Aviva Romm PDF

Connecting Womens Health & the Microbiome
Guest: Dr. Aviva Romm
The purpose of this presentation is to convey

information. It is not intended to diagnose, treat, or
cure your condition or to be a substitute for advice
from your physician or other healthcare
professional.
Dr. Kellman: Hello, everyone! Im Dr. Raphael

Kellman from KellmanCenter.com. I am excited to
welcome you to this amazing segment of the
Microbiome Medicine Summit. The microbiome
and its role in maintaining health and healing disease is one of the greatest
medical discoveries in modern medicine. We are so excited to share key
insights that will help you uncover the unseen root causes of your health
issues.
According to research, we are made up primarily of bacterial cells that control

virtually every aspect of our physiology. And in this segment, as well as
throughout the summit, we will shatter the myth that bacteria are the enemy.
And you will see that, in fact, these bacteria of the microbiome are actually
your greatest allies when it comes to improving health. And it will enable you
to activate your highest potential.
With that said, let me introduce a very special guest, Dr. Aviva Romm. And
Aviva Romm goes back a long time in holistic medicine. Shes really one of the
pioneers. And shes been seeing the benefit of holistic and functional medicine
before vitamins were really popular. Am I right, Aviva? Youve been around
doing this for a long time?
Dr. Romm: That is true. I date myself.
Dr. Kellman: Well, not really. Yeah, you just started early with very, very
2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 1

important new paradigm, new way of thinking.
So Dr. Aviva Romm is on a mission to create a better world, one in which the
current medical system is transformed into one that instead that respects the
intrinsic healing capacities of the body and nature, while specifically
empowering women to gain control of their own health. As a board-certified
family physician, midwife, herbalist, and the creator of herbal medicine for
women, a distance course with over 800 students around the world, Aviva has
made great progress in the field of integrative medicine.
She is an internationally respected authority on botanicals and functional

medicine in general, especially for women and children. With 30 years of
clinical experience, she is the author of seven books on natural medicine,
including Botanical Medicine for Womens Health, which won the American
Botanical Councils James Duke Award, among other awards and recognition.
Aviva received the Internal Medicine Award from her alma mater Yale for
outstanding academic achievement and community service. What a beautiful
background.
So welcome, Aviva! And thank you so much for being here. Your background
is so diverse and so interesting. And youre coming to this new way of
approaching medicine from so many interesting perspectives. What got it all
started so many years ago? How did you start thinking in such a different
way?
Dr. Romm: It was really food politics that got me thinking in a different way.
And food politics and environmental politics have a big intersection with each
other. And so I was looking for ways to take care of myself, and starting with
my food, that werent dependent on big food, if you will, and big Pharma and
other industries that were having an impact on the Planet in negative ways.
And that led me into organics and natural eating.
And that led me into, Well, if Im not going to have junk in my food, I dont
really want junk in my medicine either. So all at once, I started to explore

how I could take care of myself naturally.
And back thenthis was around 1980-1981I sort of knew three things more
than everybody else at that time because most people werent really thinking
about that back then. So by default, I just became an expert. And as my
knowledge expanded, more and more people asked me to share that
information with them.
And then, I was having my own kids. And people, my friends, my colleagues in
my midwifery field, saw that my family was really healthy. We werent
depending on antibiotic use. My kids were gravitating towards eating natural
foods. People started to ask me, Well, how are you doing this? So I started to
talk about it and share about it and write about it and teach about it. And
thats how it all evolved.
Dr. Kellman: Amazing! And what was it that was so different then about the
diet and the approach to food that you had then that was so different than
what was around you?
Dr. Romm: Well, back then, it was pretty much the Standard American Diet.
Most Americans lived on fast food because were busy and its hard to take
time to cook. I think thered been a generational disconnect between lets say
my grandmother who, even though she worked, she was home at 2 oclock
every afternoon to cook food. And then, my mom, who was a single mom and
working two jobs. And we saw a real shift in the culture.
And so for me, it was really about reclaiming the kitchen and reclaiming
knowledge of how my food grew rather than being disconnected. So many kids
think that milk comes from a carton. They dont know it comes from a cow.
And fruit comes from the fruit bin, not from a tree.
And so for me it was about reconnecting what with that disconnect, which is
food is from supermarket. For me, food became from nature. And that
extension was about learning to eat foods in as close to their natural and

whole form as possible. Whereas, in the 80s, we were very much in the heart
and continual emergence of more and more processed and packaged foods
that we were eating.
Dr. Kellman: And why is it so important to be able to see the connection

between the food that youre eating and where it actually comes from? Why is
that important?
Dr. Romm: These are emerging in droves about the impact, for example, of
how our meat, for meat eaters out there, is raised. And actually, this doesnt
just affect meat eaters. It really affects everyone. So when we think about how
an animal would have been traditionally raised and then brought to slaughter
and to the market, it would have been on the food that was either growing in
the fieldsthe grassesor foods that the farmer raised and fed to their animal
or got from another farmer in the community.
But now, when we think about how animals are raised, just as one example,
theyre raised in these mass cattle lots crowed together. They get sick easily.
Theyre given antibiotics to prevent illnesses. But theyre also given antibiotics
to grow faster and grow fatter. And whats happening is those antibiotics, just
for one example, are not only getting into our meat and into our bodies
directly, but theyre seeping into fields and streams. And so even if youre not
a meat eater, you can be getting the run off of these antibiotics in your water
systems, for example.
And whats happening with these antibiotics that were getting in our foods
and in our systems is that were developing incredibly resistant infections that
we cant fight. There are, people hear about E. coli from hamburgers. But that
form of E. coli thats very dangerous wasnt even found present in meat until
around the 1980s. And now its potentially deadly. So this disconnect from
how our food should be grown and meat is just one big example of that and
how it is grown. And that impact on our health is potentially life-threatening.
Its pretty serious.

