Back Clinic Gut and Intestinal Health. The health of an individual’s gut determines what nutrients are absorbed along with what toxins, allergens, and microbes are kept out. It is directly linked to the health of the whole body. Intestinal health could be defined as optimal digestion, absorption, and assimilation of food. But this is a job that depends on many other factors. More than 100 million Americans have digestive problems. Two of the top-selling drugs in America are for digestive problems, and they run in the billions. There are more than 200 over-the-counter (OTC) remedies for digestive disorders. And these can and do create additional digestive problems.
If an individual’s digestion is not working properly, the first thing is to understand what is sending the gut out-of-balance in the first place.
A low-fiber, high-sugar, processed, nutrient-poor, high-calorie diet causes all the wrong bacteria and yeast to grow in the gut and damages the delicate ecosystem in your intestines.
Overuse of medications that damage the gut or block normal digestive function, i.e., acid blockers (Prilosec, Nexium, etc.), anti-inflammatory medication (aspirin, Advil, and Aleve), antibiotics, steroids, and hormones.
Undetected gluten intolerance, celiac disease, or low-grade food allergies to foods such as dairy, eggs, or corn.
Chronic low-grade infections or gut imbalances with overgrowth of bacteria in the small intestine, yeast overgrowth, parasites.
Toxins like mercury and mold toxins damage the gut.
Lack of adequate digestive enzyme function from acid-blocking medications or zinc deficiency.
Stress can alter the gut’s nervous system, cause a leaky gut, and change the normal bacteria.
Visits for intestinal disorders are among the most common trips to primary care doctors. Unfortunately, most, which also includes most doctors, do not recognize or know that digestive problems wreak havoc in the entire body. This leads to allergies, arthritis, autoimmune disease, rashes, acne, chronic fatigue, mood disorders, autism, dementia, cancer, and more. Having proper gut and intestinal health is absolutely central to your health. It is connected to everything that happens in the body.
For individuals switching to non-dairy and plant-based diets, can oat milk be a beneficial substitute for non-dairy milk drinkers?
Oat Milk
Oat milk is a dairy-free, lactose-free alternative nearly free of saturated fats, has more protein than most nut-based kinds of milk, adds fiber, and offers a healthy dose of B vitamins and minerals. It contains steel-cut or whole oats soaked in water that are then blended and strained with a cheesecloth or special milk bag that is cheaper to make than almond milk and is environmentally friendly.
Nutrition
Individuals can acquire 27% of daily calcium, 50% of daily vitamin B12, and 46% of daily B2. The nutritional information is for one serving of 1 cup of oat milk. (USDA FoodData Central. 2019)
Calories – 120
Fat – 5 grams
Sodium – 101 milligrams
Carbohydrates – 16 grams
Fiber – 1.9 grams
Sugars – 7 grams
Protein – 3 grams
Calcium – 350.4 milligrams
Vitamin B12 – 1.2 micrograms
Vitamin B2 – 0.6 milligrams
Carbohydrates
According to the United States Department of Agriculture, the number of carbohydrates in a cup of oat milk is 16, higher than other milk products.
However, the carbohydrates come from fiber and not fat.
Because oat milk is made from steel-cut or whole oats, there is more fiber per serving than cow’s milk, which offers no fiber, and almond and soy, which only contain one gram of fiber per serving.
Fats
Oat milk contains no fatty acids, no total saturated fat, and no total trans fats.
The milk does have 5 grams of total lipid fats.
Protein
Compared to cow’s and soy milk, oat milk has less protein, with only 3 grams per serving.
But compared to other substitutes, like almond milk and rice milk, oat milk provides more protein per serving.
This is beneficial for individuals following a vegan or dairy-free diet.
Vitamins and Minerals
Oat milk contains thiamin and folate, both B vitamins necessary for energy production.
The milk also has minerals, including copper, zinc, manganese, magnesium, and trace amounts of vitamins and minerals such as vitamin D, A IU, riboflavin, and potassium.
Most commercial oat milk is fortified with vitamins A, D, B12, and B2.
Calories
One serving of oat milk, about 1 cup, provides approximately 120 calories.
80% outgrow the allergy, but the remaining 20% still deal with the allergy into adulthood, making dairy alternatives necessary.
