Last week I was fortunate enough to be able to view The Gut Movie, an entertaining and thought provoking documentary by journalist Kale Brock. View it HERE.

Overall I really enjoyed the movie and believe it portrayed some very important messages about the importance of the Human Microbiome (gut bacteria) in all areas of human health, both physical and psychological. As a Dietitian and Nutritionist, specialising in treating people with gut disorders (IBS, IBD and more), none of the information presented was new to me. However, I did leave feeling that some aspects of the movie could be confusing to the general public: the emphasis on the importance of fibre and starch/carbohydrate (with a very humorous reference to “Woolies (white) potato”) in promoting a healthy Gut Microbiome AND then constant reference to the GAPS diet, which is an elimination diet protocol designed to treat gastro-intestinal and neurological conditions, and which largely cuts out all fibre and starches. Anyone else confused by these two opposing messages?

On reflection I decided there seemed to be two distinct take-home messages from the movie:

  1. FOR THE GENERAL PUBLIC: a plant based diet, high in fibre, from wholefoods (unrefined and unprocessed) is deal for optimal gut bacteria and therefore optimal health.
  2. FOR PEOPLE WITH GUT CONDITIONS: (and we are now finding probably psychological and neurological conditions): the GAPS diet is an elimination protocol recommended by Dr Natasha Campbell-McBride (interviewed in the gut movie) to re-balance the gut flora.

I’d like to point out here that the GAPS diet is just one dietary strategy to treat/manage these conditions. There are several therapeutic elimination diets available to Dietitians/Nutritionist which are designed to treat or alleviate gastro-intestinal disorders or symptoms and improve health. The following are examples of such diets, each with differing levels of scientific evidence behind them, which I am not going to discuss here:

  • Low FODMAP Diet
  • SIBO Bi-Phasic Diet
  • Anti-inflammatory Diet for IBD (IBD-AID diet)
  • Specific Carbohydrate Diet
  • Food Chemical Elimination Diet (RPAH diet)

So, back to point 1) how do the general public translate the information in the movie to their everyday life? i.e. how do you eat a plant based diet high in fibre?

  • Eat more vegetables. Research shows that only 4% of Australians eat the recommended 5 serves of vegetables/day. 1 serve of vegetables = 1 cup salad greens or ½ cup cooked vegetables. It’s pretty hard to eat the recommended 5 serves in one meal, so you need to eat vegetables/salad in at least 2 meals/day preferably more, and snacks too! Prepare extra vegetables/salad at dinner time so you can take them for lunch the next day with a lovely Extra Virgin Olive oil dressing (see recipe below).
  • Eat fresh vegetables and fruit, seasonal if possible. Leave skin on fruits and vegetables where possible as the skin is high in fibre. For people on a tight budget, frozen vegetables/fruit are a good option as snap freezing methods retain nutrients.
  • Eat more legumes. The Mediterranean Diet, which was also referred to in The Gut Movie as having a positive effect on the gut microbiome, is a well-researched diet for having numerous positive health outcomes and it recommends legumes be included in the diet at least 2x week, preferably more. For example: lentils, chickpeas, kidney beans, black beans etc. Think home-made hummus with vegetable sticks as your mid afternoon snack, Mexican black bean tacos, lentil dahl with your next curry. But “legumes make me feel bloated and give me a lot of wind”, I hear some people say. This is because the fibre in legumes is feeding the bacteria in your gut which are then producing gas (short chain fatty acids, including Butyrate). We are meant to ‘fart’, it’s healthy and a natural process. However, if you are not used to eating legumes they may make you feel uncomfortable to start with, so introduce them slowly: only 1 spoonful the first time. As we gradually increase in our intake, we can become more tolerant (or maybe our gut bacteria is changing). I can provide more individualised advice regarding tolerance to legumes and other foods another time.
  • Eat nuts/seeds every day. For Example: sprinkle walnuts, almonds and flaxseed onto your porridge for breakfast; include chia seed in your smoothies; sprinkle toasted pumpkin, sesame and sunflower seeds on your salads; have a small handful of nuts as your snack; or sprinkle chopped nuts on natural yoghurt and berries for dessert, or try this easy-to-make chia seed pudding.
  • Eat unrefined whole grains. e.g. whole oats in porridge or muesli, quinoa, brown rice, buckwheat, wholegrain sourdough bread (see Mediterranean Diet again).
  • Include some Resistance Starch. Resistance starch was mentioned in the movie frequently, but what is it? Resistance starch is starch (carbohydrate) that resists digestion in the small intestine and travels through to the large intestine where it is fermented by the bacteria. i.e. it acts like a fibre although it is not actually the same as other dietary fibres. Resistance Starch in particular favours the production of the Short Chain Fatty Acid Butyrate which was also mentioned frequently in The Gut Movie as Butyrate plays a key role in maintaining the integrity of the gut wall.