Dr. Kellman: Yeah, most of the antibiotics that we consume, 80% of the
antibiotics we consume is not coming from our local doctors. Its actually
coming from the foods that we eat. So if we want to cut back on our
antibiotics, we have to really consider where our meats and our poultry is
coming from. And the whole industry of overwhelming animals with
antibiotics, its one of their fundamental premises of how they produce meats
and chicken is by giving then antibiotics. So I absolutely agree. I think its a
very, very important point.
And so its not only trying to limit the overuse of antibiotics from your doctors,
but most important really is from the foods that youre eating. So antibiotic-
free food, poultry, and meat is very, very important, eat less, but eat foods that
are preferably GMO-free and organic in the sense that the animals were fed
healthy foods and also free of antibiotics.
And from what I know a little bit of you is this is a very fundamental point
that youre trying to drive home into society.
Dr. Romm: It is. And for me, one of the most exciting areas that has emerged
in science and medicine for me, which I know is close to your heart, is the
microbiome. And what I find so exciting about all of this and this connection
with our food is getting foods in their natural form. Its okay if they have a
little dirt on them. Were going to be getting inoculated with important
organisms that come from the soil as opposed to eating foods that have been
exposed to just this rampant amount of antibiotics in addition to pesticides
and herbicides and other chemicals.
But initially, my concern with the antibiotics was antibiotic-resistance and

also the impact on the microbiome because the microbiome just affects
everything in our health. But what I discovered in my research about the
antibiotics in animal and also when theyre given to us directly, whether to our
kids or to us, is that theyre actually obesogens. So like the herbicides and
pesticides, antibiotics actually make us get fatter. And so eating these

chemical-laden foods affects our microbiome and it affects our fat production,
as well.
So we have an obesity epidemic going on right now. We have all kinds of

allergies, asthma, chronic autoimmune problems that people are facing. And
we can tie a lot of that back to the foods that were eating, both because some
cause inflammation, but also because of how our food is grown.
Dr. Kellman: And specifically, as youre mentioning, is that in addition to all

of that, that it adversely affects the microbiome.
Dr. Romm: Absolutely.
Dr. Kellman: And so what would you suggest to people that they do? What
would be like the top three important things to do in order to eat in a healthy
way thats more connected to nature and at the same time is also healing and
improving the health and the diversity of the microbiome?
Dr. Romm: So I have a simple food rule. And I love good food. Im not
someone whoUnless someone has pretty significant health problems. And
even then, I think food should be pleasurable and as unrestrictive as possible
so that we can enjoy it. Like this is one of lifes basic simple things that is so
nourishing and meaningful, But I do have some rules because I think living
healthy is also nourishing and meaningful.
And so my top rule is try to eat foods that only have one ingredientthe food.
So when I go into my own pantry, for example, I have lots of jarsbig Mason
jars. And they dont have labels on them because its just rice or just red
beans or just black beans or just quinoa. And if you go into my refrigerator,
there are a few packaged foods. I have sauerkraut and I have some
condiments, things like that. But most of food is one ingredient. Its kale or its
carrots or its Brussel sprouts. I keep it pretty simple. So thats a big piece for
me.

I know that for a lot of people, eating organic can be cost prohibitive. So I
encourage my patients and my students and my family members, friends to
pick and choose. And a great resource for picking and choosing is the
Environmental Working Groups top lists of clean foods and dirty foods.
Theyre called the Dirty Dozen and the Clean 15.
So the Clean 15 are the foods that are the least likely to be heavily
contaminated with herbicides, pesticides, antibiotics, things like that. So even
if you cant afford to eat those organic, theyre okay to eat more conventional.
But the Dirty Dozen, which has some foods that we feed to our kids a lot like
strawberries and celery are almost always on that list. Those, if you cant
afford to eat organic, I encourage either keeping out of the diet or eating as
little as possible. But those are the foods where if youre going to create a food
budget, thats the direction to go.
And then, let me back up with that. They dont usually put meats and dairy.
Meats and dairy, if you include them in your diet, that is where to spend the
money on going organic because you cannot put a price on your health. And
as a society, were spending a disproportionate amounts of money on lets say
peoples last 20 years of life because theyve become so sick, instead of us
distributing that resource allocation earlier in life to spending the money on
food that may cost a little more, but really cost less for everyone in the long
run.
And then the third thing is as much as possible to avoid food packaging. So
food isnt just whats in the food, but its what the food comes in. So I really
encourage people to be mindful of not, as much as possible, avoiding foods
that come in soft plastic wrap, trying to go for BPA-free as much as possible
by usingAnd Im concerned that were going to find that the BPA, which has
been replaced with BPS, Im not sure that the BPS is that much better. So
whenever you can, get foods that are in glass packaging instead of cans or
paper packaging or some of these newer cartons that you can get things in like
almond milk and soup broth, things like that in.

And then not heating up your foods in plastic. And then avoiding things like
non-stick and Teflon because those all leach into our foods and are unwitting
sources of contamination that really can have an impact on our metabolism,
our hormones, cancer promotion.
Dr. Kellman: You mean like Teflon pots and pans?
Dr. Romm: Yep, anything with a non-stick coating. So cook in stainless steel
or ceramic or glass or enamel coated.
Dr. Kellman: And what are your thoughts of the chips and all these snack
foods many of the so-called healthy companies are producing, the gluten-free,
GMO-free, everything-free? Except, its not free. Its pretty expensive. But its
still non-GMO corn chips. And then, maybe theyll throw in some sprinkles of
kale or beans or something or quinoa. And it is promoted as a health food.
What are your thoughts about that?
Dr. Romm: There was a study done a number of years ago that actually
people were served an identical plate of food. So two different groups, they
were served an identical plate of food. Except one group had fat-free crackers
on the plate. So everything was exactly the same though. They had their
protein, their vegetables, their starch. And then one group got fat-free
crackers.
And so it created a mental health halo by having those fat-free crackers. In

peoples minds, they translated that to, Oh, this must be a lower calorie
meal. And so they actually, calorie for calorie, consumed significantly more.
And over time, that diet would have been predicted, even though it had
something fat-free added to it, to make those people gain more weight.
And we see this phenomenon where foods look healthy, but maybe arent.
They have what I call a health halo around them. We think theyre healthy
because of the way theyre marketed. But really, theyre the same junk.

