Gut Health, Part 3: 10 Ways to Help Support Gut Health

Gut Health, Part 3: 10 Ways To Help Support Gut Health

This is the third part of my series on gut health. Do check out The Basics of Gut Health and Probiotics and Prebiotics in Gut Health for further information on this popular topic.

How to eat more fibre

  1. Start with the basics

Whenever I am asked to consider ways to support individual organ systems or processes (such as brain health, skin health, immunity etc.), I always start by saying that we can’t isolate just one part of the body and focus only on that.

We exist as an intricately connected whole system. What affects one area of our body will also affect everywhere else, to a greater or lesser extent. This concept applies to our gut health. So while there are certain strategies that may specifically benefit our microbiota or digestive health, we must consider their wider effects, too.

Likewise, many aspects of our lifestyle beyond just diet can also influence our gut – from lack of sleep, to stress, to being consistently sedentary. Therefore, perhaps the most important first step to nourishing our gut is actually to nourish our whole body and mind. To establish those fundamental basics of health: restorative sleep, moderate alcohol intake, regular movement, a balanced and nourishing diet, active stress management and social connection.

Often, we may find that when these basics are in place, consistently (not perfectly – that’s not a realistic goal), much of the rest takes care of itself.

  1. Take time to eat, sit down & chew properly

Our digestion needs time to work properly, so sit down to eat, and try to give yourself at least 10 minutes for each meal, ideally undistracted. The more relaxed we are when eating, the more we activate the ‘rest and digest’ state of our nervous system. Which, as the name suggests, is very helpful to support efficient digestion.

Chew your food well and give your digestion a break between meals (I suggest at least 4-5 hours). These two simple factors can do an awful lot of good when it comes to gut health, especially bloating, without changing a single thing in your diet.

If you’d like more information on how to practice mindful eating (including a mindful exercise) as well as more on digestive health and nutrition, I suggest taking a look at my online course  which explores many of these topics in detail.

  1. Drink enough water

Your body maintains a finely tuned fluid balance by absorbing more water from your gut if you are getting a little dehydrated. This hardens the contents of your bowels, and so dehydration is a common cause of slow gut transit time and constipation.

Good hydration enables good elimination! For gut health, it is suggested that we aim for around 30-25ml fluids per kg of body weight per day (although this will vary according to the temperature and amount of exercise you are doing too, so as always, please listen to your body).

  1. Include healthy fats in your diet

For simplicity’s sake when it comes to healthy fats, I generally recommend using plain olive oil for cooking, and your fancy extra-virgin olive oils for salad dressings and drizzling. Other healthy fats, such as avocados, oily fish and nuts & seeds, are also very gut friendly.

There is a lot more information on how to build a healthy diet, including which healthy fats to go for in my third book, Nourish & Glow: The 10 Day Plan.

  1. Focus on fibre

A fibre-rich diet is associated with an increased diversity of the gut microbiota (and, in general, the greater the diversity the better), as well as helping to reduce constipation and other bowel-related problems. It may potentially even help to reduce the risk of heart disease and stroke (Wald, 2013) (Gobson and Shepher, 2010) (De Filippo et al., 2010).

Plus, fibre is filling and low in available calories, so great for those who are watching their weight. Aim for at least 30g/day, which you can get from lots of fresh vegetables, beans and pulses, and unrefined, whole-grain carbohydrates (oats, millet, quinoa, amaranth etc.).

See my article ‘Eat More Fibre’  for lots more on this topic.

  1. Eat a colourful diet rich in polyphenols

Plant polyphenols are important naturally occurring compounds that are found in a range of plants, fruits and vegetables which are thought to have all sorts of beneficial effects for both your gut and your body as a whole (Puupponen-Pimia et al., 2002).

Good sources of polyphenols include:

  • Citrus fruits (whole fruits though, not just the juice!).
  • Dark green leafy vegetables (spinach, chard, cabbage, kale etc)
  • Green Tea
  • Red and purple berries (I often recommend a portion a day for gut health – frozen ones are fine when fresh are out of season)
  • Nuts and seeds. Linseeds (also known as flax seeds) and chia seeds are a good example, although I would recommend soaking them for a few hours or overnight in water before eating them for maximum nutrient absorption. I would suggest trying to have a moderate portion of nuts, seeds or nut butter every day (assuming you tolerate them well and have no allergies)
  • Cacao – yep, that means chocolate! Either go for raw cacao or organic cocoa powder, or look out for organic chocolate with a cocoa content of > 85%. 10-25g per day is a sensible amount (that’s about 1-2 large squares).

