NUTRITION FUTURES SUMMIT 2026 Araleena Isse: The Triad Quietly Shaping Gut Ecology and Inflammation: Movement, Hydration and Motility Source: ZOOM0007 (auto-transcript; speaker name spelling corrected, otherwise unedited) ZOOM0007 (01:02:21.326) Hello, my name's Araleena. I'd like to talk to you about the terrain of the gut, is how I think about it. And I actually think about it as a natural medicine practitioner superpower. I've been a naturopath for about 20 years. I work in private practice. I'm very traditional naturopath. Everybody gets herbs, some people get nutrients, some people get probiotics, but food is the foundation of everything that I do. Not just what we eat, but when we eat it, how we eat it, what we know about it and how we feel about fuelling our bodies. Because let's face it, food is our pleasure, our leisure and for many of us, our language of love. ZOOM0007 (01:03:15.027) So what is the terrain? When we step back from labelling conditions and diseases and diagnoses, what are we actually dealing with in terms of the underlying structure of the gut and how we think about and how we individuate what we're doing? You already know about the health interventions that I'm talking about today, but I want to bring them together in a new way and talk about how they fit together, how food and fluid and movement all interrelate to create change, especially in patients where change is really difficult. What connects these three things and why do they matter? When we, we often pulling apart the elements of the digestion. But I want to bring it together again as a systems or look at it from a systems perspective. know, and when I think about terrain, I think about the individual environment of that patient. What is the conditions of their body and especially their digestion? To talk about terrain, we don't need to get complicated. We don't need to go into ionic charges and deep dive into molecular structures. We can actually look at it from a very holistic perspective and that's what I want to do today. So we've got, sorry, where to, what to do and where to start. So I'm gonna think about an inflamed patient. We've got, sorry, I've lost my place. ZOOM0007 (01:05:09.57) I must have moved forward, sorry. Look, let's think about an inflamed patient. The more we give them, the worse they get. That patient. They've often been told, they're hearing the rhetoric of nutrition and naturopathy all the time, but nothing changes for them. In fact, they're doing everything that we recommend or they're not doing it because it feels impossible. and they're not seeing any change. So let's look at it from their perspective and let's see what's lying underneath. And I think the core message of my talk today is when results aren't coming, before you start giving another treatment, let's look at three core factors that could be where the issue is. ZOOM0007 (01:06:11.16) So the three core factors that I've pulled apart are hydration, movement and transit. And we all know these three factors, right? But think about hydration a little bit more broadly than just drinking water. We're talking kidney function, we're talking blood volume, we're talking about factors that influence everything about that person's body. With movement. Movement in the studies that I work with, is basically defined by at least five 30-minute episodes of significant movement. But that doesn't have to be going to the gym. And we need to be starting to think about movement beyond exercise. We're talking muscles, metabolic health, circulation, lymphatic flow, digestion. And I want to talk about a third factor that I don't think it gets enough airplay, but it's transit time. I've included a whole lot of information in the handout that I've created for you guys around transit time, because I don't have enough time to really deep dive into it. But we've got whole gut transit. So how long are things taking to get from the mouth out into the toilet bowl? And it covers like stool formation, stool frequency. And I've included some information about a corn transit testing, which I think is really important. I do with every patient. So none of these three things are new, but how are we connecting them? How are we prescribing them? And what is essential to inspiring real change in our patients? And I've got some information about how we're collecting information and prescribing what are essentially core functions of being a natural therapy practitioner. So the connecting factor. I am a naturopath, so I love bile and luckily in this situation bile is the connecting of your hydration and your movement, your transit and your microbiome. But I'm going to talk a little bit more in depth about this. ZOOM0007 (01:08:28.398) I have a great analogy that I like to think of. I think of the transit time as the car, the microbiome as the passengers and the bile as the fuel. Hydration is the engine oil and movement is the road. So we're talking about a system here. Without the parts the trip doesn't happen or it happens but at a cost. And this is the terrain. of the gut and how the gut terrain is influencing the body as a whole. And we've heard today about the bile and the breakdown of bile by the microbiome and then that promotes excretion. So that's working into our transit. Everything that's spoken about today actually sort of nicely fits into this little very, very simple diagram. But I actually hadn't heard anybody's speeches before. this moment so I feel sort of little bit chuffed. This is how I think about all of this fitting together. I've included this in the pack that I've created. So let's just break it down a little bit. Hydration. Look, this dude Math et al in 1987 studied some patients with abillary drainage and what they found is that drinking water increased biosecretion. Svernberg in 85, they found that drinking water caused the gallbladder to empty. hydration has a very critical part to play in the way that bile works in our body. And we see patients that are dehydrated and how increasing water intake ZOOM0007 (01:10:33.194) influences them but I think a really important part of getting people to drink more water is for them to understand the critical function of water. And we know that bile is going to impact stool hydration and transit time and water is going to also impact that, but they actually come together and impact it together. Movement. I'm just looking at how I get down to be able to see my deeper notes. Thank you. with movement, Morville in 2018, compared an endurance cycling with some resistance exercise in hen healthy men. And they actually found that that altered bile acid signalling. So the ability for bile acids to transform in the gut was influenced by exercise. We also know that... that