Dr. Kellman: So tell me, what exactly would be unhealthy? Is it that its
typically fried, the oils they use, the calorie? What is it? Or is it okay? Its
certainly better than the previous generation of snack foods.
But I think one of the mistakes the health-minded people make is that those
foods are okay because theyre made by companies that are so-called health-
oriented. And there may be some truth to that. But my personal feeling is that
its a double-edge sword. So I wanted to get your input on that.
Dr. Romm: Yeah, I think that if were going to eat the same food or were
eating it organic, maybe the packaging is a little bit better, maybe it has a little
bit of something healthy added to it, its still better than the old school
straight up junk made with poor-quality oil. So if something has olive oil, olive
oil chips with an organic potato, I definitely think thats a better option.
Dr. Kellman: Sure. What about if theyre using, lets say, canola oil? And
theyre typically fried, right? Some of them are baked. But what about the fried
ones? Is it okay?
Dr. Romm: Yeah. Heres how I look at it. First of all, in my life I take about
what I call a 95/5 rule. And even though, I probably eat closer to 99 and 1,
that rule to me says that if youre eating healthy 95% of the time, you can
afford to have a little something here and there because our bodies are
remarkable at repair and healing.
And so a little bit of something, something that you enjoy or youre out on the
road and you got something quick because you couldnt stop for something a
little bit healthier, something that you really loveyou just love a little bit of
potato chips now and then. Or youre at somebodys house and they serve you
something and you dont want to be rudeI think our bodies are really
capable of handling that.
Dr. Kellman: I like that point.

Dr. Romm: Yes. So its when most of the diet is filled with those foods or if
youre not getting the healthy things like the antioxidants in your fruits and
vegetables that can help your body to tolerate and detoxify from those things.
So I think that for most people we dont have to be so crazy strict that we start
to get neurotic about food and think about food and dont enjoy it because I
actually think that has an impact on our immune systems, as well.
To be having negative thoughts while were eating doesnt really help our
digestion or our mood. On the other hand, I think we do have to be careful
about just substituting eating chips and crackers all the time, instead of
eating whole grains and things like that.
Dr. Kellman: Yeah. It reminds me of a story. I was once eating with a friend.
We were invited to somebodys house. And the food that this friends wife
made, it was really unhealthy. But they were so happy to have us and that I
was their guest. And it was really so, so generous and kind and loving.
And then so I ate the food. And after we left, my friend said, How come you
ate all that unhealthy food that they were serving? I said, You know, the
pleasure and the happiness that they received because I ate their food, that
even though they were so happy that I was eating their food and I participated
in their meal and the satisfaction that I had that they felt so good totally
outweighs any of the negative impact that the unhealthy food that one time
that I may have eaten it on my body.
So I think there are many levels that we live in. And one of those is this World
that Im talking about. And, yes, that plays a role, too. So sometimes like you
said, sometimes simple enjoyment of your food is also important. You have to
enjoy your food. If you dont, that has a negative impact on the digestion, the
physiology, the metabolism, the assimilation.
And also on another level, I deeply believe this, whether theres research to
support it or notif it doesnt exist now, it will come out one dayin that how
we sit to eat, like you said, what are our thoughts? why are we eating in the

first place? And here if I was eating because I knew that first and foremost, it
was a form of giving to the host. Because even though, I was the one eating, I
was giving to them because they enjoyed it so much that I was eating in their
house. So that also has to be part of the equation in terms of whats good
health? My receiving of their good food was a great act of giving, paradoxically.
And it tremendously, my belief is improves my health, even if it was fried foods
and unhealthy foods, etcetera.
So I think thats an important message that Im glad you brought that point
up that its not just about the ingredients in the food, its also about
sometimes you should enjoy your food. Its the company that you keep. Its the
intention of why youre eating, who youre eating with, the conversation, are
you under stress? Are you not under stress?
And also, that leads to the big topic of the microbiome that we mentioned
before that so much of our health depends on the microbiome. Thats what the
research is showing. Im very interested in hearing your spin about it. And
first of all, why are you so excited about the microbiome and the research
thats coming from the microbiome? And how are you using it to improve the
lives of so many people that youre affecting.
Dr. Romm: Thats a great question. So the reason that I find myself so excited
about the microbiome is that for so longfor thousands of years pretty
muchWestern science has created a lot of compartmentalization and silos.
So what happens in the brain is separate from what happens in the gut,
which is separate from what happens in the immune system and the
hormonal system. And Western medicine reflects this. If you have a neurologic
problem, you go to your neurologist. If you have a digestive problem, you go to
gastroenterologist, and so on.
And also, science from also thousands of years has separated itself and
elevated itself above nature. And to me, the beauty of the microbiome is it
reconnects everything because all of the research on the microbiome is
showing for one thing, were really not separated between whats in us and

whats on us and whats outside of us. Theres a continual flow between us

and these organisms with our whole world.
And on an even further level, as I mentioned with antibiotics in the food,

antibiotics that are leaching into the soil, into the water system, we also know
that through our understanding of the microbiome, what were doing to the
world around us has an impact on our health. So I think for the first time,
medicine and science and environmentalism are brought together.
And then, for the individual patientAnd I dont think this has really trickled
out far enough into conventional medical practice. But for those of us like you
and me who are practicing integrative and functional medicine, were able to
explain in very effective terms.
And sometimes my patients do want to hear the hard science or they want to
see the lab tests or they want to know the proof so that their analytical mind
can believe some of the more magical things about what happens in the body.
And what do I mean by magical? I mean mysterious and amazing thingsso
to be able to show my patient some research on why whats going on in their
digestive health.
For example, why the fact that they may be having gas and bloating and
alternating between constipation and occasional loose stools, might relate to
the fact that theyre having anxiety or depression or having trouble with
detoxification. Or why they might have polycystic ovarian syndrome or a
fertility problem.
So to me, this is just absolutely brilliant. And Im finding that for my

particular area that Im very passionate about, which is the impact of stress,
both social and external stress, but also stress on our bodies from
inflammation, through the adrenal system, the stress system, even that is
related to the microbiome because when we experience stress, it changes the
chemical environment in our gut. It changes what we crave to eat and all of
that has an impact on the microbiome.

