a supermarket, nicely packaged, nicely high, with a lot of hygiene and a salmon hydroponic. And we have all these new technologies improving the food industry. One of the biggest problems that we're having now is that the microbiome that originally comes from the food and should contribute to your microbiome. We're losing it because it's also hygienic and clean. We're losing this exposure to certain types of microbiome. And, there's a very famous paper where they're showing that kids that live in farms, have a less, less chances to develop asthma, for example, than kids who live in the cities.
Fernanda Lima Sento Sé 00:40:23 And possibly one of the exposures is to the different kinds of microbiomes. Yeah, those kids actually have a much more diverse microbiome than those who just just live and sleep in an apartment and not very exposed to those bacteria. So I grew up in a generation, late 80s 90s, where everything was sterilized, and now we're actually promoting completely different. Let your kids put their fingers in the soil.
Abdullah Boulad 00:40:53 Yeah, that's also something, what I experienced, or I experienced as a child, it was very, very hygienic and clean and, because because it was meant, like everything has to be like that. but we learned over the years, my wife and I, to to be more dirty in that sense. So it's difficult for me to accept. But with dirty, I mean, live around animals. Be with them. We have we have a little farm, like with chicken and horses and and dogs. And just two days ago, I was with my son with the chicken. And he likes to put works around them and prepare their houses and so on.
Abdullah Boulad 00:41:36 And then he brings the little axe and then gives me in his, in my hand. So I'm automatically, connected with, with, with it through, through them because they have it now more than I had it. So that's the learning we, we have been doing as a as a family basically.
Fernanda Lima Sento Sé 00:41:54 Yeah. I also think society is changing this perspective and it's shifting back to how it originally was. I think the other big thing is breastfeeding. breastfeeding is the first, not the first second source of enrichment of our gut microbiome and is in charge on how our immune system responds. The number of papers that talk about this is crazy. Like the publishing every day, more and more papers linking breastfeeding with one thing or the other, different kind of parameters and health immune response chances to cancer. And the list is is really long. But before that, the other thing that's very important is the birth of a child. So if you have a natural birth, that's the first exposure you have to microbiome.
Fernanda Lima Sento Sé 00:42:54 And that directly has an impact on how your gut or that baby's gut microbiome will then respond. And that's just their acquired immunity that comes from the mother. Some comes from the father. And then the first thousand days of life of a child is extremely important where breastfeeding, exposure to animals to third natural dirt, not the ones from the car fumes, but just natural dirt to animals to just diversity. Other children, other adults just build a better immune system. We as animals have always lived in community and living in community has demonstrated, and we pass our microbiome one to another as well. So that's the reinforcement also from our immune system. And we're slowly living more and more isolated and not exposed to that many amount of people.
Abdullah Boulad 00:43:50 Yeah. While you were talking also about, like the environment and what we use and women were like more, more in contact with, let's say like creams and hair product and so on. I was just thinking about my, one of my daughters who, who just turned 13 and she, in social media.
Abdullah Boulad 00:44:15 And I've been observing this a little bit like it's a big hype around how you do your skincare and how you treat your hair and what type of products. It's it's a huge industry around that. You know, I was always trying to explain to her, look, these products are not always helpful. So as they are promoting this and having more natural hydrating approaches is better. And and and I tried to give her also alternative Information. Alternative little podcasts or or information she can read about, or to make her own opinion. And not just to believe what what she watches there. But it's a big hype because this is one of the biggest topics within the girls, particularly at school and within within their friends circle. And they they show each other. Now I have this I don't want to mention brand. This is the this is the new one. And and I have to tried this and, that's that's the society we are in today.
Fernanda Lima Sento Sé 00:45:22 They even have those mini fridges where they store their makeup. I'm godmother of four girls and three of them are teenagers now, one of them very obsessed with makeup, like your daughter.
Fernanda Lima Sento Sé 00:45:33 And it's very hard because we grew up in a society where you got home, you had TV and your parents and your friends from after school activities. There wasn't much external influence. So what your parents taught you at home had a very huge impact. Now, I think parents sometimes are struggling to fight social media. It's quite hard. I think the you have alternatives with natural products, non-toxic. I really hope some of the toxins used in, in some of the toxic products used in some uni lines are not allowed to be used anymore. But it takes a long time these laws to get processed, to demonstrate. It's such a huge work, like we've known for 20 years that PFAS are not healthy, which is the anti adherent product that's on pants. The black thing on the pens. Now we have laws that been approved in half of Europe where it's not going to be commercialized anymore. But you've had a whole scientific community trying to fight this back. For years. And it's not until now that they found a lot of pressure, especially from social media.
Fernanda Lima Sento Sé 00:46:53 So there's also some good things from social media, whether banning, because that's another hormonal disruptor. And that also creates a chronic inflammation. So it's it's the we are exposed to a lot of things that have an impact. We can decide on a lot of things. We can decide the origin of our food, where we source it from, which kind of products we're using to clean the house, or personal hygiene products. But then what cooking were you using at home? It's something that I really like from the southern part of Europe, the very Spain, Italy, France. They're very, attached to their traditional pans and traditional way of cooking. And now that all this evidence is out there, I appreciate it even more because the way they've been so like, no, it needs to be this pan and cooked this way has demonstrated that actually that pan and that way is healthier than the new modern pans.
Abdullah Boulad 00:47:54 Yes. That's all. All contribute to the toxins we we have. And I'm pretty sure our body can react and can can clean up most, most of the toxins.
Abdullah Boulad 00:48:07 But to a certain degree, like the the example you gave like a little drops if, if it's if it's becoming full then then it's too much we cannot handle anymore. so you mentioned stress. Not enough water.
Fernanda Lima Sento Sé 00:48:25 fruits and vegetables.
Abdullah Boulad 00:48:26 Fruits and vegetables. The the environmental toxins is there. Did we miss anything?
Fernanda Lima Sento Sé 00:48:33 We're missing the proteins and the carbs. Yes. So, when we eat calves. Calves have been a big debate. I'm. I'm still a big fan of whole grain bread and having potatoes and and pulses. There are an incredible source of different kinds of fibres that are necessary for a system, a different kind of, shorter chain, carbs, carbohydrates that help produce, for example, butyrate, which is essential to regulate our, how we manage our mental health. It has a direct impact on on depression if we don't have enough butyrate in a system. So all these little changes when people remove one thing and then do more of the other than it effects. So I really like I'm a big fan of carbs but in a moderate quantity, small quantities.
Fernanda Lima Sento Sé 00:49:33 So Mediterranean style. New Nordic style. Traditional local carbs are very good and then proteins. Humongous trend nowadays on hyper proteins diets shakes different source. I have no idea. Every time I look in the supplement shops, I see more and more of these powders. And, First of all, 70% of the people taking them don't need them. With a diet, you can get enough plenty enough proteins, but you don't. A lot of people don't know how to calculate how much proteins we need.
Abdullah Boulad 00:50:18 How much do we need?
Fernanda Lima Sento Sé 00:50:19 So the minimum is 0.8g/kg. So how we translate this is a tricky part where people say, oh so I need 0.8. If I weigh 60 and eat 60g or 60g of chicken. No. Then inside each protein source, we have different quantities of protein. So you have to elaborate a little calculation. Ideally for me it's one gram of protein 11.2. If you have a reasonable active life where you do exercise four days a week, 3 to 4 days a week, 11. two grams, that will be ideal.
Abdullah Boulad 00:51:03 There are different types of diets. Let's say you mentioned carbohydrates or are needed, and protein depends on your body weight. like keto diet for example. Eliminates carb completely. Yeah, so is this. But many have been claiming it has been helping them manage weight and manage, blood sugar and, and other mental health issues in some cases. do you have experience with, with this specific type of diet and where would you see deficiencies arise on? On the mid long term.
Fernanda Lima Sento Sé 00:51:41 I'm a fan for keto diet for specific conditions. So for. It's been very useful for kids with schizophrenia for example. It's been it's one of the therapies that they've, they've tried to, to implement. but then it's very tricky with keto diet because how was that person eating before? We only talk about the results of this diet, where we never talk about how was that individual eating before doing a keto diet. In my experience, most people come from a uncontrolled diet where they had no knowledge of what they were eating. They read a book, do a small research, and they implement a keto diet.
Fernanda Lima Sento Sé 00:52:40 The thing is, if you're at that moment starting a keto diet and you're struggling with mental health conditions, if you do it without control and supervision, it could lead to you to have more stress and anxiety and could have a negative impact on your health. Uncontrolled keto diet eliminates a whole group of fermentable fibers, could create constipation, could create liver issues, so could create renal issues as well. So it needs to be done correctly and shouldn't be your long term diet. It's unsustainable.