An alternative to dairy milk for:
Allergies to dairy
Lactose intolerance
Following a vegan/dairy-free diet
Oat milk offers some of the same health benefits as cow’s milk, that include:
Protein to build and repair tissues.
Maintain hair and nail health.
Calcium for strong bones.
Macronutrients like folate help make red and white blood cells.
Lowers Cholesterol
A review determined that consuming oats and oat products has a profound effect in lowering total and LDL cholesterol levels. (Susan A Joyce et al., 2019)
The researchers found significant support between oat beta-glucans and blood cholesterol levels, showing that adding oats to one’s diet can help lower the risk of cardiovascular disease.
Cancer Fighting Properties
According to a review of plant-based milk alternatives, oat milk may contain anti-cancer properties and high nutritional value. (Swati Sethi et al., 2016)
Bowel Movement Regulation
Because a great deal of carbohydrates in oat milk come from fiber, it is also higher in fiber than regular milk.
Fiber can help because the nutrient absorbs water to regulate bowel movements and decrease constipation.
Spending on alternative milk has risen, and the consumption of dairy milk has dropped, not only for the benefits and taste but because of environmental concerns.
Dairy milk uses nine times more land to make one liter compared to rice milk, soy milk, almond milk, or oat milk.
Allergies
Oat milk is a beneficial alternative for individuals who are lactose intolerant or suffer from any other type of dairy allergy or those who have a nut allergy and can’t drink almond milk.
However, individuals should be careful of intake if they have celiac disease or any type of wheat allergy/sensitivity.
Individuals can still drink oat milk, but the labels need to be read to make sure the product contains gluten-free wheat.
Oats are gluten-free, but manufacturers often process them using the same equipment as other wheat products, which could cause a reaction.
Adverse Effects
Oat milk can contain acidity-regulating phosphates, which are common additives in processed foods and are linked to kidney disease.
American College of Allergy, Asthma & Immunology. (2019). Milk & Dairy.
Joyce, S. A., Kamil, A., Fleige, L., & Gahan, C. G. M. (2019). The Cholesterol-Lowering Effect of Oats and Oat Beta Glucan: Modes of Action and Potential Role of Bile Acids and the Microbiome. Frontiers in nutrition, 6, 171. doi.org/10.3389/fnut.2019.00171
Sethi, S., Tyagi, S. K., & Anurag, R. K. (2016). Plant-based milk alternatives an emerging segment of functional beverages: a review. Journal of food science and technology, 53(9), 3408–3423. doi.org/10.1007/s13197-016-2328-3
Quagliani, D., & Felt-Gunderson, P. (2016). Closing America’s Fiber Intake Gap: Communication Strategies From a Food and Fiber Summit. American journal of lifestyle medicine, 11(1), 80–85. doi.org/10.1177/1559827615588079
Nadkarni, G. N., & Uribarri, J. (2014). Phosphorus and the kidney: What is known and what is needed. Advances in nutrition (Bethesda, Md.), 5(1), 98–103. doi.org/10.3945/an.113.004655
For individuals wanting to eat pancakes regularly, are there ways to increase pancake nutrition and lower the calorie and carb counts so they can be included in a balanced diet?
Pancake Nutrition
This high-carbohydrate meal can provide enough energy to fuel a day’s physical activity.
Nutrition
The following nutrition information is provided for:
Pancakes made with whole-wheat flour offer more fiber and protein. The following is nutrition info for two or three whole-wheat pancakes (150g) made from a mix. (Child Nutrition Recipe Box. 2023)
Calories – 348
Fat – 15g
Sodium – 594mg
Carbohydrates – 45g
Fiber – 6g
Sugars – 6g
Protein – 12g
Carbohydrates
Pancakes will increase carbohydrate intake. The body uses carbohydrates as a primary fuel source, making them an important nutrient. However, most nutritionists suggest that individuals get their daily carbohydrates from nutrient-dense sources. Pancakes typically don’t fall into this category. White flour pancakes do not provide much fiber, and around 60 grams of carbohydrates are consumed in this meal. Substituting whole-wheat flour changes the amount to around 6g of fiber or 20% of the daily recommended value.
Fat
Pancakes can include dairy and eggs and are topped with butter that contributes a significant amount of fat. Pancake mix may contain trans fat. Some brands include partially hydrogenated oils. Health experts recommend that individuals limit or completely avoid foods containing trans fat. If the label ingredient list contains partially hydrogenated ingredients, it is recommended to avoid it. (MedlinePlus. 2022)
Protein
Pancakes may provide some protein, which varies based on the type of flour used. Some brands add protein powder to increase intake.