it doesn't really matter whether you're exercising to burn calories. It's not actually really what exercise is about. There's in fact a much deeper metabolic conversation that is going on in the body, which influences how the body is handling fuel that goes beyond calories in, calories out. And this is a really, really important message for patients, especially patients that are hearing the message. ZOOM0007 (01:12:14.318) eat less, exercise more and eat more fibre. And they follow that message and they don't get the outcome that they would hope. So for patients to understand that movement isn't, it doesn't relate to calories, it relates to functions of the body that is operating a lot more deeply is really important in my experience. Transit time. So the time that your food spends in your gut will dictate the fermentation and that will dictate whether we're conjugating bile acids and pooing them out or we're just reabsorbing them and creating more LDL cholesterol. But more importantly than that, as you can see, your hydration, your movement and your transit time all coming in together into this relationship that we have with the microbiome, your insulin, your pancreatic enzymes and most importantly inflammation. So when we zoom out and we're not looking at diagnosis, we're not looking at conditions, we're not looking at anything microscopically about the person that we're treating, but we actually zoom out and look at how these bigger picture players are interrelating, we can see that there is inflammation drivers that don't even have anything to do with supplements or interventions that cost our patients anything because their movement, their walking, their hydration and their inputs of their food can often matter more. ZOOM0007 (01:14:17.388) So one thing that I find really interesting is that there was a number of studies that showed that you can increase people's fibre and you can change what they're eating and that you won't impact their constipation. exercise, mean sorry, diet alone isn't enough. You actually do need movement. And so there's actually been quite a few studies that have shown that only when movement was involved did they see that constipation shifted. And I think that sometimes when we're working with really inflamed and stuck patients who aren't moving, the issue that we face is that they don't want to move. They've lost connection with their thirst and they've lost connection with their desire to move. And we know that this is a part of being inflamed. And so there's a cascade of actually addressing some of the fundamentals within them, hearing them, affirming that what they're experiencing is true, and then bringing in the interventions like movement as they move along in their journey. So we have to balance these three keys and assess them and figure out which ones are missing and which ones might be in there too much. Do we in fact have patients that are over exercising? I recently had a patient who got a doubling of her muscle mass when I actually got her to stop exercising because she had muscle inflammation. It was clearly showing up. So. Together these three keys are often the blocks I find to moving patients forward, bringing them all together and getting them to work together. So assessing transit time, I assess transit time in almost every patient and I use the corn test for that. Assessing their water needs and creating water structure. ZOOM0007 (01:16:25.39) I'm sure that most of you have this experience when you ask patients how much water they drink. How many people get told two litres? Two litres. Drink it. People either tell you what you want to hear or they don't even really know. And so I create and implement water structure and my water structure is that you drink between 500 and 800 millilitres litres in the morning before tea or coffee and that you do that again between breakfast and lunch, between lunch and dinner and after dinner. And that without structure most people won't drink enough water and in fact I think I refer to a study where they looked at water consumption and they let people drink however much they wanted and however much they wanted was always under 800ml. true story. So we need to stop guessing and start assessing. We need to just structure water. We need to make movement meaningful. We need to help our patients build capacity. I know that we aren't exercise physiologists, but we are actually often the person that understands the impact of exercise on the person as a whole. And we need to assess trends at time. So I've given you some take-home tools. some information on water structure, movement at the why, the how, transit time, corn tests, and resources on influencing transit time, and especially food-related resources about influencing transit time. ZOOM0007 (01:18:15.18) So I have an experience where I realised, I was just reflecting what patients actually remember. When they go back and they think about a treatment that they've had two or three years ago, do they remember any of the supplements that they take? Do they remember what happened? And so I actually went back and I asked some of my patients and the only thing that they remembered was the practitioner. And the other thing that they remembered was they remembered the turning points. Like, I remembered that moment when you said to me, you know, that if I wanted to see a change, I was going to have to change. So I want you to realise that you are actually the person that your patients will remember and they will remember their relationship with you and they will remember that crossing over when they went from not understanding what was going on to understanding what was going on. They'll also remember that you made them drink a glass of water first thing in the morning. But the real value isn't telling somebody drink more water. It's helping them to understand why water is foundational. It's actually helping them to understand why movement is foundational and what gets in the way of their movement, which is usually inflammation and weight, which is inflammation. When people start to associate their 30 minutes worth of exercise, with increased bowel motions. There's a really core shift that happens in their empowerment about their health. ZOOM0007 (01:19:59.438) And that's the core foundation. That's where you actually get to inspire change because at the end of the day, people won't maintain supplementation. They sometimes will struggle to maintain food changes. But if they have whole life changes on which to... hang the peg of the other interventions, then you have actually really created broad spectrum change and a sustainable change for your patients. Thank you very much. I'll share some of my references that I've used.