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The Biggest Gut Health Mistake We Need To Fix In 2020

Will Bulsiewicz, M.D., MSCI
Gastroenterologist By Will Bulsiewicz, M.D., MSCI
Dr. Will Bulsiewicz, M.D., MSCI is a gastroenterologist and internationally recognized gut health expert. He completed a bachelor’s degree from Vanderbilt University, a medical degree from Georgetown University, and a master's in clinical investigation from Northwestern University.
Variety of Healthy Produce, Fruits, Vegetables, and Legumes

Image by Jamie Grill Atlas / Stocksy

OK, so it's not really the beginning of a new year if we don't talk about the diets that have come and gone (and the ones we're bound to see in 2020). Between the carnivore diet, the gluten-free diet (even if you don't have celiac or a wheat allergy), or diets that tell you to ban all whole grains and legumes, the trend in dieting for the last 20 years has had two very specific characteristics—eliminate and restrict. If it causes a problem, just chop it out.

Curious about how this affects us over the long haul? Here's what you need to know about why a healthy diet doesn't mean getting rid of food groups and why your gut will benefit from you keeping your options open. 

Why shouldn't I eliminate certain foods?

Here's the thing: Elimination diets aren't bad. In fact, they are a great way to determine whether certain foods or ingredients might be causing health setbacks. But with the exception of food allergies or specific medical conditions like celiac, there's no reason to vilify a specific food—grains, legumes, fiber-rich produce—as a means for achieving better health.

But the latest diets say otherwise, with "just eliminate it" being the solution to any and all health issues, including an unhappy gut. And, yes, the avoidance of foods that cause digestive distress can help you avoid discomfort in the short term. But, paradoxically, the biggest mistake people make when trying to heal their gut is to categorically eliminate plants. Whether it's the elimination of FODMAPs, gluten-containing foods, beans, or whole grains, there's study after study showing us that categorical elimination of these (and other foods) leads to undesirable alterations in the gut microbiome. And if you've been following some of my past articles, then you already know I'm all about keeping that gut microbiome in tiptop shape.

But let's pause for a second here. Many of you are probably freaking out right now: What about gluten? Gluten has been the supervillain of nutrition for a few years now. I'm not saying you should maximize gluten in your diet. After all, most gluten-containing foods are ultraprocessed (and if there's one thing you can wipe clean from your diet, it's processed everything). But what I am saying is that even the gluten-containing foods contain redeeming, health-promoting parts. Recent studies have found that people who eliminate gluten when they don't need to increase their risk of heart disease. Let's not throw the baby out with the bathwater! Or, as I like to say, let's not throw the fiber out with the Fritos!

Let me break it down for you with this simple example: Fiber is good for you. Prebiotic fiber feeds the healthy microbes in your gut, releasing short-chain fatty acids to have healing effects throughout the body. You'll find prebiotic fiber in whole plant foods. But if you strip the fiber and splash some chemicals in there, you'll end up with a processed food, like Fritos. The tables have turned!

The point is, we should rid ourselves of the ultraprocessed foods, even if they're "plant-based" but keep around the foods that are more than just plant-based—they're actual plants.


But what if plants hurt my gut?

All of this leads us back to plants, which is my favorite subject to talk about in terms of how they can benefit a healthy gut.

In case you haven't heard yet, a plant-based diet is the ideal diet to support a healthy gut. In the largest study to date that correlates diet and lifestyle with the health of our microbiome, the single greatest predictor of a healthy gut microbiome was the diversity of plants in our diet. Are we surprised? I certainly am not.

Short-chain fatty acids (SCFAs) like butyrate, acetate, and propionate reverse dysbiosis; optimize our immune system; lower cholesterol; regulate blood sugar; protect us from killers like heart disease, stroke, and cancer; and even cross the blood-brain barrier to improve brain function. They are the currency of gut health, and we get them exclusively from prebiotic fiber. And guess what? Plants have a monopoly on this category. 

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But beyond fiber, we also know that every single fruit, vegetable, whole grain, seed, nut, and legume has a unique mix of vitamins, minerals, and phytochemicals, which are healing chemicals that you will find exclusively in plants.

So yes, plants are the ideal food to nourish the healthy microbes in your gut. But there's an 800-pound gorilla in the room right now, so I feel like we should talk about something. Many of you feel unwell when you eat plants. Especially if you overindulge on the four-bean chili or the giant raw salad.

Here’s the thing—about 15 to 20 people have food sensitivities, but if you have irritable bowel, then that number may be as high as 80%. Many of you out there with digestive disorders struggle with fiber and plant foods. Gas, bloating, abdominal pain, changes in bowel habits are all possible. So you might be wondering, "How can these foods possibly be gut healing?"

Digestive distress after eating fiber and plant foods is due to a gut that's overwhelmed. For some, this is just overdoing it with one big meal. But for most, this is evidence of a damaged gut. You may have been told that this is proof that these foods are causing inflammation. They're not. It's just sloppy digestion. In other words, your body is struggling to keep up.


So should you stop eating plants?

In short, absolutely not. 

But let's bring this convo full circle. You will not heal your gut by eliminating plants from your diet. However, you can reduce the digestive distress that comes from having damage to your microbiome (aka dysbiosis). That doesn't mean you've healed it. In fact, what you have done is made yourself less capable of reintroducing these foods over time. 

Think of your gut like a damaged knee: If you rehab the knee, you fully know there's going to be some pain that comes with it. That's part of the process and it's healthy. By working through it, you ultimately strengthen the knee and get back to running, jumping, staying active. Health throughout your body results from healing your knee and being able to stay active. Or you can stop walking. You will not have any pain in your knee! That's good in the hyper-short term. But then you're not physically active, you can gain weight, and your health can get worse. Plus, the knee is even weaker because you stopped using it.

This is my way of telling you that, yes, your gut might be unhappy when it first begins rehabilitation for digesting plants. But that doesn't mean you shouldn't continue to do the work of making it stronger by consuming plants.

The bottom line. 

Elimination and restriction are not the solutions to better gut health, and, in fact, it's quite the opposite—it's abundance. The paradox is that the food that you need the most is also the whole, nutritious food that hurts you when you eat it. But if we think of this process as similar to rehabbing our knee, then we know that when we begin to introduce sensitive food groups, we may experience some discomfort. The key is to reduce the dose down to an amount that your gut can actually handle. 

Of course, if you continue to experience distress, then it's worth working with a qualified nutritionist, as well as a medical professional to make sure there are no other medical issues that need to be addressed. 

Let's make 2020 the year of diversity and abundance. Yes, you can cut the crap (ultraprocessed foods), but otherwise, let's make restrictive diets a thing of the past. Your little friends in your gut will thank you—I promise.


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