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24 January 2019

A PRIMER ON GUT HEALTH

by Jacob Schepis 0

The happenings of one’s insides have rapidly become all the rage in modern fitness. From fermented foods to the complete elimination of food groups, improving gut health is now a huge focal point for health nuts and coaches.  ‘Gut health’… What an ambiguous, loaded, vague and complex concept… From leaky gut, inflammation, allergies and sensitivities,…

The happenings of one’s insides have rapidly become all the rage in modern fitness. From fermented foods to the complete elimination of food groups, improving gut health is now a huge focal point for health nuts and coaches.

 ‘Gut health’…

What an ambiguous, loaded, vague and complex concept…

From leaky gut, inflammation, allergies and sensitivities, gut health is an all encompassing term that has led to some seriously unconventional and extreme dietary practices along with unnecessary fear amongst society and especially the health and fitness industry.

What is more concerning is that now personal trainers and fitness professionals feel they are qualified to talk about and prescribe intervention for a pathology that is not only complex, but they are overtly giving advice in an area of ‘health’ that are unqualified to do so, myself included.

Better yet, lifestyle and fitness bloggers have joined in on the action and perpetuate similar nonsensical and sensationalist means to improve the ‘health’ and function of their follower’s belly, and rest assured they care for their following, but only if  they use their discount code.

With this increasing alarmism, poor gut health has now been stated to be the rate limiting factor in body compositional improvements and lead to dire health outcomes.

But is there good reason to be concerned about gut health?

And more importantly is this even a subject that fitness professionals should be discussing?

Sure, regular and severe discomfort in the stomach can negatively impact one’s well being and quality of life and I’m not dismissing the importance of feeling good inside and out in being able to live a healthy and  meaningful life. However, let’s bring to the discussion that with any health complication comes demand for a solution, and many coaches are now cashing in on the increased demand or at least the prevalence of individuals feeling any form of sensation or permutation of their insides.

We all feel and experience different feelings in our GI tract on a daily basis. From flatulence, queasiness, rumbling and bloating, but I find it rather concerning that fitness professionals are now directing all of their efforts towards minimising these sensations otherwise known as ‘inflammation’ and ensuring their clients have healthy insides. Especially when scientific research is unclear as to the mechanisms behind the guts function and its expression…

Improving digestive health by reducing inflammation or improving gut flora has seen many practitioners centres their protocols around eliminating substances such as chemicals, medications, pesticides, herbicides, processed foods and entire food groups or worse, advocating diets that aim to maximise or address a specific biological processes, and this quackery is rather disturbing.

It may be well intentioned, and sure, too much inflammation can lead to negative health outcomes, but inflammation is after all a normal biological process. And don’t forget, that too little inflammation is equally as harmful as too much. And while we are at it, the human digestive system isn’t some fragile organism that will crumble at the sight of anything foreign. In fact, it’s rather robust and adaptive, hence we are still here years after the introduction of many ‘processed’ foods and chemicals.

Dare I get into the fact that many of the ‘gut health’ gypsies are likely consuming copious other ‘recreational’ chemicals?

Not today…

Moreover, the success of dietetic recommendations as they relate to gut health probably depends on the genetic makeup of the individual and more pressing a concern is the fact there is there are no reliable means available for coaches to measure and assess any improvements in their clients digestive function as a result of their gut glistening interventions…

I digress…

As they say, common sense is not so common, and when it comes to fitness and specifically gut health, there is very little logical or evidence based advice available for fitness enthusiasts (except HERE) so here we are.

In this article, I’m going to cover:

  1. What gut health is;
  2. The methods of assessing gut health;
  3. The difference between allergies and intolerances/sensitivities; and
  4. How to improve gut health.

 

1. WHAT IS GUT HEALTH?

Firstly, gut health lacks a clear scientific definition, which is problematic in and of itself.

Health, by definition is ‘the absence of diseases’, and one might define gut health as a state of physical and mental well-being:

  • In the absence of GI complaints that require the consultation of a doctor
  • In the absence of indications of or risks for bowel disease; and
  • In the absence of confirmed bowel disease.

So ask yourself, is some rumbling in your stomach, bloating or the need to take a dump really a sign of poor gut health?

All jokes aside, here are the positive aspects of the gastrointestinal (GI) tract:

  • The effective digestion and absorption of food,
  • The absence of GI illness,
  • Normal and stable intestinal microbiota,
  • Effective immune status and
  • A state of well-being.

Although the above can give some direction as to what does and does not constitute a healthy GI tract, from a scientific point of view however, it is still extremely unclear exactly what gut health actually encompasses, how it can be defined and how it can be measured.

