“Gut health” is everywhere.
We’re told to eat for our gut health, take probiotics for our gut health, increase fibre for our gut health, eat fermented foods for our gut health, and that our gut can influence everything from our immune system to our hormones and mood.
But what does gut health actually mean?
Because your gut is much more than your microbiome, and having a healthy gut isn’t simply about having lots of “good bacteria” or producing the perfect bowel movement every morning!
In this episode, I’m stripping this wellness buzzword right back and explaining what a healthy, well-functioning gut actually looks like.
What is “gut health”?
Despite how commonly we use the phrase, gut health isn’t one single measurable thing.
At its simplest, we can think of good gut health as a gastrointestinal system that is functioning normally, without active gastrointestinal disease or persistent gut symptoms significantly affecting your quality of life.
And importantly, gut health and microbiome health are not the same thing.
Your gut microbiome (the enormous community of bacteria, fungi, viruses and other microorganisms living within your gastrointestinal tract) is incredibly important.
But it’s only one part of a much bigger digestive ecosystem.
Your digestive system includes your mouth, oesophagus, stomach, small and large intestines, alongside organs such as the liver, gallbladder and pancreas that contribute to digestion.
It involves stomach acid, digestive enzymes and bile; the intestinal lining and protective mucus layer; immune cells; nerves and muscles controlling gut motility; and, of course, your microbiome.
All of these components interact with one another.
So what are some of the characteristics of a healthy gut?
1. Adequate stomach acid and effective digestion
Gut health starts much further upstream than the microbiome.
Your stomach produces hydrochloric acid, which helps break down food, particularly protein, activates the digestive enzyme pepsin and contributes to the absorption of certain nutrients.
The acidic environment of the stomach also provides an important defence against potentially harmful microorganisms entering through our food and drink.
As food moves into the small intestine, digestion continues with the help of pancreatic enzymes and bile produced by the liver.
Ultimately, one of the most fundamental jobs of the gastrointestinal system is to break down the food we eat and allow us to absorb and utilise its nutrients.
And digestion actually starts before food reaches the stomach.
Seeing, smelling and anticipating food helps prepare the digestive system, while chewing begins the physical and chemical breakdown of food.
This is one reason why simple habits such as sitting down to eat, chewing thoroughly and avoiding rushing every meal can be surprisingly important for digestive health.
2. A healthy intestinal barrier
You’ve probably heard the phrase “leaky gut”, but the physiological process we’re really talking about is intestinal permeability.
And there’s an important distinction here:
A healthy intestinal lining isn’t completely impermeable, it’s selectively permeable.
We need digested nutrients, water and electrolytes to be able to cross the intestinal barrier so our bodies can use them.
At the same time, the gut needs to regulate the passage of substances from inside the gastrointestinal tract into the rest of the body.
A single layer of epithelial cells forms much of this barrier, with structures known as tight junctions helping to control what passes between those cells.
When intestinal barrier function becomes disrupted, permeability can increase, and alterations in intestinal permeability occur in a number of gastrointestinal and inflammatory conditions.
However, this doesn’t mean that every symptom from fatigue and headaches to bloating or weight gain can automatically be attributed to “leaky gut”.
The intestinal barrier is one important component of a much bigger system.
3. A robust protective mucus layer
One incredibly important aspect of gut health that gets far less attention is the intestinal mucus layer.
This isn’t simply an inert layer of slime!
Mucus forms an important part of the gut’s physical and immunological defence system.
Particularly within the colon, it helps maintain separation between the enormous microbial population living within the intestine and the cells lining the gut wall.
It also provides an environment in which particular members of the microbiome can live and interact.
This illustrates beautifully why we can’t really separate the different components of gut health.
Our mucus layer, microbiome, intestinal barrier and immune system are constantly interacting with one another.
Gut health is an ecosystem.
4. A diverse and resilient gut microbiome
Our gut microbiome contains trillions of microorganisms that interact constantly with both our diet and our bodies.
Gut microbes help ferment fibres and carbohydrates that we can’t completely digest ourselves, producing compounds called short-chain fatty acids, including butyrate, acetate and propionate.
These compounds have important roles within the intestinal environment, with butyrate in particular providing an important source of energy for cells lining the colon.
Gut microbes also interact with the immune system and intestinal barrier, participate in bile acid and vitamin metabolism and help create an intestinal environment that can make it more difficult for pathogens to become established.
But there is an important nuance around microbial diversity.
