Your Gut Health Matters! (Part 3)

This is the third and final part of my gut health mini series! Part 1 covered the importance of gut health and some of the things that can go wrong with it. In Part 2, I provided some of the signs and symptoms of an unhealthy gut as well as some tests that can be done at home to assess your own gut’s integrity. So if you haven’t already read those, be sure to check them out prior to reading this post, which is all about how to improve gut health.

Healing Your Gut

If you find that you have some problems with your digestion, there are ways that you can improve your symptoms. However it is important to keep in mind that gut healing does not happen overnight. The process can be quite lengthy and requires a decent amount of patience. Gut healing is also a bio-individual issue, meaning that each person will have different needs and respond differently to certain interventions. This is why it is always best to work with a coach or consultant so that you can have an objective view on your body’s responses. If your symptoms are not in your digestion, then it is even more important to work with someone because it is possible in such cases that your issues lie elsewhere. But if you directly feel your discomforts somewhere along your digestive tract, you can make efforts to improve your gut on your own, while assessing your progress along the way. I’d also like to note that the changes that are made during this process are not set in stone for the rest of your life. They are a temporary therapeutic intervention for improving your GI tract, so do not panic. I personally do not believe that any diet in particular should be complacently adopted for life.

My main source for outlining the gut healing process is Dr. Michael Ruscio, who is a researcher and practitioner who specializes in gut health and has loads of useful information, so if you’d like to learn more than what is provided on this post, click here to visit his website and take a deeper dive into his work.

Dietary Changes

The very first thing that should be done to improve gut health is to remove food triggers, meaning you should identify which foods make you symptomatic and eliminate them. Your approach to this depends on where you are currently.

If most of your current diet looks like the standard American diet, then you are pretty much setting yourself up for digestive upsets. This may be the root cause of your issues and might be the only thing that you have to change to remove your symptoms. Start by switching over to a whole-foods based diet. This should be the dietary foundation for anyone concerned with longevity and maintaining health. Ideally, a whole-foods based diet will remove processed foods (cereals, pastas, chips, pastries, processed meats, etc.), and emphasize home-cooked meals as opposed to relying on shelf-stable products. Do this by eating foods that do not have a label or that only contain one ingredient (e.g. rice). Dr. Ruscio recommends that a person continue adhering to this diet until improvements plateau, sticking to it for at least 3 weeks. If after doing this for about 3 weeks, you have not noticed improvements or your improvements have plateaued (but you’re still symptomatic), then you can move on to adopting a whole-foods based Paleolithic diet. Otherwise, if you are pretty much symptom free, then you can start to relax a little bit and experiment with digestive-aiding/gut-healing foods, which I will list towards the end of this post. Once you’ve done this and your digestion feels optimal, you can incorporate some indulgent processed foods in small amounts, if you’d like. Keep in mind that doing so may or may not trigger digestive upsets once again.

A paleo diet can be very beneficial for easing digestive symptoms because it removes foods that commonly upset the GI tract. It excludes all grains, dairy, legumes, refined sugars/sweeteners, and common food additives. For a list of some of these additives, read my post Common Food Additives to Avoid. Keep in mind that there are things like “paleo brownies” and “paleo chips”, etc., which can contain things that might trigger symptoms like natural sweeteners (e.g. maple syrup, honey) and “paleo” additives (e.g. guar gum, xanthan gum). It’s because of this that during this process you should continue to follow a whole foods based diet underneath the paleo diet. Continue following this diet until your improvements plateau, following it for at least 3 weeks. If after doing this for about 3 weeks, you have not noticed improvements OR once you have plateaued (but you’re still symptomatic), then you can move on to a whole-foods based, paleo, low-FODMAP diet. Otherwise, if at this point you find that your symptoms are gone, then you can move to the probiotics section of this post.

