EP.261/ Three Essential Strategies for a Healthier Microbiome and Less Endo Belly
If you’re a long-time listener of the show, you’ll know that endo belly – that classic bloating many of us get – is not just caused by endometriosis itself, but it is often the result of co-conditions and complications that people with endo face, such as small intestine bacterial overgrowth and microbiome imbalances.
Gut dysbiosis, which means an imbalance of the bacteria in our gut, has been found in the research in people and animals with endometriosis. Whilst some more drastic measures can be taken, such as using antimicrobial herbs to kill off the ‘bad’ or opportunistic bacteria, one of the most essential and core things you can do to bring about balance, is to support your healthy gut bugs with their favourite foods, so that they can get back to the right numbers again.
Many of us think that eating for gut health is about taking probiotics and drinking kombucha, but in fact, these strategies are just drops in the ocean – they are the paint on the walls, but first, we need to build the wall. We need to build the foundations of good gut health, so today – I am covering just that. Three essential strategies to building a healthier microbiome.
Now, as you know, the strategies I provide you with in these episodes are just options for you – you don’t have to do them, and you don’t have to do them in any particular time frame. You could spend a year working through these at a sustainable pace, and I promise you, your gut will still be healthier for it, whether you take a month or a year. And in fact, when it comes to eating for gut health, it often helps to take these steps slowly, because most of them will result in an increase in fibre, and if you do that quickly, you’ll often end up with stomach upset, so you need to give your gut a chance to adjust.
Okay, let’s get to it.
Eat for blood sugar balance
Number one is eating for blood sugar balance. I know this is a surprising one, but there’s actually research supporting this. Diets high in sugar and processed foods have been shown to disrupt the healthy balance of the microbiome, promoting an inflammatory environment in the gut, and causing damage to the intestinal lining. In contrast, diets rich in fibre and plant foods have been shown to support a healthy microbiome balance, creating an anti-inflammatory environment in the gut whilst supporting a healthy gut lining that functions properly.
The British Dietetic Association advises that the first step to treating IBS through nutrition should be increasing fruit and vegetables and reducing sugar, processed foods, alcohol, and caffeine - and this guide was created as a result of a review of eighty-six studies. Pretty much all of these steps would improve blood sugar balance because typically, most alcohols, processed foods, sugar, and some caffeinated drinks spike blood sugar, whereas the fibre from fruits and veggies help to stabilise blood sugar.
Whilst there are lots of tips and tricks and add ons to stabilising blood sugar, the two core strategies would be to:
Number 1) Ensure there is fibre, healthy fats, protein, and complex carbs with each meal. To break that down further, we’re looking for half of your plate to be fibre, so that’s low starch veggies like tomatoes, broccoli, cauliflower, spinach, etc. and then we’re looking at a quarter of your plate being protein, so eggs, meat, fish, or beans, for example; and then the final quarter is complex carbs in the form of starchier carbs or veggies, so sweet potatoes, pumpkin, quinoa, beans, or rice for example – and then you top it all off with about two heaped tablespoons of healthy fats, so say half a medium avocado, two tablespoons of olive oil, or nuts and seeds.
That’s the basic ratios – if you’re struggling with blood sugar, you may do better starting off with a ratio of 50% fibre, 25% protein, and then that final 25% is split between the complex carbs and fat, rather than an entire quarter of the plate being starches. Over time, you should be able to tolerate the original ratios I shared, if you want to and if that suits your body and energy needs.
Number 2) Minimise added sugar and refined carbohydrates such as pasta, pizza, and sweets (this doesn’t include fruit)! Now, this doesn’t mean you can never eat these foods again, but it’s about being mindful of your intake and not having these as the foundations of your diet.
Eat a higher plant to animal products ratio
We know that a diet high in plant foods supports a healthier microbiome, but what about diets that include animal products?
Well, for those of you who do eat meat, it’s not about cutting meat, fish, etc. out entirely. The research shows that a diet high in meat can irritate the gut, affect the microbiome, and cause intestinal inflammation, but that doesn’t mean a diet that includes meat is inflammatory full stop.
So, for example, a high adherence to the Med diet, whether participants were carnivore, vegan or vegetarian, was shown to produce higher levels of short-chain fatty acids, which are crucial for good gut health. So, what’s included in the Med diet? Olive oil, beans, nuts and seeds, high amounts of fruits and veggies, whole grains, a moderate amount of fatty fish and fish, some poultry and a low to rare intake of red meat.
Additionally, diets rich in veggies, fish, whole grains, nuts, legumes, fruit, and a higher intake of plant foods over animal foods are consistently associated with lower intestinal inflammation.
Finally, and this leads me onto my next point, the largest study to date on the human microbiome, on 10,000 people, found that those with the most diverse microbiome ate 30 plus plant foods a week - this was regardless of whether they also ate meat or were fully plant based.