Vitamins and Minerals
Pancakes and ready mixes are generally made from enriched flour. Enriched foods are those that have had nutrients added during the manufacturing process. In most cases, the nutrients, vitamins, and minerals are stripped away, and then some are added back in during processing. Constantly eating enriched bread products limits diet-friendly fiber and nutrients. The enriched flour in pancakes and added sugar and syrup raise blood sugar levels rapidly and then generate hunger shortly afterward.
Calories
Total nutrition numbers also depend on serving size. The numbers on the label only apply to a single serving which is just two medium pancakes. Many individuals consume 3-4 medium pancakes and double the amount of butter and syrup as well. This can add up to more than 1,000 calories.
Benefits
Whole-wheat pancakes made with whole-grain flour are more nutritious than pancakes made with white flour and can be a delicious way to eat more whole grains. They can be topped with berries or other fruits for added fiber and nutrients.
Digestion
Whole-wheat pancakes made with whole-grain flour provide significant fiber for healthy digestion. Fiber helps with waste evacuation and has prebiotic compounds that fuel beneficial gut bacteria. (Joanne Slavin. 2013)
Improves Hunger Satisfaction
Whole-grain pancakes taste heartier and include fiber that keeps the body fuller longer than pancakes made with faster-digesting refined flour.
Decreases Risk of Heart Disease
A review of studies examining whole grain consumption and heart disease found that eating whole grains was associated with a reduced risk of heart disease. (Dagfinn Aune, et al., 2016)
Reduces Risk of Obesity
Research suggests that whole grain intake reduces the risk of obesity and could help individuals maintain a stable weight. (Katrina R. Kissock et al., 2021) The fiber will also help keep the fuller longer after the meal.
Slavin J. (2013). Fiber and prebiotics: mechanisms and health benefits. Nutrients, 5(4), 1417–1435. doi.org/10.3390/nu5041417
Aune, D., Keum, N., Giovannucci, E., Fadnes, L. T., Boffetta, P., Greenwood, D. C., Tonstad, S., Vatten, L. J., Riboli, E., & Norat, T. (2016). Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. BMJ (Clinical research ed.), 353, i2716. doi.org/10.1136/bmj.i2716
Kissock, K. R., Neale, E. P., & Beck, E. J. (2021). Whole Grain Food Definition Effects on Determining Associations of Whole Grain Intake and Body Weight Changes: A Systematic Review. Advances in nutrition (Bethesda, Md.), 12(3), 693–707. doi.org/10.1093/advances/nmaa122
Centers for Disease Control and Prevention. (2022). Folic acid.
For individuals with digestive and other health issues, could resistant starch provide health benefits?
Resistant Starch
Typical starchy foods are simple starches that are rapidly digested. This sends their sugars into the bloodstream, contributing to weight gain and increasing the risk of diabetes and heart disease. (Erik E. J. G. Aller, et al., 2011) Resistant starch is a food component that is a type resistant to digestion. This means that it passes into the large intestine and interacts with the gut flora. Foods that contain resistant starch pass through the stomach and small intestine without being absorbed. In the large intestine, they are fermented by the gut bacteria which releases substances that are beneficial to health.
Health Benefits
Studies on the health benefits are ongoing. Scientists are researching how it can help with weight management and colon health:
Weight Management
Research is beginning to show indications that foods with resistant starch can help with weight loss and the ability to help offset the diseases associated with weight gain that include: (Janine A. Higgins. 2014)
High cholesterol
Diabetes
Metabolic syndrome
Cardiovascular disease
Colon Health
In addition, researchers are finding preliminary evidence indicating that resistant starch might possibly help with: (Diane F. Birt, et al., 2013)
A prebiotic that encourages a healthy balance of gut flora.
Inflammatory bowel disease symptom improvement.
Prevention of colon cancer.
Protection against diverticulitis.
However, more research is needed.
Consumption Amount
Estimates on how much should be consumed range from a minimum of 6 grams to a maximum of 30 grams. It is estimated that most individuals consume less than 5 grams per day, (Mary M. Murphy, et al., 2008). As individuals increase their intake, it is recommended to do so slowly, to minimize unwanted gas and bloating.
