If you weren’t already aware, gut health is having a bit of a moment. So, with probiotics and prebiotics now getting a front row seat in the health industry, you might be wondering why everyone is interested in what’s going on down there. “I would never rule the gut out as something to try and enhance, as it has such a big impact on so many things,” says gut health expert and registered nutritional therapist, Nicola Moore. Whether it’s about the soggy salad you’re having for lunch or the dodgy takeaway you had last night, your gut will want to have a conversation with the rest of your body about it. But how do those conversations work? And, how can we make them positive? In this guide, our experts share why good health begins in the gut.
What is the gut?
It’s all well and good trying to maintain good gut health, but what actually is it? “The gut – that long, winding tube that’s housed within your abdominal walls – runs a good nine metres and harbours tens of trillions of gut microbiota [a community of microorganisms, including bacteria and fungi],” explains Dr Riccardo Di Cuffa, GP and founder of Your Doctor. “The gut is a hot house for a huge network of highly functioning cells and bacteria that work symbiotically to help our bodies digest food, produce particular vitamins, send our brain important messages and keep our immune system and general health in check. Each individual’s composition of the gut microbiota is unique, and can weigh up to two kilograms!”
The gut brain axis
Ever had an initial gut reaction to something, but dismissed it as nothing? It turns out that you should start paying more attention to those feelings. The gut isn’t known as the ‘second brain’ for no reason – in fact, it could be in charge of more decisions and feelings than you realise, including your cravings and mood. And, if your gut isn’t in its best condition, it can affect more than just your digestive system. So, how exactly is your brain connected to your gut, and how can you ensure that the link is a healthy one? We called in the experts to find out.
The second brain
“The brain controls and governs our digestive system,” says Dr Meg Arroll, health psychologist and author of IBS: Navigating your way to recovery. “However, it’s not only the brain that plays a part in the workings of our guts. The gut and the brain have two-way connections between them and communicate bidirectionally, like a telephone. The links are made via neurotransmitters, which release chemicals that transmit nerve signals across the central nervous system.
“When we talk about the gut-brain connection, we often call the actual brain ‘the big brain’, and the enteric nervous system located in the gut ‘the small brain’. This brain-gut-axis is involved in keeping balance and stability in the digestive system, appetite and weight control. The big brain is, of course, the most important organ in these processes, but we are beginning to learn more about how the microbiome also has an important role to play, not just in gut health, but in our overall health and wellbeing.”
The gut and mental health
“When we think of improving our mental health, we automatically direct our attention to things like meditation, sleep and work life balance, but one key ingredient we often don’t address is the impact our gut has on our mental health and wellbeing,” say the experts at Fresh Fitness Food. It’s something that we should all be looking at, though, thanks to the gut-brain connection, as it can have such an impact. “Mental stress, for example, alters the environment of our guts in favour of pathogenic microbes, makes our gut permeability to pathogens increase, and reduces mucus production,” the experts add.
“What’s more, gut diseases linked to dysbiosis [an imbalance] of our microbiome, such as irritable bowel syndrome and Crohn’s disease, have been proven to increase the risk of mental illnesses, such as anxiety and depression. Microbes also communicate with our brains by producing the same neurotransmitters that the brain uses; serotonin and dopamine – in simple terms, the hormones that make you feel happy. This is how your microbes can affect your mood, and partially explains why food makes us feel good!”
Irritable bowel syndrome symptoms
Irritable bowel syndrome is a collection of symptoms affecting an unhealthy gut. People with IBS can have difficulty digesting food or going to the loo. “There is no specific test for IBS,” explains Jo Travers, a specialist in gut health. “It’s sometimes affected by what we eat, or even by stress. It’s diagnosed using strict criteria that takes into account symptoms, triggers, and how often they occur. Your GP should test for and rule out coeliac disease and other inflammatory conditions like Crohn’s before diagnosing IBS. Treatment often depends on the individual, but many people find that changing their diet helps, and others find stress management techniques beneficial.” Symptoms of IBS include: bloating, wind, diarrhoea, constipation, abdominal pain or discomfort, and cramping.
How to improve gut health
“Improving poor gut health is key to transforming your overall health and wellbeing,” says Dr Megan Rossi, registered dietitian and co-founder of Bio&Me. “It starts with your gut microbiota – the trillions of microbes that live within us.” Try the following tips to improve your gut health today.
