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By Melissa Blake, ND

The evidence is overwhelming: diet matters. Much of the benefit of diet is related to the impact on the gastrointestinal system.

A few signs that your digestive system may not be working at its best include:

• Gas
• Bloating
• Discomfort
• Belching
• Cramps
• Changes in bowel movements (more frequent, less frequent, painful, urgent, loose, hard, changes in color, etc.)
• A bad taste in your mouth
• Changes in appetite

When it comes to optimal digestion, many foods and supplements support a strong digestive tract, while others do not and may even cause harm. This article is a discussion on the top five foods, or food-like substances, you may want to avoid or reduce for a happy and healthy gut.
“There is no medicine you can take that will replace what you can do for your own health.”―Aarti Patel

1. Refined sugar

Sugar is everywhere, and we are doing a terrible job when it comes to consuming it in moderation. The average American is eating sugar at a rate that far exceeds the daily recommended intake.1

The gut connection:
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Helpful bacteria in the gut rely on fiber as an energy source. Whole fruit, for example, provides natural sugars along with fiber, vitamins, and minerals. Refined sugar is just sugar, with all the good stuff removed. Essentially, a diet high in refined sugar provides little to no fiber and changes the food available to the gut microbiome. As a result, the good bacteria starve which leaves an opening for harmful bacteria to flourish.1

​2. Artificial sweeteners

Noncaloric artificial sweeteners arrived on the scene partly in an attempt to reduce the trend in weight gain attributed to sugar consumption.2 They unfortunately did not live up to their expectations.
Current evidence suggests these now common food additives contribute to changes in blood sugar that can result in an increase in appetite, a higher intake of calories, and unwanted weight gain.3 Wait! Is that not the opposite of the desired effect?

The gut connection:
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Much of this unwanted impact may be the relationship between artificial sweeteners and the microbiome. We are still not clear exactly how these sugar alternatives work against the gut bacteria. It might be that they harm the helpful bacteria or directly promote the growth of harmful ones.4
Either way, the results are not exactly the sweet story we were hoping for.

​​Artificial sweeteners are also known as: nonnutritive sweeteners, noncaloric sweeteners, and sugar substitutes.

​3. Alcohol
​
Alcohol affects human health by influencing the function of many organs and systems, but perhaps most importantly the gastrointestinal system.5

The gut connection:

Specifically, chronic alcohol intake disrupts the microbial balance, contributing to a remarkable shift in the gut community and an increase in intestinal permeability.5,6
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The resulting dysbiosis (imbalance in your digestive bacteria) has a negative impact on the production of important metabolites, including short-chain fatty acids and precursors to neurotransmitters and hormones.7   

In addition to the impact on the gut and associated dysbiosis, acute alcohol consumption promotes unsafe behaviors, is a stress on the liver, contributes to sleep disturbances, and is a source of sugar and empty calories.8 Not exactly news worth making a toast to.

​​4. Conventionally raised animal products
​
Animal products can provide a wide variety of important nutrients, including amino acids, B12, and iron. Problems can arise when a high intake of animal products leads to a lower intake of vegetables and other plant foods.

The gut connection:

Long-term adherence to high-protein diets, especially in the absence of plant fiber, contributes to an imbalance in gut bacteria.10,11 It makes sense, then, that a higher intake of meat, red and processed meats in particular, contributes to lower levels of protective metabolites and an increase in harmful metabolites produced by gut bacteria.12

It is not just quantity, but also quality that matters.

Conventional farming and the associated exposure to pesticides has implications for both the farmers and the environment,while organic farming promotes better animal welfare and a slightly better nutritional profile.13,14
​
A major concern related to conventionally raised animals is the extensive use of antibiotics that is contributing to resistant strains of harmful bacteria.15 Although research has not yet extensively studied the specific implications of prophylactic antibiotic use in animals to the gastrointestinal tract in humans, we can only assume this global health and environmental issue is also a gut one.15

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​5. Conventionally grown coffee

Now, let us talk coffee.