Bananas
Bananas are a healthy source of resistant starch.
They have the maximum amount when they are unripe.
The resistant starch content reduces as the banana ripens.
If green/unripe bananas are not appealing, making a smoothie can help with the taste.
Potatoes
Potatoes have their highest level of resistant starch when raw.
However, individuals can maximize their intake by allowing the potatoes to cool before eating.
Rice
Levels of resistant starch depend on whether the rice is white or brown.
Similar to potatoes, intake can be maximized from rice by allowing the rice to cool.
Oats
Cooking oats in water, as most are accustomed to making oatmeal, diminishes the resistant starch content.
Rolled or steel-cut oats are recommended as dependable sources of resistant starch.
Chickpeas
Chickpeas, also known as garbanzo beans, are nutritional powerhouses.
They are a healthy source of dietary fiber, along with many vitamins and minerals, and resistant starch.
Cooked and/or canned chickpeas contain high levels of resistant starch.
They go with salads or as a side dish or snack.
For individuals with IBS, well-rinsed canned chickpeas are considered to be low in FODMAPs or carbohydrates that can contribute to symptoms. (Anamaria Cozma-Petruţ, et al., 2017)
It is recommended to keep the serving size to a 1/4 cup.
Lentils
Lentils serve as a healthy source of plant-based protein.
Cooked they can provide resistant starch.
They can be prepared in soups or side dishes.
From a can, they can be IBS-friendly by being well-rinsed and limited to a 1/2 cup serving.
Bread
Various breads offer varying levels of resistant starch.
Pumpernickel bread contains high levels.
Breadsticks and pizza crusts have high levels.
Individuals with IBS may be reactive to the FODMAP fructan or the gluten protein.
Other recommended high-resistant starch options are corn tortillas or artisanal sourdough bread that is traditionally prepared.
Green Peas
Green peas, even when cooked, are a healthy source of resistant starch.
They can be prepared in soups or as a side dish.
However, green peas have been found to be high in the FODMAP GOS and could be problematic for individuals with IBS. (Anamaria Cozma-Petruţ, et al., 2017)
Beans
Most types of cooked and/or canned beans are recommended sources of resistant starch.
The highest levels are found in white and kidney beans.
They can be served in soups, as a side dish, or mixed with rice.
Beans are a high-FODMAP food and could contribute to digestive symptoms in individuals with IBS.
Body In Balance: Chiropractic Fitness and Nutrition
References
Aller, E. E., Abete, I., Astrup, A., Martinez, J. A., & van Baak, M. A. (2011). Starches, sugars and obesity. Nutrients, 3(3), 341–369. doi.org/10.3390/nu3030341
Higgins J. A. (2014). Resistant starch and energy balance: impact on weight loss and maintenance. Critical reviews in food science and nutrition, 54(9), 1158–1166. doi.org/10.1080/10408398.2011.629352
Birt, D. F., Boylston, T., Hendrich, S., Jane, J. L., Hollis, J., Li, L., McClelland, J., Moore, S., Phillips, G. J., Rowling, M., Schalinske, K., Scott, M. P., & Whitley, E. M. (2013). Resistant starch: promise for improving human health. Advances in nutrition (Bethesda, Md.), 4(6), 587–601. doi.org/10.3945/an.113.004325
Murphy, M. M., Douglass, J. S., & Birkett, A. (2008). Resistant starch intakes in the United States. Journal of the American Dietetic Association, 108(1), 67–78. doi.org/10.1016/j.jada.2007.10.012
Cozma-Petruţ, A., Loghin, F., Miere, D., & Dumitraşcu, D. L. (2017). Diet in irritable bowel syndrome: What to recommend, not what to forbid to patients!. World journal of gastroenterology, 23(21), 3771–3783. doi.org/10.3748/wjg.v23.i21.3771
Individuals need to eat more fiber for optimal gut health. Can adding avocado to their diet help improve the gut microbe diversity?