There does however appear to be two important functional entities related to gut health, which everyone is getting their knickers in a twist about:

  1. GI microbiome; and
  2. The GI barrier,

The GI barrier adjacent to the GI microbiota appears to be the key to understanding the complex mechanisms that maintain gut health, and that’s all well and good. However, coaches, personal trainers and nutritionists have very little understanding of the intricacies relating to such mechanisms.

Not to mention the promotion of diets that aim to act on these mechanisms, such as eliminating gluten to improve the regulation of the intestinal barrier function via the zonulin pathway, is severely missing the forrest for the trees.

Say what?

2. METHODS OF ASSESSING GUT HEALTH 

As with any health complication, measurement to determine a state of ‘disease’ is a requirement before intervention.

Clearly we have issues here, as how the hell does a coach actually assess these factors in a reliable and objective manner when determining the ‘health’ of a clients gut or the efficacy of their protocols in eliminating so called disease?

With any ‘test’ their needs to be a reliable means to detect change in the form of either subjective or objective measures. And unfortunately for the gut gurus, bowel functions are so multifaceted and variable making even diagnostic testing such as stool samples, blood and renal tests, endoscopies or ultra sounds are still questionable and unreliable.

The assessment of the gut health by coaches is usually in the form of the reduction in subjective complaints relating to discomfort.

Whilst subjective assessment such as GI symptom scores, eating habits assessments and other questionnaires can help establish correlation to potentially problematic foods or food groups, the probability of such measures being able to accurately determine causation is low, meaning they are highly ineffective.

I know for a fact that most coaches don’t have access to or seek out lab testing. Even if they do, the ability to accurately interpret measures of gut health such as markers of functionality, intestinal integrity and immunity requires in depth expertise, which a 6 month certification in gym instruction and reading a few blogs online obviously doesn’t afford.

So when a coach claims to be able assess and fix your digestive health via their methods and have copious testimonials/anecdote supporting their practices, just stop and think for a second and consider whether or not overall improvements in diet, weight loss and increased activity levels alone may be the reason their clients are experiencing such improvements…

Despite the unfortunate reality that all testing of gut health being inconclusive, seeking help and advice from experts and specialists if you present serious symptoms of GI discomfort should be your first point of call for appropriate testing, not your PT and most certainly not me.

3. ALLERGY VS INTOLERANCE 

There is a huge difference between an allergic reaction and having an intolerance or sensitivity to a certain food group. A food allergy is an auto immune response to a certain chemical and is often confused with or mislabeled as a food intolerance. Food allergies affect 1% of the population and result in severe reactions such as difficulty breathing, rashes, swelling of the face or throat and require the complete abstinence from the cause of the reaction. If you are allergic to gluten, even sharing a toaster with products that contain gluten could lead to an allergic reaction, and I’m certain all of the gluten free yuppies thought of that…

An intolerance on the other hand is usually caused due to the amount of the food consumed when a food exceeds the threshold level for what the GI tract can ‘tolerate’. Lactose, gluten and other ‘problematic’ food groups may lead to discomfort or an intolerance for some, but often elimination isn’t the answer and moderation is a far better starting point.

Symptoms or signs that intolerance is present is again highly subjective and extremely difficult to pin point to an exact food group without exact control of all dietary and lifestyle variables.

Furthermore, digestive issues are often exacerbated when certain food component (such as gluten and lactose) are consumed when the gut cannot produce the requisite digestive component efficiently enough to break down that food due to infrequent exposure to that specific enzyme or when it is consumed in quantities that exceed its digestive capacity.

Hence, eliminating carbs for weeks and then binging on chocolate, who would’ve thought…

4.  HOW TO IMPROVE GUT HEALTH

I’m no expert, nor am I qualified to give specific and detailed advice relating to gut health, so I’ll keep it rather simple and within my scope of practice.

  1. Manage stress, better yet, prevent it from becoming chronic.
  2. Exercise regularly, move more than you sit and stay active.
  3. Eat a balanced diet (energy controlled, consistency in meal timing and structure)
  4. Drink water (aiming for clear urinations)
  5. Moderate fiber intake and consumption of sugar alcohols.
  6. Trial different foods and diet compositions to find what causes you the least amount of discomfort.
  7. If pain persists, seek assistance from a medical professional or registered dietician, not a PT.

Wow, what an anti climax…

Apologies for that, but hopefully this article has shed light on why coaches have no business discussing gut health and the importance of critical thinking when it comes to all things ‘fitness’…

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