Conventionally grown coffee is one of the most heavily chemically treated foods in the world. Think synthetic fertilizers, pesticides, herbicides, fungicides, and insecticides that have short and long-term implications for farmers and local environments.16 Reason number one to choose an organic, fair-trade option.

Here are a few more reasons to keep coffee intake to a moderate level and always choose a quality option.

The gut connection:

Drinking coffee causes an increase in stomach acid. This might be okay for the average Joe, but too much acid can irritate the stomach lining and contribute to sensation of burning and digestive distress. This irritation does not stop at the stomach but can move along the entire digestive tract, contributing to its laxative effect and promoting cramps, spasms, and diarrhea.17

When it becomes a habit, coffee can contribute to dependency and symptoms of withdrawal when trying to reduce intake. Coffee is also a diuretic and can contribute to dehydration, especially as consumption increases and it starts to replace water intake.18
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In moderation, coffee can be a delightful morning ritual, but if you already suffer from stomach or digestive complaints, coffee is likely to make things worse.

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​Summary:
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Food choices play a huge role in gut health. Certain foods can wreak havoc on the digestive system by contributing to an imbalance in the microbiome, irritating the gut lining, and influencing the amount of digestive enzymes present.

An optimal diet goes beyond looking at food as simply a source of calories. Diet composition and quality are important factors to consider when it comes to optimizing function and promoting health.

Three takeaways to help improve your digestive health:

• Choose local, organic options when possible, especially animal products and coffee.
• Eat more vegetables. Aim for the ideal plate that includes 50% vegetables, 25% whole grains/starchy vegetables, and 25% protein as often as possible.
• Keep track of how you feel physically, emotionally, and mentally when you eat/drink certain foods or food-like substances. This knowledge will empower you to make decisions that best reflect your health and wellness goals.

References:

1. Di Rienzi SC et al. Adv Nutr. 2020;11(3):616-629.
2. Mooradian AD et al. Clin Nutr ESPEN. 2017;18:1-8.
3. Pearlman M et al. Curr Gastroenterol Rep. 2017;19(12):64.
4. Bokulich NA et al. Cell Metab. 2014;20(5):701-703.
5. Dubinkina VB et al. Microbiome. 2017;5(1):141.
6. Bishehsari F et al. Alcohol Res. 2017;38(2):163-171.
7. Qamar N et al. Behav Brain Res. 2019;376:112196.
8. Delker E et al. Alcohol Res. 2016;38(1):7-15.
9. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at http://health.gov/dietaryguidelines/2015/guidelines/.
10. Russell WR et al. Am J Clin Nutr. 2011;93(5):1062-1072.
11. Singh RK et al. J Transl Med. 2017;15(1):73.
12. Zeneng W et al. Eur Heart J. 2019;40(7):583-594.
13. Nankongnab N et al. J Agromedicine. 2020;25(2):158-165.
14. Mie A et al. Environ Health. 2017;16(1):111.
15. Seal BS et al. Anim Health Res Rev. 2013;14(1):78-87.
16. Hutter HP et al. Int J Environ Res Public Health. 2018;15(8):1641.
17. Boekema PJ et al. Scand J Gastroenterol Suppl. 1999;230:35-39.
18. Seal AD et al. Front Nutr. 2017;4:40.

Melissa Blake, ND

Melissa Blake, ND is the Manager of Curriculum Development at Metagenics. Dr. Blake completed her pre-medical studies at Dalhousie University in Halifax, Nova Scotia, and obtained her naturopathic medical training from the Canadian College of Naturopathic Medicine. Dr. Blake has over 10 years of clinical experience, specializing in the integrative and functional management of chronic health issues.