Avocado Gut Support
A diverse gut microbiome is beneficial to overall health. According to a recent study, eating one avocado a day can help maintain the gut microbes healthy, diverse, and balanced. (Sharon V. Thompson, et al., 2021) The researchers observed positive changes in gut bacteria and increased bacterial diversity in individuals who consumed an avocado every day for 12 weeks. (Susanne M Henning, et al., 2019)
Gut Diversity
The gut microbiome refers to the microorganisms living in the intestines. There are around 100 trillion microorganisms, including bacteria, viruses, fungi, and more, exist in the gastrointestinal tract. (Ana M. Valdes, et al., 2018) Having a diverse microbiome means that the body has a range of different organisms that offer various health benefits. Not having enough bacterial diversity has been linked to: (Ana M. Valdes, et al., 2018)
Arthritis
Obesity
Type 1 diabetes
Type 2 diabetes
Inflammatory bowel disease
Celiac disease
Arterial stiffness
Atopic eczema
Why Avocados?
The Institute of Medicine recommends a daily fiber intake ranging from 19 grams to 38 grams per day, depending on various factors like age. (Diane Quagliani, Patricia Felt-Gunderson. 2016)
Including foods like avocados in a healthy diet can help meet daily fiber requirements.
Fruit fiber like pectin, has been shown to promote a healthy gut microbiome as well. (Beukema M, et al., 2020)
Researchers suggest this could be because of pectin’s positive effect on beneficial probiotics.(Nadja Larsen, et al., 2018)
Although further research is needed fiber is believed to help protect the lining of the colon by increasing the bulk and weight of stool and expediting elimination.
Fiber also adds bulk to an individual’s diet and slows the speed of digestion, which makes the body feel fuller longer.
Improved Gut
Individuals can support a healthy microbiota by making small adjustments in their diet, including:
Eating a variety of fruits and vegetables with the skin, as this is where a majority of the nutrition is.
Fermented foods like yogurt, kombucha, sauerkraut, kimchi, and kefir.
Limiting consumption of processed foods, sugar, and artificial sweeteners.
If there are more avocados that can be eaten before they overripen, they can be frozen.
Peel and slice them first, then place them in freezer bags to have year-round.
They are rich in healthy fat, however, in moderation, they are not likely to contribute to weight gain.
Individuals can work toward having a diverse gut microbiome by paying attention to the foods they eat. Specific foods and dietary patterns can influence the different types of bacterial diversity which can support health.
Smart Choices, Better Health
References
Thompson, S. V., Bailey, M. A., Taylor, A. M., Kaczmarek, J. L., Mysonhimer, A. R., Edwards, C. G., Reeser, G. E., Burd, N. A., Khan, N. A., & Holscher, H. D. (2021). Avocado Consumption Alters Gastrointestinal Bacteria Abundance and Microbial Metabolite Concentrations among Adults with Overweight or Obesity: A Randomized Controlled Trial. The Journal of nutrition, 151(4), 753–762. doi.org/10.1093/jn/nxaa219
Henning, S. M., Yang, J., Woo, S. L., Lee, R. P., Huang, J., Rasmusen, A., Carpenter, C. L., Thames, G., Gilbuena, I., Tseng, C. H., Heber, D., & Li, Z. (2019). Hass Avocado Inclusion in a Weight-Loss Diet Supported Weight Loss and Altered Gut Microbiota: A 12-Week Randomized, Parallel-Controlled Trial. Current developments in nutrition, 3(8), nzz068. doi.org/10.1093/cdn/nzz068
Valdes, A. M., Walter, J., Segal, E., & Spector, T. D. (2018). Role of the gut microbiota in nutrition and health. BMJ (Clinical research ed.), 361, k2179. doi.org/10.1136/bmj.k2179
Quagliani, D., & Felt-Gunderson, P. (2016). Closing America’s Fiber Intake Gap: Communication Strategies From a Food and Fiber Summit. American journal of lifestyle medicine, 11(1), 80–85. doi.org/10.1177/1559827615588079
Beukema, M., Faas, M. M., & de Vos, P. (2020). The effects of different dietary fiber pectin structures on the gastrointestinal immune barrier: impact via gut microbiota and direct effects on immune cells. Experimental & molecular medicine, 52(9), 1364–1376. doi.org/10.1038/s12276-020-0449-2
Larsen, N., Cahú, T. B., Isay Saad, S. M., Blennow, A., & Jespersen, L. (2018). The effect of pectins on survival of probiotic Lactobacillus spp. in gastrointestinal juices is related to their structure and physical properties. Food microbiology, 74, 11–20. doi.org/10.1016/j.fm.2018.02.015
For individuals with stomach issues, can maintaining gut flora balance promote and improve gut health?
