The idea of balancing overall gastrointestinal (GI) health is something we can all strive for but may not fully attain. Researchers are discovering breakthroughs every day, and this will likely always be the case. The good news is registered dietitian nutritionists can help clear the air when it comes to the information we receive about GI health and how it relates to our own situation/symptoms. Learn how you can take small steps to improving your gut health related to IBS, pre/probiotics, fiber intake and nutritional supplements.
Cooper Clinic’s Gastrointestinal Nutrition Specialist, Gillian White, RDN, LD, CNSC answers a few questions to provide insight on this topic, specifically in young adults. White completed her undergraduate education at Texas Tech University with a degree in Human Nutrition and Dietetics. She then completed her internship and residency at Baptist Health Systems in San Antonio where she began her clinical practice. She became a Certified Nutrition Support Clinician (CNSC) and managed patient’s nutrition support including TPN (a form of medical nutrition therapy). Through her clinical practice she decided to pursue a specialty in GI.
Q: What is the biggest mistake you see people make when trying to solve GI problems?
A: People begin cutting things out of their diet. If you start cutting certain foods out you believe are the problem, and then get tested for conditions such as celiac disease, the issue might not show up on the test results. Gluten and dairy are the two foods people typically cut out first. If you are being tested for celiac disease, the test looks at the antibodies in gluten—gluten is a single protein found in wheat, barley and rye—If you cut gluten out of your diet, you may receive a false negative for celiac and not get to the root of the problem. Before you begin the “cut out” method, it is highly encouraged for you to see a nutritional specialist who may refer you to a gastroenterologist or allergist before taking your gut health into your own hands.
Q: Are there nutritional supplements that can make GI symptoms worse?
A: Unknowingly taking numerous types of probiotics and prebiotics can worsen the symptoms of people suffering from issues like irritable bowel syndrome (IBS). For instance, people with IBS have a higher rate of small intestinal bacteria overgrowth (SIBO). In the general health population people have a balance of good and bad microbes that keep each other in balance and are a part of the gut’s natural flora. You could consider the “good” microbes as your own native probiotics that keep the less beneficial microbes in check. If you have SIBO, your body has trouble keeping bacteria in the colon (where it is supposed to be). So, if you consume probiotics, it could introduce bacteria in the wrong place—like the small intestine. It is not harmful bacteria, but when they are in the wrong place it can worsen symptoms. However, certain strains of probiotics can help your GI tract but are condition specific. It is not the magic bullet as it helps some people and not others. To date there is no universal probiotic for general health as everyone’s gut flora is like a unique fingerprint and highly individualized. To get a better grasp on which strands of probiotics are most suitable for you, I recommend visiting usprobioticguide.com.
Q: What, in your opinion, are the best “gut foods” for normal functioning GI tracks and sensitive ones?
A: The foundational factor in maintaining good GI health is overall fiber intake. There are many subgroups of fiber, the big two being soluble and insoluble. Fiber has varying degrees of solubility which means how much they dissolve in water (they also vary in viscosity which means how gel-like they become in water) or how fermentable they are with bacteria.
For an individual with a normal functioning GI tract, it is important for your gut health to have diversity of the fiber subgroups in your diet. On the other hand, if you battle IBS or inflammatory bowel disease (IBD) such as Crohn’s, you would most likely be advised to consume less insoluble fibers and more soluble—especially if you are experiencing a flare up. Since insoluble fiber does not dissolve in water, it does not change form and acts like an exfoliant in the GI tract. That is why it is good for a normal functioning GI tract and not for someone with pre-existing GI inflammation or increased sensitivity as it can be more irritating. Examples of insoluble foods are:
- Wheat bran
- Nuts
- Green beans
- Cauliflower
- Potatoes
Soluble fiber is beneficial for someone with Crohn’s disease, other GI issue, and gut health in general because it can help produce anti-inflammatory substances called short-chain fatty acids (SCFAs) when broken down by gut bacteria and may lower intestinal inflammation. Soluble fibers can be easier to digest because it is gentle and gel-like to avoid obstructions in the intestine or bowel. Its gel-like properties are the reason soluble fibers help regulate blood sugar levels and lower cholesterol because the fiber can slow the absorption of sugar and help improve blood sugar levels. SCFAs may also assist in strengthening the immune system through the gut (which makes up 70% of our overall immunity).
Most foods have a combination of both insoluble and soluble fibers. For example, the skin of most fruits, such as apples, is insoluble fiber while the inside is soluble. Some good food sources of soluble fiber are:
- Black beans
- Chia seeds
- Brussels sprouts
- Avocados
- Pears
We encourage you to talk with a registered dietitian nutritionist to determine the best next step to take with your diet!
Q: In a basic diet, is there a certain vitamin or supplement someone should take to make up for a deficiency?
A: The most common vitamin deficiency is vitamin D. Although you can obtain vitamin D from the sun, there are limited food sources. You can absorb some vitamin D by eating mushrooms, fortified dairy products and egg yolks in moderation. To make up for what you don’t consume in your diet, a supplement may be necessary. To explore vitamin D further, read the Decision article called “The Power of Prevention” by Kenneth Cooper, MD, MPH, and his advice on vitamin D supplements.
Q: Is “coating” your stomach by drinking pressed juice a viable way to prevent bloating before eating a meal?
A: There is no research or evidence to support this, so most likely not. There is really nothing food-wise that can “coat” the stomach. This is an example of where science and marketing clash because over-the-counter supplements and nutrition trends do not always cater to everyone. Bloating can tell you a lot about the origin of your digestive troubles and help narrow down the best plan of action for improving symptoms. If you are struggling with bloating on a day-to-day basis, doctors may encourage taking Simethicone (Gas-XÒ) before eating meals as a preventive measure.
A few key take-aways for those who suffer from GI distress include diversifying one’s intake of fiber subgroups, do not cut out certain foods before you are tested, pay more attention to science over marketing and most importantly, talk with a registered dietitian nutritionist.
To schedule an in-person consultation or tele-visit or to learn more about Cooper Clinic Nutrition, visit cooperclinicnutrition.com or call 972.560.2655.
For more information about services and screenings offered at Cooper Clinic, visit cooper-clinic.com or call 972.560.2667.
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