Abdullah Boulad 00:53:23 Yeah. It's unsustainable. I feel if I heard and read a lot about the keto diet, I tried it myself also for for a while, but it's just not sustainable.
Fernanda Lima Sento Sé 00:53:36 It's not sustainable.
Abdullah Boulad 00:53:38 you know, if you if you live in a, in an environment and social and, and interact and travel, you know, if every, every type of diet or way of living, if you do it strict in a controlled environment and don't interact and don't change, but then it becomes so strict. is this life?
Fernanda Lima Sento Sé 00:53:59 It has a huge toll on mental health.
Fernanda Lima Sento Sé 00:54:01 Huge toll. It's really, really hard and it creates more stress. And we don't want that kind of stress. But it has, it has it can be used for different things. but I always think diets where you eliminate. So elimination diets depending the type it is it can be keto. It can be low FODMAPs, it can be low histamine. It can be we have infinite. It can be vegetarian and vegan if you don't know how to do it, get informed by a professional. This is the first thing I always say. The amount of vegetarians that sat on the other side of my desk and have all group of issues or body risk physiological responses, and it's because they didn't know how to do a real vegetarian diet or a vegan diet. because you can be vegan and still eat candy. You can be vegan and still only eat pasta and bread and potato, but you're not eating the vegetables that you need. You're not having a balanced source of proteins. So you need to be. If you don't know, ask for help.
Fernanda Lima Sento Sé 00:55:10 It's like when you like when you start, driving a car, you don't know someone's teaching you or you learn how to ski or snowboard. You don't know. You get a teacher, you get a coach, you get someone to teach you. So if you're trying a new type of diet where you don't have enough knowledge and to be honest, nowadays anyone can publish a book and say claims of scientific evidence but doesn't really have them. It can have a negative impact. I've seen so many people doing this kind of restrictive diets, especially because they've been working with low FODMAPs diet for a long time. For IBS, individuals and even doctors have been implementing this, this, this protocol incorrectly, because you only have a little bit of the information. You don't have all of it. It's like you need to take antibiotics for this. Okay. How much how many days do I need to take probiotics afterwards? You know, all this kind of it's the same. It's applicable the same for these different kind of diets.
Fernanda Lima Sento Sé 00:56:16 Same comes to low histamine. People come to me and say, oh, I've done I've tried that. Diet doesn't work okay. How did you do it? How long did you do it? Did you do the phases and phases. That's usually the response is other phases in the diet. It's like yeah, it's like intermediate fasting as well. Yeah. Excellent. Love it when you have to do it properly and you can't have stress if you're very stressed and you put this on top of your plate, that's super full. It's, it could make things harder.
Abdullah Boulad 00:56:56 And it shows me also that every person is individual and there cannot be that one size fits all. Exactly. So, like, talking to, like, an expert, like you are with experience in the different areas. Can can be more directive specific about my personal health condition. if it's something severe and not just like, okay, I'm healthy or I feel healthy and I just want to lose weight or something?
Fernanda Lima Sento Sé 00:57:27 Exactly.
Abdullah Boulad 00:57:27 But even even then, there are differences.
Abdullah Boulad 00:57:30 And your body metabolism and react differently to different types of food and and just trust on general information out there is not just. It's not sufficient.
Fernanda Lima Sento Sé 00:57:42 Exactly. It's not sufficient. And also people have different lifestyles. It's not the same. I don't have kids. Then someone has three kids. How do you juggle an elimination diet with the three kids and take them to school and cooking for the whole family? This is. This is what I see every day in the practice. How do I juggle this? How do I break it down? It's not here a book. Do it from here. No. Let me take you step by step on how we can incorporate this to your lifestyle. And if it's not doable, I will be very honest and say, maybe now's not the time. We need to wait a couple of months until you eliminate some things from your from your plate It's quite full. And then we'll tackle this down because stress is the biggest trigger of digestive conditions for example. And if the person sitting in front of me is so stressed that adding another thing in the list is going to make them even more stressed, I'd rather just send them to a colleague who's a psychologist or a psychiatrist and help them manage their mental health, or if they need to change life, lifestyle, do more exercise, take some more time off, whatever helps them to reduce the stress level.
Fernanda Lima Sento Sé 00:58:59 And then we can assist this because it's it's it's it makes it harder for them.
Abdullah Boulad 00:59:06 That's interesting what you just said because so people make come to you because of a health condition or or a got nutritional advice, sports advice, around their weight and so on. But when would you when would you consider to recommend to them to go to a psychologist or a psychotherapist to get help on stress and other other issues which affect as an underlying cause their condition?
Fernanda Lima Sento Sé 00:59:38 So most registered dietitians, we get coached on diagnosing when someone has tendencies to eating disorders. So that's the first red flag when you see that someone's playing. I've done this diet and this one and this one. And then we reassess it. Sometimes it's not so clear. Another time it's super clear as soon as they sit in front of you, you know? Yeah. So, it's, sometimes not a very nice conversation or comfortable conversation, but then you go into the area where you talk with them about mental health, how your mental health is linked to your digestion, and, for example, someone with IBS.
Fernanda Lima Sento Sé 01:00:20 And if mental health is 50% of of the recovery of some an individual with IBS. If we don't have a good mental health and a good support, then it's really hard to manage it. I can give you the best diet in the world. I can go to your house and cook to you, you know, make the whole plan tailor made to everything. But if your mental health is not in a good space, you will still be triggered. They've done plenty of studies where they've put individuals in specific control settings, and without the mental health, there's nothing to do. It's very little for us to do. So this is, they improve a week or two and then they get triggered again, and then this back and forth, and it just becomes this cycle that never ends. And I don't want patients to be dependent on me forever. I want to help them have tools to manage their condition.
Abdullah Boulad 01:01:19 Yeah. And and start also with their behavioral or.
Fernanda Lima Sento Sé 01:01:22 Exactly.
Abdullah Boulad 01:01:23 Other emotional regulation traumas. whatever comes up.
Fernanda Lima Sento Sé 01:01:28 Depending on the profile, you know, one psychologist might work best or the other, or you just ask them to find for help. Have you considered doing physical activity? And you talk a little bit around how is their daily lifestyle. And you give tips on you can do exercise. You need to drink more water. Let's see with these changes how you feel. And come back and we'll see if the elimination diet is really necessary. And then I also need an appropriate diagnosis. And with digestive conditions, a lot of the times we don't get it, unfortunately, because some digestive issues don't have a specific test that you can do and others do. So it's tricky. They need to get the test done. Some some doctors just say, oh, you have this and they give you a paper. That's that's your diagnosis. And individuals are like, what can I do now? So they start googling. The internet's fantastic for a lot of stuff, but for other stuff, if you're not critical with what you read, it can be tricky.
Fernanda Lima Sento Sé 01:02:37 And they do low FODMAPs diet for months. The recommendation is no more than eight weeks. That's no more you the general. For most people, it's 2 to 4 weeks and then you do reintroduction step by step. It's like a treatment. Yes. And people just do it indefinitely because no one gave them the information. No one said, hey. And if you have IBS but you're constipated, this diet is actually not going to help you. It only helps for individuals that have diarrhea or have mixed IBS. So there's a lot of yes, we have a lot of tools, but a lot of the times are not implemented adequately. So each individual has a different need. Yeah. And different way of regulating themselves as well.
Abdullah Boulad 01:03:29 What is the problem today around modern food and how we how we source it?
Fernanda Lima Sento Sé 01:03:38 First of all is we've disconnected ourselves from consuming local produce and understanding the seasons of the foods. Some are very clear, like strawberries or cherries, but letters and tomato. We assume we have them all year round, and in theory, we shouldn't eat them all year round.
Fernanda Lima Sento Sé 01:04:00 And then I think we also lost a bit of the tradition. here in Spain I observed like, yes, we live in a mediterranean and we do have a kind of Mediterranean diet, But more and more we're getting more disconnected of it and, eating more convenient processed or pre-packed food. And I think that that probably is one of our one of the biggest challenges I find. People don't know anymore where food comes from. Is it from a tree? From a bush, from a plant on the ground? Basic knowledge around the food is has been lost.
Abdullah Boulad 01:04:43 Why is it so important to eat local and to eat not the same food all year long?
Fernanda Lima Sento Sé 01:04:53 So I like to think nature is extremely wise and they provide us with what we need in that time of the year. So now we're in spring. In spring here where we're living. We have a lot of citrus fruits. And by coincidence, or maybe not. We actually need that extra vitamin C this time of the year because the weather fluctuates a lot.
