Gut health blog Q&A with Certified Nutrition Consultant and Director of Education, Angela Ysseldyk

See below Q&A from our Wellness Table Discussion May 5^th in cased you missed it! 

What is gut health?

To be put bluntly, gut health represents everything from your mouth to your butt.   It represents the place where digestion, metabolism and absorption occur.  (aka your gastrointestinal (GI) system)

The health of your digestive tract is linked to other systems in the body such as your immune system, your skin, brain and more.   So, what happens ‘down there’ is linked to how you feel and shows up daily. 

What keeps your GI tract alive and well is the unique ecosystem, which includes the gut microbiome.  These include trillions of microorganisms in the intestinal tract.  Its composition shows strong individual specificity and plays a crucial role in the human digestive system, immune health, metabolism and more. [1] These microbes are either helpful, neutral, or harmful.[2] The beneficial ones are also referred to as probiotics.  A disturbance in the balance can lead to dysbiosis (or microbrial imbalance), which is when you typically experience some discomfort.

What are the clues if my gut is off?

If you are looking for clues then gas, burping, constipation, and diarrhea are some outward signals that something is not balanced ‘down there’.  You should also look at the consistency and cadence of your daily bowel movements.  All people should be having 1X12 inch bowel movement daily (or 3 x 4s) and it should be effortless.  So, you may want to pay attention!  

In addition, lesser-known signals or clues of gut inflammation are linked to joint issues, brain fog, skin problems, leaky gut, and being immune compromised to name a few.  Approximately 70% of your immune system is situated along the intestinal tract tissues.[3]   Knowing this, the human gut is WAY more complex than previously thought and has a huge impact on whole-body health, so it makes sense to look after it.

What causes gut issues?

When looking at digestive health and the microbiome it is important to understand the factors contributing to dysbiosis (or imbalance)

1. Eating Habits – what foods are you eating daily?   Are you relaxed when you eat?  What is in your grocery cart?   Processed and refined foods, trans fats, alcohol and sugars can all be gut disruptors.  And even some foods that seem healthy can cause issues for some folks due to low grade intolerance. 
2. Living Environments - chemical pollution, air pollution, climate change, disease-causing microbes, lack of access to health care, poor infrastructure, and poor water quality.
3. Metabolic Levels – how quickly things run through your body and how energy is generated.
4. Stress Levels - stress stops us from digesting and sends a spiral effect to all other parts of our body.
5. Antibiotic usage – this wipes out both the good protective bacteria as well.
6. Cigarettes,, alcohol and other drugs have also shown to be disruptive.  Many nonsteroidal anti-inflammatory drugs (NSAIDs), over-the-counter remedies such as aspirin and ibuprofen, do have impacts on the bacteria found within the gut microbiome and even cause damage to the small intestine.
7. Genetic variants – in some cases this can cause a higher propensity for gut issues or sensitivity to certain foods – which we can discuss like lactose. 
8. Hormone Changes (such as perimenopause, menopause through the women’s cycle) – this can lead to more downstream effects such as urinary tract infections and more. 

Everyone has a different set of microbiome unique to them, which starts at birth.   It is important to be aware of the various internal and external contributors to imbalance so you can make the right choices in areas you can control.

For the ladies;  Are there links with gut health and vaginal health?

Yes, gut health is linked to vaginal health

For women, vaginal health can be impacted by gut health, and a healthy microbiome can help to maintain good levels of healthy bacteria within the vagina. [4]

Disruptions to the vaginal microbiome can occur from the same reasons you get imbalance in your gut health as mentioned above.

There are about 50 different species inhabiting the vagina. The main regulators of the vaginal micro-environment include the Lactobacillus strain species.  5 Lactobacillus sp. strains are the dominant strains in the urogenital tracts of women; however, diverse strains are important to consider for all ethnicities. 

Imbalance in the microbial composition influences the health of the vaginal microenvironment; dysbiosis may lead bacterial vaginosis and urinary tract infection (ie yeast infections). [5]

We want to keep it all balanced down there because a healthy vaginal microbiome inhibits the growth of unwanted strains through multiple actions.

Do women experience additional issues surrounding gut health? 