Dr. Kellman: Absolutely.
Dr. Romm: So to me, its so beautiful and so elegant.
Dr. Kellman: Yeah. Yeah. Thank you, Aviva. Thats beautiful. Theres a lot of
research to show that the gut bacteria are actually modulating and
determining our level of stress. And if you do transplants of the bacteria that
are found in stressed out mice, and then you transplant it into mice that are
not stressed, the second pair, the latter will then become stressed. And the
opposite is true, too.
Dr. Romm: Oh, were seeing this with humans, too, with all that fecal
transplants are starting to happen. Weve got a patient in my practice who was
one of the other doctors patients who had gotten a fecal transplant. They did
it through a medical practice. But they used a family members stool. And it
was for a person who was having significant immune problems. And they used
the stool of what was an otherwise healthy family member, unwittingly not
knowing that this family member suffered from severe anxiety. And then, the
person who got the transplant who had never had anxiety before started
having severe anxiety.
Dr. Kellman: Incredible.
Dr. Romm: Its powerful stuff.
Dr. Kellman: Right. Right. So its in other words, the research is not only in
animals, but its were seeing this in humans, as well. And thats why when
people ask me, Aviva, Should I consider a fecal transplant? If they want to
know what my opinion is, I tell them no that its not the best option.
Dr. Romm: Yeah, Im with you.
Dr. Kellman: Because of the possible detrimental effects.

Dr. Romm: Except for maybe C. diff is possible.
Dr. Kellman: Oh, well, obviously, but if its really severe. But because of its
impact on our personality, I tell patients jokingly, Well, if you want your
donors personality, then absolutely, then get the fecal transplant.
Dr. Romm: Its true.
Dr. Kellman: But if youre happy with your own, then dont. Thats the way I
look at it. And its just incredible that so here we are, were in the gut. And it
seems so far away from the brain. And yet the two systems are so intricately
inextricably interwoven as one system, which is exactly what youre saying is
that the systems in the body are not separated from each other.
It all starts out as one cell. And that one cell becomes two and then four and
then eight. And whats so amazing is that they retain their connection on one
level or another, even if they are seemingly anatomically so far apart. Well, it
makes sense. They all came from the same cell.
And, in fact, whats even more amazing is that if you trace cells from the way
they started splitting up in the process of embryology and if certain cells that
end up in different organs started out in a similar place embryologically
because we know theres the ectoderm, the endoderm, the mesoderm, there
are different layers of cells that are the progenitors of the cells that become
organs and systemsthat if they come from the same source, they retain an
incredible connection.
So if theres a problem in the organ that comes from, lets say the ectoderm,
other organs or systems that originate from that original line of cells is also
likely to have a problem. And this is frequently happening behind our backs.
Since we dont have that way of seeing, we havent developed the technology to
see this phenomenon. But it exists nevertheless. I see this. I see that systems
that seemingly have nothing to do with each other are actually following the
same trajectory.

And one of the systems that links all the systems is the gut bacteria. And the
reason is is that we co-evolve with these bacteria. That were part of a unity.
Were part of an alliance that works together. And these bacteria go back a
long, long time. They are the origins of all life on Earth in the fact that they
can shuffle DNA so swiftly amongst each other. If you think about it, its such
an incredible thing. The story of life is really the story of DNA.
And we, whether youre talking about a plant or youre talking about an
animal or youre talking about a fish or youre talking about a human, we all
come from the exact same script, from the same language, from the same DNA
that has expressed itself in such incredible ways that we see this incredible
diversity in front of us. And guess what? Who supplied this DNA in the first
place? The bacteria.
Dr. Romm: Mmm hmm. Absolutely.
Dr. Kellman: In fact, the microbiome really should be looked at as a

microbiota, a reservoir of the language of life. And thats why it makes sense.
The more diverse the microbiome is, the wealthier it is so to speak, the greater
expression can occur, the greatest opportunity for flexibility and growth and
overcoming health issues lies in the capacity of the DNA to express itself and
to be transferred from one bacteria to the other. And that information then
transferred into our self.
And, folks, this is really whats happening with the microbiome. Its a game
changer. Its changing everything. And I think its going to be a very potent
vehicle to change the bottom line, to change the paradigm, to change the way
we see things, to change the way we see ourselves, to change the way we see
nature. Like youre saying, Aviva, to better appreciate the interconnectedness
and ultimately to change the whole enterprise of healing.
And I know, Aviva, that your mission is to change the World. And so what is
itNo. I know. Thats a small mission. Thats nothing. Thats small. Im with
you. Thats good. Why not? Just tell you the truth. Thats what your mission

is.
Dr. Romm: I agree. I agree.
Dr. Kellman: Yes. Yes, dont be shy. Thats your mission. What is it
specifically about the world, about the way were living our lives today that
you want to see changed?
Dr. Romm: Oh, that is such a great question. I think fundamentally, I see so
many patients. And its not just patients. Its when I teach at conferences, Im
seeing individuals from all walks of lifeschool teachers, engineers, medical
doctors, kidsstruggling with this overwhelming overwhelm. Everyones just
overwhelmed. They are anxious. They cant ever get done. Everything thats on
their plate that they need to do. Theres just this everyone Im meeting seems
like theyre stuck in the on position. And theyre a little bit burnt out and
exhausted.
So what Id really love to do is to help people reconnect to how they feel in

their bodies. How theyre living their lives. And are they living their lives in
ways that allow them to actually enjoy life. I think the enjoyment of living day
to day is going out of life for so many people.
And as that happens, people are getting sicker. So theyre not enjoying their
end years as much. Theyre spending their end years on medications. And the
predictions are going to be that at least one in three people has diabetes in the
next 10 years. So that means people are going to potentially be spending
Youre a medical doctor working with patients all the time. You know what it
means for somebody to be on dialysis three times a week or to be dealing with
end-stage neuropathies or eye problems. So for me, its about helping people
reclaim their life and take their life back and enjoy it. And to do that, I really
feel like we have to feel better if were going to live better. And we have to live
better, if were going to feel better.

