Guidelines for optimal wellness
So how do we actually go about healing the gut–brain axis? Do we target mental health and watch digestive function fall back into place? Or do we heal the gut and wait for improvements in mood?
The answer is that we do both.
Recent research suggests that in people with both digestive upset as well as some form of mental illness, two-thirds of the time it’s the gut issues that comes first.6 The remainder of the time, depression or anxiety precedes the tummy troubles. What this tells us is that the relationship works both ways.
It’s worth remembering that the gut has its own nervous system, called the enteric nervous system (ENS), which contains as many nerve cells as the spinal cord. It is constantly collecting information from the digestive system and relaying it to the brain, and returning the brain’s own signals back to the gut.
The ENS itself is intricately connected to the parasympathetic nervous system (PNS), which is also called the ‘rest and digest’ nervous system because it is activated during times of rest and stimulates digestion. On the other hand, our ‘fight-or-flight’ digestive system, known as the sympathetic nervous system (SNS), is involved in the stress response and can disrupt healthy digestion. This is perhaps most obvious in cases of a ‘nervous tummy’, where feeling anxious can send someone rushing to the bathroom or give them a terrible tummy ache.
For a truly holistic approach to treating the gut–brain axis, we need to come at it from multiple angles.
Now consider that the messaging runs in the other direction too. Most notably, the many different bacteria that call our digestive system home release a cocktail of compounds—both good and bad—that cause changes in the brain, impacting mood and cognition. Many also impact inflammation in the digestive and nervous system tissues.
You’re probably starting to get an understanding of just how complex the relationship between gut and mind is now, and we’re only scratching the surface. In this still-emerging branch of healthcare, there is still so much we’re yet to learn. What is clear is that for a truly holistic approach to treating the gut–brain axis, we need to come at it from multiple angles.
It’s my prediction that in coming years we are going to see continued advances in our understanding and treatment of gut health. But we’ve actually got enough to get started already and to take charge of our gut health naturally.
Throughout this book we take a closer look at three of the biggest factors that are taken into account when assessing gut health from a naturopathic point of view. The first is ensuring proper stomach acidity and digestive enzyme release in the gut. The second is decreasing inflammation in the digestive tissues, and symptomatically treating complaints that arise from an unhealthy gut. Finally, and perhaps most importantly, we consider the role of the gut microbiota—that’s the bacteria who call our digestive tracts home. On top of that, we’ll also take a look at dietary and herbal approaches to directly influence mood, energy and sleep.
But before we get into the specifics, it’s important to build a solid foundation. The following guidelines, informed by modern research as well as traditional wisdom, form the basis of my natural protocol to enhance digestion and mental wellbeing through diet, lifestyle changes, and traditional herbal therapies.
FOOD AS MEDICINE
I’m not a fan of fad diets. To really have a healthy diet, it’s essential to start with a healthy mindset, and I just don’t think that trends and tricks are the way to do that. We need to first recalibrate to think of good nutrition as nourishment, and not as a means to punish ourselves. We need to let go of the idea of ‘clean eating’ as if our indulgences are somehow dirty or shameful. We need to let go of the clique culture that come with so many of the current foodie fashions—no matter how well intentioned—and instead embrace healthy eating for what it is: our number one weapon against the rise in lifestyle-related disease. And we’re all in this together. Every one of us has experienced a sugar binge or an irresistible carbohydrate craving. And I imagine that most of us have been a little heavy handed when pouring the wine at times. We’re all human.
But if we peel back the labels from these seemingly different diets, we can instead take a look at what’s similar about them. About 90 per cent of their basic principles are shared, and can be summed up in a single phrase: eat whole foods. The profound health benefits of enjoying a diet made up of fresh fruits, vegetables, whole grains, nuts and seeds are well documented. When in doubt over an ingredient, I always ask myself whether my pop—the man who taught me how to grow my own food—would be able to identify it. He would be unfamiliar with most of the packaged and processed foods we see today, but could name any fruit or vegetable you placed in front of him. It’s these real foods that should make up the bulk of our diets.
Do this an you’re most of the way there. But there are still a few more things you need. It’s these things that make up my ten guidelines for a healthy gut–brain axis and that inform the remedies and recipes in this book.