Fernanda Lima Sento Sé 01:05:22 We have a lot of changes. It's warm, it's cold, so we need to give our body an extra support of our immune system to face this challenging changes. And, I think that's that's a beautiful thing that we have with seasonal food. It just provides us with the nutrients that we need in the summer when we're exposed to sun and heat and humidity and nature in the Mediterranean provides us with a bunch of fruits and vegetables, rich in water and rich in minerals that help us hydrate us, and rich in antioxidants, which also help us fight back the effects of the sun in our skin and in our body. For example, that oxidation that takes place. So nature is quite wise in this way, with just most of human or most of society has lost this connection of of eating seasonal and we just eat all year round the same. So the tomatoes in in January are not local. So they probably have a lot of pesticides and fungicides, which we don't really want an excessive amount of those of those in our system.
Fernanda Lima Sento Sé 01:06:41 We need to make sure to wash them properly and remove them from those vegetables. And they're not as tasty and not as rich in antioxidants. It's like having a diluted version of those antioxidants than those beautiful tomatoes you get in the middle of the summer.
Abdullah Boulad 01:06:57 We have a lifestyle today. We travel. Yes, we, we may be in spring, go for vacation and somewhere, in the Middle East or and all these activities, all we have to travel for business to Japan or to to South America. So this is completely disturbed for many people. Yes. For business or leisure reasons. So how? How is it? How is it for. For for them. Is it really necessary? And the other point is, I mean, where we live, let's say, in Majorca, Kiwi may not be the, the fruit of, of of, of the environment, but still. So we should never eat them. Kiwi or how, how should we react to fruits and vegetables which never grow in our area?
Fernanda Lima Sento Sé 01:07:55 I like to keep it neutral.
Fernanda Lima Sento Sé 01:07:56 I think individuals need to get enough information and then be able to decide by themselves what is more convenient for them. I think it's as a healthcare professional, it's a responsibility we have to inform you. Give you all the information we have from the specific topic. If you don't have that information. And once you have the information, you can decide. It's like when you go and buy a car, you go and check all the information of the car consumption, pollution, taxes, how expensive it is, the features, and you compare it to many others, and then you decide which one is more suitable for you or when you go and buy a home. Same thing. So when you're going to buy food, you need to understand are you willing to commit ethically or not? Because if you don't, then it's up to you. Are you willing to commit in a way where you want to have a clean eating habits, and you don't want to have pesticides and fungicides on your diet? It has a cost.
Fernanda Lima Sento Sé 01:08:55 It has a commitment. It has it conditions your diet. So if it conditions your diet, you need to be able to to do it responsibly. But that's one thing. So once that's cleared and then also you have the religious part behind it. I like to respect everyone's religion. So if you don't eat one thing, let me give you another alternative that is suitable for you. And then there's the other part. You know who doesn't love a nice, beautiful mango? I think I've never met anyone that doesn't like mango. I love mango. Luckily, now in Majorca, we have mangoes and avocados. They're not the same price as the ones that get flown from South America or from the south of Spain. But they're local. So what are you committing to? The price to the what's on your fruit and vegetable? It's it's it's that's the tricky part. So for me, it's a very open conversation. For me personally, I like to eat clean. I eat as much as I can, locally sourced food.
Fernanda Lima Sento Sé 01:09:58 And from the season my husband complains in the winter is very boring. But it's a commitment that I decided to take with my dietary habits a long time ago. Yeah, I'm a bit spoiled because I grew up in Mallorca and I have access to.
Abdullah Boulad 01:10:16 A.
Fernanda Lima Sento Sé 01:10:16 Lot to farms and a lot. And, you know, I have in the family, my brother has a small little farm, so we can get a lot of our veggies from there. Or we have the local farmers market that are very accessible to to go and purchase. But of course, it's not economically accessible for everyone. So I think that's the big the big things. And then when you're traveling, I personally love eating local food. I do my own research from what's seasonal or not in the area. Of course, my education helped me a lot with this because I did study anthropology and food and food and culture, so I have a lot of knowledge of this, but a lot of people don't. but when you go to a foreign country.
Fernanda Lima Sento Sé 01:11:05 Why don't you just try their food? Well, it's a big part of their culture.
Abdullah Boulad 01:11:09 This is what I find maybe difficult. Or I would claim that most of people find it difficult to recognize what is local, what is not local, and and what is what is seasonal, what is not seasonal in the area I am right now. So if I go to the to the to the shopping supermarket next door, some may may have challenges to decide. Okay, now I need to buy something local. What is it local? Because everywhere you have the same things all year around, every tomato is available all year long. strawberry is are available in the shops all year long. So we lose the connection to to nature in a way that understanding. Oh, now does strawberry comes in January or in February or March or. We don't. We don't have this sense anymore.
Fernanda Lima Sento Sé 01:12:08 Have a sense where your base is, where home is, where you do the majority of your meals. So not home, but where are you living, where you go to work and when you're traveling? Just go back to the real basic eating a vegetable.
Fernanda Lima Sento Sé 01:12:26 So make sure half of what you eat is vegetables. Make sure you eat some fruit every day. Recommendation 3 to 4 pieces of fruit a day. And those are easy tips that you can apply anywhere you go in the world. Maybe not anywhere. I mean, in the tundra is quite hard to have enough veggies. Yeah. So you just eat reindeer and fish. And if you're in in the middle of nowhere. But that's a very small percentage of a of the globe where if you're traveling for business, all of this, 99% of the times can be extrapolated to your diet veggies, fruit, enough water intake, a healthy kind of protein, and some carbs and just build your plate around it. And for me, that's that's the I like to use the picture of the plate. It's a move trying to move away from the nutritional pyramid and doing a more visual tool for individuals, where you visualize a plate and half of the plate of the veggies, one quarter would be your carbohydrates and one quarter would be your protein source.
Fernanda Lima Sento Sé 01:13:44 It's quite balanced. You can play around with the yes, you know, they're not fixed, fixed, but what it is fixed and what should be the main role of your plate. Like I like to say, it's the vegetables actually and not the steak.
Abdullah Boulad 01:13:59 So half 50% of what we what we eat should be veggies basically cooked or ro. Is there any.
Fernanda Lima Sento Sé 01:14:08 On your day to day basis? Raw vegetables are very suitable. Some vegetables are not so nice to eat raw or you can digest them differently. And then when you're traveling it depends where you're traveling. So if you're in Japan extremely hygienic, you can eat whatever wherever very little chance that you're going to have a food poisoning. If you're going to Southeast Asia, Eating salad can be tricky.
Speaker 3 01:14:35 So maybe you will go.
Fernanda Lima Sento Sé 01:14:37 For a cooked meal with vegetables. And if you have a look at their traditional meal, a lot of their vegetables are cooked. Yes. And then when it comes to fruit, make sure that you yourself, if it's an area where you know, it's a bit tricky to have proper hygiene, you wash them and you manipulate them.
Fernanda Lima Sento Sé 01:14:53 You chop them. if not, if you're, you know, Europe, more westernized, much more hygienic environment. And then just you just eat fruit. Very simple. Instead of eating processed meal.
Abdullah Boulad 01:15:11 I've been listening also to like that fruits with the sugar amount. So preferring veggies compared to fruits. You've been mentioning a whole lot of fruit. Fruit, fruits? Yeah. how how do you see the differences here? And what's your recommendation on fruit?
Fernanda Lima Sento Sé 01:15:31 Fruits and vegetables have different properties, but in there. But they're very similar at the same time. And the similarities that are packed with antioxidants and fibers and the one of the biggest roles of fibers in their digestive system is to regulate how we absorb nutrients. But for that, we also need water. And here's where the balance comes. So yes, you can eat 3 or 4 portions of fruit a day. It won't be an issue unless you have diabetes and you eat them all in one go or you're juicing them. eating one orange and having the juice of one orange have completely different glycemic peaks, because the juice removes all the fibers, and it's much easier for your body to absorb those carbs and make a big peak so your sugar levels go up, and then they go down.
Fernanda Lima Sento Sé 01:16:25 And when they go down, it makes you be more tired. But on the other hand, if you eat that orange, then the way your body absorbs those sugars is not so easily. So the fibers. Let's imagine you have here a molecule of the sugar. Here are the fibers. You need to break this to be able to absorb it. So it takes a physiological process to be able to absorb. And it won't be absorbed in the same rate. And it won't be metabolized on the same rate.
Abdullah Boulad 01:16:53 So it's the same amount, but it's digested during a much longer period by the body.
Fernanda Lima Sento Sé 01:17:00 So you won't have those big peaks? Yes, you will go up and then it will stay high and then it will go slowly down.
Abdullah Boulad 01:17:07 Yes. What about, juice out of fruit? Veggies?
Fernanda Lima Sento Sé 01:17:13 It's a personal debate because in Latin culture, South American cultures, we drink a lot of fruit juice, smoothies. It's a big cultural thing. Then, on the other hand, you have this glycemic peaks.
