The Garden Within: A Whole-Body Approach to Gut Health
Inside each of us is an ecosystem. Our intestines are home to roughly 100 trillion bacteria, fungi, and viruses that are not parasites or bystanders, but instead are essential partners in our survival. Their presence is vital in helping us digest food, fine-tune our immune systems, and even modulate our brain activity. They are as much a part of us as our eyes and ears are. Our task is to create the conditions for our microbiome to thrive so we can as well.
Why your gut matters beyond digestion
In the previous century, the gut was thought of as just a simple tube that processes food and creates waste. We realize now that it is in reality far more than that.
• Roughly 70% of your immune system resides in and around the gut which plays a direct role in defense of the body, but immune dysfunction, like autoimmune disorders, can also arise if intestinal bacteria are not in balance
• The gut and brain are in constant conversation along what we call the gut-brain axis; the state of one shapes the other, influencing mood, focus, and even sleep.
• Gut microbes help regulate metabolism, blood sugar, and the inflammation that underlies many chronic diseases.
It is important to keep this inner ecosystem balanced and diverse, and it will diligently support the whole body. When it is depleted or disrupted, the effects ripple outward and can cause disturbances to digestion, immunity and even mental well-being.[1] Your gut bacteria let you know if they are not thriving.
To achieve a balanced microbiome, and consequently good gut health, you have to work on a few diet and lifestyle habits at the same time:
Your Diet
The most important step is to be intentional about what you eat. You should think of the microbiome in your gut as a garden that needs tending, and eating fiber is how you water it. Fiber is the foundational fuel for your beneficial microbes. Though we are unable to digest consumed fiber, our gut bacteria utilize it for nutrition and create byproduct compounds that nourish our intestines. Your colonocytes, or colon lining cells, depend entirely on those byproducts for nutrients. If they don’t have access to them, because you’re not taking in enough fiber, they don’t function well and can cause a leaky gut. This can lead to symptoms like constipation, bloating, and abdominal pain.
You should eat a wide variety of high fiber foods, and consider adding fermented foods such as yogurt, kefir, sauerkraut, or kimchi, which introduce helpful microbes directly.
Utilize fiber supplements if needed, but getting your fiber from food is always preferable. Refer to my previous entry, “A Surgeon’s Guide to Fiber” for tips on what type of supplements to take.
Equally important is to decrease foods that are not optimal for your health. You do not need to completely avoid things you enjoy, but moderation matters. In general, try to decrease the following:
• Ultra-processed foods and added sugars, which tend to feed the less ideal bacteria and promote inflammation.
• Alcohol, in excess, irritates the gut lining and disrupts the microbial balance.
• Caffeine can offer health benefits, but too much, especially late in the day, can aggravate reflux and disrupt your sleep.
Drink Water
Good daily water intake is crucial, especially when increasing fiber intake. If fiber is consumed without adequate water, it can often have the opposite effect, causing constipation or at times, loose stools. Aim for 8-10 cups a day and increase it slightly with vigorous exercise. Be guided by your urine, which should be a pale yellow color.
Movement
Regular physical activity is good for the gut and it should be just that, regular. Movement helps maintain the forward propulsion of the digestive tract and is associated with a more diverse, resilient microbiome. You do not need to train intensively; you just need a consistent habit of moving about and staying active throughout the day. If your job involves being seated for much of the day, try to take breaks and walk around. Work on building in 150 minutes of moderate exercise or 75 minutes of vigorous exercise per week as recommended by the American College of Cardiology.
Sleep
Your gut functions on a daily rhythm, and poor or irregular sleep throws that rhythm off, affecting everything from appetite to the microbial community itself. Prioritizing consistent, sufficient sleep is very important to keep your gut on track.
Manage Stress
Your mood and mental well-being are modulated by intrinsic chemical signals like serotonin and dopamine. Many of these chemicals are created in the gut, where healthy bacteria instruct intestinal cells to manufacture them, and they are then transported to the brain via nerves in the gut-brain axis. Dysbiosis, or imbalance of the good vs invasive bacteria, decreases the production of these positive signals and can lead to conditions such as irritable bowel syndrome or even depression. Chronic sustained stress can alter the microbiome directly causing these disorders. Try to make room for rest, connection, and the activities that settle your nervous system, and this will help restore both gut and mental balance.
This advice is not to overwhelm or create a checklist for you. It is to demonstrate how we can’t simply take a few fiber supplements and solve our symptoms of irregular bowel movements, bloating, gassiness, or abdominal discomfort. We need to understand the interconnectedness of all the aspects of our lifestyles, and in working towards them, we will improve not only our gut health, but our overall well-being.
[1]Valdes AM, Walter J, Segal E, Spector TD. Role of the gut microbiota in nutrition and health. BMJ. 2018;361:k2179.