The healthy gut guide: how your diet is affecting your mental health
Every year, we in the UK spend about three quarters of a billion pounds on probiotic products as we search for elixirs that promise to balance our microbiome. We put kefir on our muesli, sip on kombucha and order kimchi with our sushi. Gut health has proved to be far from a flying fad – it is increasingly thought to be the key to optimum health, especially in these extraordinary Covid times.
According to market analysts Mintel, 68 per cent of UK consumers agree that actively looking after your gut is essential for overall health. In fact, Google searches for ‘gut health’ and ‘gut-brain axis’ have reportedly grown by 669 per cent and 227 per cent respectively in the past five years. But why are we so obsessed with our gut bacteria?
For one, our modern-day lifestyles, which for many include a diet full of convenient processed foods and an onslaught of non-stop stress, are not designed for our ancient digestive systems, which are suffering with everything from bloating and irritable bowel syndrome (IBS) to gut-related autoimmune conditions such as arthritis, psoriasis and Hashimoto’s disease (a thyroid complaint) more than ever before, as poor gut health leads to poor immunity. It’s thought that 20 per cent of the UK population suffers with IBS and 10 per cent of GP consultations are spent discussing patients’ gut health – and that’s not accounting for the 41 per cent who are believed never to divulge their digestive issues to their doctor.
If you have a serious gut issue, as I do, you’ll be familiar with the endless quest to put your microbiome back to its rightful, orderly place because, when your gut bacteria is out of kilter, the negative toll on your health can be life-altering. Not just in physical ways, but emotionally too – because experts have found our gut is our ‘second brain’ and it’s where 90 per cent of serotonin (the mood-regulating hormone) is made.
Throw your gut out of balance and research shows your mental well-being is likely to disintegrate with it, which can lead to chronic low mood, anxiety or panic attacks. Yet most of us don’t know that our mental health could be linked to a gut microbiome that’s in disarray. And since 12.8 million working days are lost to stress and anxiety each year in the UK, knowing how to best feed your gut could be a game changer for so many suffering from feeling generally overwhelmed to serious depression.
Having never had a digestive problem, as I neared my mid-40s, I developed debilitating gut issues, alongside anxiety and low moods, and have been in and out of GP and nutritionists’ offices ever since. Seemingly overnight, foods I would normally have tolerated easily, such as milk and yogurt (and even my beloved coffee), began to turn my stomach into a violent rage within seconds, lasting anywhere from a week to a month. Hour to hour, I would oscillate between having a flat stomach and a painful, distended belly, never knowing what food or situation had caused it, as it cruelly varied each time.
Simultaneously, I began to feel uncharacteristically anxious about ordinary situations I had never worried about previously, such as getting in an elevator, which I still have to avoid. My doctor referred me to a hospital specialist, which kickstarted a two-year cycle of appointments and a battery of tests, including stool samples and bloods. At one point, I was being treated for a mystery bladder condition I’m convinced I never had.
One consultant looked at a scratch on the inside of my arm and excitedly told me he had a ‘hunch’ I was allergic to something, and put me on an elimination diet so strict, I barely left the house for fear of eating something that would exacerbate my ‘IBS’. Yet none of the above fixed my gut – or anxiety. If anything, the confusion of mixed expert opinions was leading me further away from the answers and only increasing my stress levels.
In the end, I sat down and forensically examined my life events up until the point that my gut health deteriorated. When I connected the dots, it was clear that my first gut episode had coincided with my divorce and a 12-week course of antibiotics. Bingo.
A bout of chronic stress combined with bacteria-destroying antibiotics is the perfect storm for an unhappy gut, which I now know is what’s referred to as a ‘trigger’ in functional medicine (a growing field that treats the individual by identifying the triggers and drivers that cause the condition, rather than solely treating the symptoms). The trigger is the pivotal moment that starts a cascade of symptoms, which in my case was a ‘schizophrenic’ digestive system.
I have since curbed my anxiety and, in my job as a health and beauty journalist, I’ve interviewed enough nutritional experts to piece together diet and lifestyle changes that make my gut issues manageable. Still, four years later and my digestion is still not back to where it was in my 20s and 30s, and perhaps it never will be, as one nutritionist told me, ‘these things’ tend to rear their head in middle age.
When I mention my experience to Eve Kalinik, author of the new book Happy Gut, Happy Mind: How to Feel Good from Within, she isn’t surprised. She explains, ‘Just as we might notice changes in our appearance as we get older, changes in the make-up of the gut microbiome and the overall functioning of the gut are a natural part of the ageing process. And just as our obvious physical abilities, such as movement and muscle strength, wane as we get older, so too do our digestive powers and the number of different species of bacteria residing in the gut naturally decreases.’
Indeed, it was Kalinik’s own struggles with gut health that led her to become a certified nutritional therapist and functional medical practitioner. Accredited at the Institute for Functional Medicine, alongside running her own private practice in London, she is an established health columnist and author, and sits on the Gut Conversations panel with other leading health experts, including Dr Rangan Chatterjee and Professor Simon Gaisford. So where did Kalinik’s interest in gut health come from?
‘I was working in the fashion industry for 13 years in a high-pressure environment. I was constantly travelling and surviving on huge amounts of caffeine and half a bottle of wine a night, which led to crazy adrenal fatigue and chronic kidney infections which were being treated regularly with antibiotics. My gut was completely out of whack,’ she recalls.