Fernanda Lima Sento Sé 01:17:34 So juicing, especially with vegetables, can be an incredible source of electrolytes and a natural isotonic a way of rehydrating. I'm not a big fan of these diets of juicing. because there's a high risk on the other side, which no one talks about, which could be, not having enough proteins, not having enough fibers, encouraging sugar peaks. in some individuals, it could affect your microbiome severely. and it's just this it's like the small letter that no one tells you with juicing. But I think it's an incredible tool. And in a few occasions, it can really help you rehydrate. So someone that's going through a process who is severely dehydrated. It can be a very good tool to help them, but also trying to flush too many toxins in someone that, for example, has a habit of, abusing substances. If you try to flush them all in one go and not respect the natural flow of the body. It can have a severe effects on how the person is managing the flushing out. On your mental health, on stress.
Fernanda Lima Sento Sé 01:19:03 So it's it's a tricky one.
Abdullah Boulad 01:19:06 So whenever you want to do too much in a short period of time, it's not always a healthy process.
Fernanda Lima Sento Sé 01:19:13 No.
Abdullah Boulad 01:19:14 Like like a complete strict diet or diets. just with with liquids. there is also I've, I've come across like, retreats with water diets. They only drink water to I mean, everything you leave out, it will have an effect on your body, but also negative effects. What you're saying.
Fernanda Lima Sento Sé 01:19:38 So it depends on how much time you're doing this. So if you're doing it to a through a short period of time and it's exclusively juicing for a couple of days, Ease. For some people, they find it helpful. Scientific evidence is some studies say it's very beneficial. Some studies say it's not. But we go again to what we talked previously, which is how was those individuals eating before this intervention. So I'm more in favor of let's balance and give you the, you know, the base of your diet. Give it some stability and see how your body responds.
Fernanda Lima Sento Sé 01:20:17 If you need something extra. Then we'll do it. This quick hacks doesn't really help, and if you really need those nutrients urgently, we have other options. We can have it intravenous. You can have supplements that have a better assimilation, probably less side effects. A lot of people, when they do juicing, they have severe diarrhea. And they're actually not rehydrating. They're dehydrating. So it's it's again one size doesn't fit all.
Abdullah Boulad 01:20:46 So doing something for a short period of time may work for some people. But doing this over a longer period of time, to be careful and have professional support?
Fernanda Lima Sento Sé 01:20:57 Yes.
Abdullah Boulad 01:20:58 Can we go a little bit deeper into the topic of IBS? You mentioned that a couple of occasions like IBS and the microbiome and and how how is it connected? wherever you would like to start.
Fernanda Lima Sento Sé 01:21:14 So when our digestive system suffers a big change and it's not functioning how it should be. So how the how is that so? Going to the bathroom wants to three times a day, max.
Fernanda Lima Sento Sé 01:21:32 And every day or every max three days. That's a normal rhythm of depositions of your feces. Anything outside of that? It's an abnormal transit of your fecal bolus or of your feces. So once that is clarified and people understand this, they start understanding and interpreting their feces better. IBS is irritable bowel syndrome. It means that there's a part of your large intestine that is incapable of fermenting a group of fibers. And that causes you to either have diarrhea or constipation or mixed symptoms. And it can come along with other symptoms, which can be headaches, joint pain. Again, all those symptoms from this chronic inflammation, you can have schemas, highly linked to neurodivergent individuals. So especially in the spectrum of the autism or ADHD as well. Or, and so there is a huge link also with these conditions that just have conditions and these kind of neuro divergences. And basically when your bowels don't work well, your microbiome gets altered because some bacteria will thrive better in a certain environment than other. So if you have a lot of water in your system, in your digestive system because of diarrhea, and it's having this osmotic effect where water is getting drained from your body into the lumen of your intestine, then some bacteria thrive better in that environment, but others just get flushed out.
Fernanda Lima Sento Sé 01:23:19 And then when you're constipated and the environment is more dry and has a different pH than other bacteria, thrive better. But also the food that we eat and the stress has an impact on bacteria. And we have bacteria from our mouth all the way to our anus. So in all our digestive track, these bacteria have different roles. Not all of them are bad bacteria. It's completely the opposite. They live. They live in an ecosystem. They need a certain balance to be able to thrive and do their job in a certain way. And some bacteria are in charge of degrading. Some are in charge of moving some nutrients to one place to another. Some are in charge of communicating to your hormonal system. Hey, we have enough iron. We can work this way so they have different roles between them. And together they make that our body work. The way it works. So they are essential for us. But we need the balance and the balances. It's like nature. It shifts. It's not fixed.
Fernanda Lima Sento Sé 01:24:33 It's it can be modified. But then when it's out, either too much or too low, then everything else gets unbalanced and then you can have other effects. So it's a very complex environment.
Abdullah Boulad 01:24:48 The microbiome absolutely understand it's complex. And I mean when we talk about billions of of of bacteria in our guts and how much do we really know today about it. So we can we can we can tell with evidence this is it.
Fernanda Lima Sento Sé 01:25:07 We know a lot. We'll be surprised. So it's not only bacteria, it's viruses, it's protozoa. So it's a whole ecosystem. We do know that, we have bacteria that transports nutrients. So all of those are identified. We do know that we have bacteria that help regulate, that are influenced by cortisol. We do know that we have bacteria that regulates serotonin. We do know, for example, we do know that some nutrients feed some bacteria that have an impact on serotonin, which we just talked before. We also know that there are specific type of bacteria that are in charge of regulating the transit of our intestines.
Fernanda Lima Sento Sé 01:25:50 So how long does the fecal bolus need to take place inside and be out? We also know that if we are lacking specific groups of bacteria, we're going to be there's a correlation that we're lacking some sort of nutrient or is affecting one of our hormones or a group of hormones. And, yeah, the list is quite amazing. we also have bacteria that have been identified, like, our commences has been identified to regulate our appetites, is linked in our appetite and how we manage appetite. So this there's a lot there's so many studies being published. It's probably one of the areas that's been mostly researched nowadays because we're linking bacteria to everything respiratory health, gut health, mental health.
Abdullah Boulad 01:26:49 It's fascinating. You know, all these combinations and and diversity, which is available in our gut. I compare it with like the comparison, like in the forest or the biodiversity. Yes. There is this, this, this, this concept of, the nature has to be diverse in a, in a certain ecosystem to function in a, in a best way.
Abdullah Boulad 01:27:15 And, is it correct if I assume the same, let's say, for our gut.
Fernanda Lima Sento Sé 01:27:19 Microbiome exists in many different areas of our body. We have it in our skin. We have it. Woman has it in a vagina. We have it in the lungs. But the most diverse one is probably the one that goes from our mouth all the way to the gut. And that's a whole ecosystem and it's like different. I'm trying to think like the world. Imagine it for the world. And each part of our body is a country or a continent, and they each have a role to keep it all in balance. So it's a little bit the same in the mouth. We have a group of bacteria to help degrade the food, and then we have some bacteria all the way down to our stomach. And then in the stomach, because we have a different pH, we have a different group of bacteria that thrive. And those are the one in charge with the acid to degrade the food, to make it more easy for our intestines to absorb.
Fernanda Lima Sento Sé 01:28:21 And then the intestines, which are an amazing organ and huge in each area of the small intestine, is in charge of absorbing different types of nutrients or vitamins or minerals. And it's all enabled by bacteria that work together. And then it goes all the way down into your anus. So at a very known example, B, if you have a liquid capillary, it will be located usually in where your stomach connects, where you have a splinter that connects the stomach to the small intestine. Right there it's a it's a place that they like to be. It's where they test to see where it is. But you can also find them in your stomach and you can find them in your intestine, depending where it's located and where it decides to thrive the most. It can create your pH in your stomach to go down, so you lose the ability to digest food properly. So your body is creating more kinetic assets to digest food, but then that has an impact on all the way down until the anus. Because if the fecal bolus has changed the pH, then all the bacteria around has to shift and adapt because the pH is different and they don't thrive the same way on pH variations.
Fernanda Lima Sento Sé 01:29:45 So usually individuals that have a huge amount of Helicobacter pylori and they get this diagnosed, oh, you have Sibo or dysbiosis because Helicobacter pylori just means this specific bacteria has managed to move and shake around the rest of the bacteria in your system, and that's having an impact on how you digest and absorb food. And as a result, you're probably having diarrhea and acid reflux.
Abdullah Boulad 01:30:12 This biodiversity has been also I've been reading, reducing over time. Yes. also in some some old cultures when they live in thrive tribes and, and and more in nature, they have a more diverse. Yes. gut bacteria or all over microbiome. how is this affecting our health? And this is one of the factors from the epigenetic side. affecting our gut and vice versa then affecting how we respond to our environment.