Foods containing Resistance Starch:

  • Cold cooked potato (yes white potato can be good for you), rice and pasta. Think brown rice salad for lunch, brown rice sushi rolls, pasta salad with home-made pesto or olive oil dressing (not the creamy pasta salad you buy at a supermarket deli).
  • Firm bananas
  • Barley
  • Legumes
  • Nuts and seeds
  • Oats

Simple Olive Oil Dressing Recipe: In a small jar mix about 3 Tbsp Extra Virgin Olive Oil + 2 Tbsp balsamic vinegar OR white wine vinegar OR Apple Cider Vinegar OR lemon juice + tsp mustard +/- tsp honey. Shake vigorously with lid on.

In addition to eating a plant based diet high in fibre, regularly consuming foods with probiotics (live bacteria) is also important for a healthy gut microbiome. Good food sources of Probiotics include:

  • Good quality yoghurt (look for ones that have ‘ABC cultures’),
  • Yakult TM,
  • Filmjölk (traditional Swedish fermented milk),
  • Kefir (fermented milk drink, although can be made as water or coconut water kefir),
  • Kombucha (a fermented tea, although amount of probiotics in commercial kombucha is unreliable),
  • Kimchi (a Korean spicy fermented cabbage),
  • Sauerkraut (fermented cabbage common in German diet, only unpasteurized sauerkraut will contain probiotics so make it yourself or buy from a local market/health food store),
  • Miso (fermented soya-bean paste that may contain rye or other grains, not to be confused with instant Miso from the supermarket which does not contain probiotics),
  • Tempeh (fermented soya-beans),
  • Sourdough (traditionally made with a live culture not yeast. NB most commercial sourdoughs contain yeast, not a live culture, so make your own or perhaps buy from a local market),
  • Raw apple cider vinegar (will appear cloudy),
  • Natto (fermented soya-bean).

 

Now, back to point 2) For people with Gut conditions, how can an elimination diet help? The various therapeutic Elimination Diets (examples listed above), are NOT long term diets. Generally these diets come in 3 phases: elimination, systematic reintroduction (done in a specific way according to the diet), and individualisation to customise the diet to the individual.

The short term elimination phase of these diets is usually very strict and therefore should not be followed long term as they can result in nutrient deficiencies by avoiding certain foods.  They can also be quite hard to follow in everyday life (eating out, travelling, work engagements, celebrations etc) and should be undertaken with a supervising Dietitian/Nutritionist, to provide the correct reintroduction protocol in order to get the benefit from the diet.

What I found confusing in The Gut Movie, is that most of the aforementioned high fibre foods are eliminated during the elimination phase of these therapeutic diets including the GAPS diet. Which is why I wanted to write this post. And my take home message is: if you are the General Public (and not suffering from any disease), eating a high fibre plant based diet is beneficial for your gut bacteria and therefore your health!

If you are suffering from a gastro-intestinal disorder e.g. IBS, IBD, diverticular disease, coeliac disease or any other, seek advice from a Gastroenterologist and a specialist Dietitian/Nutritionist (or maybe get a Fecal Transplant).