You’ve probably heard that vitamin C supports your immune system. This essential micronutrient seems to be everywhere! And it’s a good thing because, unlike most mammals, humans can’t synthesize vitamin C on their own.1 Also, vitamin C is water-soluble, which means the body quickly loses this essential vitamin through urine, so it’s important to make vitamin C a daily part of your diet.1
Having extremely low levels of vitamin C for prolonged periods can result in scurvy, a historical disease linked to pirates and sailors who faced long journeys at sea without fresh fruits and vegetables. While cases of scurvy in the United States are rare, a recent study reported that 31% of the US population are not meeting the daily recommended intake of vitamin C.1 Greater than 6% of the US population are severely vitamin C deficient, while low levels of vitamin C, associated with weakness and fatigue, were observed in 16% of Americans.2 As a whole, 20% of the US population showed marginally low levels of this essential micronutrient.2
How much vitamin C do I need?The US recommended daily dietary allowance of vitamin C is 75 mg for women and 90 mg for men.3 Experts recommend an estimated 200 mg of vitamin C daily for favorable health benefits.4 Adults can take up to 2,000 mg of vitamin C per day; however, high doses of vitamin C may cause diarrhea, nausea, and stomach cramps.5 Due to the varying health needs of individuals, it’s always a good idea to work with your healthcare practitioner to ensure that you are getting the right amounts of micronutrients in your daily diet.
Where can you find this marvelous, multifaceted micronutrient?

Written by Julia Mellios

Your gut is one of the hardest working systems in your body. Meal after meal, it hustles to digest your food and extract the nutrients required to sustain you. Despite it’s solid work ethic, your gut can experience occasional performance hiccups, leading to digestive symptoms. While many of these are normal, others may indicate something more serious. Read on to discover what your symptoms say about your gut and ways to improve them.

Normal, Everyday Symptoms

Transient Belly Bloating
​What is it? Short-lived abdominal swelling due to trapped gas.

• What causes it? During and after meals, your gut produces enzymes and acids that break down your food, creating gas during this process. While bloating isn’t considered normal, it commonly occurs if you deviate from your standard diet, such as eating larger portions, rich and fatty meals or foods that are more laborious to breakdown, including excess carbohydrates and fibre. These place more burden on your digestive processes, subsequently increasing gas production and bloating. 
• How do you improve it? While mild bloating generally passes with time, chewing your food thoroughly, consuming smaller meals and spacing out your carbohydrate and fibre intake can help.

During and after meals, your gut produces enzymes and acids that break down your food, creating gas during this process. While bloating isn’t considered normal, it commonly occurs if you deviate from your standard diet, such as eating larger portions, rich and fatty meals or foods that are more laborious to breakdown, including excess carbohydrates and fibre. These place more burden on your digestive processes, subsequently increasing gas production and bloating. 

Flatulence

• What is it? Farting.
• What causes it? Gas is produced by normal digestive processes, and ‘passed’ at regular intervals. Additionally, increased fibre, fat or sugar intake can create gas. Your microbiome (gut bacteria) also influences the amount of gas produced by fermenting foods to help your digestion.1
• How do you improve it? It is normal to pass wind around 15 times per day.2 Additionally, the odd smelly fart is no big deal, particularly if caused by an increase in refined, processed foods (who can say no to the occasional slice of pizza?). However, if you would like to reduce flatulence, moderate your intake of these foods.

Borborymus

• What is it? Stomach growling or rumbling.
• What causes it? The movement of food, liquid or gas through your digestive tract. Your gut may also ‘growl’ to signal hunger.
• How do you improve it? Give your gut a helping-hand by chewing your meals thoroughly, which helps break down your food more efficiently prior to digestion, and reduces gas. Additionally, satisfying your hunger will stop the growl.

Symptoms That Require Attention

Chronic Constipation

• What is it? The infrequent passage of hard poop (less than once daily), often accompanied by straining, a sense of incompletely emptying the bowel and discomfort.3
• What causes it? Insufficient fibre or reduced fluid intake can slow your transit time (the time it takes for your food to travel from your mouth through to the other end), making you less ‘regular’. Dysbiosis (an imbalance in the types and levels of gut bacteria) can also influence digestive processes and reduce your transit time.4 Additionally, chronic constipation is associated with irritable bowel syndrome (IBS), a condition that affects the function of the bowel.5
• How do you improve it? Consume more fibre-rich foods, including fruit and vegetables, and drink enough water. A prebiotic and probiotic supplement may also support bowel regularity and provide relief for symptoms of medically diagnosed IBS.