Fernanda Lima Sento Sé 01:30:48 So obviously less close exposure to other individuals has a direct impact. We we exchange bacteria with individuals. Very interesting factors. You sometimes you most of the times choose a partner that has a microbiome that could be compatible to yours.
Fernanda Lima Sento Sé 01:31:07 And they balance each other. Very interesting fact. And we are not usually we live with our partners or our family. We don't live in big communities anymore. We don't have to go very back in history to see that. Four generations ago, most individuals were living more in like bigger groups of families, bigger communities Together. It's not that long. It's only 3 to 4 generations ago where you had the grandparents and the uncles and cousins all in the same house, or all spending time in one house, usually the grandparents, and then at night time. So all of this time, social dynamics have changed a lot and we've become very individualistic. Then we're not so exposed to the soil. We're not exposed to this food directly in contact with the soil anymore. We have a lot of hydroponic farming that also has an impact. So the diversity is slowing slowly being not so diverse or that's what we think. But we were studying microbiome the way we're studying now 100 or 200 years ago. We can go look back in samples.
Fernanda Lima Sento Sé 01:32:18 Sometimes you can figure out that there's been more variety, but a lot of the times it's more assumptions. We don't really have the actual data, but we do know that we are slowly reducing that diversity.
Abdullah Boulad 01:32:36 On the one hand side, we are using the microbiome diversity, but we definitely affect each other with our microbiome on different levels health and and and mental health level. And one one thing comes to my mind. My father used to say, tell me who you are as a child. I remember as a child he was telling me like, tell me with who you surround yourself with, and I tell you who you are. And maybe, maybe we can apply this also to the microbiome. Tell me what microbiome you interact with, and I tell you what your health is.
Fernanda Lima Sento Sé 01:33:16 Yes. This is why, microbiome or fecal transplant has come as one of those new emerging therapies. PS they don't directly get feces and feed it to you. They encapsulate it. They, you know, extracted and they elaborate this very nice capsules to give you the bacteria that you need or that the individuals think you need to be able to diversify, because sometimes some individuals get so removed of bacteria that they don't have this diversity, but certainly it has.
Fernanda Lima Sento Sé 01:33:53 There's a correlation between who you're surrounding yourself and your mental status or how you're feeling. Levels of happiness, being active or not. also, if you're using or abusing of substances or not, all these things, you see, it's people in specific surroundings. And sometimes there's obviously a social part of it, which is an a psychological part of it, which is a big part. But there's also this microbiome part to it that contributes. So it's always multifactorial. It's not only one thing.
Abdullah Boulad 01:34:35 Definitely it's not the one one way. Yeah. It's it's more complex and as an ecosystem by itself. But I like the idea. If I surround myself with happy people, I might be happy from the inside out.
Fernanda Lima Sento Sé 01:34:47 Yeah.
Abdullah Boulad 01:34:49 So yeah. No, that's that's fascinating. And and I understand we the microbiome affects our mind, affects our mental health as well. It's not just on what what our immune system or inflammation will be as an effect. What's your experience. Have you any examples or what what is it it affects on the mental health side?
Fernanda Lima Sento Sé 01:35:17 So before I was digging so much in the microbiome in my career, I could clearly see individuals with chronic pain, chronic conditions once they've improved their dietary habits and their day to day habits, improving sleep, a better mental health management and giving different kind of tools, and walking in nature and all the group of things.
Fernanda Lima Sento Sé 01:35:46 They certainly have a better state of mind. And that was very clear. I have this one case I think I'll never forget. This case was a lady. She had a multiple chemical adverse reaction, and she she couldn't live a normal life. And previous to when she came to see me, she was cleaning hotel rooms and she developed chronic pain. And she was just flaring with Multiple substances being exposed to perfume, to coloring and clothes. So she sent me a very kind email saying, I have this situation. This is the report from the other geologist. When I come to see you, please use don't use anything with perfume. Nothing. And I was like, wow, okay. And she, she was working in the, in this hotel in the south of the island. And I was like, okay, sure. So I booked the whole afternoon with for her. I made sure my colleagues went there in that clinic. And she came and explained, and I told her, I'm going to be very honest.
Fernanda Lima Sento Sé 01:37:01 I don't know where to start. But I do know that your diet needs to improve. So let's give it a shot and let's see how it goes. Because I this was ten more than ten years ago, I think I was like, I don't know where to start. There's no official protocols for someone in this Situation. Anti-inflammatory diet. That's the only tool I had. So we did an anti-inflammatory diet. Her digestion has improved, her immune response was improved, and she started feeling better. So she started being able to access other therapies as well. So she started doing osteo. She started doing physio to help with her chronic pain. And then she stopped coming. Sometimes this is something we see in the private practice. People just stop coming. You never know what happened to them. And five months later I got a really nice email. Fernanda, thank you so much. My health improved so much that I can take my kids to school. She wasn't able to take her kids to school in four years.
Fernanda Lima Sento Sé 01:38:03 She couldn't leave the house without a face mask for talking to me for Covid. Before, face mask was something normalized in the Western world. So she was wearing face masks. She was wearing this big goggles, super paranoid and scared. And she said, That my health improved and is nothing because we don't know how to measure this, but improved. And she could take the kids to school. She could go to a supermarket. She wouldn't react the same towards chemicals. She will have an itchy skin, but she wouldn't have a massive flare up that ended up in an air. And this for me was like, wow, this, this is what I this is why I'm doing what I do, because I wanted to give people a better quality of life. And this is probably one of the most extreme cases I faced where no one knew what to do. And I said, I don't know, but I let's try this tool and let's see how it goes. I can't promise anything because I don't I don't have any scientific data to back me up.
Fernanda Lima Sento Sé 01:39:05 But I do know and I'm certain that if you if your immune system responds better, your symptoms should be improved and not so dramatic. And it was. And it was amazing. And this person. She couldn't go back to work. She's very restrictive lifestyle. But the fact that she can do small little day to day things that made her so happy was already amazing. So yeah, some things you can't really measure or we're still trying to find a way to measure it or put it in a tangible way.
Abdullah Boulad 01:39:41 Yeah. Oh beautiful story. So definitely had a huge impact on one person's life. Yes. They're yeah we understand like the all the stress and and lifestyle. We we have these tensions we talked about about our job, other areas I could think about the neck people get tense with but but a lot of emotions I feel like people hold in their in their gut. Yes. In a way that they are disconnected from their from their gut, from the body. But most, most of of the the body is kind of also around around the gut.
Abdullah Boulad 01:40:26 And and this disconnection leads to, to to tension in the gut. And has this also like emotionally an effect on the microbiome, the level of diversity and, and the IBS and the inflammation and everything we're talking about here.
Fernanda Lima Sento Sé 01:40:49 Yes. So actually the interesting thing is when we have tension, the first part where we usually hold it is in our diaphragm. that's why breathing properly is so important. Yeah. And it's so underestimated. I think slowly people are getting more conscious. So there's a bunch of, of papers. Very interesting talking about how stress makes our diaphragm be on a hyper tone. So it's always contracted and not relaxing properly, and how that has an impact. Imagine you have your diaphragm here and it goes all the way up when you inhale and it stays up. It doesn't really go down the way it needs to. It affects all the muscles that support your digestive system from the stomach all the way down to the anus, because pulling this up makes all your abdominal area work in a different way.
Fernanda Lima Sento Sé 01:41:49 So people with chronic stress experience bloating, probably also because the gut brain axis and how stress affects cortisol and how cortisol affects the microbiome. But also physically we have the situation where our we can't relax our diaphragm and then our abdominal area also gets impacted. So again multifactorial circumstance where physically and then by the enzymes we have this connection. And then how that also affects the microbiome and then how everything is linked. So and then probably it also links to how we oxygenate ourselves. there's so much papers being published now that they're trying to link one thing and the other and say one is the absolute truth. But I'm a strong believer that the whole put together has an impact directly. So yes, stress has this direct physiological impact on the muscle, but also how the vagus nerve is connected to our intestines.
Abdullah Boulad 01:43:04 You can observe yourself how your breath is being handled, but how can we on a biological level, test if we have a healthy gut or healthy microbiome?
Fernanda Lima Sento Sé 01:43:18 First, easiest and cheapest way of doing is looking at your thesis.
Fernanda Lima Sento Sé 01:43:25 That is the number one result. So not only observing how your body responds, so does it feel heavy? The digestion? Do I have a bit of reflux or not? Is my abdomen extremely bloated at the end of the day? So do I need to unbutton the button of my trousers in the afternoon because I can't keep with them the whole day? Those little physical things that we can observe, but also observing our stools. And it's a big social taboo where people doesn't like talking about them, but it's something I always bring on to my practice. It's one of the first questions I ask how are your stools? And most people say normal and you're like.