Yes, women in general will experience a higher prevalence of symptoms in some instances.

For example, IBS (irritable bowel syndrome) has been reported be more common in women, with a female-to-male ratio of 2–2.5:1 in terms of those who seek medical care. [6] [7]

Dysbiosis (imbalance in the microbiome) has been identified in folks with Irritable Bowel Syndrome. [8]

Despite limited comprehensive data, sex hormones are believed to contribute to these gender differences as well as cultural factors and gender roles as it relates to stress load. [9]

Women with IBS tend to report more fatigue, mood issues, less positive well-being and self-control, and higher levels of anxiety than men with IBS. [10]

We have this thing called the gut-brain axis – which means your brain is listening to what is going on down there!

It makes sense then that if there are imbalances happening in the gut that it effects your brain, mood, appetite and perceived energy levels.  Research shows that 80 to 90% of communication between the gut and the brain originates in the gut. [11]

Alterations in the gut microbiome may impact hunger and satiety messages to the brain and could play a role in obesity. [12] Persistent low-grade inflammation has been associated with the genesis and worsening of symptoms of mood disorders. [13]

Are there any additional racial propensities surrounding gut health?  What should we look for?

Fun fact: Almost 70% of the world’s population has lactose intolerance [14]

Interestingly, symptoms of gas, bloating, inflammation, flatulence and diarrhea are not only some symptoms of IBS, but they may also point to lactose intolerance or another type of food not agreeing with you.

FYI: Lactose is a milk sugar and the only sugar of animal origin.  (It is also the sugar of a mother’s breast milk). While most infants can digest lactose, many people begin to develop lactose malabsorption—a reduced ability to digest lactose—after infancy.   Interestingly, mother’s breast milk also contains high amounts of lactase, the enzyme required to digest lactose. 

And for your question - Lactose malabsorption is more common in some parts of the world than in others. In Africa and Asia, majority of people (over 50%) have lactose malabsorption. [15] [16]

Various ethnicities will express gut microbiome characteristics based on multiple factors including gene expression.  Genes are influenced by eating habits, living environments and metabolic levels which can influence the characteristics of the gut microbiome differently depending on race.  More research is needed to understand this, but interesting to note. [17]

Lactose malabsorption is higher across various racial ethnicities due to genetic factors. For example:  [18]

• Black people (with African ethnicity)
• Indigenous peoples
• Asian ethnic groups [19]
• Latinos (Latin ethnicity)

Because these ethnic and racial groups are more likely to have lactose malabsorption, those are also more likely to have the symptoms of lactose intolerance. [20]

Fun fact: If you are wondering why this happens, certain racial groups have a down regulation of the enzyme lactose in the intestine, which can lead to maldigestion.   Recent studies show that the risk of symptoms after lactose ingestion depends on the dose of lactose, lactase expression, intestinal flora, and sensitivity of the gastrointestinal tract.[21]

• Lactose also triggers increased water that causes distension in gut walls, leading to increased peristalsis, bloating, flatulence and diarrhea [22]

*Though you can get tested for lactose intolerance/malabsorption by your health care practitioner to be sure.

What are some simple things I can do to keep my gut health on track?

What you eat is important to maintaining both your GI and Vaginal microbial environments

Here are my top Lifestyle, diet and supplement tips:

1. Reduce stress. Stress plays more of a role than we realize.  Let yourself rest and digest.   Our nervous system has 2 parts.  When we rest, we allow our body to digest.  Chew your food.  Sit and eat.  Give yourself space and time to digest what you are consuming.   It will do wonders for your digestion.
   
   
2. Consume gut friendly foods high in probiotics and prebiotics fibres such as:
   • High prebiotic fibre foods: Prebiotics are fibers that aren’t digestible by your body but can help good bacteria grow in your gut. Since your body doesn’t digest these plant fibers, they travel to your lower digestive tract to be a food source for the healthy bacteria in your gut. Some examples include:  greens, garlic, artichoke, onions, bananas, whole oats, apples
     
     
   • Fermented Foods: Naturally cultured or lacto-fermented foods contain enzymes and bacteria that help digest food and eliminate wastes.  Most Canadians do not eat enough fermented foods. Some examples of naturally fermented foods include: Kimchee, miso, tempeh, kombucha, buttermilk, yogurt, Kombucha
     