For more information on polyphenols, take a look at my article Why ‘eating the rainbow’ is not just a cliched phrase – also contains lots and lots of colourful recipe inspiration.

  1. Include some probiotic & prebiotic foods

Probiotic foods include organic fermented dairy products such as bio live plain yoghurt, sour cream, aged cheese or kefir (if you tolerate casein protein and lactose). Alternatively, kimchi, kombucha, miso, natto, sauerkraut and tempeh are fermented too. Do make sure that these contain ‘active, live cultures though’ – if they have been pasteurized or heat-treated after fermentation then they will no longer have significant probiotic function.

Prebiotic foods include things like asparagus, under-ripe banana, aubergine, endive, garlic and onions, Jerusalem artichokes, leeks, pulses (such as beans, peas and lentils) and chicory. Unrefined wholegrains may also have some prebiotic function.

Please note: It’s recommended that you always start to include these foods very gradually into your diet. Adding a lot of probiotics and prebiotics at once can potentially lead to a significant exacerbation in gut symptoms. Sometimes I recommend just a teaspoon every other day to begin with (although others may be fine adding more). Listen to your own body, as always.

  1. Consider possible food allergies & intolerances

If you have a specific food allergy or intolerance, this food may need to be eliminated for a while (or indeed, indefinitely in some instances), to allow your gut and symptoms to heal.

It’s always best to speak to a Registered Nutritionist, Nutritional Therapist or Dietitian to advise you on this (head over to my FAQs page for info). As far as possible, eating a widely varied diet is important to ensure we don’t inadvertently develop nutrient insufficiencies, and to minimise the stress and anxiety we might feel around eating.

Please be wary of any online company that offers at-home tests to find if you have any allergies or intolerances – most of these are not proven to be effective, and may result in you restricting your diet unnecessarily.

  1. Reduce ultra-processed foods

It’s a good idea, both for our overall health as well as for our gut health, to cut down on the amount of heavily processed and/or junk food we consume, especially processed meats and high-sugar, high saturated fat foods. Although all foods do have their rightful place in a balanced diet, moderation is important when it comes to these sorts of foods. It’s best to base the majority of our meals on whole foods, such as fruits, vegetables, high-quality proteins, pulses, wholegrains and nuts & seeds, cooked simply.

  1. Actively manage stress

Stress can be a big factor in both our gut health and our overall health. Our brain, microbiota and gastrointestinal tract are all intricately connected, and can all affect each other. This book explains that connection really well.

Although we all feel stress, and a bit of it can actually be beneficial to us, too much is definitely unhelpful. Actively managing stress can take many forms. Some people find exercise incredibly helpful, others self care and others still seek social connection in times of challenge.

It’s less about what you do than actually doing it consistently. This book, offers a great deal of ideas, tips and suggestions if you’re not sure where to begin when it comes to reducing your own stress levels.

SHOP THE EDIT

Eat Yourself Happy | Dr Megan Rossi

SHOP

Be Good To Your Gut | Eve Kalinik

SHOP

The Joy of Healthy Eating | Amelia Freer

SHOP

Nourish & Glow: The 10 day plan | Amelia Freer

SHOP

Green Tea | Clipper Tea

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The Stress Solution | Dr Rangan Chatterjee

SHOP

Please note, this website uses some carefully selected affiliate links. If you buy through these links, we may earn an affiliate commission, at no additional cost to you. This helps to keep all of our online content free for everyone to access. Thank you.

Please note: This article is for information only and in no way replaces medical or personal nutrition advice. You should always speak to your healthcare provider in the first instance if you have any concerns whatsoever about your digestive or gut health. Please do not disregard or delay treatment based on anything you read on this website. I am not a doctor, nor am I your Nutritional Therapist. The information I share is very general and may not be relevant or appropriate for you as an individual.