Gut Flora Balance
Maintaining gut flora balance is part of optimal digestive health. Gut microbiota, gut microbiome, or gut flora, are the microorganisms, including bacteria, archaea, fungi, and viruses that live in the digestive tract. The type and amount of bacteria present depend on their location in the body which could be the small intestine and colon. This is the storage housing for waste/stool, and the colon comprises hundreds of different types of bacteria, which have specific jobs and functions.
Unhealthy Flora
The more common pathogens are bacteria that can cause illness if left unchecked, including germs like streptococcus/strep throat or E. coli/urinary tract infections and diarrhea. Other common germs found in the colon include: (Elizabeth Thursby, Nathalie Juge. 2017)
Clostridioides Difficile
C. diff overgrowth can cause watery foul-smelling stools daily, and abdominal pain and tenderness.
Enterococcus Faecalis
Enterococcus faecalis is a cause of post-surgical abdominal and urinary tract infections.
Escherichia Coli
E. coli is the most common cause of diarrhea in adults.
This bacteria is present in almost every healthy adult’s colon.
Klebsiella
Klebsiella overgrowth is associated with a Western diet that consists of various meat and animal products.
Bacteroides
Bacteroide overgrowth is associated with colitis, which causes painful inflammation of the colon.
Healthy Flora
Healthy bacteria like Bifidobacteria and Lactobacillus, help maintain gut flora balance and keep the unhealthy bacteria in check. Without healthy flora, the entire colon can become overrun by bad flora, which can result in symptoms like diarrhea and/or illness. (Yu-Jie Zhang, et al., 2015) These protective, microscopic germs have important functions that include:
Assisting with vitamin synthesis – vitamins B and K in the small intestine.
Increases immune system function.
Maintaining regular bowel movements.
Maintaining a clean colon naturally without the need for colon cleansers.
Destroying the unhealthy bacteria.
Preventing unhealthy bacteria overgrowth.
Breaking up gas bubbles from food fermentation.
Bacterial Dismantling
Whether labeled as healthy bacteria or unhealthy, they are both single-celled organisms that can be destroyed quite easily. Sometimes, it is necessary, like when having to take antibiotics to kill a strep throat infection. However, the antibiotics also kill the beneficial bacteria, which can lead to compounding problems that can include: (Mi Young Yoon, Sang Sun Yoon. 2018)
Bowel irregularity – diarrhea and constipation.
Yeast overgrowth – can cause itching, burning around the anus and lead to vaginal and oral yeast infections.
Dysbiosis – the technical name for a lack of healthy bacteria or a bacterial imbalance.
Complications for individuals suffering from irritable bowel syndrome.
There are different ways to destroy bacteria including.
Prolonged diarrhea – can flush out the bad and good bacteria.
Stress
Completing a bowel prep, like those required for a colonoscopy.
Diagnosing Gut Flora Issues
Many times, problems with gut flora will correct themselves, and no action is required. However, individuals facing chronic bowel problems, like colitis or inflammatory bowel disease, may require medical intervention of their colon’s bacteria.
Comprehensive Digestive Stool Analysis/CDSA is a stool test that checks what type and amount of bacteria are present, nutrient absorption rates/digestion speed, and how well food is digested.
If there is a significant difference in the proportion of unhealthy versus beneficial bacteria, a healthcare provider may suggest taking a probiotic or a live microbial supplement to help repopulate and maintain gut flora balance.
Gut Dysfunction
References
Thursby, E., & Juge, N. (2017). Introduction to the human gut microbiota. The Biochemical journal, 474(11), 1823–1836. doi.org/10.1042/BCJ20160510
Zhang, Y. J., Li, S., Gan, R. Y., Zhou, T., Xu, D. P., & Li, H. B. (2015). Impacts of gut bacteria on human health and diseases. International journal of molecular sciences, 16(4), 7493–7519. doi.org/10.3390/ijms16047493
Yoon, M. Y., & Yoon, S. S. (2018). Disruption of the Gut Ecosystem by Antibiotics. Yonsei medical journal, 59(1), 4–12. doi.org/10.3349/ymj.2018.59.1.4
Quigley E. M. (2013). Gut bacteria in health and disease. Gastroenterology & hepatology, 9(9), 560–569.
Should individuals with existing gastrointestinal problems eat bananas?