Eat more fibre
“We may not be able to digest fibre, but it’s what feeds your gut flora, which in turn produce these beneficial compounds for you,” say the experts at Fresh Fitness Food. “Most people will therefore benefit from an increase in fibre intake. The recommendation is 30g per day, but research suggests that in the UK we only get about two thirds of that. Dietary fibre is found in plant foods only, so load up on vegetables and unrefined, resistant starch to increase your intake.”
What is fibre?
“Fibre is a type of dietary carbohydrate, and carbohydrates can be broadly divided into sugars, starches and fibres,” explains Rick Miller, clinical and sports dietitian at the Institute of Sport Exercise & Health (ISEH). “The vast majority of carbs in our diets tend to come from plant-based foods, grains and cereal products, naturally occurring sugars in fruits and some vegetables, starchy vegetables (such as potatoes) and dairy products (which contain a special type of sugar called lactose).
“Naturally occurring sugars and starch are the ‘stored carbohydrate energy’ part of a plant. These sugars and starches are broken down easily in the small intestine when we eat them and provide an easy source of energy from food. But, unlike starches and sugars, fibrous carbohydrates make up the cell walls of plants. They are much tougher, and termed ‘indigestible’ because they’re resistant to our digestive juices – they can’t be broken down in the small intestine. So, we rely on the work of bacteria in our large colon to support the digestion of fibre. In turn, this supports a healthy gut microbiota colony.”
The two types of fibre
Fibre can be classed as two different types – soluble and insoluble. “Soluble fibre includes pectins and beta glucans and is found in foods such as oats, beans, lentils and fruits,” says Georgia Head, nutritionist at Fresh Fitness Food. “It dissolves in water to form a gel-like substance, which increases food transit time between the stomach and the small intestine. This process slows the absorption of glucose into the bloodstream, which helps to keep you feeling fuller for longer (or at least until lunchtime rolls around) and also promotes more stable blood sugar levels. It supports the growth of the healthy bacteria required for optimal gut health.
“Meanwhile, insoluble fibre includes cellulose and lignins found in wholegrains, vegetables and nuts. As the name suggests, insoluble fibre doesn’t dissolve in water. It remains relatively intact and so speeds up the passage of food through the digestive tract. This helps to maintain good gut health by increasing stool bulk and promoting regularity, and preventing constipation. Most fibre-rich foods usually contain both types of fibre, but the amounts of soluble versus insoluble varies.”
Why do we need fibre?
It’s all well and good saying that we should eat more fibre, but do you know why that is? “Short term benefits include a reduction in the amount of cholesterol in the blood, as fibre absorbs some of it in the gut, lubricating the gut and helping to naturally support stool movement out of the gut,” explains Rick. “It can also help the bowel contents to swell, promoting fullness, which may support weight loss, and it slows the release of other sugars into the bloodstream, controlling blood glucose levels.”
If that wasn’t enough, fibre can also help to decrease your chance of certain diseases. “The European Food Safety Authority suggests that incorporating fibre-rich foods in a healthy balanced diet can improve weight maintenance and help reduce the risks of cardiovascular disease, type 2 diabetes and bowel cancer,” says Melanie Bulger, nutrition manager at Clasado.
“Fibre is also important because it can help increase the beneficial bacteria in our gut, and a healthy microbiome has been shown to be important for boosting immunity, as well as improving both our digestion and mood.” And what happens if we’re not consuming the right amount? “If we don’t get enough in our diets, it can result in constipation, decreased diversity of beneficial gut bacteria and increased risk of developing certain health conditions,” warns Kristy Coleman, nutritionist at KC Nutrition.
Avoid late night snacks and drinks
“Eating late at night prevents your gut from regenerating, which contributes to bloating, gas and food intolerance,” says Dr Di Cuffa. “Give your gut a break to kill unwanted harmful bacteria and help the natural regeneration needed for healing digestive problems, such as inflammatory bowel diseases and leaky gut syndrome.”