References & Bibliography:

Bjarnason, I., Williams, P., Smethurst, P., Peters, T.J. and Levi, A.J. (1986) ‘Effect of non-steroidal anti-inflammatory drugs and prostaglandins on the permeability of the human small intestine’, Gut, 27(11), pp. 1292–1297. doi: 10.1136/gut.27.11.1292.

De Filippo, C., Cavalieri, D., Di Paola, M., Ramazzotti, M., Poullet, J.B. and Massart, S. (2010) ‘Impact of diet in shaping gut microbiota revealed by a comparative study in children from Europe and rural Africa’, Proceedings of the National Academy of Sciences, 107(33), pp. 14691–14696. doi: 10.1073/pnas.1005963107.

De-Souza, D.A. and Greene, L.J. (2005) ‘Intestinal permeability and systemic infections in critically ill patients: Effect of glutamine*’, Critical Care Medicine, 33(5), pp. 1125–1135. doi: 10.1097/01.ccm.0000162680.52397.97.

Dethlefsen, L. and Relman, D.A. (2010) ‘Incomplete recovery and individualized responses of the human distal gut microbiota to repeated antibiotic perturbation’, Proceedings of the National Academy of Sciences, 108(Supplement_1), pp. 4554–4561. doi: 10.1073/pnas.1000087107.

Gibson, P.R. and Shepherd, S.J. (2010) ‘Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach’, Journal of Gastroenterology and Hepatology, 25(2), pp. 252–258.

Lambert, G., Boylan, M., Laventure, J.., Bull, A. and Lanspa, S. (2007) ‘Effect of aspirin and ibuprofen on GI Permeability during exercise’, International Journal of Sports Medicine, 28(9), pp. 722–726. doi: 10.1055/s-2007-964891.

Puupponen-Pimiä, R., Aura, A.., Oksman-Caldentey, K.., Myllärinen, P., Saarela, M., Mattila-Sandholm, T. and Poutanen, K. (2002) ‘Development of functional ingredients for gut health’, Trends in Food Science & Technology, 13(1), pp. 3–11. doi: 10.1016/s0924-2244(02)00020-1.

Wald, A. (2013) Patient information: High-fiber diet (Beyond the Basics. Available at: UpToDate (Accessed: 1 December 2015).

Photos by Jen Rich and Darryl Leja


Gut Health, Part 2: Probiotics and Prebiotics in gut health

Gut Health, Part 2:  Probiotics & Prebiotics in Gut Health

What are probiotics?

Probiotics are “live micro-organisms, which when consumed in adequate amounts, confer a health effect on the host”. Use of probiotic foods is an ancient tradition – even as far back as the time of Genghis Khan, fermented milk was being drunk as an elixir of strength and health.

In the second part of this gut health series, we are going to look at the role of probiotics and prebiotics in gut health – possibly one of the most exciting new topics to emerge in nutrition in the last few years. If you missed Part 1: The basics of gut health  take a look at it first to give you a little more background.

Most often, probiotic foods or supplements contain strains of either Lactobacillus or Bifidobacterium bacteria, usually from fermented dairy products. However, before starting to act, they have to survive the hazardous journey to reach our gut:

  1. They need to first get through manufacturing, transportation and storage processes, to reach our fridge or kitchen cupboards alive and in good condition.
  2. Then they must make it through the acidic environment of our stomach (designed precisely to kill off any wayward bacteria) and through the swamp of potent digestive juices and enzymes secreted by the gallbladder and pancreas.
  3. Finally, if they succeed in reaching their destination, the large bowel, they then actually need do some good for the host rather than just going along for a free ride, or even possibly doing some untoward harm.

Because of these difficulties with getting the right probiotics to the right place, it is important to point out that the benefits which are seen in clinical trials may not all be possible to achieve with the yoghurts, tablets or other supplements available over-the-counter.

Despite all these challenges, however, good quality strains of probiotics have been associated with beneficial effects in some disease processes, such as reducing antibiotic-associated diarrhoea.  Researchers are also examining a huge range of other conditions that may benefit from probiotics (Tuohy et al., 2003) (NHS Choices, 2015). Further research is very much ongoing.