Diarrhoea

• What is it? Soft, loose or watery stool that occurs more than three times daily.
• What causes it? Diarrhoea may be a symptom of a bacterial or viral infection, such as gastroenteritis, or be related to certain medications, particularly antibiotics.6 Additionally, IBS and inflammatory bowel disease (IBD), a condition involving inflammation of the digestive tract, may cause diarrhoea.
• How do you improve it? IBS and IBD are serious conditions that require a professional diagnosis and care from a health Practitioner. However, if your symptoms are associated with antibiotic use, Metagenics Ultra Flora Intensive Care may help to restore healthy intestinal bacteria and relieve diarrhoea.

Malodorous Gas

• What is it? Farts that clear a room.
• What causes it? Your microbiome consists of a range of bacteria (38 trillion microbes!) that help digestion by fermenting your food, particularly fibre. Imbalances in the levels of different bacterial species can lead to increased gas production with a pungent odour.
• How do you improve it? Metagenics Ultra Flora Intensive Care provides three specific probiotic strains (types of bacteria), Lactobacillus rhamnosus (LGG®), Saccharomyces cerevisiae (boulardii) and Bifidobacterium animalis ssp lactis (BB-12®), which have been shown to help restore a healthy balance of bacteria within your microbiome.

Abdominal Pain

• What is it? Sharp, dull, stabbing, cramp-like, or twisting pain in your abdomen. Most people experience occasional gut discomfort, however severe gut pain that is episodic, regular or continuous requires assessment, particularly if accompanied by other symptoms such as fever, changes to your poop, nausea and/or vomiting.
• What causes it? Abdominal pain has many potential causes, the most common being gas pain, food intolerances or allergies, or indigestion. However, abdominal pain can also be a sign of something more serious, including appendicitis, gallstones, ulcers, infections, kidney stones, and many other conditions.
• How do you improve it? If gut pain has become a pattern rather than a one-off incident, seek guidance from a healthcare professional.

If you regularly experience one or more problematic symptoms, consult with a Natural Health Practitioner for further investigation, particularly if it is new or getting worse. Additionally, healthcare Practitioners have a suite of testing available to investigate the driver behind your symptoms. For instance, a stool test enables Practitioners to identify all of the bacteria and other microorganisms that inhabit your gut and how they contribute to your gut function and digestive symptoms.

Ditch the Gut Glitches
Don’t let your gut feelings bum you out! Instead, switch up your diet and lifestyle habits and rid yourself of symptoms such as bloating, gurgles and gas. If your gut symptoms are troubling you, speak with a natural healthcare Practitioner for a comprehensive plan to get you gut comfort, today.

References1 Manichanh C, Eck A, Varela E, Roca J, Clemente JC, González A, et al. Anal gas evacuation and colonic microbiota in patients with flatulence: effect of diet. Gut. 2014 Mar;63(3):401-8. doi:10.1136/gutjnl-2012-303013.
2 Victoria State Government, Better Health Channel. Flatulence [Internet]. Melbourne VIC: Victoria State Government, Better Health Channel; 2014 [updated 2014 Aug; cited 2020 Jan 30]. Available from: https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/flatulence.
3 Colledge NR, Walker BR, Ralston SH. Davidson’s principles and practice of medicine. 21st ed. Edinburgh (UK): Elsevier/Churchill Livingstone; 2010. p. 763-844.
4 Zhao Y, Yu YB. Intestinal microbiota and chronic constipation. Springerplus. 2016 Jul 19;5(1):1130. doi: 10.1186/s40064-016-2821-1.
5 Colledge NR, Walker BR, Ralston SH. Davidson’s principles and practice of medicine. 21st ed. Edinburgh (UK): Elsevier/Churchill Livingstone; 2010. p. 763-844.
6 NPS Medicinewise. What are the side effects of antibiotics? [Internet]. Sydney NSW: NPS Medicinewise; 2012 [updated 2017 Mar; cited 2020 Feb 18]. Available from: http://www.nps.org.au/medicines/infections-and-infestations/antibiotics/for-individuals/side-effects-of-antibiotics.

