There is more and more research emerging when it comes to gut health and I often get lots of questions on my instagram page about the gut and digestive health. I thought it would be beneficial for a lot of you if I dedicated a blog post to this topic, and I am delighted to introduce the lovely @TheMissionDietitian AKA Kaitlin Colucci, Registered Dietitian and gut health specialist, to give you the low down on gut health…
What do we mean by ‘gut health’?
When you type ‘Gut Health’ into Google, you get more than 1 billion results returned. From books, to blogs, to the BBC – everyone is talking about gut health.
The gut is referring to the function of your gastrointestinal (GI) tract. The GI tract starts at your mouth, and finishes…down the other end. So includes your oesophagus, stomach, small intestine, large intestine, rectum and anus.
The main function of the gut is to absorb nutrients from the food we eat, whilst also ridding solid waste from the body. As well as this, the gut also hosts a huge amount of bacteria – both good and bad, which is better known as the gut microbiome.
Approximately 100 trillion micro-organisms exist in the human GI tract and these can all aid with digestion of nutrients, support a healthy immune system, and more recently have even shown a link between stress, anxiety, insomnia and weight gain via something called the Gut-Brain-Axis. This is essentially a pathway in which the gut talks to the brain and vice versa.
Bad bacteria does find it’s way into the gut and when it does can cause symptoms such as diarrhoea or constipation, excessive gas, and irritable bowel.
There is no universal definition for ‘good gut health’ and no two people’s gut microbiota are the same. The absence of gut symptoms such as bloating, constipation, diarrhoea, excess flatulence, abdominal pain etc. may be an indicator of good gut health. However, research has shown that 1 in 3 people suffer from one or more of these symptoms.
What sort of factors may influence our gut health?
Studies looking at human twins have shown that although there is a heritable component to the gut microbiota, there are many factors that independently influence the composition of the gut microbiota.
There are many causes for this, some of which can’t be helped such as ageing and becoming ill. However stress, unhealthy dietary habits, antibiotics, mood, sleep and smoking are among the causes that can be helped.
Aiming to reduce and manage your stress levels can do wonders for your gut health. Aiming to do 30 minutes of exercise every day, or even 10 minutes of mindful meditation can help to reduce stress levels. Lifestyle factors such as stress and sleep have been shown to have a significant impact on the gut bacteria, which may explain the association between lack of sleep and weight gain.
We all become ill at times when antibiotics are a necessity, but avoiding antibiotics unless absolutely necessary saves healthy gut bacteria from being wiped out and causing long term changes to your gut microbiota.
Healthy eating is also key to good intestinal health. Studies done in animals have shown that eating a diet low in fibre and high in processed foods has been linked with alteration in gut microbiota and increased chronic disease risk.
A variety of plant foods are necessary to have a variety of strains of good bacteria in the gut. Try to eat the rainbow when it comes to fruit and vegetables, or eat the alphabet when it comes to plant based foods.
Can IBS symptoms be controlled through our diet?
Some people, particularly those with IBS have a very sensitive gut and can’t tolerate some types of fermentable carbohydrates termed FODMAPs (fermentable oligosaccharides, di-saccharides, mono-saccharides, and polyols) and may be recommended to trial a low FODMAP diet. FODMAPs are types of prebiotics. Prebiotics are types of dietary fibres that reach the large intestine undigested where the bacteria ferment them. Foods rich in prebiotics include artichokes, onion, garlic, asparagus and leeks.
The low FODMAP diet is a diet that is recommended for 4-8 weeks and should be delivered by a Registered Dietitian. The diet aims to reduce the amount of these fermentable fibres from the diet and therefore reducing IBS-like symptoms. Research has shown that the low FODMAP diet can be effective in up to 70% of people with IBS. However, once your symptoms have reduced to below your tolerance threshold, it is important to trial a structured reintroduction of each high FODMAP food, again with guidance from a Registered Dietitian. This is because not everyone responds to high FODMAP foods in the same way, and it is important to reintroduce some fermentable foods that don’t trigger symptoms back into your diet to increase variety, and help keep your good gut bacteria happy.
Are probiotics really worth it?
Probiotics are foods that contain live beneficial bacteria such as yogurt, kefir, kombucha and kimchi. You can also buy probiotic capsules or drinks. However, evidence for the effect of probiotics is mixed and the most convincing evidence is in the prevention of antibiotic associated diarrhoea and treatment of travellers diarrhoea.
Nevertheless, it is important to remember that these types of foods have been eaten as part of a healthy diet for centuries and lack of evidence does not always equate to lack of benefit.
We know that probiotics do not cause harm. Therefore if you want to trial a probiotic supplement you should trial one for at least four weeks whilst monitoring the effect. Always take at the dose recommended by the manufacturer.
Are there certain things we can be doing or certain foods we should be eating to help with our digestion?
- Eat a varied diet rich in fibre
Adults should be aiming to eat 30g of fibre each day, but most of us are only achieving around 18g. Aim to eat plenty of fruit, vegetables, wholegrains, legumes and pulses. Aim to gradually increase your fibre intake and ensure to drink plenty of fluid as well.
- Experiment with new foods
Try a new food each week, especially those containing natural probiotics as these can help the good bacteria in your gut and don’t come with a big cost that some supplements do.
- Avoid unnecessary medications
Particularly overuse of antibiotics as these can wipe out your good bacteria and cause long term changes to your gut microbiota.
- Stop smoking and drink alcohol in moderation
Cigarette smoking has a bad impact on your gut bacteria and alcohol can alter the balance of bacteria within the GI tract.
Ensure to exercise regularly as this can help to regulate bowel habits. We should be aiming to do 150 minutes moderate aerobic activity every week such as cycling or brisk walking. You can break that down into 30 minutes five times a week. We should also aim to do two additional days of strength exercises that work all major muscles.
- Simple habits
Digestion starts in the mouth, so chewing our food really well is an important part of digestion. Take your time to eat and enjoy food sat at a dinner table where you can.
Also avoid wearing excessively tight clothes, especially high-waisted trousers that sit right by the stomach as external pressure can worsen your symptoms.
- Create time to relax
Due to the Gut-Brain-Axis, if we are stressed this can have a negative impact on our gut bacteria. Therefore aim to find time in your day to relax and de-stress.
- Know when to seek medical advice
Always be on the look out for red flags, and if something doesn’t seem right, talk to your doctor or GP. Red flags include:
- Unexplained and unintentional weight loss
- Blood in your stool
- Family history of coeliac disease, bowel cancer, or inflammatory bowel disease
- A change in bowel habit lasting more than six weeks if you’re over the age of 60years.