A low-FODMAP diet can be very helpful for people experiencing digestive issues during the healing process and should not be continued long-term. The goal should be to eventually reintroduce the high-FODMAP foods without adverse effects. Following a low-FODMAP diet for an extended period of time may have some long-term negative effects on the diversity of the gut microbiome, although there is still some controversy on the subject.. So what is this diet? “FODMAP” is an acronym for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. The level of FODMAPs in different foods varies from close-to-none to high, with some vegetables having some of the highest FODMAP content. Chris Kresser of the Kresser Institute has created a very useful chart for FODMAP content of common foods. Click here to access the full PDF.

lowfodmapchart1

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Notice how in this chart there are some foods that “may cause issues” meaning that you may or may not tolerate them well. So if you are in the process of removing your food triggers, this will require a bit of trial and error for determining what does and does not work. My advice is remove all the “Best Avoided” foods for 1-2 weeks, and then remove the “May Cause Symptoms” if symptoms persist. Stick to your customized low-FODMAP paleo diet until your improvements plateau, adhering for at least 3 weeks. Once you have plateaued OR after at least 3 weeks, it is time to introduce some probiotics.

Probiotics

It is essential that diet be addressed before introducing probiotics. I also would not recommend taking probiotics if you are experiencing chronic constipation, as it is important for that exit pathway to be open. After dietary intervention has taken place and there are no more noticeable improvements happening, introducing probiotics can be done in order to create a healthy diversity and balance of gut microbiota. But not all probiotics are created equally. There are so many different types of probiotics and they affect each individual differently. As Dr. Ruscio explains, there are three main subcategories of probiotics that seem to work well in improving gut issues, which are lactobacillus-bifidobacterium blends, saccharomyces boulardii, and soil-based probiotics. As Dr. Ruscio explains, one strategy you can use when adding probiotics is to introduce each of these probiotics separately to determine which ones work well for you. Start by adding a probiotic with lactobacillus-bifidobacterium and try that for a few days. It is normal to experience mild digestive changes when introducing a new probiotic, but if the symptoms do not normalize within a few days, then you can quit that probiotic and move on to a different category like saccharomyces boulardii strains. Conversely, if after a few days, the probiotic does seem to work well for you, then you can continue that first category of probiotic and try adding a saccharomyces boulardii strain on top of it. Continue this process until you’ve tried all three of the categories.

Choosing a probiotic brand

This is where it can get a bit complicated. There are so many probiotic brands on the market, some of which are very cheap in price, and others which are extremely pricey. On one hand, the consumer might be inclined to purchase the cheaper brands to save money, but on the other hand they might want to choose the costly one because it might imply a better quality product. So how do you choose a brand while ensuring that you’re not overpaying but also getting something that actually works? First let’s look at how probiotic supplements are regulated. They are considered food supplements, as opposed to pharmaceutical drugs and biotherapeutic agents, and therefore their efficacy and quality is not stringently considered during the regulation process. Because there are so many different strains of probiotic and their supplement forms are not tightly regulated, it is very likely that a probiotic supplement, if not carefully manufactured and not tested for its contents after processing, does not contain the contents listed on the label and is therefore completely ineffective. This makes it especially important to choose a brand wisely, one that expresses transparency, care, and integrity in the production of their products (which I’d argue is important for anything we consume), and undergoes third-party testing. Some reputable brands that you can look into are:

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If you are interested in purchasing a probiotic supplement, I would recommend choosing one these brands as opposed to simply picking one up at your local drugstore (because the odds are that those won’t do much for you). Some of these brands are available through amazon, and the others you can purchase on their individual websites.

Therapeutic Foods

In addition to all of this, there are some gut soothing foods that you can incorporate to supplement you on your journey.

Bone broth is my favorite therapeutic food for gut healing. It contains amino acids that are commonly scarce in our typical diets because of our tendency to eat mostly muscle meat and exclude other animal parts from our diets. One of these is glutamine, which is an anti-inflammatory amino acid that is the preferred fuel source of the small intestinal cells and has been shown to aid in healing intestinal hyperpermeability and can also help curb cravings for sugar and alcohol (which can damage gut health). Proline is another amino acid found in bone broth that aids in wound healing (including that of the gut) while also helping support and repair the bones, joints, tendons, skin, and nails. Also found in bone broth is glycine, an amino acid that helps in wound healing and supporting the liver, an organ that plays a crucial role in healthy digestion. Bone broth also contains arginine, which also aids in wound healing by stimulating the production and secretion of human growth hormone. Arginine can also help in relieving constipation and preventing liver disease.