For me, its funny. I went to medical school at Yale. And then, I started out
doing my residency in internal medicine. But I had been a midwife for so long.
And as I realized in about 11 months into my intern year that I was seeing so
many patients who already had pretty far gone diseases. In their 50s, 60s,
70s, theyre on 8 to having 20 medications. Theyre coming in for surgeries for
all things. And I realized that a big piece of it for me was bridging that work
that I did as a midwife with being a medical doctor.
So my focus is womens health. But a big piece of what I am really trying to

make a shift in is this area of preconception and prenatal care. Because a lot
of what were talking about starts really far upstream. And the moms
microbiome, before she even gets pregnant, can determine how easily she gets
pregnant.
And we know that one in eight women is struggling with a fertility problem.
We know that whether she has a healthy microbiome affects her vaginal flora.
And that can affect whether she has a pre-term labor. And pre-term babies
have lifelong developmental and cognizant problems potentially, not to
mention the stress and the cost to family and society for pre-term deliveries
and pre-term care.
Moms microbiome health and whether or not mom has a C-section, which
now 34% of women do, and whether mom is given a probiotic if shes had a C-
section, all of this presets the barometer of the babys health and can
predispose to adult problems like obesity, diabetes, cardiovascular disease,
and Alzheimers.
Dr. Romm: So thats a big part of healing. Yeah. So to me is starting as far

upstream, even before women get pregnant and then helping pregnant women
and getting to young babies with really nurturing the health of the
microbiome, avoiding unnecessary antibiotic use. And 70% of all antibiotics
given by doctors to children and adults are unnecessary. So thats how Im

bringing it into my work.
Dr. Kellman: What are some of the suggestions that you tell moms, families,
that want to improve their health or they want to ensure or attempt to ensure
the health of their baby? Whats some of the practical advice? What do you tell
them?
Dr. Romm: Yeah, so eating a diversity of food, eating ample amounts of fruits
and vegetables, organic when possible, actually nurtures the health of the
microbiome. I actually get concerned at how restrictive people are getting with
their food because one of the things we know is that a healthy microbiome is
best fed with a diversity of foods.
Dr. Kellman: Any types of foods that come to mind?
Dr. Romm: Whats that?
Dr. Kellman: What foods come to mind when you think of diversity?
Dr. Romm: So especially leafy green vegetables or a variety of vegetables. And

then a lot of dark-colored berries are good for them just because theyre very
high in antioxidants and cut inflammation. And inflammation is part of the
heart of what goes wrong. When the microbiome gets disrupted, we get
problems in the gut. And the downstream effect of that is ultimately
inflammation. And thats why were seeing all these chronic health problems.
Dr. Romm: So I work on that. I encourage families. This sounds so simple

and so silly, but get dirty. Let your kids play in the dirt. Let your kids get
dirty. Yes, wash your vegetables off when you bring them from the grocery
store. But if you can grow a small garden and let your kids eat out of the
garden, thats really great for nurturing the microbiome.

Including foods in the diet that are fermented. So if you eat dairy and tolerate
dairy without a problem, then small amounts of fermented dairy like yogurt,
really great. And if you dont tolerate dairy and even if you do, dont get all
your fermented food from dairy, add in some lacto-fermented vegetables.
Sauerkraut, kimchee, these are all forms of foods that people have eaten
traditionally and are so healthy.
Dr. Kellman: If someone has a lot of bloating and gas, what do you tell them
about the fermented foods and prebiotic foods? Do you limit it? Or are you
okay with telling them to consume them?
Dr. Romm: It depends. Yeah, it depends. So if they already have a lot of gas
and bloating, Ill usually start with an elimination diet. And so if theyre not
already eating fermented foods, I might not add them in right away. Ill usually
do an elimination diet where I take out the big common food triggers like
dairy, gluten, and gluten cross-reactive foods, fermented foods like yeasted
foods, yeasted breads, kombucha, things that have alcohol. And if the bloating
is pretty significant, I may actually take fruit out for a while, too, because
some people are actually fructose intolerant. So then, we slowly add things
back in and see what the triggers were if symptoms return.
Dr. Kellman: What about grains? Would you remove that?
Dr. Romm: I dont often take it out. If theyre very sensitive, theyre having a
lot of blood sugar problems, if theyre really bloated, then I will usually take
out most of the dietary sugars, including grains for a short time. Im not
someone who recommends everyone shouldnt eat grains. Its very
individualized.
Dr. Kellman: I agree.
Dr. Romm: But if youre having a lot of gas and bloating and theyre craving a
lot of starches, thats usually an indication to me that that might be someone,
Lets peel back the grains. Lets get the gut The way I explain it to my

patients is when you think about it, if youre making bread, what you do is
you put your yeast in the bowl. Unless, youre making sourdough, of course.
You put your yeast in the bowl. And what do you feed the yeast with? You feed
it with sugar. And anything thats going to break down to sugar is going to
feed the bad yeast. So we take out anything thats going to break down into
sugar, including grains, usually for three weeks.
And then, if theyre feeling a lot better, Ill slowly add things back in and see if
the gas and bloating comes back. If it does, it doesnt mean that they are
allergic to, for example, or cant tolerate grain, it may just mean that we may
need to do some more work on repairing the gut. So I might do that for three
months or six months, depending on the severity of the symptoms, and then
add things back in.
So sometimes there are true food intolerances or sometimes there are even
true food allergies. But a lot of times, its just gut disrepair that makes the
food not well tolerated.
Dr. Kellman: Right. So at that point, you may add like the microbiome
superfoods like jicama and leeks and things like that and Jerusalem
artichoke?
Dr. Romm: Yep, Jerusalem artichokes. Yep, anything that has the prebiotics
in it that feed that good gut flora. And even leafy green vegetables feed that
good fiber, feeds the good flora.
Dr. Kellman: Right. What I was saying was that if someone had a lot of
bloating and gas, you would keep that to a minimum the first few weeks,
those types of prebiotic foods?
Dr. Romm: I do.
Dr. Kellman: Right. Okay.