Limitations

Most of the clinical research that has been carried out on prebiotics has been in unwell populations, and even then they are not yet in widespread use. We do not yet know much about the impact that taking probiotics might have in generally healthy people (Puupponen-Pimia et al., 2002). Anecdotally, I have found them to be of tremendous benefit for myself and some of my clients. However, anecdote is not a strong form of evidence, and I am always cautious about recommending any supplements on this sort of platform, so please do speak to your doctor or an appropriately qualified nutrition professional prior to commencing any supplements.

Furthermore, probiotics, even as tablets, are also still regarded as foods. Therefore they do not have to undergo the same rigorous testing as medicines do, so it is difficult to know if they actually contain the bacteria they claim, alive, in an adequate dose, and are able to give you a tangible benefit (NHS choices, 2015). The European Food Safety Authority has even gone so far as to ban the probiotic food industry from certain advertising claims, such as that they ‘boost the immune system’, because there is insufficient evidence to back such claims up at the moment. A healthy dose of skepticism is often helpful in nutritional science!

As Dr Alessio Fasano so neatly puts it, we can compare our current knowledge of the microbiota to our knowledge of space. We know the universe exists (our microbiota), and we are getting to grips with the fact the Milky Way is there (the major strains of bacteria), but we are far off knowing where London is! In other words, there is a lot of detail still to understand before we are able to fully utilize probiotics for health.

What about prebiotics – are they the same thing?

No. Prebiotics are a class of nutrients called ‘oligosaccharides’ (a type of fibre) which pass through the upper portion of the gut undigested, to feed and stimulate the growth of microbes further down. I think about it as nectar for gut bugs!

Types of prebiotic that are thought to influence the microbiota include (Tuohy et al., 2003);)

  • Inulin & Fructooligosaccharides – found in foods such as Jerusalem artichoke, asparagus, leeks, green bananas, chicory and onions (Sabater-Molina et al., 2009)
  • Lactulose
  • Galactooligosaccharides – found naturally in breast milk to help feed the microbiota of new born babies.

In general, a dose of more than 20g a day of all of these combined, may lead to unwanted side effects such as flatulence and bloating (Tuohy et al., 2003). I would therefore suggest it is a sensible idea to always ‘start low and go slow’ when introducing these to your diet.

As an added benefit, when our gut microbes break down these prebiotic fibres, especially inulin, they release a compound called butyric acid (Scott et al., 2013). This may be particularly important in gut health, as not only is it thought to be anti-inflammatory, but it also helps build up the gut defence barrier and decreases oxidative stress. Plus it might even help to signal to our brain that we are full and satisfied at the end of a meal (Hamer et al., 2007).

My pragmatic approach, if you are generally well, and would like to boost your probiotic and prebiotic intake, is to use foods first as much as possible.

In part 3 of this series,10 Ways to Help Support Gut Health, we will explore lots of practical ideas on how to do this.

SHOP THE EDIT

Gut | Giulia Enders

SHOP

The Joy of Healthy Eating | Amelia Freer

SHOP

Eat Yourself Happy | Dr Megan Rossi

SHOP

Be Good To Your Gut | Eve Kalinik

SHOP

Smoky Pink Kraut | Eaten Alive

SHOP

Organic Kefir | BioKef

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Please note, this website uses some carefully selected affiliate links. If you buy through these links, we may earn an affiliate commission, at no additional cost to you. This helps to keep all of our online content free for everyone to access. Thank you.

Please note: This article is for information only and in no way replaces medical or personal nutrition advice. You should always speak to your healthcare provider in the first instance if you have any concerns whatsoever about your digestive or gut health. Please do not disregard or delay treatment based on anything you read on this website. I am not a doctor, nor am I your Nutritional Therapist. The information I share is very general and may not be relevant or appropriate for you as an individual.

References & Bibliography:

Hamer, H.M., Jonkers, D., Venema, K., Vanhoutvin, S., Troost, F.J. and Brummer, R.. (2007) ‘Review article: The role of butyrate on colonic function’, Alimentary Pharmacology & Therapeutics, 27(2), pp. 104–119. doi: 10.1111/j.1365-2036.2007.03562.x.

NHS Choices (2015) Probiotics – NHS choices. Available at: http://www.nhs.uk/Conditions/probiotics/Pages/Introduction.aspx (Accessed: 11 December 2015).