Greater diversity is often associated with health, while reduced diversity can occur in some disease states. However, there is currently no single “perfect” microbiome that everybody should have.
There can be enormous differences between the microbiomes of perfectly healthy people.
So rather than trying to micromanage individual bacterial species, it can be much more useful to think about creating an environment that supports a diverse, resilient and functional microbial ecosystem.
5. Good digestive function
Finally, there’s a very practical characteristic of good gut health:
Your digestive system needs to work reasonably well!
You should generally be able to eat and digest food comfortably, absorb nutrients, move waste through your gastrointestinal tract and have comfortable bowel movements without persistent digestive symptoms significantly affecting your life.
But healthy digestion does not mean perfect digestion.
Gas is a normal product of digestion and microbial fermentation.
Occasional bloating can happen.
Your bowel habits might change when you travel, eat differently, experience stress or move through different stages of your menstrual cycle.
Your digestive system is dynamic and constantly responding to your food, hydration, movement, hormones, stress, sleep, medication use and environment.
There’s an important difference between normal digestive variation and persistent symptoms that affect your quality of life.
Ongoing or concerning symptoms, particularly persistent abdominal pain, significant changes in bowel habits, blood in the stool, unexplained weight loss, difficulty swallowing or persistent vomiting, warrant proper medical investigation rather than simply assuming that you need to “heal your gut”.
So how can you support good gut health?
This is where gut health can become unnecessarily complicated.
For most of us, the foundations are much simpler than wellness marketing would have us believe.
A varied, nourishing diet containing plenty of different plant foods provides a range of fibres and polyphenols for our gut microbes.
Think vegetables, fruit, berries, beans and lentils if tolerated, nuts, seeds, herbs, spices and whole grains.
Fibre is particularly important, although increasing fibre gradually can be much more comfortable if your current intake is low.
Polyphenol-rich foods such as colourful fruit and vegetables, berries, herbs, spices, extra virgin olive oil, cocoa and tea can also help support the intestinal environment.
Fermented foods such as live yoghurt, kefir, sauerkraut and kimchi can be useful additions if you enjoy and tolerate them, but they’re not compulsory!
And gut health isn’t about living on vegetables.
Eating enough food, including adequate protein and overall nutrition, matters for maintaining and continually renewing the gastrointestinal tract.
Other simple foundations include:
- Chewing your food properly
- Eating in a reasonably relaxed state
- Staying adequately hydrated
- Moving your body regularly
- Getting enough sleep
- Supporting your nervous system and managing chronic stress
- Avoiding unnecessarily restrictive diets
- Investigating persistent symptoms rather than blindly taking supplements
You don’t necessarily need to “heal your gut”
Perhaps one of the most important messages from this episode is that you don’t need to heal a gut that isn’t broken.
There are absolutely situations where digestive symptoms need investigation and targeted support.
Conditions such as IBS, coeliac disease, inflammatory bowel disease, gastrointestinal infections, malabsorption, constipation, genuine food intolerances and other digestive disorders require appropriate assessment and treatment.
But if you generally digest your food comfortably, have normal bowel function, eat a varied diet and aren’t experiencing persistent symptoms affecting your life, you probably don’t need an elaborate “gut healing” protocol.
Supporting gut health doesn’t have to become another full-time wellness job.
Your digestive system is extraordinarily sophisticated and adaptable.
Give it a diverse, nourishing diet, plenty of fibre and plant foods, adequate nutrition, movement, hydration, sleep and the opportunity to digest your food properly, and then allow it to get on with doing its job.
Because gut health isn’t about perfection. It’s about function.
In this episode, you’ll learn:
- What “gut health” actually means
- Why gut health is about much more than your microbiome
- Why stomach acid is important for digestion and defence
- What the intestinal barrier and “tight junctions” actually do
- What people really mean when they talk about “leaky gut”
- Why your intestinal mucus layer is so important
- What a healthy gut microbiome actually looks like
- Why greater microbial diversity doesn’t automatically equal better health
- What normal digestive function can look like
- Why occasional gas and bloating aren’t necessarily signs that something is wrong
- The simple food and lifestyle foundations that support gut health
- Why you don’t necessarily need to “heal” or “reset” your gut
If you’d like to go deeper into the relationship between gut health, hormones and perimenopause, you can also listen to my previous episodes on Perimenopause & Your Gut and The Gut–Hormone Connection in Perimenopause.
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