When the gut–liver–brain connection becomes disrupted, energy, mood and long-term health can all feel harder to sustain. Changes in the microbiome can influence immunity, inflammation and even how the brain processes stress. In this episode, Dr Lee David speaks with Professor Debbie Shawcross – hepatologist and leading researcher in chronic liver disease – about how the gut, liver and brain communicate and what helps this system stay in balance.

They explore the role of the liver, how the microbiome functions as a complex community and why diversity in diet, movement and daily habits matters. Debbie shares emerging research on the microbiome in chronic disease, including the PROMISE trial on faecal microbiota transplantation, and offers simple, realistic choices that can support metabolic health, mood and resilience.

This is a conversation about understanding the body’s interconnected systems – and how small, compassionate choices around food, alcohol and movement can strengthen wellbeing in meaningful ways.

Highlights & key moments

00:00 Introduction – the gut–liver–brain connection
01:53 Debbie’s background – from gastroenterology to microbiome research
04:04 The liver’s role – metabolism, detoxification and whole-body health
05:58 What the microbiome does – diversity, immunity and mental health
09:54 How antibiotics, diet and lifestyle shift microbial balance
11:15 Nutrition choices – fibre, colour and reducing ultra-processed foods
13:29 Alcohol – how it affects the gut, liver and mood
17:03 The impact of alcohol on sleep and emotional processing
18:30 Apples, pectin and supporting microbiome diversity
20:19 Choice Pause – tuning into your body
22:14 Research insights – repairing a ‘sick’ microbiome
24:00 Faecal microbiota transplantation – safety and potential benefits
26:46 Alcohol-producing bacteria and cravings
28:25 Small, affordable dietary changes that make a difference
32:03 Exercise – benefits for the microbiome, liver and mood
35:15 Micro-movements and reducing sedentary time
36:47 Final reflections – movement, mood and looking after the microbiome

About the guest

Dr Debbie Shawcross is Professor of Hepatology and Chronic Liver Failure at King’s College London and Consultant Hepatologist at King’s College Hospital. A specialist in hepatic encephalopathy and cirrhosis, she is EASL Secretary General, chairs the BSG Research Committee, and is Clinical Advisor to the British Liver Trust. Her research investigates the gut-liver-brain axis and microbiome in chronic liver failure, leading European trials of faecal microbiota transplantation, including the NIHR-funded PROMISE Trial. A long-standing advocate for gastroenterology training and mentorship, she has held key leadership roles with the BSG, Health Education England and charities supporting liver and digestive health.

About the host

Dr Lee David is a GP, CBT therapist and author specialising in mental health and wellbeing. Lee has written many books on CBT, mindfulness and teen wellbeing, and speaks regularly at conferences and in the media. Away from work she enjoys running, hiking, singing in a choir and spending time outdoors with her family. You can find Lee through her website and on Instagram, TikTok (@dr.lee.david), Facebook and LinkedIn. You can find more about her books, wellbeing courses and therapy here: https://linktr.ee/dr.lee.david