Gut Health & Fibre

Fibre is becoming more and more talked about particularly in relation to gut health… I also get a lot of questions about gut health so wanted to bring you guys the latest research on it –

What we do know, is that fibre has a positive impact on gut health. Here in U.K., stats show that we need to boost our fibre intake by around 60%. We are recommend to eat 30g of fibre a day and the countries estimated intake is currently around 18/19g.

The UK get most of their fibre from cereals and cereal products such as bread, rice and pasta. It is important to note that refined grains such as white bread, have been stripped of their fibre. This is not to say we shouldn’t eat white bread, but opting for wholegrain the majority of time provides us with more nutrition. Other foods high in fibre include fruit and veg! Often people forget about this.

How does fibre work?

Fibre plays many different roles including helping to improve glycemic controls, blood sugar balance and stimulating the colon. And as know, it is also becoming increasingly famous for its effect on gut microbiota

Fun facts

  • Our gut microbiota, is something we develop with age and it weighs as much as our brain!
  • It has been estimated that we are 45% human and 55% microbes /bacteria by number of cells
  • The gut produces vitamins and hormones, it strengthens the intestine and trains the immune system.
  • It can also communicate with our Central Nervous System

Health benefits

Research by Rossi & Dimidi found that for every 7g increase in fibre:

  • 9% lower risk of cardiovascular disease
  • 7%lower risk of colon cancer
  • 7% lower risk of stroke
  • 6% lower risk of type 2 diabetes

What does 7g look like?

  • a potato with skin
  • bowl of baked beans
  • a portion of veggie sticks (carrots / cucumber)

Jacka et al. 2017 looked at gut brain axis in mental health. The study looked a patients diagnosed with depression and found that dietary intervention may help with symptoms. (Note these patients were still on medication but the study showed that a high fibre diet helped their symptoms further). This diet included 50g fibre a day!

Diet in general (added omgega 3s may also have helped) so were looking at whole diet -not just reliant on one nutrient but it is helpful to look at the specific mechanisms behind it.

Barriers in regards to including fibre

  • perceived as more expensive
  • perceived as boring

But, it doesn’t have to be boring or more expensive…

How to increase fibre in diet –

  • Include more nuts, legumes, whole grains, fruit/veg in your diet
  • Freeze your fruit and veggies – it tends to cheaper and they may retain more nutritional value
  • Buy tins of lentils, beans and chickpeas – they’re cheap and easy to add to meals.

Please note that those who have been diagnosed with IBS may need more guidance in regards their diet and fibre intake and should seek advice from a registered health professional.

References

https://kclpure.kcl.ac.uk/portal/en/publications/irritable-bowel-syndrome-and-diet(d6c9322c-5079-4073-add7-b803f15131f4).html 

https://kclpure.kcl.ac.uk/portal/en/publications/dietary-fiber-intervention-on-gut-microbiota-composition-in-healthy-adults(f9b2521e-1513-43f5-9739-777023204fbc).html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641835/ 

Get to know your Gut!

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.

  • Exercise

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
  • Anaemia
  • A change in bowel habit lasting more than six weeks if you’re over the age of 60years.

Make sure you follow Kaitlin over on her Instagram page @TheMissionDietitian!

Anorexia & Gut Health… What Does the Research Say?

Having attended a conference at the Royal Society of Medicine looking at the role of diet in mental health last week, I have had a lot of requests to talk more about gut health and anorexia. I always think it is beneficial to team up with other professionals in the field so I have invited the wonderful Bari the Dietitian (@barithedietitian) – (who also happens to be my best friend!) to help me document what we know about this area of research. Bari and I met on our postgraduate MSc programme and she happened to do her final research project looking at this exact area! We hope you enjoy the read!

What is Anorexia?

Often misunderstood as a disorder of vanity, Anorexia Nervosa is the mental health disorder with the highest mortality rate of all psychiatric disorders. It is characterized by extremely low body weight, insufficient food intake and intense fear of weight gain… Anorexia does not discriminate based on age, gender, race, socioeconomic status, etc., but the demographic with the highest prevalence rate in females of 0.4%. As the exact cause remains unknown, treatment is a complex obstacle.

