Natural Solutions to Improve Gut Health

First, what is gut health?

Gut health has been a buzzword in the health and wellness world lately. We are learning more and more that gut health can be an important factor in overall health and wellbeing. But what is it? Here, I break down gut health for you into three different parts.

First, gut health refers to the microbiome. The gastrointestinal tract is home to a complex system of bacteria, known as the gut microbiome. This system of bacteria helps to digest food, protect against disease, and regulate the immune system. When the gut microbiome is balanced and healthy, it can help to reduce the symptoms of digestive issues, such as IBS.

Second, gut health refers to the health of the intestinal lining itself. The epithelial layer and smooth muscle. Are these cells and muscles acting as they should? Are the cells creating mucous to protect your body from irritants and toxins? Are the junctions between the individual cells functioning and keeping things out of our blood stream that should be, while allowing in essential nutrients? And is the smooth muscle of the gut contracting and relaxing at a regular rate to move matter through our system?

Lastly, gut health refers to the gut-brain axis, or the gut-brain connection. This is a term for the two way signaling between our gastrointestinal lining and our brain. Much of this messaging occurs through our nervous system (e.g. nerve endings and neurotransmitters, like serotonin), especially via the vagus nerve. This nerve directly connects the gastrointestinal tract and the brain and is involved in involuntary actions within our body like breathing, heart rate, and digestion. Additionally, messages are being sent via immune system signaling and hormones, such as GLP-1, ghrelin, and neuropeptide Y.

What are signs of an unhealthy gut? How do you know if your gut needs improvement? Below are some correlated signs and symptoms of an unhealthy gut.

1. Digestive issues that occur frequently (at least 1 day a week) include:
   • Unpredictable digestion, including constipation, diarrhea, or a mixture of both. Please note that constipation doesn’t only mean you don’t go to the bathroom. It can also mean that you are going to the bathroom daily, but that your stool may look like rabbit pellets or that you are having trouble evacuating your bowels.
   • Bloating, more specifically severe bloating, as slight bloating and distension is normal. It can occur after certain food triggers, gradually throughout the day, or immediately from the first bite of food or sip of fluid in the morning. 
   • Abdominal pain, discomfort, or any cramping associated with bowel movements. 
   • Low energy levels. Dysbiosis, or an imbalance level of bacteria within the gut, can be an underlying factor in both blood sugar imbalances and poor sleep. All factors can contribute to unstable energy levels. Additionally, patients dealing with IBS flares often present with fatigue as a symptom, potentially due to the distress caused by other GI symptoms.
2. Increased stress, anxiety, or depression:There is a bidirectional influence on gut health with mental health. Although there is still much to be studied and understood, we do know that of the people who have IBS, 84% have depression and 44% have anxiety. There is a major link between gastrointestinal issues, microbiome imbalance, and psychiatric disorders. 
3. Hormonal imbalances.Poor gut health is linked to endometriosis. One of the major issues associated with endometriosis is excess estrogen which is typically excreted via the GI tract. An imbalance of bacteria in the gut, combined with more pathogenic or harmful bacteria, can cause estrogen that has been “deactivated” to change back into its active form. The imbalance occurs when this “deactivated” estrogen is then reabsorbed back into the bloodstream.
4. Food allergies:Those who have a disrupted microbiome and immune response are more likely to end up with food allergies. 70% of our immune system lies within the gastrointestinal tract and a healthy microbiome helps to modulate our immune system.  When we lack bacteria in the gut due to not being exposed to enough bacteria or being overprescribed antibiotics, our immune system can go into overdrive. This can cause an increased inflammatory response and stretch our intestinal permeability, allowing the inflammation to spread throughout the body. 
5. Chronic skin issues. The connection between skin issues like eczema and poor gut health is a complex one. While the exact relationship is still being researched, there is evidence to suggest that the two are linked. It is believed that an imbalance in the microbiome can lead to or exacerbate skin conditions such as eczema. When the microbiome is out of balance, it can have a negative effect on the immune system, leading to an overactive immune response, inflammation, and irritation of the skin. 