Puupponen-Pimiä, R., Aura, A.., Oksman-Caldentey, K.., Myllärinen, P., Saarela, M., Mattila-Sandholm, T. and Poutanen, K. (2002) ‘Development of functional ingredients for gut health’, Trends in Food Science & Technology, 13(1), pp. 3–11. doi: 10.1016/s0924-2244(02)00020-1.

Sabater-Molina, M., Larqué, E., Torrella, F. and Zamora, S. (2009) ‘Dietary fructooligosaccharides and potential benefits on health’, Journal of Physiology and Biochemistry, 65(3), pp. 315–328. doi: 10.1007/bf03180584.

Scott, K.P., Martin, J.C., Duncan, S.H. and Flint, H.J. (2013) ‘Prebiotic stimulation of human colonic butyrate-producing bacteria and bifidobacteria, in vitro’, FEMS Microbiology Ecology, 87(1), pp. 30–40. doi: 10.1111/1574-6941.12186.

Tuohy, K.M., Probert, H.M., Smejkal, C.W. and Gibson, G.R. (2003) ‘Using probiotics and prebiotics to improve gut health’, Drug Discovery Today, 8(15), pp. 692–700. doi: 10.1016/s1359-6446(03)02746-6.

Photos by Darryl Leja


Gut Health, Part 1: The Basics of Gut Health

Gut Health, Part 1: The Basics of Gut Health

In the Autumn of 2020, I asked my lovely newsletter subscribers what they would like to see more of from me in the future. The overwhelming response was ‘gut health’.

So, in response I have given this gut health mini-series (originally written a few years ago) a real overhaul, updated it to meet my current practice and philosophy, and linked in all sorts of useful and relevant articles to expand on various topics. I’ve also added some of my favourite products and gut health books at the end of each section, in case you’d like a few of my personal recommendations.  I hope you find it helpful.

What do we mean by the ‘gut’?

The gut is a collection of organs, running from the mouth to the bowels, with help from the stomach, liver, pancreas and gallbladder along the way. All of these structures work together to extract the greatest amount of nutrition from whatever we choose to eat.

Alongside our digestive organs, we increasingly understand the powerful impact that our gut microbiota has on health. The microbiota consists of trillions of microbes (bacteria, yeast, funghi and viruses), which live inside our bowels, interacting not only with the food we eat, but also with each other and with us. Each microbiota is unique to each person.

When in harmonious balance, these microbes helpfully aid our digestion, make vitamins and other nutrients, break down dietary toxins, strengthen the body’s internal barrier against the contents of gut, prevent overgrowth of bacteria which can make us unwell, and can even influence our immune system and mood (Butel, 2014). But when out of balance, these microbes may also have the potential to negatively impact our health, too. I therefore now see the ‘gut’ not only as an organ system, but as an ecosystem too.

All sorts of factors may affect the composition and function of our microbiota, and therefore our gut health, including:

Hippocrates reportedly said that ‘all disease starts in the gut’. Clearly this isn’t true all of the time (take genetic disorders, for example), but a significant proportion of chronic diseases may indeed be linked to gut health. It has just taken medical science a few thousand years to catch up!

What is a healthy gut?

There is actually no specific definition of what makes a ‘healthy’ gut, because that depends so much on the individual.

But in general, I personally would consider a healthy gut to:

  1. Be free from persistent digestive symptoms (such as bloating, abdominal pain or disrupted bowel habits). We all get the odd mild symptom from time to time though, but when things change, are persistent, or show any worrying signs (see below) this should be flagged to your healthcare provider promptly.
  2. Eliminate regular, formed (but easily passed) stools*
  3. Allow complete digestion and absorption of nutrition. The average time for the entire process of digestion / absorption is 24 hours, although this does vary a lot between individuals.

* This little step, which wraps around your loo, helps your body adopt a physiological squatting position when opening your bowels which some people find beneficial with constipation.

What is an unhealthy gut?

There are certain unhealthy gut symptoms that are known as ‘red flags’. These are important warning signs that should be discussed with a doctor as soon as possible. Although some of them may represent a harmless condition that will settle itself, it is important if you have any of these symptoms to seek a medical opinion promptly.

