Saturday 20 January 2018

10 ways to manage your digestion


A regular meal schedule can be of great practical benefit, says our dietitian
A regular meal schedule can be of great practical benefit, says our dietitian

Áilín Quinlan

Registered dietitian and member of the Irish Nutrition & Dietetic Institute Dara Morgan shares her expert gut-health tips.

1 Have Regular Meals

Skipping meals is commonplace in our fast-paced world - but one of the first changes you need to implement if you are experiencing gut discomfort is to establish a regular meal pattern and avoid skipping meals or leaving long gaps between meals.

"I notice that people presenting with issues relating to gut health can often have erratic eating patterns," says Dara. "In my practice, I find that introducing a regular meal schedule can be of great practical benefit."

2 Pace Not Race

Slow down mealtimes. Eating too fast or on the run can cause you to gulp lots of air, leaving you feeling bloated and uncomfortable.

Take time to enjoy how your food looks and smells; this in turn helps to kick-start the digestive process. Chew food well and put your knife and fork down between mouthfuls.

Good posture is also conducive to good digestion, Dara explains: "People struggling with reflux, for example, can find that sitting in an upright position during mealtimes may help with symptoms."

3 Eat More Fibre

Four out of five Irish people (80pc) are not getting enough fibre in their diet. Adults need 24-35g fibre every day, while the recommended amount for children is based on their age + 5g fibre per day (for example, a 10-year-old child requires 10 + 5g fibre per day = 15g).

Fibre in the diet, says Dara, does far more than prevent constipation. In the large intestine, dietary fibre is fermented into short-chain fatty acids.

These help improve the transit of material through the large bowel, provide energy to the cells in the colon, nourish the protective mucous layer in the colon, strengthen the gut barrier and support the immune system.

They may also help prevent colon cancer and balance blood glucose levels. It's believed they may also play a role in obesity prevention.

4 Get enough Soluble and Insoluble fibre daily

There are two main types of fibre in the diet - soluble and insoluble fibre. Plant-based ingredients or foods generally contain a mixture of both. Soluble fibre disperses when mixed with water, making the digestive contents more viscous. This helps to slow down digestion, keeping you feeling fuller for longer.

This 'slowing down' effect is associated with lowering glucose and insulin responses after eating and also helps lower LDL cholesterol levels by interfering with the absorption of cholesterol in the gut. This has implications for the prevention and management of type 2 diabetes and raised cholesterol levels. Soluble fibre is mainly found inside the cells of fruits, vegetables, beans, pulses, barley, oats and seeds.

Insoluble fibre has a water-binding capacity, which helps make our stools softer and bulkier and plays a crucial role in the correct functioning of the gastrointestinal (GI) tract and prevention of constipation. Insoluble fibre is found in wheat, wholegrains, fruit and vegetables.

See the panel below for tips on boosting your fibre intake.

5 Hydrate well

A good rule of thumb is to drink 35ml fluids/kg/day for adults (18-60 years) and 30ml fluids/kg/day for adults over 60 years old - more simply, an approximate guide is eight to 10 glasses of water per day, although you will need to drink more if you are exercising.

A simple way to know if you are drinking enough is to look at the colour of your urine, which should be pale yellow.

If it's darker, that is a sign you are dehydrated and need to drink more. Water is the best option but other options to help you reach your target include milk, fruit juice, tea and coffee.

For people who have Irritable Bowel Syndrome (IBS) or reflux issues, caffeinated drinks can trigger symptoms, so these may not be the best hydrating options if you suffer from either.

6 Keep Track of Symptoms and Know Your Body

If you're experiencing uncomfortable gut symptoms such as reflux, bloating, gurgling, belching or flatulence, it can be a good idea to keep a food and symptom diary over a few weeks to see if there are any patterns emerging in terms of trigger foods.

"Obviously, it's not advisable to remove too many foods - or indeed entire food groups - without getting professional guidance from a registered dietitian," says Dara.

"However, it may be the case that there are just a few foods or drinks that are the obvious culprits and are easily avoided - such as spicy foods or caffeine, for example."

Always discuss any persistent digestive issues with your GP.

7 Be Physically Active

Physical activity stimulates the muscles in the bowel to contract, helping to promote a regular bowel habit.

Regular activity has so many other health benefits to offer that we should try to be active every day, Dara says.

Using a pedometer can be a great way to monitor your activity levels, she suggests, adding that 10,000+ steps per day indicates that you are active.

If you are not active currently, you can build up to this level gradually.

8 Top up your probiotics...

The human gastrointestinal tract contains trillions of bacteria and more than 1,000 different species, collectively known as the gut microbiota.

Probiotics are the 'good' bacteria found in certain food and supplements that can beneficially affect our health by improving the balance of the gut bacteria.

They can be found in a variety of forms such as capsules and powders or in foods like fermented milk drinks and some yoghurts.

9 ... but don't pop probiotics like they're multivitamins

Probiotics are strain-specific, to specific disorders. What this means is that probiotics are definitely not a case of 'one size fits all'.

"We must match the probiotic to the condition or benefit you want, and be guided by the original research papers in terms of the dose used," says Dara, who says more research is needed on the most effective mode of delivery of probiotics.

Seek advice from a registered dietitian or your doctor regarding the evidence for probiotic use in specific conditions, she advises.

Although probiotics are generally considered safe for the general population, Dara specifically cautions that people with a suppressed or poorly functioning immune system should speak to their doctor or registered dietitian before including them in their diet.

10 Fermented foods are not a panacea

Although fermented foods have been around for a lot longer than probiotic supplements or products, their natural probiotic effects are much less tested in clinical trials, Dara cautions.

"That's not to say that they don't work, but how they work - in whom or in what dose - is much less studied," she says.

Examples of fermented foods that have been soaring in popularity are kimchi, kefir, miso and sauerkraut but again, Dara emphasises, more research is needed for us to understand their specific benefits.

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