5 Things You Should Know About: Gut Health

 In this series I help you understand the science behind popular food, nutrition, and wellness topics in the media and what you really need to know about each topic. First up: Gut Health.

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2017 was the year of gut health, and it's expected that this topic will only continue be top of mind in 2018.  A quick #guthealth search on instagram yields over 800K results, which should tell you that it's a mainstream health concern by now. We now know that the health of our gut affects much more than digestion -- it plays a role in the function of many other systems and may contribute to our risk for chronic disease. The more we learn about it, the more important it appears to be.

When we talk about gut health, we're mostly referring to the colony of billions of good bacteria reside in our gut (primarily in the large intestine), known as the gut microbiome.  When everything is working as it should, these bacteria live in balance with your body (aka symbiosis -- does this take you back to 9th grade biology class?) and keep your digestive function in tip top shape (meaning you, ahem, go to the bathroom regularly). These bacteria are also responsible for removing toxins from your body while retaining the nutrients you need. When the bacteria get out of balance, which is called dysbiosis, mayhem ensues.

Typical symptoms of dysbiosis include bloating, gas, constipation or diarrhea, and even upper-GI symptoms like acid reflux. But emerging research suggests that dysbiosis can can manifest in other ways such as through skin conditions like acne and eczema as well as autoimmune disorders. 

While scientists have likely only scratched the surface in terms of the how the gut affects other systems, there is already plenty of convincing evidence suggesting that gut health is incredibly important. However, it can be overwhelming with all of the information out there to know what really matters, so let's get to the basics. Here are 5 things you should know when it comes to your gut: 

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Emerging research has linked dysbiosis with a number of other health conditions ranging from diabetes and metabolic syndrome to rheumatoid arthitis. Some research has connected obesity to with an altered gut microbiome. But, there is no cause and effect relationship defined thus far and we don't know which comes first -- being overweight or the altered microbiome; or, if it's related to lifestyle (see more below) and has nothing to do with weight at all. 

Beyond chronic diseases, scientists have also made a connection between the gut and the brain, often referred to as the gut-brain axis, suggesting that the gut can play a role in mood, anxiety, and depression. Links have even been made between gut health and hormonal imbalance and fertility. 

How could the gut really affect that many systems?

A side effect of dysbiosis is inflammation (another hot topic in the wellness arena to be covered another day). It's thought that when our bacteria are out of balance, the lining of our gut becomes permeable, allowing proteins and other toxins that shouldn't pass through into our blood stream, possibly leading to inflammation.  Inflammation is linked to a number of chronic health conditions, so inflammation is likely at least part of the explanation for the the connection between gut health and some chronic of these conditions.

2. Stress Plays a Major Role in Gut Health

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If you've ever experienced digestive upset during a stressful time, you're aware of the connection. Chronic stress or even a short-term very stressful time can lead to dysbiosis. Big life events, family stress, work stress, and other life stressors that fall into the emotional stress category are probably what comes to mind first. But physical stress such as over exercising, under eating, poor diet, or lack of sleep can be just as damaging. Getting a handle on your stress is one of the best things you can do to improve your gut health (and overall health too!). 

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Not surprisingly, diet plays an important role in gut health. Following a mostly whole foods diet, while limiting processed foods, is a good place to start.  You'll also want to focus on eating both probiotic and prebiotic-rich foods.

Probiotics are a hot topic these days because they are what keep the good bacteria in your gut flourishing. You get them by consuming fermented foods and drinks like sauerkraut, kimchi, kefir, miso, tempeh, and kombucha. Some yogurts have probiotics, but a much lower dose than other fermented foods. A little goes a long way in this department, and I recommend starting slowly if you've never eaten fermented foods before. Too much too fast can lead to gas, bloating, or other intestinal symptoms. 

The other half of the powerful gut health duo is prebiotics, which are food for probiotics and found in plant foods. While most plant foods offer some prebiotic fiber, these foods are known for providing a good dose: dandelion greens, sunchokes (Jerusalem artichokes), garlic, onion, leeks, asparagus, bananas, barley, oats, apples, and flax seeds.

Cruciferous vegetables like dark leafy greens, Brussels sprouts, and cauliflower -- to name a few -- also provide health promoting compounds that can keep your gut happy. 

No one food (unless you are allergic or intolerant to that food) is going to throw off your entire digestive system. So, don't worry about being perfect. Limit processed foods including process meats and refined carbohydrates, but you don't need to avoid them altogether. In fact, the stress of trying to keep a "perfect" diet can do more damage than good, so enjoy what you eat. 

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Do you eat while distracted or as quickly as possible? This can add stress to your digestive system and increase the release of stress hormones. Make it a goal to eat at a table, undistracted. That means putting away the technology (facebook will still be there later!) and taking time to focus on what you're eating and enjoy it. Being more mindful while you eat has many other benefits like improved satisfaction and less chance of overeating, too. 

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I always take a food first approach, but sometimes a supplement is beneficial. For example, if you've recently taken antibiotics, which can wipe out a lot of the good bacteria in your gut, taking a broad spectrum probiotic (one with a variety of species) for about 30 days can be useful. Not all probiotics are created equal, though.  Each product provides different strains in varying amounts and depending on your symptoms, some strains may be more effective than others. So, do some research and/or talk to your doctor or registered dietitian to help you choose the best one for you. In general,  it's best to get a product that is third party tested -- look for USP, NSF, or Consumer Lab on the label.

An important caveat is that probiotic supplements should not be a long-term solution. The amount of time you need to take them varies depending on your health condition and symptoms, but you should eventually be able to stay healthy with dietary and lifestyle changes, in most situations. If your symptoms remain unresolved, I recommend seeing your doctor and possibly a registered dietitian that specialized in gut health/disorders for more personalized help. 

Disclaimer: Advice in this post is meant for general informational purposes and should not be taken as medical advice. For more personalized recommendations, schedule a nutrition consultation with me and if I'm not the right fit I can refer you to someone that is.