Healthy Gut, Healthy You: The Personalised Plan to Transform Your Health from the Inside Out

by Dr. Michael Ruscio. (2018)

First off, let's deal with the issue of the "Dr" bit.  It turns out that Ruscio is not a doctor in the  conventional sense.  Rather he is a "functional medical practitioner, clinical researcher and international lecturer".   What is functional medicine, you may well ask?  This is what Wikipedia has to say:

"Functional medicine is a form of alternative medicine which proponents say focuses on interactions between the environment and the gastrointestinal, endocrine, and immune systems, but opponents have described it as "pseudoscientific silliness" and quackery. 

Of course, it is infinitely preferable not to take anything as gospel simply on the basis that an official authority told you so and equally, far be it for me to dismiss anything on the basis that it comes from even the most apparently disreputable source.  Forget argumentum ab auctoritate - when deciding between competing theories, you must always look for the better argument, which according to current epistemology is "the explanation that is hardest to vary".   However, selling oneself on the basis of being a doctor and holding back on a full explanation as to what this might mean, well, I have to admit, it made me approach this book more sceptically than I otherwise would have done.

This may be a mistake of course!  The science on this sort of subject is so far from settled that conventional medicine is also bound to be making many errors, and indeed could perhaps improve by paying heed to unconventional sources. This book did at least hold out the promise of being able to offer actionable advice where other books on gut health have dared not venture for lack of evidence and the author does seem to have a mountain of experience of seeing how his various interventions have turned out.  Perhaps there are nuggets of wisdom in here, though I couldn't help but remain sceptical.

It didn't help that the author's preference, in the first instance, is to recommend avoiding carbs and high fibre foods, and that I was reading this at a time when the press was full of stories about how we should all be massively increasing our fibre consumption.  There does seem to be some conventional backing for limiting carbs though, according to the NHS related website Patient Info. However,  this is only for a limited number of people who may be experiencing but one kind of irritable bowel syndrome. In other words, the preferred "healthy gut" process recommended in this book may only work for a tiny number of people.  On the other hand, perhaps the instruction to cut back on carbs, starches and fibre might have the same effect on the gut microbiome as fasting since it could conceivably mean a reduction in calories, and therefore an increase in microbial diversity in the gut, so perhaps it is a valid argument after all, albeit with a slightly different explanation.

It isn't as if this book doesn't come with a stack of conventional references, and indeed Ruscio is insistent that one looks for best quality trials.  It is just that one has to be aware that when he does come out with a slightly less conventional argument, eg: about adrenal fatigue, there is suddenly a distinct lack of referencing. It might be easy to miss this!

All in all, I suspect that this book might be useful for those with irritable bowel syndrome as a way of sorting out what is and isn't causing problems, even if some of the explanations may be a bit suspect.  I, for one, won't be cutting back on carbs on my feast days, (still doing the 5:2 diet), as I just don't seem to have any issue with them and actually felt worse on the few days I did try it.  To be fair to Ruscio again, he is clear that one should be aware of this sort of biofeedback and that one should take action on the basis of this.

The book loses couple of extra marks for being very repetitive, particularly towards the end and also for being a covert way of selling Ruscio's services.

Rating 3/10