House Call: For a healthier 2023, focus on gut health

Happy New Year! January truly is a good time to reset after the holiday celebrations.

One of the most common resolutions is to shed a few pounds. But that can be a tough target to hit and even gauging how much to lose isn’t always easy depending on your body type, muscle mass and more. One study showed that overweight people set a goal of losing three times the amount they actually needed to achieve better health. Many of my overweight patients come to me and say, “I’ve got to lose 50 pounds, doc!” That may be a great goal but often difficult to achieve. My advice is often to focus on a more modest goal – say 10 pounds of weight loss through consistent lifestyle modification.

There’s another way to approach your health resolution in the new year: Nurture your digestive health. Eating right and caring for your gastrointestinal (GI) tract can have big health impacts including heart health, moderated blood sugar, better energy and, yes, it can lead to weight loss, too.

Striving for a healthy weight is still important and you should discuss healthy weight goals with your health care provider. But instead of a hard focus on the bathroom scale, small adjustments for your digestive health can be a more sustainable goal leading to lasting lifestyle changes. If you like pickles, homemade granola and blueberries like I do – it’s enjoyable, too. A few years ago, I decided to change my typical lunch from a sandwich and chips to a piece of fruit and a couple of hard-boiled eggs. I couldn’t believe the difference in my energy level the rest of the day.

Your gut is a garden

It helps to know a little about the digestive system and why you should pay attention to it even when you don’t have heartburn. The human GI tract is full of beneficial microorganisms that have a big role in digestion and metabolism, how you use and absorb food and calories and in your immune system function.

There is a complex ecosystem of approximately 300 to 500 bacterial species within the human GI tract: the microbiome. In fact, the number of microbes in our bodies, which are mostly in the gut, is approximately 10 times that of all the cells in the human body. Some strains of our friendly bacteria even help us produce vitamins like K and B.

The GI tract also processes the bacteria, viruses and toxins that aren’t so beneficial, and it’s quite efficient at doing so if it’s functioning well. A healthier gut has “microbiome diversity” meaning a balance of good bacteria and microorganisms to bad.

What you eat and drink has an impact on the whole GI tract and systems like the pancreas which is important for producing the enzymes and hormones that digest food and managing your use of sugar from digestion.

It’s an impressively complex system that can impact everything from blood sugar and diabetes to mood and memory, heart health and just plain gastrointestinal distress. The good news is that supporting your gut health itself is not that complicated and it’s highly adaptable to many tastes and favorite foods.

Supporting good digestion and your microbiome

Much of a healthy digestive system aligns with basic healthy nutrition including maintaining a diet that is high in fiber and rich in fruits, vegetables, legumes and whole grains and limiting sugar, processed foods and unhealthy fats like red meat and fried foods.

Here are a few ways to support overall digestive health:

• Eat whole foods. Picking foods like vegetables, grains and lean meat as your main meals means you’re filling your plate with nutrient-dense foods that pack in vitamins, antioxidants and fiber. Processed foods like fast food, baked goods and processed meats are often laden with sugar, salt and unhealthy fats that not only cause heart disease and weight gain, but they can also cause inflammation and other issues in the digestive tract. They also tend to be low in fiber.

• Ramp up your fiber (slowly). A diet that is rich in fiber with foods like beans, vegetables and whole grains may decrease inflammation in the gut and increase good bacteria as a prebiotic. Fiber also helps prepare your body for digesting food. It’s not all bran muffins; there are tons of tasty fiber options like berries, avocados, artichokes and whole wheat pasta. If you’re not used to a lot of fiber, increase it over time.

• Add fermented foods. Fermented foods like yogurt, sauerkraut and pickles have their own beneficial bacteria that make them easier to digest and help prepare your gastrointestinal tract for digestion, keep your gut’s ecosystem balanced and support your immune system. Like fiber, you want to introduce these slowly if you don’t eat much now.

• Look for better beverages. Water helps your body break down food, and staying hydrated is important for many of the body’s systems. Cut back on alcohol, soda and sweetened coffees.

• Exercise. Exercise and physical activity can benefit your digestive system, improve circulation, which improves digestion, and can even change the predominant bacteria in your gut. Activity increases blood flow and heart rate, so it can improve circulation that is critical for digestion. It also relieves stress and there is ample evidence that stress can impact digestion.

• Get screened for colorectal cancer. If you’re 45 years or older, part of caring for your digestive tract includes regular colorectal cancer screenings, whether a FIT Kit by mail or a colonoscopy depending on your risks and history.

When you make a change, it’s a lot easier to find the foods you enjoy and the habits that stick by going gradually. I spoke with one someone recently who set monthly food goals to add habits like finding recipes with legumes for fiber one month and eating more fruit another.

If you have digestive health symptoms or other specific health concerns, talk to your health care provider about your GI health. Interestingly, there is evidence that autoimmune GI diseases like ulcerative colitis and Crohn’s disease may be improved, and in some cases cured, by something called fecal transplant which essentially replaces the bacteria that exist in a particular patient’s gut. Certain bacteria have the same receptors on them as the GI cells that line the gut and researchers think it’s possible that the immune system gets fooled into attacking its own lining causing colitis because those receptors make the cells look like bad bacteria.

New Year’s resolutions are a good way to pinpoint your health goals for the new year. Resolutions that focus on gradual, achievable lifestyle changes can have the most impact on your health from year to year and factoring in gut health and healthy diet should be an important part of any health plan. Here’s to a happy and successful 2023 with whatever goals you set out to achieve.