Kalinik’s deteriorating health, and the lack of solutions beyond medication, inspired her to seek help from alternative-health specialists, until she landed on a functional-health practitioner who put her on the road back to good health, with a plan that included managing her chronic stress, a major driver in gut imbalances. ‘Out of desperation, I saw plenty of wacky alternative therapists and underwent all manner of questionable healing ceremonies looking for answers, until I eventually found a practitioner who was able to identify the triggers that got me to where I was. It wasn’t a linear healing journey, but over time I was able to come off my medication for good and I’ve never felt better.’
Eventually Kalinik stepped back from her job in fashion PR and began training as a nutritional therapist specialising in gut health, with a focus on the mind-gut connection, the topic of her new book. ‘I began to notice that every client who comes to my practice for nutritional support always has some level of cognitive symptoms, whether it’s low moods, anxiety or panic attacks. The two aren’t unrelated,’ says Kalinik, who tellingly has a psychology degree to her name.
Research into the ‘gut-brain axis’ is gaining credibility in the medical profession as numerous scientific studies conclude that there is a link between gut health and mental health, from Parkinson’s to depression. She says, ‘We all have an intuitivity known as butterflies in our stomach, but in the last 10 years, new science has shown how the health of the gut has a huge role to play in mental health.’
Kalinik says that, although treating the gut for depression is still a long way off common practice, there are many pioneering studies, including one conducted by Professor K Ray Chaudhuri at the neurology department at King’s College Hospital, London, that showed the impact of oral probiotics improving the gut microbiota on motor and non-motor symptoms in Parkinson’s disease.
In her book, Kalinik also points to emerging research into ‘psychobiotics’, a ground- breaking new area in the field of neuroscience, pioneered by Professor Ted Dinan and Professor John Cryan at University College Cork. ‘Psychobiotics refers to supporting the health of the gut microbiota and using probiotic supplementation to directly target and positively enhance brain function,’ she explains.
‘They researched how the food we eat affects the gut microbiota, and how gut microbes can in turn influence our emotions. The suggestion is that beneficial bacteria ingested from probiotic supplements or fermented foods have the potential to change the output of neurotransmitters and ultimately shape the health of our brain. This could have a major impact on conditions related to cognitive health.’ So are you ready to improve your own gut health – and feel happier at the same time?
5 steps to a healthy gut (and mind), from Eve Kalinik
1 Manage chronic stress
For most of us, stress is the biggest hurdle to overcome, but Kalinik emphasises that chronic, rather than acute, stress is the baddie here: ‘Stress hormones such as cortisol are produced when the body is in fight or flight mode to alert us to danger. For this reason, it’s the overriding hormone that essentially “wins” over every other system in the body. This is fine in short bursts, but if you are living with constant stress, and producing stress hormones with no respite, longer term this can have a knock-on effect and potentially lead to issues with gut health, fertility, immunity, skin and mood. It is therefore paramount when looking to make positive effects on your health, including gut health, to try to address the underlying causes of your stress and where you can take steps to help better manage this. We cannot always change the stressors but we can try to find ways to cope with them.’
2. Don’t ‘over supplement’
Many probiotic supplements have been shown in studies to improve gut health, but Kalinik advises that they aren’t silver bullets. We need to get as many nutrients from our food as possible, in the form of a varied diet rich in fibre and colour, including vegetables, fruit, grains, nuts and seeds, alongside adequate sources of protein, adding in some fermented foods where possible. ‘Organic sauerkraut has become a trendy health food to buy, but really it’s only cabbage massaged with salt. These simple fermented foods are inexpensive and easy to make, tasty and have been used for millennia to support gut health.’
3. Fibre is the magic ingredient
The microbes in your gut use dietary fibre as fuel to produce lots of positive substances that support gut health and control systemic inflammation in the body, including the brain. ‘Inflammation has been identified as a common denominator in many cognitive conditions,’ says Kalinik, who stresses there are different types of fibre which feed different gut microbes, so variety is key. ‘Lots of white, refined foods and not enough colour in the diet could result in a lack of dietary fibre which doesn’t provide any kind of nourishment for gut microbes, so try to include plenty of vibrant plant-based foods to keep them happy and healthy.’
4. Rest and digest
‘It is important to give your gut a bit of a rest between meals – ideally four to five hours. We have different gut microbes that help us to absorb our food and others that come in for the “clean- up” operation, so they need some breathing space. It is only in recent decades we have had constant access to sweet treats and salty snacks. Previous generations seemed to follow a pattern of three meals per day with clear breaks. Some studies have shown that fasting periods can have a range of benefits, including improving the balance of microbes in the gut, reducing the risk of type-2 diabetes and a reduction in belly fat.’
5. Drink bone broth
Animal collagen in bone broth is an amino acid that can help to support the health of all connective tissue, including in the gut. ‘Bone broth contains amino acids, including collagen and glycine, that may help to support the integrity of the gut barrier. If this barrier becomes damaged or compromised in some way, it can allow substances that should remain in the gut to essentially “leak out”. This can create heightened inflammation and impact on how the immune system responds,’ says Kalinik, who recommends the broth be organic and home-made if possible. ‘Bone broth is one of the cheapest and easiest things you can make – get good-quality bones from your butcher or save after roasting a chicken and simply boil them up.’ Or try boroughbroths.
Follow Kalinik’s five steps and try some of her gut-friendly food ideas. Happy Gut, Happy Mind, by Eve Kalinik, is published on Thursday (￡25, Piatkus). Order your copy from books.telegraph.co.uk