Your bones aren’t stones, and osteoporosis isn’t just a calcium problem. Bone is living tissue that continuously remodels, and the signals that guide that process may start in an unexpected place: your gut. We dig into the gut–bone axis and the emerging field of osteomicrobiology with Dr. Laura McCabe.

We discuss:
• How bones are living tissue that continuously remodels
• Osteoporosis as a common silent disease—and why fractures are often the first sign.

• Osteomicrobiology and how the gut–bone axis may influence inflammation, immune signaling, and hormones

• Fiber fermentation and short-chain fatty acids that may support calcium absorption and gut barrier health
• The gut microbiome, vitamin K, and its role in bone mineralization
• Prunes as a whole-food intervention and the evidence behind six prunes per day
• Fermented foods like yogurt and kefir, plus the importance of protein for muscle and bone health
• Menopause, estrogen loss, changes in the gut barrier, and inflammation linked to accelerated bone loss
• Calcium from food first, caution with high-dose supplements, and practical dairy options including lactose-free choices
• Weight-bearing exercise, strength training, and yoga as bone-loading signals and how exercise may also affect the microbiome
• Why people respond differently based on genetics, lifestyle, medications, and steroid exposure
• Where the science is heading, from metabolomics to more personalized nutrition approaches

We hope you’ll share this episode and help spread the word about bone health!

This episode was sponsored by Activia.

References:

De Martinis M, Sirufo MM, Polsinelli M, Placidi G, Di Silvestre D, Ginaldi L. Gender Differences in Osteoporosis: A Single-Center Observational Study. World J Mens Health. 2021 Oct;39(4):750-759.

De Souza MJ, Strock NCA, Williams NI, Lee H, Koltun KJ, Rogers C, Ferruzzi MG, Nakatsu CH, Weaver C. Prunes preserve hip bone mineral density in a 12-month randomized controlled trial in postmenopausal women: the Prune Study. Am J Clin Nutr. 2022 Oct 6;11

McCabe LR, Irwin R, Schaefer L, Britton RA. Probiotic use decreases intestinal inflammation and increases bone density in healthy male but not female mice. J Cell Physiol. 2013 Aug;228(8):1793-8.

Pang Y, Chen Z, Ju Y, Yang B, Hou J, Zheng S, Li Z, Liu T, Xia H, Xia M, Zhong Y, Li J, Li Z, Jiang X. Association between dietary fiber intake and bone mineral density: a systematic review and meta-analysis of observational studies. Eur J Nutr. 2026 Feb

Learn more about our guest, Laura McCabe, PhD

Don’t forget to subscribe, rate, and leave us a comment.
You can also follow us on social media @TheGutHealthPodcast, where we’d love for you to share your thoughts, questions, and experiences.

Learn more about Kate and Dr. Riehl:

Website: www.katescarlata.com and www.drriehl.com
Instagram: @katescarlata @drriehl and @theguthealthpodcast

Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS.

The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

What happens when the stress of being a first responder doesn’t just stay in your head but starts showing up in your gut?

Today, we’re joined by Police Chief Michael Assad Jr. of the Rochester, Massachusetts Police Department for an honest conversation about the often-overlooked connection between first responder stress, gut health, IBS, and nutrition.

From high-pressure calls and long shifts to those unexpected “code brown” moments, chronic stress can take a serious toll on the digestive system. We’ll talk about recognizing those warning signs, why gut health deserves more attention in the first responder community, and how nutrition, stress management and everyday habits can play a role in feeling better and performing at your best.

This is a conversation about stress, resilience, and taking care of the part of your body that may be trying to tell you it’s time to slow down and pay attention.

We share practical ways to build a culture where officers can recover from adrenaline, fuel better on shift, and get support without stigma.
• why shift work and disrupted routines can trigger IBS symptoms
• the “SHIT” acronym: shift work, high octane habits, irregular nutrition, tactical stress
• how energy drinks, dehydration, and gas station food can backfire fast
• simple leadership moves that normalize wellness and real help seeking
• fitness incentives, workout on duty, and building a wellness room
• on scene tools like box breathing and diaphragmatic breathing
• gentle diet cleanup basics: adjusting caffeine, alcohol, hydration, and fiber, per tolerance
• nicotine pouches and stress habits that can worsen gut symptoms
• when to see a doctor and what red flags to watch for
• why a clear diagnosis can lower stress and improve symptoms

Don't forget to subscribe, rate, and leave us a comment. You can also follow us on social media @TheGutHealthPodcast, where we'd love for you to share your thoughts, questions, and experiences.

