GOOD GUT

The gut has increasingly become an area of interest as Australians seek to better manage digestive and dietary related issues.

We are what we eat, the old adage goes – and Australians, it seems, are more aware of it than ever.

In growing numbers, we declare ourselves to be vegetarian, vegan or pescatarian. Many of us have been diagnosed as – or believe ourselves to be – lactose intolerant, coeliac, prone to Irritable Bowel Syndrome (IBS), or are allergic to or intolerant of foods such as wheat, gluten or fructose.

And research shows that looking after our gut is vital for our optimum physical and mental health.

Marina Payne, dietitian at Camberwell Junction Medical Clinic, said so much research is happening in this space that “we’re learning something new every day”.

“Our gut microbiome seems to impact so many of our bodily systems, such as our immune system and heart health,” Ms Payne said.

“Currently, there is a lot of interest around the gut-brain axis, and the impact on brain health and mood. Ensuring your gut microbiome is in good health is, therefore, super important.”

Ms Payne said there is a lot of work still to be done in the area of gut function, and because of that we should be careful of overinflated claims surrounding microbiome testing and food sensitivity testing.

“My advice would be to see an accredited practising dietitian prior to going through with any of this type of testing or food restriction. These tests aren’t cheap and there’s a lot of misinformation out there,” she said

She also warns against fad diets and quick-fix life-changing claims. “Really, we should only eliminate foods for medical reasons,” she said.

“No one diet is best for health. Cutting out food groups completely can actually negatively impact on gut health and the diversity of your gut microbiome.

“Each bacterial species requires different nutrients to grow. If, for example, you only ate bananas every day, you’d end up with only banana loving bacteria. Variety is key.”

Fibre is vital, Ms Payne said, and the way to get most of our fibre is from vegetables, fruit, and wholegrains.

“Fibre is great for energy and mood stabilisation, keeps you satisfied between meals, helps control blood sugar levels, lower cholesterol, lower blood pressure, and of course keeps your digestive system functioning at its best,” she said.

The dietitian recommends including all of the five core food groups, with a special focus on increasing plant intake and plant variety for optimum gut wellness.

“It has been shown that including at least 30 different plant-based foods each week improves gut bacteria diversity, which is linked to a healthy gut microbiome,” she said.

“Wholegrains like multigrain bread, wholewheat pasta, brown rice, barley, couscous, whole bran and rolled oats are great food sources for our good bacteria.”

Ms Payne said while there is limited clinical evidence and more research to be done, fermented foods like yoghurt, kefir, kimchi, sauerkraut and kombucha look promising for improving gut health.

Dietitian Marina Payne

DIET THERAPY ON THE RISE

Dr Jane Muir, a nutrition researcher at Monash University has been exploring the gut since 2001.

She is part of the world-renowned FODMAP research team developing new diet therapies to treat and control diet-related gastrointestinal dysfunction.

A major focus has been the study of poorly absorbed short-chain carbohydrates known as FODMAPs (Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols) and the impact of these on the gastrointestinal tract.

Dr Muir and the team created a comprehensive FODMAP food composition table that has been shared around the world via the Monash University FODMAP diet app.

She believes people have become more comfortable talking about gut issues but warns rather than consulting ‘Dr Google’ and diagnosing ourselves, we should talk to our GP about problems.

“The medical profession has become accepting of good diet therapy and a good GP is happy to refer a patient to a dietitian,” Dr Muir said.

“A proper and confident diagnosis is very important before someone proceeds with a dietary approach. Serious conditions such as colon cancer and other cancers, inflammatory bowel disease, endometriosis and other things could be the cause of the pain.”

When Dr Muir began researching FODMAPs there was little for gastroenterologists to offer IBS sufferers.

“Now diet is the first line of therapy in Australia and is really explored,” she said.

“You need a multi-disciplinary team to help people with IBS and some need more help than others.”

Finding FODMAPs that trigger an individual’s IBS is done in conjunction with a dietitian, and the process of eliminating the foods and reintroducing them to a diet is generally a three-phased program.

“It is all about gaining knowledge about what foods to avoid, what your trigger foods are, rather than just being handed a diet to follow,” Dr Muir said.

“At the end of the process the person is informed and comfortable knowing they can manage their IBS.”

One of the best things we can all do to improve our gut health is eat more fibre, Dr Muir said – ideally five serves (75g is one serve) of vegetables and two serves of fruit a day.

“Drink plenty of water and keep active, too,” she said.

FOODS TO FIT A DIET

Finding the right foods to cater to dietary requirements is thankfully easier than it has ever been.

In Camberwell shopping precinct, finding gut-healthy ingredients is pretty effortless, with stores such as The Source Bulk Foods and Great Earth offering variety.

Bec Corbett, co-owner of The Source Bulk Foods in Camberwell, said her customers are often well-informed and know what they want, in terms of healthy eating or catering to dietary requirements.

Products such as green banana flour, bran, psyllium husk, slippery elm powder, and kombucha are popular items.

Ms Corbett said people who are trying to transition to a healthier way of eating usually come in looking for “healthy swaps – alternatives for foods they are already eating”.

"For example, someone who normally would eat a processed breakfast cereal can try an untoasted muesli with fresh fruit. Someone who might snack on a muffin mid-morning could try a less processed wholefood-based snack such as paleo balls or homemade granola bars,” she said.

Major supermarkets, including Coles, Woolworths, and Aldi, are now also stocking a wide range of dietary-specific foods. Products that cater to gluten free, low fructose, and dairy free diets, for example, have now become staple items on shelves and are often found in the health food aisle.

What comes next for this area of gut health is anyone’s guess, but one thing is for certain: the demand for dietary-friendly food is here to stay.

No one diet is best for health. Cutting out food groups completely can actually negatively impact on gut health and the diversity of your gut microbiome.

- Marina Payne