Bananas
Bananas can be easy to digest and are often recommended for nausea and diarrhea, however, not everyone can tolerate them. (MedlinePlus. 2021)
Bananas are high in fructose, sorbitol, and soluble fiber, which makes them a common trigger for gastrointestinal problems.
Additionally, individuals not used to eating a high-fiber diet may find it helpful to gradually increase fiber and drink more water to alleviate unpleasant symptoms.
If there is a suspicion of intolerance, IBS, or malabsorption, it is recommended to speak with a healthcare provider for an evaluation.
Bananas can make the stomach hurt due to:
Irritable bowel syndrome (IBS)
Cramping
Gas
Bloating
Other gastrointestinal (GI) problems.
Individuals can experience stomach discomfort if there is a fructose intolerance or a rare banana allergy.
Stomach Pain
Bananas are used to replenish potassium and other essential nutrients lost from vomiting or diarrhea.
Some individuals can experience bloating and gas after eating them.
One reason is because of their soluble fiber content.
Soluble fiber dissolves in water and is more readily fermented in the colon than insoluble fiber.
Bananas also contain sorbitol – a naturally occurring sugar that acts as a laxative and can cause gas, bloating, and diarrhea when consumed in large amounts. (U.S. Food and Drug Administration. 2023)
Irritable Bowel Syndrome – IBS
Bananas can be a common trigger food for individuals with IBS.
Bananas are also high in fructose/simple sugar especially when they have overripened.
Individuals who have IBS are advised to avoid bananas because they can trigger many of the same side effects as undigested lactose/sugar in milk. (Johns Hopkins Medicine. 2023)
Ripe bananas are considered to be high in FODMAPS – fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.
Individuals following a low FODMAP diet to manage IBS may want to avoid or limit consumption.
Fructose malabsorption is when the body cannot digest or absorb fructose correctly. This causes bloating gas and abdominal discomfort.
Hereditary fructose intolerance is very rare. It happens when the liver cannot assist in the breakdown of fructose.
This condition often causes more severe symptoms and requires additional treatment besides removing fructose from an individual’s diet. (UW School of Medicine and Public Health. 2019)
Most can tolerate small amounts of fructose found in fruits like bananas.
If you’re eating bananas that are too green or unripe, you may also experience stomach discomfort.
Unripened bananas contain high amounts of resistant starch. In large quantities, this can cause mild symptoms like gas and bloating. (Jennifer M Erickson, et al., 2018)
Jackson Siegelbaum Gastroenterology. Colon gas and flatus prevention.
U.S. Food and Drug Administration. Sorbitol.
Capili, B., Anastasi, J. K., & Chang, M. (2016). Addressing the Role of Food in Irritable Bowel Syndrome Symptom Management. The journal for nurse practitioners: JNP, 12(5), 324–329. doi.org/10.1016/j.nurpra.2015.12.007
Johns Hopkins Medicine. 5 foods to avoid if you have IBS.
Monash University. Bananas re-tested.
Dayıoğlu A, Akgiray S, Nacaroğlu HT, Bahçeci Erdem S. The clinical spectrum of reactions due to banana allergy. BMB. 2020;5(2):60-63. doi: 10.4274/BMB.galenos.2020.04.013
Family Medicine Austin. Banana allergy.
UW School of Medicine and Public Health. Fructose-restricted diet.
Erickson, J. M., Carlson, J. L., Stewart, M. L., & Slavin, J. L. (2018). The Fermentability of Novel Type-4 Resistant Starches in In Vitro System. Foods (Basel, Switzerland), 7(2), 18. doi.org/10.3390/foods7020018
The Johns Hopkins Guide to Diabetes. What is resistant starch?
The digestive system breaks down the foods eaten so the body can absorb the nutrients. During digestion, the unnecessary parts of these foods are turned into waste/stool, which is evacuated during a bowel movement. When the digestive system stops functioning properly due to factors such as diet change, eating unhealthy foods, lack of physical activity/exercise, medications, and certain health conditions, can cause constipation. Constipation occurs when the body cannot have a regular bowel movement. The distention, gas, bloating and not being able to have a bowel movement cause irritability and stress, which can worsen constipation. Incorporating recommended nutrition can help restore regular bowel movements and gut function.
Recommended Nutrition For Constipation
Symptoms like abdominal pain, bloating, and difficult bowel movements are common. Diet and proper hydration have a significant role in digestive health, especially in relieving and preventing constipation. High-fiber foods, prebiotics, and adequate hydration from foods and beverages are essential for healthy bowel movements.