These are just some of the signs associated with “poor gut health” and they come with a caveat. Health issues are multifactorial and complicated. Poor gut health can be a root cause of some health issues but keep in mind that it is just one piece of the puzzle. When it comes to health, there is usually no direct “cause and effect.” Typically many factors are going on at once that affect our health (psychosocial, environmental, behavioral). As with all issues pertaining to your health,  see a healthcare professional to help diagnose, treat, and manage your issues. 

Now, to the fun part…

How do we help to treat or maintain good gut health “naturally”?

As with all health issues, we have to take a holistic approach to good gut health. Yes, diet is important, but so are lifestyle factors like stress, sleep, and activity levels. The aim when starting to treat gut health should be to improve the density and diversity of our microbiome, lower inflammation in the gut, and calm the nervous system so that the digestive system works as effectively as possible. Here are a few starter tips for improving gut health: 

1. Fiber:We have to increase our fiber intake. Only 5% of Americans meet the recommended fiber goals, which are at least 25 grams for women and 30-38 grams for men. Why do we need fiber? The primary reason is that fiber helps to create more regular and solid bowel movements. It helps to create bulk in our stool and to bind everything together, improving both constipation and the solidity of loose stools. Additionally, fiber is our microbiome’s main fuel source! The bacteria in our gut uses fiber (which is mostly indigestible to humans) and create beneficial byproducts from it to improve the health of our gut lining. Do you want to improve the density of diversity of your microbiome? Fiber is the key, not probiotics.
2. Water:Water is essential for the smooth passage of stool. As a dietitian, I often see clients that are underhydrated also suffering from constipation. For soluble fiber (one type of fiber) to do its job of “gelling” together, it must resorb water. This can help to create a sense of fullness and tell our body to slow down or stop eating. With an increase in fiber, we must increase water intake. I typically recommend an increase of 8 ounces of water for every 3-5 grams increase in fiber. How much water do you need? Start with 1/2 your body weight in ounces.
3. Movement: If I could name the top three things to adjust to improve gut health, it will always be fiber, water, and movement. We tend to jump past the basics to more extreme measures (e.g. expensive supplements). That is a band-aid approach;  you may feel good at first, but without getting the necessary habits in place, you will be back at square one. Aim for five days of cardiovascular exercise to help improve the density and diversity of your microbiome, as well as increase blood flow to our gastrointestinal tract to improve motility (the movement of food through your GI tract via smooth muscle contractions). In addition to exercise, we want to reduce sedentary time as this is a major contributor to gastrointestinal disease and issues. Try to stand up every hour if you can.
4. Diet Diversity: I cannot stress this enough; you cannot get the varied types of fibers and micronutrients you need for a healthy gut from one or two types of foods. Eating a salad every day doesn’t cut it. The key is varying whole food sources and then colors within those sources. For example, your daily fruit intake should fluctuate throughout the week. Change it up. Blueberries have a very different makeup than bananas and we want both! You may have heard that we want to “eat the rainbow”, and that is a very good approach. Red foods like tomatoes, papaya, and red bell peppers are high in lycopene (a phytochemical that acts as an antioxidant) and vitamin C (essential for immune function and acts also acts as an antioxidant). A diet with varied phytochemicals is essential to preventing inflammation within the gut and helps to balance our microbiome by stimulating growth of beneficial bacteria and inhibiting growth of harmful bacteria. Additionally, different food sources have differing types of fibers, which feed different types of bacteria. For example, galactooligosaccharides within legumes (e.g. black beans) provide fuel to the bifidobacteria genus.
5. Stress Coping Mechanisms: As you’ve learned in this post, what happens in our gut affects our brain and vice versa. Stress maintenance can be essential to proper digestion and improved gut health through the regulation of neurotransmitters and hormones. Reducing stress helps us to turn on our parasympathetic nervous system, so that we can “rest and digest” properly. Specifically, techniques that modulate the vagus nerve (remember that direct line between gut and brain) can have anti-inflammatory and calming effects for our digestive tract. Two helpful techniques to improve vagal tone (the activity of the vagus nerve) are diaphragmatic breathing techniques and practicing mindfulness meditation.