Additionally, what makes treating this disorder so difficult, is the fact that different individuals respond differently to various forms of treatment.

Consequences of anorexia include a range of both physical and psychological side effects. Some of these include malnourishment due to extreme weight loss, feeling tired, faint or dizzy, osteoporosis, digestive issues, and weakened immune system.

What is Gut Health and Why Is It Important?

Gut health seems to be a term that is thrown around a lot these days, as it has become “on-trend” in the media, and for good reason! Our guts are home to billions of bacteria, viruses, and fungi, which have a combined weight of approximately 1kg – fundamentally the same weight as the human brain. The gut microbiome (all the microorganisms and their genetic material) has a strong impact on digestion, immunity, metabolism, as well as mental and brain functions.

A “healthy” gut is described as having a wide range of diversity! On the other hand, a sub-par gut is described as the loss of beneficial microorganisms, the expansion of harmful microorganism, and/or the loss of overall microbial diversity.

The microbes in your gut also communicate with your brain via the “gut-brain-axis”. This means the bacteria that inhabit your gut can talk to, and influence your brain regarding mood, stress, and anxiety.

Interestingly, new research is now suggesting that our gut microbiome may be affected and ‘altered’ by various different factors. We know that antibiotics can have a negative effect on gut health, and it is advised that probiotics are taken alongside them, particularly if taken for a prolonged period of time. A body of research also tells us that our gut loves fibre (found in fruit, veg, and whole grains). In fact, it is recommended that we eat around 30g of fibre a day and the average intake in the UK is only around 18g.

What Does the Research Tell Us About Gut Health In Individuals Who Suffer From Anorexia?

Our gut bacteria are greatly influenced by the foods we eat. Therefore, the lack of food and associated malnutrition can alter the gut microbiome and result in sub-optimal conditions. Here are some negative side effects of Anorexia Nervosa (AN) in relation to the gut:

  1. Decreased intestinal wall thickness, which leads to increased permeability of the gut, can increase the risk of infections and inflammation, and cause GI symptoms, such as bloat, pain, and inevitable “leaky gut”. This also increases the risk of developing an auto-immune disease.
  2. Microbial diversity decreases and the quantity of harmful bacteria increases. For example, those with Anorexia have higher concentrations of M. smithii, which has been shown as an adaptive mechanism in patients with AN to achieve optimal extraction of calories from very low-calorie diets.
  3. Dysbiosis (sub-optimal bacteria profile) also exists in those with depression, OCD, and anxiety, all of which are co-morbidities of Anorexia. Additionally, the low mood experienced by those suffering from Anorexia may be due to the poor nutritional intake. Thus, AN may promote low mood, which then contributes to the progression of the disease, which makes treatment more difficult.
  4. A gut-healthy diet rich in fermented foods and low in processed foods has been shown to reduce symptoms of stress and anxiety.
  5. Recently, however, there has been compelling evidence that the intestinal microbiota may regulate symptoms and maintaining factors of AN, including weight, energy metabolism, immunity, anxiety, and depression. Variations in gut bacteria may be associated with extreme weight loss, thereby perpetuating AN via direct effects on weight and mood.

 

Why Is This Important?

Good gut health is important for digestion and AN sufferers usually experience a lot of digestive discomforts. What we don’t know yet is the types of anorexia that may have a more detrimental effect on the gut. More research is needed to identify whether or not gut symptoms are worsened by prolonged periods of food restriction and purging, for example. Although AN behaviors and symptoms differ from person to person, the present research strongly indicates that poor gut health is associated with this mental health disorder and when treating this illness, gut health research should be used as a tool for recovery.

So, the big question remains: Is an altered gut microbiota simply an obvious result of long-term reduced food consumption, potential dietary deficiencies, and weight loss? Or, alternatively, does microbial composition have the potential to cause these metabolic outcomes and possibly, to contribute to disordered eating behavior? We need more large-scale follow-up studies to clarify these relationships. However, this may offer novel ways to treat eating disorders, specifically Anorexia!

If you are suffering from disordered eating patterns and digestive issues as a result, please seek help from a qualified professional. Other helpful resources can be found at https://www.beateatingdisorders.org.uk/

To book a Nutrition Consultation with me in clinic, please email me at Sophie@rhitrition.com