     
3. Take a probiotic daily: Jamieson has many to offer.  If you want to cover both your gut and vaginal health, try Women’s Probiotic Complex by Jamieson!  It’s got a solid ratio of lactobacillus and bifidobacterium sp.  Some probiotic supplements could be an effective treatment for IBS in terms of symptom improvement, so look for ones that make those claims.[23]
   
   Probiotics have also been reported to inhibit micro-inflammation of the intestine.  However, the therapeutic effect of probiotics in IBS depends on the strains of probiotics used and the different mixtures and dosages of these strains. [24]
   
   There are ways to have your cake and eat it too.  Research shows that there is a positive relationship through taking certain probiotic strains and lactose intolerance. [25]  In addition, taking digestive enzymes containing lactase will also help. 

4. Drink WATER!! 8-10 glasses daily! Not only is drinking water important to helping you stay hydrated, but it also improves digestion and elimination by keeping your intestines smooth and flexible, helping the food we eat easily move through our intestines. I recommend drinking a glass of warm water or herbal tea first thing in the morning to kick-start digestion. It’s a great way to start the day!

What are key things people should look for in a probiotic?  Why would someone take a women’s specific formula vs generic?

What to look for in a women’s probiotic

1. Multi Strain and with both Lactobacillus and Bifidobacterium strains
2. TRU-ID certified. TRU-ID is a completely independent certification program that uses DNA technology to verify the correct identity of the probiotic/or botanical species declared on product labels.
3. Designed with you in mind – look for a women’s probiotic formula such as Women’s Probiotic Complex by Jamieson! [26]

• Specially formulated with probiotic strains for women's health
• Supports intestinal and gastrointestinal health
• Contains 5 Unique Strains providing 7 billion active cells
• With Advanced Tube Technology to guarantee active cell count to expiry
• Could promote a favourable gut flora.

With all this in mind it’s easy to see why looking after your gut health and vaginal health is an important part of your health regime.  It’s never been so easy to feed your body what it needs on a daily basis.    Remember to keep yourself and your health at the top of your priority list.  You are worth it!

[1] Ursell, L. K., Metcalf, J. L., Parfrey, L. W., & Knight, R. (2012). Defining the human microbiome. Nutrition reviews, 70 Suppl 1(Suppl 1), S38–S44. doi:10.1111/  j.1753-4887.2012.00493.x

[2] Iebba, V. Totino, A. Gagliardi, F. Santangelo, F. Cacciotti, M. Trancassini, C. Mancini, C. Cicerone, E. Corazziari, F. Pantanella, & S. Schippa. (2016). Eubiosis  and dysbiosis: the two sides of the microbiota. New Microbiologica, 39, 1-12

[3] Howarth, G. S., & Wang, H. (2013). Role of endogenous microbiota, probiotics and their biological products in human health. Nutrients, 5(1), 58–81.  https://doi.org/10.3390/nu5010058

[4]   Kerry, G., et al. (2018). “Benefaction of Probiotics for Human Health: A Review.” Journal of Food and Drug Analysis 26.3 (2018): 927–939

[5]   Kerry, G., et al. (2018). “Benefaction of Probiotics for Human Health: A Review.” Journal of Food and Drug Analysis 26.3 (2018): 927–939

[6] Boeckxstaens, G. E et al & COST Action BM1106 GENIEUR members (2016). Phenotyping of subjects for large scale studies on patients with IBS. Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society, 28(8), 1134–1147. https://doi.org/10.1111/nmo.12886

[7] Talley N. J. (1999). Irritable bowel syndrome: definition, diagnosis and epidemiology. Bailliere's best practice & research. Clinical gastroenterology, 13(3), 371–384. https://doi.org/10.1053/bega.1999.0033

[8] Korecka, Agata, and Velmurugesan Arulampalam. “The Gut Microbiome: Scourge, Sentinel or Spectator?” Journal of Oral Microbiology 4, no. 1 (January 1,  2012): 1–14. http://www.tandfonline.com/doi/abs/10.3402/jom.v4i0.9367.