Cinnamon is a spice that can be used post-meals to stimulate weak digestion, particularly in cases of heartburn and indigestion shortly after a meal. Of course, you can also use cinnamon in your cooking if you enjoy the flavor.

Cayenne can be used pre-meal or as a spice added to a meal to help stimulate the secretion of saliva and digestive fluids in the stomach. This can result in better food breakdown and absorption of nutrients.

Ginger & peppermint can also help stimulate weak digestion while encouraging healthy bile flow, which results in better fat digestion. Both ginger and peppermint can also aid in releasing gas and and reduce gastrointestinal inflammation.

Beets can be very supportive of gallbladder and liver function by increasing healthy bile flow, which can aid in fat digestion and the absorption of fat-soluble vitamins.

Apple cider vinegar & lemon before a meal can aid in creating an acidic environment in the stomach, which is crucial for healthy digestion and prevention of bacterial/viral/fungal infections.

Papaya contains papain, an enzyme that can help break down protein as well as kill off parasitic worms.

Dandelion root helps the gallbladder release stored bile, and thus can help in gallstone prevention. It also contains inulin, which encourages the growth of the gut bacteria bifidobacterium and lactobacillus.

While these foods can aid in healing the gut, they must be consumed only if they’re tolerated. If you notice that any particular food is triggering your symptoms, it is best avoid it until your digestive tract has regained its integrity.

Reintroducing Foods

Once you feel confident in your gut’s integrity, you can start to reintroduce some of the foods that were once problematic for you. This must be done slowly. Do this by introducing 1 food at a time in small quantities. If after a few days of consuming the food, you don’t notice any detrimental effects, then you can introduce a second food as well, and continue this process. If at any point you experience digestive upsets, then scale back by decreasing the amount of that particular food or quitting it altogether, at least for the time being. Ultimately, the goal is to consume the most diverse diet possible without experiencing any detrimental effects. And this can be done. I can tell you from my own personal experience that there have been foods that I did not tolerate at certain times of my life that I can now consume daily with no issues.

I cannot stress enough that the diet is the very first thing that should be addressed when dealing with digestive problems. Simply skipping to probiotics or therapeutic foods will probably be ineffective at improving your GI tract and may even exacerbate your symptoms. If after incorporating all of this, you still feel like you need more support, I strongly recommend that you check out Dr. Michael Ruscio’s work, which contains so much more useful information regarding this topic. I also recommend that you work with an understanding holistic nutritionist/practitioner that can look at your situation objectively and guide you throughout your own bio-individual gut healing journey.

If you found this helpful, have anything to add, or have any questions, I would love to hear from you in the comments section below!

References
De Simone, C. (2019). The Unregulated Probiotic Market. Clinical Gastroenterology and Hepatology, 17(5), 1542-3565, 809-817. doi:https://doi.org/10.1016/j.cgh.2018.01.018
Haas, E. M., MD, & Levin, B., PhD, RD. (2006). Staying Healthy with Nutrition: The Complete Guide to Diet and Nutritional Medicine (21e ed., Vol. 1). New York, NY: Ten Speed Press.
Tamayo, C. (2008). Clinical Research on Probiotics: The Interface between Science and Regulation. Clinical Infectious Diseases, 46(Supplement_2), 1058-4838, S101-S103. Retrieved March 26, 2019, from https://doi.org/10.1086/523332.
Tong, B. C., & Barbul, A. (2004). Cellular and Physiological Effects of Arginine [Abstract]. Mini Reviews in Medicinal Chemistry, 4(8), 823-832. doi:https://doi.org/10.2174/1389557043403305
Rao, R., & Samak, G. (2011). Role of Glutamine in Protection of Intestinal Epithelial Tight Junctions. Journal of Epithelial Biology & Pharmacology, 5(Suppl 1-M7), 1875-0443, 47-54. doi:10.2174/1875044301205010047
Ruscio, M., DC. (n.d.). Dr. Michael Ruscio, DC: Get Healthy – and Get Back to Your Life. Retrieved from https://drruscio.com

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