Abdullah Boulad 01:44:08 Brown.
Fernanda Lima Sento Sé 01:44:08 But.
Abdullah Boulad 01:44:09 Most of the time.
Fernanda Lima Sento Sé 01:44:10 And you're like, yeah, what does normal mean? Yeah. And then like, so we, I have some, some tools that I use. I have the Bristol stool chart. I either use some samples made out of plasticine or I use a little chart that I print out and I make them point out which ones.
Fernanda Lima Sento Sé 01:44:28 So I bought some today.
Abdullah Boulad 01:44:29 Oh yeah. Yes, yes I saw, I saw some okay.
Fernanda Lima Sento Sé 01:44:35 So it's a chart that what it does, it categorizes the stools in seven different points from severe constipation all the way to severe diarrhea. We're going to start with constipation. You have kids, so you've probably been forced to look at their stools. Yes. So these small ones are severe constipation. This is a result of someone that their digestive system doesn't really work well. there's a bad connection. But also they have a lack of water and fiber consumption. But sometimes individuals can also experience this with aging, but also with medication and the other level of constipation, which is not so severe. It's this one, and this one has irregular surfaces on the top. This type of constipation is usually the one that, when they're passing, can cause fissures to individuals, or when they really need to go to the E.R. and ask for help because they have a big volume and a regular surface. So it's not very nice to pass them through.
Fernanda Lima Sento Sé 01:45:49 Also, like a fiber, lack of water and a lot of the times a lack of oils, a lot of ladies doing very low fat diets have this kind of impact. Our feces need our body needs a bit of fat, but our feces also for hydration and these are the normal ones. It's like a sausage. A little bit of irregular surface. This one could use a little bit more of water, but it's normal. Yes. And then this smooth sausage will be the ideal stools.
Abdullah Boulad 01:46:23 That's what I need to have.
Fernanda Lima Sento Sé 01:46:24 This is what everyone should aim for. Easy to pass, long and consistent structure outside. And then with plasticine. This next ones. These are harder to replicate. But then you have from the smooth sausage you have very wet stools that break. And this will be diarrhoea level one. So you have small pieces and they don't have an actual shape. They just come out but it doesn't have a little fixed shape. A little bit more liquid. Then the other one. Obviously this is not the texture, but this will be no shape at all.
Fernanda Lima Sento Sé 01:47:08 But it's still not 100% liquid. So it's like when you're playing with dough to make bread and it has some consistency, but it's not fixed. And then you have liquid diarrhea, which I just visually make a big brown pattern. So you have seven. And for some people this will be number five is normal or number 1 or 2. The constipation is normal. And they don't realize that that shouldn't be your normal stools. But because they've been doing this every single day for many, many, many, many years, they assume it's so normal. Yeah. So it's a big taboo. A lot of patients get red or uncomfortable. They don't like it. So the chart is usually less invasive than this. But I like bringing this out when I have teenagers or young adults and it's, you know, we play around, we talk, and we make the conversation around tools a little bit more casual, and then they start opening up. But it's it is definitely a topic that not many people like.
Fernanda Lima Sento Sé 01:48:21 Not many doctors either likes to talk about or they just ignore it.
Abdullah Boulad 01:48:26 Do doctors have full understanding today about about these type of tools?
Fernanda Lima Sento Sé 01:48:33 yes. They at least should know the basic of the stools. I was surprised if they didn't. the thing is, it's usually not implemented in a anamnesis. So the questionnaire you do with the patients, they don't. They usually don't include it.
Abdullah Boulad 01:48:49 I cannot think about the doctor who ever asked me about my stool.
Fernanda Lima Sento Sé 01:48:53 They just ask if you go every day.
Abdullah Boulad 01:48:55 Yes. The most regularly or yes. But maybe it's also I'm not a typical, Case where I went to Doctor Woods with, with the with a gut health issue, possibly.
Fernanda Lima Sento Sé 01:49:07 Or, but it should be asked on a daily on a daily checkup, if you go to a doctor in any kind of practice because it gives us a lot of information. If they drink enough water, if they have a correct diet, do they have some sort of infection? do we need to take some samples if there's some infection? If not, what is going on that the the rhythm is not adequate.
Fernanda Lima Sento Sé 01:49:33 Do they have a condition. So what's one of the most extreme cases is, colon cancer. If we do this every day in a practice, every time you go to a doctor and they ask you about it, in just you just need three questions. Which shape, which frequency, and is it easier not to wipe with those three questions? You have so much information. If you have the knowledge to interpret it, let's say it and you could prevent colon cancer.
Abdullah Boulad 01:50:11 Good. I will definitely start looking at my, my stool. And, but you can also test take samples.
Fernanda Lima Sento Sé 01:50:20 You can take samples of microbiome. you just need to have very good labs that interpret those tests. And they go through the genomes of those, microbiome. And that will be the most precise way of testing your microbiome. But you also need to take into consideration that your microbiome changes every day, right? So it changes with your diet. It changes with stress. So if you had a very nice, relaxing Sunday that you went to the beach, you had a nice meal.
Fernanda Lima Sento Sé 01:50:50 Your microbiome will be in one way. And then it's Wednesday and you're stuck in traffic and you pick up the kids and you're like Are frustrated. That's it. Your microbiome is different. Yeah. So. It's we have some parameters and then we have some that gives us this big red flags okay. There's a Sibo or dysbiosis. We need to look into it. Otherwise there's not much more we can do there in the normal parameters. Let's see if there's some specific. Let's see if they don't have heavy metals. If they don't have parasites. Let's check if there's no Helicobacter pylori or the bad bacteria. And then there's not much more. We have a lot of information, but we're still learning how to interpret it.
Abdullah Boulad 01:51:39 What what does sport have as an effect on our stool?
Fernanda Lima Sento Sé 01:51:46 So moving activates the connection of the vagus nerve. So it stimulates the movement of our intestines. So when you're doing sports you're activating a part that's very passive in your brain, a response that's very natural. It's an animal response, let's say, and that is directly connected to your intestines.
Fernanda Lima Sento Sé 01:52:07 And it helps activate the movements of this test. So they do something like this. They contract and relax moving the the vocal below the bolus down. When you have a very sedentary lifestyle this is very slow and not as efficient and energetic. So that's a big role of sports or physical activity.
Abdullah Boulad 01:52:32 Yeah. So doing sport helps to speed up the the digestive process and to understand.
Fernanda Lima Sento Sé 01:52:40 It's not speed up. It's regulate.
Abdullah Boulad 01:52:42 Regulate.
Fernanda Lima Sento Sé 01:52:43 Yes it helps regulate and modulate the response so that our intestines work in the rhythm that it should because we're not meant to be sitting in a chair the whole day.
Abdullah Boulad 01:52:53 Yes, yes. When? When we do such a stool test you mentioned. What information do we get out of it today? And how to make interpretation of it?
Fernanda Lima Sento Sé 01:53:07 Well, there's so many labs doing stool testing now. Some are very reliable, some not so much very superficial kind of knowledge. So as I mentioned, we can measure see if we have parasites. You can see if we have the bacteria that we don't want to be there.
Fernanda Lima Sento Sé 01:53:27 We can measure if we have Sibo or dysbiosis, if we have IMO, which is a dysbiosis with those bacteria that use more methane. And we can also detect if we're lacking specific bacteria that come as a result of degrading a group of foods. And that's pretty much it. If you do genetic testing of the gut microbiome, then it can determine if your body, as it is in this moment, is capable of digesting food. So we can use it for. For IBS, for example, we can use it for detecting IMO or Sibo or dysbiosis. And then the other digestive pathologies. You can actually do it by looking at the lining of the gut. So it's a tricky one. But we can read a lot of things. We can see if the person has been consuming substances as well. There's a result in the feces sometimes, but it all depends on the type of the test.
Abdullah Boulad 01:54:36 So we understand, let's say this way what we can address, how do we treat IBS, the inflammation.
Abdullah Boulad 01:54:49 We know how it's created, how we can avoid it Maybe. But is there any specific treatment to it? You you prefer to do with your with your clients?
Fernanda Lima Sento Sé 01:55:02 So many years ago I was very focused on only a low FODMAPs diet. And then I discovered low histamine diets. So my personal protocol when I have a patient is I first analyzed how they eat and how they drink and their habits. If everything seems to be reasonably healthy, then I say, okay, what are your symptoms? And then I see what symptoms they give me. So are you constipated? Do you have diarrhea? Do you have headaches? Do you have eczema? Do you have allergies? Do you have a runny nose? Do you sneeze a lot or not? Do you have asthma? Or you need a diversion. Divergent. Do you have muscle pain? Do you have joint pain? Because all of these give me information. And we have this system of pointing of points with, for individuals that can't degrade histamine properly.
