Ask an Expert: I’ve got a gut feeling—how do I keep my tummy happy?

Gastroenterology specialist Dr. Baljinder Salh explains why diet is the most important factor to maintain a healthy gut and body.

Q: How widespread are gastrointestinal (GI) illnesses? 
Gut-related disorders—such as acid reflux, dyspepsia and irritable bowel syndrome—are very common and cause significant misery. Somewhere between 30 and 50 per cent of North Americans experience some form of gastrointestinal symptoms on a regular basis and may consequently consult a health care practitioner. IBS (irritable bowel syndrome) affects between 10 and 20 per cent of the population. 

Q: What are some of the top foods to consume to maintain a healthy gut?
You should get all of the nutrition that your body needs by eating a balanced diet that contains a variety of proteins, healthy fats and carbohydrates, as per Canada’s Food Guide. In addition, we also need vitamins and minerals. Fortified milk, cereals, flours and, more importantly, fruits and vegetables have the nutrients we need for a healthy gut and body. It is also important to get enough fibre—the un-digestible part of food that’s present in fruits, veggies and cereals—to maintain healthy gut flora and gut health. 

Q: I’ve heard a lot about the importance of probiotics and micronutrients. What are they and should they be in our diet?
Probiotics are important, but we are still striving to understand the full impact that they have on the body. When we talk about micronutrients, we are often referring to vitamins and minerals. Vitamins A, B, C, D, E, K and folic acid are the most common vitamins we refer to, and they all act on our body’s myriad metabolic processes to keep our tissues healthy. That is why fruits and vegetables are important, because they have these nutrients. Some of these vitamins—A and D in particular—are known to play significant roles in our gut function. 

There is a very complex ecological system in our guts, with many resident microorganisms playing an integral role in our health. Because micronutrients and probiotics can impact these microorganisms, they can also impact our health. Fermented products used throughout the world—such as sauerkraut, yogurt, kefir, kombucha and kimchi—are considered to be good sources of probiotics, or healthy bacteria.

Q: Is it a good idea to take vitamin supplements? 
You don’t need supplementation unless you have a clear-cut reason, such as being pregnant, malnourished or nutrient deprived. Some people say that North Americans have the most expensive urine on the planet because it is full of vitamins that we do not require and consequently do not absorb. Water-soluble vitamins, in particular, often get peed out. Importantly, taking too many vitamins can also harm you.

Q: Is it true that the acid in our stomach kills the probiotic bacteria in the food we eat, and is this a reason to take a probiotic supplement?
The acid in our stomach is a sterilizing agent, but some bacteria will get through to the colon and small bowel. Most of us don’t need to take probiotics because we already have a good complement of healthy gut bacteria. Even if you take a probiotic with tens of billions of colony forming units (CFU) of bacteria, there is a good chance that much of that will be destroyed by stomach acid. Plus, we already have much more bacteria in our gut than is found in the supplement. 

Dr. Baljinder Salh is a gastroenterologist in the Division of Gastroenterology at Vancouver General Hospital and associate professor at the University of British Columbia. Dr. Salh’s research includes investigation of gastrointestinal inflammation and risks associated with the development of colon cancer from the perspective of cell signaling, the role of diet and micronutrients and clinical variations among different ethnicities. 


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