Dr. Romm: And thats when Ill usually add in a digestive
Dr. Kellman: Enzyme.
Dr. Romm: Ill usually add in digestive enzymes. Sometimes I might add in
some betaine HCL
Dr. Kellman: Absolutely. Absolutely. Good point.
Dr. Romm: or some vinegar, if they can tolerate it. And then, Ill usually add
in the probiotic. If I add in the probiotic or if I add in fermented foods, and
then I see that their symptoms actually get worse, then I start to think that
that might be an indication that they have small intestinal bacterial
overgrowth or SIBO.
Dr. Kellman: Okay. So then, youll restrict it. Then, youll restrict it.
Dr. Romm: And then I might take a little different approach.
Dr. Kellman: Okay. Got it. Got it. And are there particular supplements that
you would recommend to heal the gut, the gut wall?
Dr. Romm: Yeah, I do. I use a classic what we call in functional medicine,
which really comes from naturopathic medicine, the 4-R approach where I do
that initial piece, which is remove. The first R is remove. So Im removing the
triggers, the food triggers. And sometimes stress is a trigger. We can change
the diet. But if youre stressed out when youre eating all the time or grabbing
food on the run because youre stressed out, we have to address that, too. So
removing is anything that may be a trigger to that imbalance in your life or
your health.
And then, I will start to replace what might be missing in the digestive system.
At that point, a lot of people are low in digestive enzymes. And some people
have low stomach acid. And so thats when I will add those things back in.

Now, occasionally, in that stage where Im removing and replacing, if there is a

lot of gut dysbiosis, theres a lot of disorder in the gut microbiome, or if Ive
done stool testing and they come back with a lot of yeast or other organisms,
sometimes I will add in either botanicals or even occasionally medications that
help to cut down on that overgrowth because sometimes its so overwhelming
that just adding in the enzymes and changing the diet doesnt reallyIts
almost as if you have to cut down the weeds before you can replant the
garden.
Dr. Kellman: I call it pruning. Pruning the vineyard. Pruning the garden.
Dr. Romm: Exactly.
Dr. Kellman: Right. Right.
Dr. Romm: Sometimes you just cant even get to the soil if its so overgrown.
So then, I have to weed out. So thats where Ill use either things like oregano
oil, which I recommend people dont. Work with a functional or integrative
doctor because some of these can be toxic in too large an amount. But things
like that or some of the berberine-containing herbs like goldenseal or coptis to
help cut that back.
Dr. Kellman: Yes, Aviva. Yes.
Dr. Romm: And then occasionally, if there is small intestinal bacterial

overgrowth, I might even use a pharmaceutical called Rifaximin, which is a
non-absorbing antibiotic that just affects the digestive overgrowth. Or if its a
lot of yeast, I may occasionally use Nystatin even for a short period of time.
And then, I go on to restoring. Thats when I add in the probiotic. And then, I
do a phase where Im repairing the actual lining of the gut. And thats where
Ill use low doses of zinc carnosine, which has been shown in studies of
ulcerative colitis and Crohns disease to help repair the gut, an amino acid

called L-glutamine. And Ill use herbal medicines like licorice. I usually use
that form called DGL, which you dont have to worry about the blood pressure.
Marshmallow root and chamomile as some examples to actuallyOh, and one
of the huge ones. How can I forget is turmeric.
Dr. Kellman: Glutamine. Oh, I thought you were going to say glutamine.
Dr. Romm: Ill use it in the form of the curcurmin.
Dr. Kellman: Yes. Yes. Aviva, we should be partners. We think so much alike.
We do so many similar treatments. Were like virtual partners. So thats really
great.
Dr. Romm: That would be fun.
Dr. Kellman: Yeah. Yeah. Who knows? I want to ask you. We know now that
the microbiome plays a significant role, not only in gut health, not only in our
ability to absorb nutrients that keep us healthy, it plays a significant role on
the gut wall. It plays a very significant role in brain health and brain function
and anxiety and depression and neurocognitive issues. It plays a very
important role in autoimmune issues. Its so vast, not surprising to us.
What are some of the things that youre seeing in terms of the connection of
the microbiome and various health issues that maybe might not be well
known by some people, even amongst us who know about the vast role of the
microbiome? Is there something that youre seeing that you really want to tell
us about that you think could be really unique and interesting?
Dr. Romm: Yeah. I think that the role of gut health in childrens immune
development is really significant. And what we know is that when mom is
pregnantAnd I think just to add into this. Most obstetricians and
gynecologists and most family doctors have no idea about the impact of gut
health on the overall big picture of health and the microbiome, specifically.

And so any of us in the integrative world, whether were health coaches,

nutritionists, doctors, were the ones who have the opportunity to reach those
women who are ultimately going to become pregnant and become mothers or
are mothers, but may have more children in the future, so including this
conversation with women is very important, regardless of what were doing
because this really is about the health of the next generation.
And what we know is that when that gut microbiome is not nurtured at the
time of labor and birth, it can set that child up for lifelong health
consequences, everything from allergies, asthma, and eczema to diabetes,
obesity, cardiovascular disease, and even potentially things like cognitive
decline later.
And now what is known is that when a baby is born vaginally, how nature had
originally intended, the baby gets exposed on its skin to the moms vaginal
flora. And ultimately, that migrates to the breast when the babys hands touch
the moms breast to breastfeed. And this even causes the actual nutritional
and immunologic constituency of the breast milk to change and adjust to meet
the babys needs for growth, development, and immunity.
Dr. Kellman: Amazing. Amazing.
Dr. Romm: Its amazing. We also know that that gut microbiome, that vaginal
flora when it becomes part of the babys gut microbiome actually triggers the
full development of a number of kinds of immunity. It triggers the types of
immune cells that get turned on that are supposed to get turned on. And it
triggers the types of hyper reactive immune cells that are supposed to get
turned off, to get turned off.
So, for example, things that shouldnt trigger us like food allergies, if they
dont get turned off, we can get triggered and get food allergic to certain things.
So all of this is happening literally in the first months of a babys life.