Fernanda Lima Sento Sé 01:56:06 And if you do this questionnaire and they give you more than three points out of five questions, then they're a good candidate to do the test. So I like to do this quick test and I take them to take it histamine test and a Dow enzyme test to see if your histamine in your system is how it should be in the levels that it should be. Or you have a build up in your system. And if you have the enzymes necessary to degrade the histamine, if you don't, then you probably have digestive response and migraines and others. So we'll do a low histamine diet. Both low histamine diet and low FODMAPs diet have things in common, but a very different diet at the same time. They are. They have a prescribed protocol where we use it as a therapeutic tool. Where you use this diet depending on the patient from 2 to 6. Max, Max, Max, Max. Eight weeks. And those will be extraordinary cases. Eight weeks, usually 4 to 6 is where it's convenient to work.
Fernanda Lima Sento Sé 01:57:15 Otherwise, if we prolong it to more, we're reducing the diversity of that microbiome in a way that could condition the health of the person in a negative way for the future. Okay. So it's a it's a therapy period.
Abdullah Boulad 01:57:31 Yes.
Fernanda Lima Sento Sé 01:57:32 And then we do the second phase where we reintroduce foods. FODMAPs diet has a very established introduction of food, but with histamine we take it depending on the patient. So I like to make it tailored. Each patient has a different way of introducing. So I introduce the foods and then we measure their tolerance. If they have a Dao enzyme deficiency which the test will give me the result. Then you try with this elimination diet we measure their threshold to some food. Because we can't do this. It's unsustainable to have a diet which is so little variety. Yes. So some people will say, okay, I can eat apples and some people will say I can't. So there will be some foods people can, some foods people can't eat, and you just see their tolerance.
Fernanda Lima Sento Sé 01:58:28 And then you create a list where you say, okay, these foods are safe for you to eat. And these depending on how you're feeling, not so much because your emotional state has a huge role into it. If you have the enzyme deficiency, there's some supplements you can take, like if you're lactose intolerant. So you take the enzymes and it will help you. So at home you can do a low histamine diet with your personalized variety of food ingredients. And when you go out, you just take the enzyme. And that will be the ideal way of doing it.
Abdullah Boulad 01:59:05 So you tailor it basically and find out, each person, what is the reaction? Yes. So it's not one can. Can you explain what histamine is and and what its function is in our body.
Fernanda Lima Sento Sé 01:59:20 So it's, it's a protein that it's present in all foods. And each one of us have a different way of degrading it. Just like lactose, our enzymes work differently. The more fermented the food is, the higher is in its domain.
Fernanda Lima Sento Sé 01:59:40 So fermented cheese, Pickles. Wine. Beer. Alcoholic beverages are really high in histamine, so a lot of individuals will have a histamine or a low tolerance to histamine. And they don't know they'll have two glasses of wine and get really red here, or they get sneezy or an itchy nose or the next day they have a lot of allergies. And that's just because your histamine tolerance is not the same. And then you have the Dow enzyme which is in charge of degrading it. So we have two things here. We have an enzyme that helps degrading it. But also your body needs to be able to eliminate it. So you need to have enough fiber in your diet and enough water fiber will do this net. Well we would collect the stuff that we don't want and it drags it out of our digestive system. And then water will also help us do this and flush it through urine and do help us with our metabolism. So both of those stuff is very important how we eliminate and our enzyme activity.
Fernanda Lima Sento Sé 02:00:56 So yeah, it's present. The estimate is that it's the incidence is going to be very high. We're just scratching the little tip of the iceberg now. And then. We think that probably half of the cases that have been diagnosed of IBS is actually, a deficiency to degrade or eliminate histamine of your system.
Abdullah Boulad 02:01:23 How does it work with fermented products? I mean, when I, when I look around and you read that fermented product or something healthy, it supports our gut helps diverse diversify it. And yes, but this is not in line with, with, Not for everyone.
Fernanda Lima Sento Sé 02:01:44 Not for everyone. Exactly.
Abdullah Boulad 02:01:46 Yeah. So you need to know what how your body is reacting to it.
Fernanda Lima Sento Sé 02:01:50 Yes. So you need to be able to listen, to listen and observe your body as well. even though people claim that it's healthy, maybe for you it isn't healthy. And fermented foods is one of those tricky ones. It's full of probiotics, but individuals with a histamine intolerance can't take it. Take fermented foods.
Fernanda Lima Sento Sé 02:02:11 They can also also take bone broth for example. And it's one of the. The go to to heal leaky gut. But we can't with these individuals. So before prescribing any kind of nutritional recommendations I like to eliminate the causes. And because the prevalence of histamine intolerance could be very high. But we still don't really know how high. We have some estimates, but we're not that sure how much it is. I just do the test. It's not very expensive. It's a cheap test. Some insurances cover it. The response is quite in 1 to 2 weeks to get a result. And then I can implement a diet or another. That's how I like to do it. Because doing a very restrictive diet, it's not very nice.
Abdullah Boulad 02:03:03 And not sustainable for a long time.
Fernanda Lima Sento Sé 02:03:05 Exactly.
Abdullah Boulad 02:03:07 The term leaky gut sounds scary. Can you explain? Can you explain to us how what it is and how it's created, and how can we prevent it or treat it?
Fernanda Lima Sento Sé 02:03:19 Imagine you have building blocks and should be able to sustain a house.
Fernanda Lima Sento Sé 02:03:24 They need to be together in a certain distance and you have the cement in between. So imagine that's the lining of your gut or your intestines. The issue comes when this this building blocks are not so tight against each other and they're a bit more separate. This usually happens when the bacteria are in charge of regulating how we absorb, are not working properly, and they are not able to to maintain the structure. Yeah. And slowly it degrades. It can also happen with a parasite or a heavy metal or a some sort of medication can also give you leaky gut. Sometimes if you have a flea on you, it can give you a leaky gut. You can get Lyme disease as well. So we have different origins to leaky gut, but the result is the wall of your intestinal lining is not solid enough. It's not tight enough. And it allows things to go through. Then we don't need them to go through in that specific format. So it could be nutrients, it could be bacteria. So the way it's being absorbed has an impact also on how we degraded.
Fernanda Lima Sento Sé 02:04:40 So if the walls are healthy, we will absorb nutrients, for example, in the format that we can tolerate them. If not, we absorbent and then we have to eliminate it through another way. Or it can give us reactions like you could give us digestive reactions, it can give us physiological reactions like an allergy reaction.
Abdullah Boulad 02:05:03 And does it does it matter where this leaky gut, in which area it, it manifests.
Fernanda Lima Sento Sé 02:05:11 It's usually in the last part of the intestine. So it's the gut. And the last part of the large intestine is where it usually happens. It does matter because every section of our intestine is in charge of absorbing different group of nutrients. So what happens there is the water absorption and also the absorption of some specific nutrients. So it can affect as you can have iron deficiencies. For example, you can be dehydrated. Yeah. So we have a so when someone comes with symptoms of a leaky gut or constant diarrhea which causes leaky gut, then we heal the gut after we eliminated the possibilities of a, for example, the a yellow deficiency or a histamine intolerance, we I focus on giving the gut stability and regaining the lining of the gut.
Fernanda Lima Sento Sé 02:06:08 And then we start with we do the diet. Sometimes we play one thing or the other. So these tools.
Abdullah Boulad 02:06:16 That can be reverted.
Fernanda Lima Sento Sé 02:06:17 It can be reverted. It is reverted. Yeah. But you need to know the origin. Is it pharmaceutical. Is it or a drug abuse. Is it from alcohol abuse. Is it from parasite. Is it because I got Lyme? You need to know where it comes from to be able to treat it. So that will be. That will be a way of of treating it.
Abdullah Boulad 02:06:41 So you like to work with diet and individualize the food intake. What about supplementation.
Fernanda Lima Sento Sé 02:06:48 Supplementation the same and like to make it tailored to the individuals. So with probiotics I have a very small range that I like. I feel a lot of them. The efficiency is not as what they claim to be, but it helps to give the gut stability and absorb the nutrients as as it should be absorbed. Then there's two go to that most people need, which is vitamin D and magnesium.