Written by Rachel Baudistel

​Fermented foods and beverages, such as sauerkraut, kimchi and kombucha, were a regular part of our ancestors’ diets for thousands of years. Originally a method of preserving produce from harvest time through the cold days of winter;1 fermentation involves adding a bacterial or yeast starter to a food. These organisms convert starches and sugars to alcohol or acids, lengthening the food’s shelf life and producing the unique and tangy flavours we associate with fermented foods. Recently, these foods have seen a resurgence in popularity, not for their shelf lives but for their claimed digestive health benefits. As probiotics have also risen in popularity for similar reasons, let us explore how fermented foods stack up against a high quality probiotic.

It All Begins In The Gut
Our interest in strategies to improve digestive health has been fuelled by an expanding body of research indicating that poor gut health negatively affects many other body systems.2 Specifically, imbalances in the microbiome, the ecosystem of approximately 38 trillion bacteria and other organisms living in your digestive tract, have been connected not only to gut disorders but to mood, immune, inflammatory and autoimmune diseases, cancer and even cardiovascular disease.3,4 

Research shows that taking live beneficial bacteria, such as probiotics, can improve microbiome health, reducing the symptoms of many health conditions,5,6 improving general health and lowering the risk of diseases such as those mentioned above.7 In light of this, probiotic supplements and fermented foods, both sources of potentially beneficial bacteria, have been put forward as effective options for improving microbiome health. Consequently, there is a misconception that they are interchangeable; however, there are fundamental differences between them.

The Pros of Probiotics
​Probiotics are defined as “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host”.8 Research has shown that specific types (strains) of probiotics, at defined doses, can help manage particular health conditions or symptoms, such as hayfever9 or bloating.

To understand this further, let us use irritable bowel syndrome (IBS), a painful digestive disorder, as an example. (To read more about IBS, click here). Research indicates that the specific probiotic strain, Lactobacillus plantarum 299v, can relieve the bloating, intestinal pain and inflammation of medically diagnosed IBS.10,11 This benefit occurs when the probiotic is taken at a dose of 20 billion colony-forming units (CFU), which is a way of expressing the amount of live bacteria contained per probiotic capsule or dose of powder.

Scientists give probiotic bacteria three names we can use to identify them and connect them to their health benefits: genus (e.g. Lactobacillus), species (e.g. plantarum), and strain (e.g. 299v). To get the health benefits associated with that strain, all three names must match the probiotic used in the scientific research, as well as the dose. Luckily, you can find information on strains and doses in a probiotic supplement just by reading the label.

By choosing a probiotic from a reputable brand committed to quality, you can feel confident that you will receive:

• A guaranteed strain of bacteria effective for your health condition
• A correct quantity of live bacteria necessary for the benefit you require
• Bacteria that are alive at the label dosage until the expiry date

So, if you are looking to improve a particular health condition, choose a strain-specific probiotic for best results. What’s the easiest way to find the right probiotic for your condition? See a Natural Healthcare Practitioner.

Fermented Foods Vs Probiotics
Although fermented foods contain live bacteria, the microbes responsible for fermentation do not confer the same health benefits as a probiotic supplement. In fact, an expert panel of scientists concluded that fermented foods have unidentified microbial content, meaning there is no guarantee of what bacterial strains or doses will be present in them. For this reason, they are fundamentally different from probiotics.12

That being said, many people experience non-specific digestive health benefits from including fermented foods in their diet, which could be related to the bacteria present, however, more research is needed to confirm this. Since fermentation breaks ingredients down into simpler parts, these foods are generally easier to digest, and fermentation also increases the nutritional value of the food.13 If you are healthy and do not require specific health benefits, fermented foods may be appropriate for you.
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Be aware that, while fermenting at home can be fun, it is not a risk-free process. Exposure to oxygen, for example, can allow mould, yeast and less beneficial bacteria to grow. High-quality probiotics, on the other hand, are produced under strict hygienic conditions that minimise the risk of introducing ‘bad’ microorganisms into your gut. If your digestive system is sensitive, you may be better off taking a probiotic.