Fiber is found in whole grains, starches, fruits, and vegetables.
Soluble and insoluble fiber are important for digestive health.
Focusing on incorporating high-fiber fruits, vegetables, and whole grains.
Foods rich in prebiotics like fermented foods are recommended when constipated.
The recommended nutrition for constipation, according to a dietitian includes.
Avocados
Avocados can be paired with just about anything and are full of nutrients and fiber.
One avocado contains around 13.5 grams of fiber.
One avocado will provide almost half daily fiber needs.
Other high-fiber fruits: pomegranates, guava, raspberries, blackberries, and passionfruit.
Figs
Figs can be eaten fresh and dried.
Figs are considered a laxative and have been shown to treat and reduce constipation.
They contain antioxidants, polyphenols, polyunsaturated fatty acids, and vitamins.
Other fruits similar to a fig: dried apricots, prunes, and plums.
Plums
Plums, prunes dried plums are packed with fiber and prebiotics that have a natural laxative effect.
The added H2O makes the stools softer and easier to pass.
Natural fruit juices, like pear, apple, or prune are often prescribed for constipation.
Other fruits that aid in bowel movements: peaches, pears, and apples.
Kefir
Fermented foods like kefir are rich in beneficial bacteria that work to maintain digestive system health.
It can be consumed on its own or used in smoothies, cooking, and baking recipes.
Other fermented foods: kombucha, yogurt, sauerkraut, kimchi, miso, and tempeh.
Oat Bran
Oat bran is oatmeal that has not had the bran removed.
The bran contains beneficial nutrients including fiber, antioxidants, vitamins, and minerals.
Oat bran contains soluble and insoluble fiber, as well as beta-glucan/non-starchy polysaccharides.
All improve the composition of gut bacteria and promote healthy bowel movements.
Other beneficial grains: oatmeal, wheat bran, rye, and barley.
Incorporating Gut-Beneficial Foods
How to incorporate recommended nutrition gut-beneficial foods into a regular menu:
Smoothie
Use kefir or yogurt as a base then balance it out with fiber-rich fruits like mango, blueberries, and kiwi.
Snacks
Diversify snacks with a plate of fiber and prebiotics.
Nuts, cheese, crackers, fruit, and a yogurt or avocado dip.
Oatmeal
Try oat bran to increase fiber.
Sprinkle a serving of flaxseeds, chia seeds, or hemp seeds for added fiber and healthy fats.
Parfait
Yogurt parfaits can maximize nutrients, flavor, and textures in a bowl.
Layer up on a favorite yogurt with granola, nuts, fruit, and seeds.
Grain Bowl
Fiber found in whole grains and seeds like barley, farro, and quinoa, helps promote healthy digestion.
Make a bowl with a grain base, then top with a protein, fresh or grilled veggies, avocado, and dressing.
Talk with a registered nutritionist or other healthcare provider to discuss recommended nutrition plan options.
Balancing Body and Metabolism
References
Arce, Daisy A et al. “Evaluation of constipation.” American family physician vol. 65,11 (2002): 2283-90.
Bharucha, Adil E. “Constipation.” Best practice & research. Clinical gastroenterology vol. 21,4 (2007): 709-31. doi:10.1016/j.bpg.2007.07.001
Gray, James R. “What is chronic constipation? Definition and diagnosis.” Canadian Journal of Gastroenterology = Journal Canadien de Gastroenterology vol. 25 Suppl B, Suppl B (2011): 7B-10B.
Jani, Bhairvi, and Elizabeth Marsicano. “Constipation: Evaluation and Management.” Missouri medicine vol. 115,3 (2018): 236-240.
Naseer, Maliha, et al. “Therapeutic Effects of Prebiotics on Constipation: A Schematic Review.” Current clinical pharmacology vol. 15,3 (2020): 207-215. doi:10.2174/1574884715666200212125035
National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms and Causes of Constipation.
National Institute of Diabetes and Digestive and Kidney Disease. Your Digestive System and How It Works.
Sinclair, Marybetts. “The use of abdominal massage to treat chronic constipation.” Journal of bodywork and movement therapies vol. 15,4 (2011): 436-45. doi:10.1016/j.jbmt.2010.07.007
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
