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DIGESTIVE HEALTH
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can also impact overall health and wellbeing, with many gluten free products being lower in fibre, higher in added sugars and fats and also lower in key nutrients.”
This is why Dr Belobrajdic advises people to seek medical advice
from their GP, who may refer them to a gastroenterologist and/or accredited practising dietitian for diagnosis, symptom management support and appropriate testing and medical advice.
Critical role of dietary fibre
Dr Belobrajdic says that to prevent constipation through regular bowel function, it’s advisable that women consume 25g of dietary fibre a
day, and men 30g – a level that
many Australians aren’t achieving. Furthermore, if someone has a chronic disease such as type 2 diabetes or heart disease, the fibre requirement increases to 30-35g a day, he adds.
He underscores that the easiest way for people to consume more fibre
is through more plant-based foods, such as fresh fruit, vegetables and wholegrain cereals and legumes, as these provide a variety of fibre well fermented by the “good bugs” in the large bowel.
“These good bugs produce short- chain fatty acids such as butyrate that contribute to the proper functioning of your large bowel and are linked to reducing risk of colorectal cancer,”
Dr Belobrajdic said.
Evidence is also mounting that products of the good bugs, together with dietary fibre, help control blood sugar levels and influence how full a person feels at subsequent meals.
Accredited Practising Dietitian Geraldine Georgeou, author of the popular book The Australian Healthy Skin Diet, which many regard as a handbook for healing skin through simple diet changes, also emphasises the importance of adequate
dietary fibre.
She tells Retail Pharmacy
Assistants that following “crazy”
diets with little to no fibre results in an imbalanced gut microbiome and “even having bugs like bacteria or parasites in the gut, which need to be medically addressed”.
Alternatively, Dr Belobrajdic
says, people turn to dietary fibre supplements, which may alleviate constipation in the short term, but which are often not well fermented by microbes in the gut.
An example, he says, is psyllium,
a soluble fibre effective in helping people become more regular in their bowel movements, but which has little effect on fermentation in the large bowel, as the bacteria cannot break
it down easily. Wheat bran is another example of a good bulking agent that is poorly fermented.
Dr Belobrajdic says the CSIRO’s research has shown that resistant starch, a type of dietary fibre fermented throughout the large bowel, increases the abundance of beneficial bacteria and the amount of short-chain fatty acids, including butyrate.
Good dietary sources of resistant starch, he adds, include beans, chickpeas, lentils, green (slightly unripe) bananas and barleyMAX,
a barley variety developed by the CSIRO.
Other resistant starch-containing ingredients to consider include potato starch, chickpea flour, green banana flour and freekeh, he says.
The CSIRO Healthy Gut Diet, written by nutritional scientists and dietitians at the organisation, was published to provide guidance on food and recipes that promote gut health.
The role of probiotics
Probiotics are live bacteria that people consume in such products as yoghurt, in the belief that they reach the bowel and provide some sort of functional
benefit, whereas a prebiotic is dietary fibre that is food for the bacteria already present in the large bowel, says Dr Belobrajdic.
He highlights that the large bowel is complex, with more than 1000 species of different bacteria.
A probiotic food or supplement typically only has a small number
of different microbes, with clinical evidence still limited in supporting whether currently available probiotics provide functional benefits for improving gut health, he adds.
Dr Belobrajdic says it’s important to keep in mind that to maintain higher levels of specific bacteria species
in the gut, a person must consume probiotics every day and/or dietary fibre, which is the food needed for the beneficial microbes to flourish.
Mr Webster says he has noted that more people are becoming aware of the importance of their microbiome for good health and the need to eat more insoluble dietary fibre as well as soluble fibre, cereals (low sugar), natural yoghurt and fermented food among other foodstuffs to feed
their microbiome.
Fermented dairy products such
as yoghurt are generally advocated for improving digestion because they contain probiotics such as Lactobacillus bulgaricus and Streptococcus thermophiles.
Claims are made that these probiotics: trigger changes in colonic bacteria and decrease the onset of Crohn’s disease, type-2 diabetes and irritable bowel syndrome; avoid inflammation of the gut and simulate antioxidants, which can ward off disease; help generate healthy short-chain fatty acids in the colon; and provide vitamins E and C while counterbalancing unfavourable bacteria associated with pain, bloating, gas and diarrhoea.
Mr Webster underscores, though, that caution should be applied when many claims are made around probiotics
and that it should be kept in mind that “dairy products are problematic for the majority of the population”.
He also cautions against the widespread belief that all fermented foods contain probiotics, and that if people consume probiotics they’ll enjoy good gut health.
“Some fermented foods have been sterilised, which means that the ingredient list has to be checked to
RETAIL PHARMACY ASSISTANTS • JUL 2020