Choose What’s Right For You
Fermented foods are a tasty addition to the diet and do appear to provide some non-specific digestive benefits to relatively healthy people, on the proviso that they are prepared correctly. However, for support with specific health conditions, it is important to choose a specific probiotic strain, at the right dose, for your condition. To access high-quality probiotics for your particular health needs, contact a Natural Healthcare Practitioner.

References1 Chambers PJ, Pretorius IS. Fermenting knowledge: the history of winemaking, science and yeast research. EMBO Rep. 2010 Dec;11(12):914-20. doi: 10.1038/embor.2010.179.
2 Alam R, Abdolmaleky HM, Zhou JR. Microbiome, inflammation, epigenetic alterations, and mental diseases. Am J Med Genet B Neuropsychiatr Genet. 2017 Sep;174(6):651-660. doi: 10.1002/ajmg.b.32567.
3 Alam R, Abdolmaleky HM, Zhou JR. Microbiome, inflammation, epigenetic alterations, and mental diseases. Am J Med Genet B Neuropsychiatr Genet. 2017 Sep;174(6):651-660. doi: 10.1002/ajmg.b.32567.
4 Maranduba CM, De Castro SB, de Souza GT, Rossato C, da Guia FC, Valente MA et al. Intestinal microbiota as modulators of the immune system and neuroimmune system: impact on the host health and homeostasis. J Immunol Res. 2015;2015:931574. doi: 10.1155/2015/931574.
5 Niedzielin K,  Kordecki H, Birkenfeld B. A controlled, double-blind, randomised study on the efficacy of Lactobacillus plantarum 299v in patients with irritable bowel syndrome. Eur J Gastro Hepat 2001;13:1-5. PMID: 11711768.
6 Costa DJ, Marteau P, Amouyal M, Poulsen LK, Hamelmann E, Czaaubiel M, et al. Efficacy and safety of the probiotic Lactobacillus paracasei LP-33 in allergic rhinitis: a double-blind, randomised, placebo-controlled trial (GA2LEN) study. Eur J Clin Nutr. 2014;1-6. doi: 10.1038/ejcn.2014.13.
7 Kalliomäki M, Salminen S, Arvilommi H, Kero P, Koskinen P, Isolauri E. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet. 2001 Apr 7;357(9262):1076-9. doi: 10.1016/S0140-6736(00)04259-8.
8 Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B et al. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014 Aug;11(8):506-14. doi: 10.1038/nrgastro.2014.66.
9 Costa DJ, Marteau P, Amouyal M, Poulsen LK, Hamelmann E, Czaaubiel M, et al. Efficacy and safety of the probiotic Lactobacillus paracasei LP-33 in allergic rhinitis: a double-blind, randomised, placebo-controlled trial (GA2LEN) study. Eur J Clin Nutr. 2014;1-6. doi: 10.1038/ejcn.2014.13.
10 Niedzielin K,  Kordecki H, Birkenfeld B. A controlled, double-blind, randomised study on the efficacy of Lactobacillus plantarum 299v in patients with irritable bowel syndrome. Eur J Gastro Hepat 2001;13:1-5. PMID: 11711768.
11 Ducrotté P, Sawant P, Jayanthi V. Clinical trial: Lactobacillus plantarum 299v (DSM 9843) improves symptoms of irritable bowel syndrome. World J Gastroenterol. 2012 Aug 14;18(30):4012-8. doi: 10.3748/wjg.v18.i30.4012. 
12 Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B et al. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat RevGastroenterol Hepatol. 2014 Aug;11(8):506-14.doi: 10.1038/nrgastro.2014.66.
13 Coyle D. What Is Fermentation? The Lowdown on Fermented Foods.  https://www.healthline.com/nutrition/fermentation#what-it-is. Healthline. Accessed July 8, 2019.