[9] Meleine, M., & Matricon, J. (2014). Gender-related differences in irritable bowel syndrome: potential mechanisms of sex hormones. World journal of gastroenterology, 20(22), 6725–6743. https://doi.org/10.3748/wjg.v20.i22.6725

[10] Kim, Y. S., & Kim, N. (2018). Sex-Gender Differences in Irritable Bowel Syndrome. Journal of neurogastroenterology and motility, 24(4), 544–558. https://doi.org/10.5056/jnm18082

[11] Breit, S., Kupferberg, A., Rogler, G., & Hasler, G. (2018). Vagus Nerve as Modulator of the Brain-Gut Axis in Psychiatric and Inflammatory Disorders. Frontiers  in psychiatry, 9, 44. https://doi.org/10.3389/fpsyt.2018.00044

[12] Sanz, Y., Santacruz, A., & Gauffin, P. (2010). Gut microbiota in obesity and metabolic disorders. Proceedings of the Nutrition Society, 69(3), 434-441.  doi:10.1017/S0029665110001813 

[13] Zalli, A., Jovanova, O., Hoogendijk, W.J.G. et al. Low-grade inflammation predicts persistence of depressive symptoms. Psychopharmacology 233, 1669–1678  (2016). https://doi.org/10.1007/s00213-015-3919-9

[14] Storhaug CL, Fosse SK, Fadnes LT. Country, regional, and global estimates for lactose malabsorption in adults: a systematic review and meta-analysis. The Lancet. Gastroenterology & Hepatology. 2017;2(10):738–746.

[15] Storhaug CL, Fosse SK, Fadnes LT. Country, regional, and global estimates for lactose malabsorption in adults: a systematic review and meta-analysis. The Lancet. Gastroenterology & Hepatology. 2017;2(10):738–746.

[16] Misselwitz B, Fox M. What is normal and abnormal in lactose digestion? The Lancet. Gastroenterology & Hepatology. 2017;2(10):696–697.

[17] Chen, L., Zhang, Y. H., Huang, T., & Cai, Y. D. (2016). Gene expression profiling gut microbiota in different races of humans. Scientific reports, 6, 23075. https://doi.org/10.1038/srep23075

[18] National Institute of Diabetes and Digestive and Kidney Diseases.  Accessed March 31, 2021 https://www.niddk.nih.gov/health-information/digestive-diseases/lactose-intolerance/definition-facts

[19] Baadkar, S. V., Mukherjee, M. S., & Lele, S. S. (2014). Study on influence of age, gender and genetic variants on lactose intolerance and its impact on milk intake in adult Asian Indians. Annals of human biology, 41(6), 548–553.

[20] Goodman, B.E. (2010). Insights into digestion and absorption of major nutrients in humans. Advances in Physiology Education 2010 34:2, 44-53

[21] Misselwitz, B., Pohl, D., Frühauf, H., Fried, M., Vavricka, S. R., & Fox, M. (2013). Lactose malabsorption and intolerance: pathogenesis, diagnosis and treatment. United European gastroenterology journal, 1(3), 151–159. https://doi.org/10.1177/2050640613484463

[22] Goodman, B.E. (2010). Insights into digestion and absorption of major nutrients in humans. Advances in Physiology Education 2010 34:2, 44-53

[23] Moayyedi, P., Ford, A. C., Talley, N. J., Cremonini, F., Foxx-Orenstein, A. E., Brandt, L. J., & Quigley, E. M. (2010). The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review. Gut, 59(3), 325–332. https://doi.org/10.1136/gut.2008.167270

[24] Lee, B. J., & Bak, Y. T. (2011). Irritable bowel syndrome, gut microbiota and probiotics. Journal of neurogastroenterology and motility, 17(3), 252–266. https://doi.org/10.5056/jnm.2011.17.3.252

[25] Oak, S. J., & Jha, R. (2019). The effects of probiotics in lactose intolerance: A systematic review. Critical reviews in food science and nutrition, 59(11), 1675–1683. https://doi.org/10.1080/10408398.2018.1425977

[26] Health Canada. Natural Product Number 80082168. Accessed April 16, 2021 at: https://health-products.canada.ca/lnhpd-bdpsnh/info.do?licence=80082168