Gut health is a hot topic these days as increasing evidence links the health of our digestive systems to immunity, chronic disease risk, and overall mental and physical well-being. So how can we optimize gut health? Let’s start by uncovering how the gut works.
What is the gut?
The gut is also known as the digestive system or gastrointestinal (GI) tract, which is a long tube that goes from the mouth to the anus. The average adult digestive tract is about 30 feet long and its main purpose is to help us digest and absorb nutrition from food and beverages. The whole digestive process can take up to three days. The Native Hawaiian word for gut is naau which is thought to be the intersection of body, mind, and spirit. Interestingly, studies show that there is a strong gut-brain connection where communication is a two-way street. If you’ve ever felt butterflies in your stomach when you’re nervous or anxious, then you’ve personally experienced this connection. In fact, individuals who struggle with digestive disorders may have higher rates of depression and anxiety. A healthy gut also protects us from harmful bacteria and viruses in our food and environment.
Food can take 24-72 hours to move through the digestive system.
Gut microbiome
There are 10-100 trillion bacteria, viruses, fungi, and microbes that make up the gut microbiome. This community of microbes, primarily in our large and small intestines, is unique to each person. The composition of your microbiome is influenced by multiple factors including how you were born (vaginally or C-section), genetics, nutrition, environment, age, and medications. Certain medications such as antibiotics can temporarily wipe out the microbiome. The balance of bacteria and microbes within our gut microbiome is a key factor in maintaining a strong digestive and immune system. One of the best ways to keep your gut microbiome healthy is through nutrition.
Nutrition for gut health
The foods that we eat daily have a direct impact on our gut health. The Standard American Diet (SAD) is high in processed foods, added sugars, unhealthy fats, and often low in fruits, vegetables, and fiber. This eating pattern increases inflammation or a state of stress in the body, which has been associated with increased rates of chronic diseases such as cardiovascular disease, type 2 diabetes, kidney disease, and gastrointestinal disorders. Eating more traditional and plant-based foods may help to improve gut health, especially foods high in probiotics, prebiotics, and fiber.
Probiotics
The term probiotic means “for life.” Probiotics are friendly bacteria that live throughout our bodies and digestive systems. They are also found naturally in certain fermented foods such as yogurt, kefir (a yogurt-like drink), kombucha, poi, kim chi, sauerkraut, and fermented soy products such as natto and miso. There are over 500 species of probiotics, and different strains may have benefits for different health conditions such as constipation, diarrhea, lowering cholesterol levels, and weight management. However, more research is needed to determine which specific strains and dosages of probiotics are appropriate for managing different health conditions. There may also be potential GI side effects of having too many probiotics such as gas and bloating. For the average healthy person, you can start by incorporating one serving of a probiotic food daily and increase as tolerated. If you’re interested in taking a probiotic supplement, speak with your doctor or health care provider for suggestions.
Check out these Ke Ola Mamo and Island Scene probiotic-rich recipes:
Prebiotics
If probiotics are “friendly bacteria” within our gut, prebiotics are the food for those bacteria. Prebiotics keep probiotics happy and healthy so they can multiply and proliferate. They’re a type of fermentable fiber found in plant foods such as apples, bananas, onions, garlic, leeks, asparagus, seaweed, and whole grains. When probiotics are combined with prebiotics, they’re called “synbiotics” and can have significant benefits for digestive health.
Fiber
Fiber is another key component to improving gut health. The average American consumes between 10-15 grams of fiber per day, which is significantly less than the USDA’s recommended daily fiber intake of 21-38 grams. Fiber can help with constipation and can potentially lower cholesterol and blood sugar levels. Good dietary sources of fiber are fruits, vegetables, beans, nuts, seeds, and whole grains such as oatmeal, brown rice, and whole wheat bread. If you’re increasing your fiber intake, make sure to do so gradually while also increasing your fluid intake to help prevent excessive bloating or gas.
Summary of foods high in probiotics, prebiotics, and fiber.
Nutritional management of common digestive issues
Constipation
Constipation is an unpleasant GI condition that most people experience at some point in their lives. Increasing fiber, fluids, and probiotic/prebiotic foods can potentially help with relieving constipation. Occasionally medications may be necessary to help with severe constipation, speak to your health care provider for specific recommendations.
Diarrhea
With diarrhea, the most important thing is to replenish lost fluids and electrolytes. Some fluids that can help are soups, electrolyte drinks, decaf teas, and coconut water. The BRAT diet (bananas, rice, apple sauce, and toast) is easy to tolerate and can help solidify stools. Probiotic foods may also have a benefit for managing diarrhea. If you have prolonged diarrhea, bloody diarrhea, or diarrhea with a fever, make sure to call your health care provider.
Lactose intolerance
Lactose intolerance is one of the most common gastrointestinal conditions worldwide. About 70% of people worldwide are lactose intolerant especially people of Asian, African American, American Indian, and Hispanic descent. Lactose is a type of sugar found in dairy products such as milk, yogurt, cheese, and ice cream. People who have lactose intolerance may not produce enough of an enzyme called lactase which helps to digest lactose. As a result, if they consume lactose containing foods, they might experience gas, bloating, abdominal pain, or diarrhea.
For people with lactose intolerance, it's helpful to choose lactose-free products or plant-based options such as soy, almond, oat, or rice-based beverages and foods. Some people also take over-the-counter lactase supplements before eating dairy products to reduce GI symptoms. Each person has varying levels of lactose intolerance, and some might be able to eat small amounts of dairy products without GI distress.
Take care of your gut
Research continues to show a direct relationship between the health of our digestive system and our overall health. Take small steps to improve your gut health by eating foods high in probiotics, prebiotics, and fiber. Check with your health care provider about when you should get your first colonoscopy, based on your risk; the United States Preventive Services Task Force and the American College of Gastroenterology highly recommend initiating screening at age 45. You can also speak with your health care provider about how you can improve your gut health and nutrition. They can refer you to a gastroenterologist or a registered dietitian if you have more specific questions.
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Ke Ola Mamo is a nonprofit organization that has been serving the community for more than 30 years. Founded through the Native Hawaiian Health Care Act of 1988, Ke Ola Mamo is one of five Native Hawaiian health care systems in Hawaii supported by Papa Ola Lokahi. They have a medical clinic and offer health and nutrition education, Native Hawaiian healing practices, and more. Learn more about Ke Ola Mamo services and programs.
Photos courtesy Ke Ola Mamo
Kristie Yeung is a registered dietitian for Ke Ola Mamo and sees patients out of the medical clinic at Kuakini Medical Plaza. She was born and raised in Honolulu and has worked as a dietitian in Massachusetts, Indiana, and Maryland in clinical nutrition, maternal and infant health, and public health nutrition. Yeung moved back home to Oahu two years ago and loves working with the community and helping patients achieve their health goals.