These signs may include (note that this is absolutely not an exhaustive list – please speak to your GP if you have any concerns whatsoever about your gut health);

  • A sudden, persistent change your bowel habits
  • Any bleeding, or black, tarry stools
  • Persistent bloating
  • Increasing heartburn, indigestion or stomach pains
  • Abdominal pain
  • Losing weight unintentionally
  • Any difficulty or pain on swallowing

Within the scope of my nutritional practice, I would also look at all sorts of other symptoms (even if they are not necessarily directly related to the gut), such as skin, mood, energy, weight and more. There’s an old phrase in Nutritional Therapy that states ‘what happens in the gut doesn’t stay in the gut’, and so I do look beyond just digestive symptoms when talking with my clients.

How might gut health affect weight?

We know that our gut needs to be functioning effectively to be able to digest and absorb the nutrition that we are eating. If this function becomes impaired, it could potentially lead to both weight loss, and perhaps even weight gain.

Perhaps the most important question to ask is firstly whether there could be an underlying medical problem that is driving poor digestion? The best way to work out if this is a possibility is to speak to your doctor or other healthcare provider. Problems with maldigestion or malabsorption may lead to an unintended decrease in weight (although not always).

Once any medical concerns have been ruled out (if necessary), the next step would be a more comprehensive look at overall digestion, and to see whether there are any signs and symptoms gut inflammation or irritation. This is often highly variable between people, so again, I would suggest that you find a well-qualified Nutritional Therapist, Dietitian or Registered Nutritionist (see FAQs for more info) to help. There simply isn’t a one-size-fits-all approach to gut health, so this individualised support is very important.

There is also a lot of interest at the moment around the potential role of the gut microbiota in the development of obesity, and obesity-related diseases. Lots of this revolves around how certain microbes may potentially alter appetite, metabolic function and energy absorption by the body.

Unfortunately, we do not know enough about this topic yet to know which types of microbe could potentially help us to lose weight (or indeed, help us to gain weight). However, there are some promising studies emerging and research is certainly ongoing (Abenavoli et al.l, 2019, Kadooka et al., 2010)

Please click the links below for further related information;

Gut Health Part 2: Probiotics & Prebiotics in Gut Health

Gut Health Part 3: Ways to Support Gut Health

Eat More Fibre

SHOP THE EDIT

Gut | Giulia Enders

SHOP

The Joy of Healthy Eating | Amelia Freer

SHOP

Eat Yourself Happy | Dr Megan Rossi

SHOP

Be Good To Your Gut | Eve Kalinik

SHOP

The Mind-Gut Connection | Emeran Mayer

SHOP

Step Stool

SHOP

Please note, this website uses some carefully selected affiliate links. If you buy through these links, we may earn an affiliate commission, at no additional cost to you. This helps to keep all of our online content free for everyone to access. Thank you.

Please note: This article is for information only and in no way replaces medical or personal nutrition advice. You should always speak to your healthcare provider in the first instance if you have any concerns whatsoever about your digestive or gut health. Please do not disregard or delay treatment based on anything you read on this website. I am not a doctor, nor am I your Nutritional Therapist. The information I share is very general and may not be relevant or appropriate for you as an individual.

References

Kadooka, Y., Sato, M., Imaizumi, K., Ogawa, A., Ikuyama, K., Akai, Y., Okano, M., Kagoshima, M. and Tsuchida, T. (2010) ‘Regulation of abdominal adiposity by probiotics (Lactobacillus gasseri SBT2055) in adults with obese tendencies in a randomized controlled trial’, European Journal of Clinical Nutrition, 64(6), pp. 636–643. doi: 10.1038/ejcn.2010.19.

Krajmalnik-Brown, R., Ilhan, Z.., Kang, D.. and DiBaise, J.K. (2012) ‘Effects of gut microbes on nutrient absorption and energy regulation’, Nutrition in Clinical Practice, 27(2), pp. 201–214. doi: 10.1177/0884533611436116.

Abenavoli, L.; Scarpellini, E.; Colica, C.; Boccuto, L.; Salehi, B.; Sharifi-Rad, J; Aiello, V.; Romano, B.; De Lorenzo, A.; Izzo, A.A.; Capasso,R. Gut Microbiota and Obesity: A Role for Probiotics. Nutrients 2019, 11, 2690.

Credit – top image:  Darryl Leya, National Institutes of Health (NIH)