Eat as many plant based foods as you can
“Every week, aim for 30 different types of plant-based foods full of gut-loving fibre and prebiotics, including fruit, vegetables, wholegrains, legumes, nuts and seeds,” says Dr Rossi. “You see, the more plant-based variety in your gut health diet, the more diverse your range of gut microbes, which is linked to the health of pretty much every organ in the body, including your skin, heart and brain. Make simple swaps, such as snacking on mixed nuts instead of just one type, going for yellow, orange and green peppers in your stir-fry instead of just red, and sprinkling mixed seeds onto your breakfast.”
Say no to restrictive diets, detoxes or cleanses
“Looking after your gut health is all about inclusivity and moderation,” says Dr Rossi. “Overly restrictive diets not only starve your gut bacteria and put you at risk of nutritional deficiencies, but they can also create a damaging relationship with food. Your kidney and your liver – the main detoxing organs – do just fine with your body’s detoxification without expensive juice diets or colon cleanses. Carbs have been unfairly stigmatised too, but they’re not to be feared! Fibre is a type of carbohydrate which nourishes our gut microbes and keeps them happy. Whole grains and legumes (two key sources of carbs) have also been linked with lower bodyweight.”
Boost your sleep quality and de-stress
“Sleep and stress can have a big impact on our gut health,” explains Dr Rossi. “To help combat stress and rewire the gut-brain axis, just 15 minutes a day of meditation (or using a mindfulness app) has been shown to make a significant difference after eight weeks. Try improving your sleep quality by setting a regular bedtime routine with relaxation exercises, limiting caffeine after 3pm and scheduling ‘worry time’ during your day to write down your thoughts and free up your head space before bed.”
Try eating fermented food
“These days, most of us know that if you want to be happy and healthy, you need to look after your gut,” says River Cottage’s nutritionist Naomi Devlin. “But what exactly keeps your gut happy, and how do you fit that into a busy schedule? There are two simple words to remember when it comes to nourishing your gut: prebiotic and probiotic. Prebiotic food provides friendly microbes with the soluble fibre they like to munch on, and feeding them well keeps your gut biome balanced and healthy. You’ll find prebiotic fibre in lots of everyday foods, such as onions, garlic, leeks, asparagus, cabbage, kale, broccoli, pulses, fruit, seeds and roots, including salsify, celeriac and Jerusalem artichokes.”
How to introduce fermented foods to your diet
However, Naomi points out that, if you don’t eat many of these foods at the moment, you should begin by slowly increasing the amount you consume to avoid any bloating. “Probiotic food contains the microbes themselves, usually because it’s been fermented,” adds Naomi. “Fermented food might sound unfamiliar, but it’s probably already part of your diet in the form of yoghurt, cheese, tea, coffee, chocolate or olives. The important thing to look for when you buy fermented food is that it has not been heat-treated by pasteurisation or roasting, so that the microbes remain alive. You’ll usually find it in a fridge.
“Ferments like sauerkraut and kimchi combine prebiotic cabbage with the probiotic bacterium used in the fermentation, making them perfect gut tonics that should be eaten little and often, as they contain higher levels of salt than unfermented food. Fermenting transforms indigestible elements of food so that we can absorb nutrients better, as well as preserving nutrients and enzymes in food better than canning or drying does.”
Health benefits of fermented food
There are further health benefits to these foods, too. “Fermentation of the milk sugar lactose by the digestive enzyme lactase makes it easier to digest for lactose intolerance sufferers, with one study showing kefir reduced perceived severity of flatulence by 54 percent,” says Natalie. “Fermented vegetables are said to improve digestion if eaten with a meal; particularly meals high in animal protein. Vegetable fermentation is known to begin the breakdown of the vegetables, particularly fermentable carbohydrates, making them easier to tolerate for those with sensitive IBS.”
And it’s not just food you should be looking out for: “There are also fermented drinks that are particularly good for repopulating the gut, such as milk and water kefir, kvass and kombucha – these should ideally be drunk on an empty stomach first thing in the morning, 15 minutes before eating,” suggests Naomi.
Move your body
“We all know exercise is good for us – and our gut microbes benefit from it, too,” says Dr Rossi. “Exercise helps to regulate your bowel habits and increase the diversity of your gut microbes, which is linked to better overall health. Sustained exercise is key, so move your body regularly, getting your heart rate up for at least 30 minutes most days. Gut-directed yoga, as I share in my book, has also been found to be equally as effective as diet changes for reducing IBS symptoms.”