This podcast was sponsored by Ardelyx.

Sorry for Kate’s raspy voice, she’s just getting over a cold! And a big thank-you to Megan for holding down the fort. ❤️

References:

Hartley TA, Violanti JM, Mnatsakanova A, Andrew ME, Burchfiel CM. Military experience and levels of stress and coping in police officers. Int J Emerg Ment Health. 2013;15(4):229-39. PMID: 24707586; PMCID: PMC4734366.

Shin A, Xu H, Imperiale TF. The Prevalence, Humanistic Burden, and Health Care Impact of Irritable Bowel Syndrome Among United States Veterans. Clin Gastroenterol Hepatol. 2023 Apr;21(4):1061-1069.e1. doi: 10.1016/j.cgh.2022.08.005. Epub 2022 Aug 11. PMID: 35964894; PMCID: PMC9918609.

Demo of diaphragmatic breathing.

Learn more about Kate and Dr. Riehl:

Website: www.katescarlata.com and www.drriehl.com
Instagram: @katescarlata @drriehl and @theguthealthpodcast

Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS.

The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

If eating has become a source of fear because of digestive symptoms, you're not alone. For many people living with IBS, IBD, and other GI conditions, repeated eating-related symptom flares create powerful food–symptom associations that make avoiding certain foods feel like the safest choice. Over time, however, this understandable protective response can become restrictive, limiting nutrition, social connection, and overall quality of life.

In this episode, we're joined by digestive health and eating disorder dietitian expert, Janelle Smith, RDN, and GI psychologist Dr. Madison Simons to explore the overlap between gastrointestinal disorders, food fear, and disordered eating.

Together, we explore how fear around eating develops, how healthcare providers tell the difference between healthy caution and fear that's limiting daily life, and how people can gradually rebuild confidence with eating through compassionate, evidence-based care. We also explain why working with a team—including a gastroenterologist, GI dietitian, and GI psychologist—can make all the difference in helping people feel more comfortable with food, expand their diets, and get back to living life more fully.

In this episode, we discuss:

• Why progressively restricting foods can worsen fatigue, anxiety, nutrition, and overall quality of life
• Why avoiding foods because of GI symptoms can be an adaptive response, your brain is trying to help you, and this isn't inherently "pathological"
• How the amygdala, your body's alarm system, and visceral hypersensitivity create powerful food-symptom associations
• Signs that food avoidance is no longer serving you and may be driven by fear
• How clinicians use open-ended conversations and screening tools to identify disordered eating and ARFID risk
• When dietary therapies like the low FODMAP diet are appropriate and when they're not
• Least-restrictive nutrition strategies, including gentle food swaps and stepwise reintroduction
• Which evidence-based supplements may help manage symptoms without adding unnecessary diet restriction
• How exposure ladders, "micro-dosing" feared foods, and coping strategies can reduce anticipatory anxiety
• Why reframing symptoms as sensations and separating discomfort from danger is a powerful part of recovery
• How a collaborative care team can help people regain confidence, nourish their bodies, and expand their lives—not just their diets.

f you or someone you love has ever felt overwhelmed by food fear because of digestive symptoms, this conversation offers reassurance, practical strategies, and hope. While some dietary changes may be appropriate to manage GI conditions, recovery is about learning to distinguish necessary restrictions from fear-driven avoidance, rebuilding trust in your body, and finding the right support so food can become a source of nourishment and enjoyment again.

This episode has been sponsored by Ardelyx.

Reference:

Simons M, Issokson K. From Food Fears to Food Freedom: How Do We Best Manage Restrictive Eating in Inflammatory Bowel Disease? Crohns Colitis 360. 2025

Scarlata K, Zickgraf HF, Satherley RM, et al. A Call to Action: Unraveling the Nuance of Adapted Eating Behaviors in Individuals With Gastrointestinal Conditions. Clin Gastroenterol Hepatol. 2025;23(6):893-901.e2. doi:10.1016/j.cgh.2024.11.010

Riehl ME, Scarlata K. Understanding Disordered Eating Risks in Patients with Gastrointestinal Conditions. J Acad Nutr Diet. 2022;122(3):491-499. doi:10.1016/j.jand.2021.03.001

Learn more about Kate and Dr. Riehl:

Website: www.katescarlata.com and www.drriehl.com
Instagram: @katescarlata @drriehl and @theguthealthpodcast

Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS.

The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.