So, when it comes to a healthier microbiome, the evidence is showing us that it’s about keeping plants as the stars of the show. Animal products can have a place in your diet if that fits with your values and nutritional needs, but the ratio of plant foods to animal foods should be higher, and of course, if you’re eating for blood sugar, that should pretty much happen naturally if you consider those plate ratios I shared.
If you’re concerned or confused about whether you should or shouldn’t eat meat for endo, I cover this in multiple podcast episodes and in masterclasses and courses. I’ll link to a few options in the show notes for further reading or listening.
Eat 30+ plant foods a week
So, as you now know, the healthiest and most diverse microbiomes are produced from a high intake of plant foods and specifically, variation in these – aiming for 30+ different plant foods a week.
Why? Well, plant foods contain a range of different types of fibres, nutrients and antioxidants which are used to feed healthy bacteria and build healthy intestinal cells.
If 30+ plant foods feels overwhelming, the good news is that all plant food counts, so that includes teas, from greens teas to black tea to herbal; coffee, oils like olive oil and coconut oil, nuts and seeds, herbs and spices, grains, beans, and fruits and veg.
Here’s a few examples to help you get close to that number:
Breakfast – Oats, berries, chia seeds, sunflower seeds and almonds sprinkled with cinnamon and accompanied by a cup of coffee (though remember to ensure you have enough protein in there). That’s seven plant foods already. And you can choose whatever plant foods you can afford, chia seeds can be expensive depending on where you buy them, but seeds like pumpkin, sunflower and poppy are all relatively cheap and if you go somewhere like Morrisons to buy them, you can usually get them for around a pound (GBP).
Lunch – Jacket potato with a protein of choice, grated carrot and cabbage, olive oil, tahini, cucumber, lettuce and two dried herbs of choice. That’s nine different plant foods and again, you can choose the ones you can afford – potatoes, cabbage, carrots, cucumber, and lettuce can all be bought for relatively low prices if you’re not buying organic and you’re going to the cheaper supermarkets but shop around and see what works for you. Of course, organic is preferable but that’s not always realistic – it certainly doesn’t mean you should not buy the fruits and veggies, it’s always better to eat more fruit and veg, organic or not.
Dinner – Lentil and beef (if you want to) bolognaise made with tinned tomatoes and dried herbs such as oregano, thyme, and rosemary, with a leafy green stirred through such as kale or spinach, and a side salad of garlicky broccoli. That’s eight plant foods and I haven’t even included the pasta yet, which would count, though it’s refined carb and we want to focus largely on whole foods (but you have lots of whole foods in this meal, so it’s fine!).
So, if this was a day’s worth of meals, you’re already looking at 24 different plant foods, and that’s without snacks. Now, if you’re used to eating a bowl of cereal for breakfast, a sandwich for lunch and a plain pasta for dinner, that probably sounds a bit overwhelming, but this is just an ideal scenario to give you an example and even if you halved the intake of plant foods in this scenario, you’d still be almost half of the way there to getting in your 30+ foods a week. Start slow, with some cucumber in your sandwich or a piece of fruit with your breakfast. Don’t try to go from five different plant foods a week to 30 overnight, you can start as slowly as you need to, even if that means you only eat one new plant food a week. And if you’re not keen on veggies and fruits, start with things you can tolerate more easily, such as dried herbs or spices, or teas.
Remember, with all of these strategies, you don’t want to rush these changes because you gut needs some time to adjust to the extra fibre, otherwise, you could end up with worsened endo belly, not better!
I hope this episode was helpful and you’re able to find even one tip you can add in to start building a happier microbiome and beating endo belly.
Show Notes
Further reading
https://endometriosis.net/living/how-to-balance-your-blood-sugar-levels-to-reduce-endo-symptoms
https://endometriosis.net/living/diet-sugar
References
https://www.cell.com/cell-host-microbe/fulltext/S1931-3128(07)00157-6?_returnURL=http%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1931312807001576%3Fshowall%3Dtrue/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7284805/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3957428/
https://pubmed.ncbi.nlm.nih.gov/26762459/
https://onlinelibrary.wiley.com/doi/10.1111/jhn.12385
https://www.sciencedirect.com/science/article/abs/pii/S0899900719301923?via%3Dihub
https://pubmed.ncbi.nlm.nih.gov/27110483/
https://pubmed.ncbi.nlm.nih.gov/26762459/
https://pubmed.ncbi.nlm.nih.gov/26757793/
https://gut.bmj.com/content/65/11/1812
https://msystems.asm.org/content/3/3/e00031-18
https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-017-1175-y
https://thegutstuff.com/gut-tips/fibre/
https://pubmed.ncbi.nlm.nih.gov/30945554/
https://www.sciencedirect.com/science/article/abs/pii/S0899900719301923?via%3Dihub
https://gut.bmj.com/content/70/7/1287#article-bottom
https://pubmed.ncbi.nlm.nih.gov/27110483/
https://doi.org/10.1128/mSystems.00031-18
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