Dr. Kellman: And to put in other words, Aviva, that researchers are showing
that the microbiome, the gut bacteria are involved in educating our immune
system, in other words, to help the immune system determine
Dr. Romm: Exactly. Exactly.
Dr. Kellman: Yeah, what it should include.
Dr. Romm: What it should be allergic to and what it shouldnt. [inaudible]
Dr. Kellman: Amazing. Unbelievable.
Dr. Romm: Exactly. It determines what types of cells get develops. It

determines whether we are what is called Th1 or Th2 dominant or whether we
have a normal ability for our helper cells to get along in the world and not
overreact or underreact. So it can set the tone for whether we develop
autoimmune conditions later. Its very powerful.
And so we know that right now in the United States, 34% of all women are
going to have a C-section. And not only that, every mom who gets a C-section
also gets an antibiotic. So those babies are getting the double whammy.
Theyre not getting exposed to the vaginal flora and moms breast milk is
getting affected by the antibiotic. And baby is getting some of that antibiotic.
So theyre getting an antibiotic exposure, and not getting the microbiome
exposure.
And then a whole other percentage of babies, maybe as much as 30% of

babies on top of that, are getting exposure to an antibiotic all during labor or
through mom because mom is positive with something called Group B strep.
And so we give the mom an antibiotic to prevent her from passing this
potentially serious infection on to the baby.
So anywhere from 30% to 40% of babies in the United States are being born
with an antibiotic exposure or absence of that good healthy immune

education.
So one of the most important things we can do is actually start obstetricians

and gynecologists and family doctors and midwives to give women a probiotic
in the third trimester. It should contain bifidobacterium and lactobacillus
species because it has now been scientifically demonstrated in humans that
moms who are given this in the last trimester are less likely to have babies
who develop whats called atopic conditions later, so allergies, asthma, and
eczema. And we know that those conditions are the same things that set you
up for the other problems down the road like the obesity and the
autoimmunity, etcetera.
And then also making sure that any newborns that mom got exposed to an
antibiotic or mom had a C-section, the newborn should also get a probiotic for
as long as nine months after birth with those same species.
Dr. Kellman: And, Aviva, would you agree? Maybe the mother should be
taking the probiotic from day one, even not wait until the third trimester.
Dr. Romm: I think so. I think it can make a huge difference because we know
that the vaginal microbiome during the pregnancy can determine whether
mom, for example, has preterm labor. So theres no harm in taking it all along.
It reduces her risk of having urinary tract infections, all kinds of problems.
Dr. Kellman: Thats right. And I just want to say since youre so focused on
preconception, thyroid is so critical. So many women, first of all, are having
difficulty getting pregnant because their thyroid is lowand its not being
picked upand also unfortunately during the pregnancy, as well.
There are a lot of women that are pregnant and their thyroids are low. And
thats absolutely affecting the health of the baby. And this is something that
we can do a lot about. I know thats a big part of your mission in changing the
world and changing the next world, not the next world after we pass on, but
the next generation in this world.

Dr. Romm: The next generation. Yes.
Dr. Kellman: Well, maybe youre interested in changing the next World, too.
Thats great. Im with you on that one. And then, thats so important in
improving the health of children is thinking about the mothers state of health.
And thyroid is a very big component in the mothers health.
Dr. Romm: Absolutely.
Dr. Kellman: Yeah, Im saying it because I know you agree.
Dr. Romm: And postpartum, too.
Dr. Kellman: Yes. Yes. Yes.
Dr. Romm: After birth also. So women are undiagnosed for Hashimotos after
birth.
Dr. Kellman: I know. I know. I know.
Dr. Romm: And it has a huge impact on whether they can produce breast
milk.
Dr. Kellman: I know.
Dr. Romm: Some women are struggling with producing breast milk and not
getting thyroid or their mood. And their energy and ability to be present the
way they want to with their babies is a huge.
Dr. Kellman: This is another podcast. Weve got to set this one up. Absolutely.
Yeah, well talk about that.

I want to ask you a very interesting question. What are your thoughts about
vaginal swabs in women who are undergoing C-sections so that their baby is
then exposed to some degree to the vaginal microbial flora?
Dr. Romm: Yeah, I think its a really important and emerging area of research.
In general, Im not encouraging the do-it-at-home method, only because there
may be other organisms that mom may be infected with. And also, we have to
wonder if the labor didnt go well, if something happens, was there already
some disruption in the microbiome?
So are we giving the baby the healthiest exposure? So if moms had a lot of
antibiotics in labor, that microbiomes already been altered, how does that
impact the baby by giving a swab? But if mom hasnt gotten antibiotics in
labor and its just before shes given the antibiotics for the C-section, I think
its very important.
Martin Blaser is a researcher, a microbiome researcher. Hes an M.D. Hes in

New York. I think hes at Stony Brook. And his wifewho I apologize, I
actually cannot recall her name is because I read his book Missing Microbe
shes actually doing research in this area of this vaginal swab.
I think its something we should definitely be aggressively promoting research

on because I think it might make a big difference. But, again, I dont think
theres enough data yet to say its completely safe to do a vaginal swab and
put it on babys face or put it in babys mouth. No, Im not there yet.
Dr. Kellman: Okay.
Dr. Romm: What do you think?
Dr. Kellman: Under the right conditions, yes. But it also depends on the
mother. If the mothers taking an adequate amount of probioticsyes,
assuming that the health of the mother is otherwise good and the antibiotics
were not usedthen yes, I would be in favor of it. Ive actually instructed a

number of patients to do so. And theres no way to tell if the outcome was
good. But my gut feeling is that it is a good idea.
Dr. Romm: No pun intended.
Dr. Kellman: Right, no pun intended.
Dr. Romm: Yeah, Im with you on it.
Dr. Kellman: Yeah. All right. Well, well explore that. Its a complex decision.
Is there one or two big points that, other than what youve already said, which
was of course so helpful, that you can leave our listeners with in terms of
staying healthy, overcoming various health issues that you see are very
common, whether its a supplement, a philosophy, an idea? It would be so
helpful.
Dr. Romm: Yeah. Thats a good question, too. So whats coming up for me is
that in order for us to be healthy, we actually have to stop. Give ourselves
permission to pause is what I call it and just stop long enough to actually
reflect on and make a decision for our self. What does health look like for us
in our life?
So many people have no idea what being healthy even is. And we run around
like chickens without our heads from here to there, grabbing fast food,
running to work, never getting everything done, getting the kids from school,
on and on and on, without really ever stopping to feel how we actually feel.
And I think we need to be able to do that. Like, on a daily basis, Am I feeling

healthy? Am I feeling rested? Am I eating well enough? Am I going to the
bathroom every day? Am I stopping long enough to go to the bathroom every
day? Are my relationships in order?
All these important questions that really do have an impact, not in some woo-
woo metaphysical way, but literally have an impact on every choice we make.