Fernanda Lima Sento Sé 02:07:23 Yes, especially because we're living in a society where we're so stressed that we actually need the the magnesium to help recover the physiological effects of stress in our body. And yes, we can get a lot of magnesium through our diet. But there are certain states of stress. Or if you have an autoimmune condition, the demand of magnesium is higher. If you're a neurodivergent individual, you need more magnesium. So we need more magnesium, vitamin D and then omega three is when you can play around individuals that don't eat much fish. Then you need to supplement with omega three, because even though they eat fish once or twice a week, the meat volume that they eat is so high that they make their diet pro-inflammatory because they're taking an excess of pro-inflammatory fats or saturated fats, and not so much polyunsaturated fats, even though you can give them olive oil and nuts and seeds and all those beautiful sources of polyunsaturated fats. It's not enough sometimes if that volume of meat is too high. So we play around with that.
Fernanda Lima Sento Sé 02:08:35 And then individuals that smoke or chest quit smoking. which is one of the things we can sometimes treat a balance. I give them vitamin C, to, to help them recover faster, from the physiological response. So just a little help to your system to recover from the damage that you possibly could have done or unconsciously done to your body. And then we have what else? I really like vitamin B, the group of vitamin B. Again, individuals doing just came out of a cancer treatment. They need a supplement of vitamin B, not during but after during. It really depends which kind of therapy they're doing. So supplements. It's quite tricky in that phase. But after they need to supplement to recover because it's very aggressive or pharmacological treatments as well. abuse of substances they really do need. All individuals functioning with an extreme level of stress. individuals that have gone through a major loss and they're grieving. Yeah, that also helps their mental health. So some supplements help. If you don't, if you can't, if you don't have the luxury to provide yourself with the break for recovering or healing or grieving, then your body will need the support.
Fernanda Lima Sento Sé 02:10:05 In nature, you'll see an animal if they lose their the companion, the animal. If you have two dogs on, one dies. The other one has a grieving period and doesn't do much. But we need to keep performing. A lot of the times, and working and functioning so we don't give us this break. So the supplements help us To keep going.
Abdullah Boulad 02:10:28 Different levels?
Fernanda Lima Sento Sé 02:10:29 Yes.
Abdullah Boulad 02:10:30 Now you can also see that there are so many supplements suggest that out there. You know, this for this and this for that. And then you see like longevity and health experts. yeah. Take hundreds of supplements, different types of supplements every day. I wonder how how this is affecting our body, our liver, our because at the end this needs also be absorbed and to be or to be cleaned out of our body.
Fernanda Lima Sento Sé 02:11:01 The foods that we eat today, unless they are sourced from a regenerative farming, system, don't have the same volume of nutrients that it used to. That's one thing we are living in a in a situation of stress, of constant stress that the human body has never experienced Experience before.
Fernanda Lima Sento Sé 02:11:25 Because before. Yeah. We've you know, we've been through critical moments in history. But then you'll close the doors, you'll be at home and that's it. You're not so much exposed to stress usually. But now we have the screens. We have the blue light. We have the lack of sleep. So it's the extra stressors that are very new to the human body. We still don't know how much effect it has, but we do know that we're living more stressed. So the physiological needs of some nutrients have increased. We're also storing so much information before you only read the local newspaper. And we're talking about one generation ago, not even two one. You go back 50 years. That's it. You were reading local newspaper, watching the local news. You'll get some sporadic news from a big event somewhere. Volcanic eruption, a war, a conflict, but just a very small news. Now we're constantly bombarded. So our, our I think our brains are still not capable of processing this volume of information that we're being exposed.
Fernanda Lima Sento Sé 02:12:39 So it's trying to keep up and it's using our resources. So I think some if you're not having a very balanced clean diet then some supplements are needed. But not all. Like I've seen crazy amount of stuff on social media.
Abdullah Boulad 02:12:57 Yeah. And and my question is also now can I take 100 different supplements in one day, you know, where is the limit? What's what's. Because you could, if I would need to take in all types of supplements which are recommended out there for me, that would be maybe, I don't know, 5200 different types.
Fernanda Lima Sento Sé 02:13:21 Yeah. I think if you have a balanced diet and you exposed yourself daily to sunlight without sunscreen for 15 to 20 minutes, then you probably only need more magnesium. And probably depending on your blood test results. Vitamin D I always ask for blood test results. I never recommend without having the results, because half of those supplements, you're going to flush them out of your system. And then in extreme situations or extraordinary circumstances where we are treating someone there is detoxifying their body from abuse of substances, for example, then we have different systems.
Fernanda Lima Sento Sé 02:14:10 We can do intravenous supplementation, which I think is an amazing tool, very easy to adhere. And you just give that a kick and it helps, Which we have a colleague who's amazing doing this, and then we have oral supplementation that can also help that they need to take it for a prolonged period of time, but it's really very individualized. And, supplements should never substitute the food or the source, because the way it comes naturally is the best way we can absorb it, but it does help. So there are cases that it is recommended.
Abdullah Boulad 02:14:49 What do you do in your personal life? Privately? to stay in balance.
Fernanda Lima Sento Sé 02:14:56 It's changed a lot throughout time. Yeah. I started off with exercise and healthy diet. Then it improved with the diet. Still with the exercise. In the past, I've practiced yoga for a long time. A lot of people don't know, but I'm also a yoga teacher. But just because I wanted the knowledge. So I think I tried to balance mental health and physical health so my rules will be sleep essential for the last five years of my life.
Fernanda Lima Sento Sé 02:15:35 I don't negotiate with my sleeping hours. It's a priority and I find myself privileged because I don't have kids, so I can do that. People that have kids struggle a little bit more. Hydrate myself properly. Always nourish my body with fruits and vegetables and good source of protein. I don't overdo the protein now anymore, except when I eat barbecue from my dad.
Abdullah Boulad 02:16:04 Okay.
Fernanda Lima Sento Sé 02:16:04 And exercise. But yeah. Sleep, sleep. It's so underrated. And, it's so essential. This is probably the last thing I've included on my on my lifestyle and I meditate. I like it in the morning when everything is quiet and I just sit and take a moment and breathe and focus and visualize. Sometimes it's natural and sometimes you kind of need to sit there, but when you've done it for a long enough time, it's it's it really depends on your energy of the day. You'll feel it immediately. So I take long mornings to be able to do those steps.
Abdullah Boulad 02:16:50 That's part of self-care and caring of your microbiome.
Fernanda Lima Sento Sé 02:16:54 But yes, I also think that when you live with an autoimmune condition and you've experienced gaining quality of life, and then you value how essential it is to feel good, yes. And you only appreciate it when you don't have it.
Abdullah Boulad 02:17:14 Absolutely. What would you recommend everyone who's listening today or anyone in the world, to do in their lives? She could speak to them.
Fernanda Lima Sento Sé 02:17:26 Take a moment to listen and observe your body. It gives you many, many cues of the state of it is it is in and how it's managing with. With life. Drink water. I think I'll never get tired of recommending this drink.
Abdullah Boulad 02:17:47 We learned that today.
Fernanda Lima Sento Sé 02:17:48 Yes, yes, I'm very interesting in this because I see it so often. It's. Keep yourself hydrated and then try to keep a balance. all these hacks, easy diets, quick fixes. It's just a bandaid. It's a temporary thing. It won't really solve the problem. So just finding a balance of having healthy diet and also being able to occasionally skip it or not really sit fixed with it because you're enjoying a different meal or you're traveling and and, you know, it's temporary.
Fernanda Lima Sento Sé 02:18:26 Yes, the lack of structure.
Abdullah Boulad 02:18:28 And maybe don't forget still to enjoy life.
Fernanda Lima Sento Sé 02:18:31 And enjoy.
Abdullah Boulad 02:18:32 Life while doing all this.
Fernanda Lima Sento Sé 02:18:33 Of course, just enjoy life. If you stick with strict rules, it's very hard to enjoy and be happy with it. I find great joy in food I love eating.
Abdullah Boulad 02:18:46 Oh, absolutely.
Fernanda Lima Sento Sé 02:18:49 It's like I was once asked, what's your favorite thing in the world? I'm like food. Everything about food, the culture. Yeah. It's, you know, it's complexity. What it nourishes you. Everything where it came from. I find it fascinating. So, yeah, you need to enjoy, enjoy life with whatever makes you happy.
Abdullah Boulad 02:19:09 This is what brings us together. Food or most of the time? Yes. Socially. Individually. With yourself. But we need to be, I believe, more conscious and grateful for. For the process of exactly enjoying food.
Fernanda Lima Sento Sé 02:19:28 Exactly.
Abdullah Boulad 02:19:30 I believe you, you have a wonderful job because it's affecting almost every every human on earth. And and everyone experienced something with their gut, with their microbiome, with their immune system, with inflammation related disorders and others that, it's so valuable.
Abdullah Boulad 02:19:50 And I, I enjoyed a lot our conversation today. And, I'm pretty sure that many, many, out there also have, no more information and tools to tackle the big topic of nutrition and, and and healthy food. Thank you very much.
Fernanda Lima Sento Sé 02:20:09 Thank you.