Health isnt a destination. Its not something you get to at the end of the
rainbow. Health is what you live along the way. So I think for each of us, being
mindful in our daily lives to check in on whether those things are in order.
And if theyre not in order, taking a little bit longer to figure out what we need
to do to get those things in order. Am I having enough time to cook good food
for myself and my family or prepare good food or get good food? If you dont
have time to cook, how am I going to get good food? Am I taking enough rest
every day? Am I taking some down time to let my nervous system recharge
itself? All these things.
So its really honoring the life that we have. What Mary Oliver calls, this one
precious life, and deciding how were going to live it and making the decision
that we are actually the author of our life. We do actually get to decide if we
want to and how were going to live a healthy life. And then taking the steps
that it really takes to do that.
Dr. Kellman: Yeah, this is our future blog, What does health look like and
what could we possibly feel in that moment that were feeling our inner
feelings? I think thats such a great topic. What does health look like and feel
like? Its something well explore perhaps in another blog.
Dr. Romm: I ask my patients that. And a lot of people dont know. Theyre
like, Huh? Nobodys ever asked me that before. Ive never actually thought
about it. We get so focused on what doesnt feel well without setting a vision
for our self of how do we want our lives to be?
Dr. Kellman: Thats beautiful. Thank you. Thats a great way to end. And
thank you all for listening to the Microbiome Summit. And thank you, Dr.
Aviva Romm.
Dr. Romm, how could people find out more about you and stay connected to
you and be in the loop?

Dr. Romm: I love that. I love staying connected. My website is

www.AvivaRomm.com. And thats where all the action happens. I publish
blogs there every week. There is information on how to get in touch with me as
a patient, for courses.
And then, I also connect over on my Facebook page, which is AvivaRommMD.

And thats really me. I do all my own Facebook. So Im in there every day with
a lot of interaction and communication. So those are both a great way.
Dr. Kellman: For all of you listening, thank you again for joining the
Microbiome Medicine Summit! According to research, we are mostly bacterial
cells that govern our health. These bacteria actually outnumber our human
cells 10 to 1. So we must learn to take care of our microbiome. So with this
information, we can tap in to their power to heal us.
Please, please, please take this groundbreaking revolutionary information

home with you by clicking on the banner beside or below and be sure to share
with your family and friends. This is Dr. Raphael Kellman! And I wish all of
you an abundant and healthy life! Thank you for being part of this microbiome
revolution!


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Connecting Womens Health & the Microbiome

Guest: Dr. Aviva Romm

The purpose of this presentation is to convey

Dr. Kellman: Hello, everyone! Im Dr. Raphael

According to research, we are made up primarily of bacterial cells that control

Dr. Romm: That is true. I date myself.

important new paradigm, new way of thinking.

She is an internationally respected authority on botanicals and functional

how I could take care of myself naturally.

Dr. Kellman: And why is it so important to be able to see the connection

But initially, my concern with the antibiotics was antibiotic-resistance and

So we have an obesity epidemic going on right now. We have all kinds of

Dr. Kellman: And specifically, as youre mentioning, is that in addition to all

Dr. Romm: Absolutely.

Dr. Kellman: You mean like Teflon pots and pans?

And so it created a mental health halo by having those fat-free crackers. In

Dr. Kellman: I like that point.

whats on us and whats outside of us. Theres a continual flow between us

And on an even further level, as I mentioned with antibiotics in the food,

So to me, this is just absolutely brilliant. And Im finding that for my

Dr. Kellman: Absolutely.

Dr. Romm: So to me, its so beautiful and so elegant.

Dr. Kellman: Incredible.

Dr. Romm: Its powerful stuff.

Dr. Romm: Yeah, Im with you.

Dr. Kellman: Because of the possible detrimental effects.

Dr. Romm: Except for maybe C. diff is possible.

Dr. Romm: Its true.

Dr. Romm: Mmm hmm. Absolutely.

Dr. Kellman: In fact, the microbiome really should be looked at as a

Dr. Romm: I agree. I agree.

So what Id really love to do is to help people reconnect to how they feel in

So my focus is womens health. But a big piece of what I am really trying to

Dr. Kellman: Absolutely.

Dr. Romm: So thats a big part of healing. Yeah. So to me is starting as far

bringing it into my work.

Dr. Kellman: Any types of foods that come to mind?

Dr. Romm: Whats that?

Dr. Romm: So especially leafy green vegetables or a variety of vegetables. And

Dr. Kellman: Absolutely.

Dr. Romm: So I work on that. I encourage families. This sounds so simple

Dr. Kellman: What about grains? Would you remove that?

Dr. Kellman: I agree.

Dr. Romm: I do.

Dr. Kellman: Right. Okay.

Dr. Romm: And thats when Ill usually add in a digestive

Dr. Kellman: Enzyme.

Dr. Kellman: Absolutely. Absolutely. Good point.

Dr. Romm: And then I might take a little different approach.

Now, occasionally, in that stage where Im removing and replacing, if there is a

Dr. Romm: Exactly.

Dr. Kellman: Right. Right.

Dr. Kellman: Yes, Aviva. Yes.

Dr. Romm: And then occasionally, if there is small intestinal bacterial

Dr. Romm: Ill use it in the form of the curcurmin.

Dr. Romm: That would be fun.

And so any of us in the integrative world, whether were health coaches,

Dr. Kellman: Amazing. Amazing.

Dr. Romm: Exactly. Exactly.

Dr. Kellman: Yeah, what it should include.

Dr. Romm: What it should be allergic to and what it shouldnt. [inaudible]

Dr. Kellman: Amazing. Unbelievable.

Dr. Romm: Exactly. It determines what types of cells get develops. It