“The profound health benefits of enjoying a diet made up of fresh fruits, vegetables, whole grains, nuts and seeds are well documented.”
Giving a concentrated sugar source to your gut bacteria is about as inadvisable as giving one to a toddler, and the result is not dissimilar. Chaos will ensue. This is especially true when those sugars are either lactose or fructose, which in sensitive individuals can be left incompletely digested, leaving them available for the resident bacteria to swoop in and use as a food source instead. This process of fermentation results in your intestines blowing up like a balloon and can leave you feeling uncomfortable.
Apart from the obvious sugar hits like lollies, chocolates, sweetened breakfast cereals and soft drinks, this also means waving goodbye to fruit juices and dried fruit. But the most common question I get around sugar is: what about fresh fruit? And it’s not a simple answer. For most people, one or two pieces of fruit per day is a good source of fibre and vitamins. But in a compromised digestive system, even the sugars in fruit can be problematic. If you think this applies to you, have a read about the low FODMAP diet on page 72 and assess what’s right for you.
Reduce refined starches and grains
There’s been a lot of confusion around grains lately. This is partly due to the popular Paleo movement, which seems to have adopted the mantra ‘we are not designed to eat grains’ while ignoring the fact that history is littered with inconvenient evidence showing Palaeolithic-era people ate grains. The real problem we face today is with the quality and volume of grain-based foods that make up the Western diet. We have stripped our grains of fibre, ground them down to refined, starchy powders and beaten them into forms that behave much more like sugar when they enter the body. So, it’s inaccurate to point the finger squarely at grains, when in fact the grains we eat are so different from how they are found in nature.
There is also a tendency to overeat this food group, due in part to the drug-like effects they exert in the brain, and partly because they’re cheap. As part of our approach to gut healing, I recommend you break up completely with grain flours, breads, pastas and white rice. Instead, get your starches from wholegrain, seed, and root vegetable sources like the ones listed below:
• Brown rice
• Oats
• Quinoa
• Buckwheat
• Millet
• Amaranth
• Sweet potato
But even then, how much can you have? What’s the golden number? There isn’t one. Every individual is going to react differently to starchy carbohydrates, but my recommendation is to start with two small half-cup serves per day of the foods listed above, and then pay attention to how your body reacts. Adjust your intake as is necessary until you find your sweet spot. In the meantime, make up the remainder of your carbohydrate intake with brightly coloured vegetables.
Embrace a plant-based diet
On that note, it’s time to talk about eating your greens. You don’t have to be vegan to enjoy the benefits of a plant-based diet. The advantages of eating mostly plants come mainly from the increase of fibre and phytonutrients, and this can be achieved without completely eliminating meat and animal products.
Specifically, for gut-health, it’s prebiotic-rich plants that we want to focus on. Prebiotics are a type of fibre that promote the growth of good bacteria in our gut. They feed these good bacteria and allow them to flourish. High levels of prebiotics are found in plants like asparagus, onion, garlic, chicory root and Jerusalem artichoke. If you’re looking at the above list with mild terror and IBS flashbacks, you’re not alone. In some compromised digestive systems—whether it be from low enzyme activity, bad bacterial overgrowth, or both—prebiotic foods can trigger symptoms of IBS. So not everybody can eat them. However, they are also key to long-term healing and are an important addition to our gut–brain axis diet. The key is to start small: build up your tolerance over time and make sure you are using bitter herbs and carminatives along the way to manage your symptoms. You’ll read more about these in chapters six and seven.
Adequate protein is essential
With all of our happy hormones—think serotonin, dopamine and GABA—being made of amino acids, it makes sense that to keep levels up in our diet. Protein is the way to do that. It also changes the way our body uses sugar, slowing its absorption and reducing the mood highs and crashes that accompany a sharp rise and fall in blood glucose.
Whether you obtain your protein from plant or animal sources will depend on your ethical stance. Personally, I choose not to eat red meat. As a guide, I recommend:
• At least two of your three main meals should contain a serve of protein from animal sources, if you eat it. For meat or fish, the piece doesn’t need to be much larger than the palm of your hand (not including your fingers, that is). If you prefer eggs, two or three is enough. Dairy is another great source of complete protein.
• Snacking between meals can be a good way to increase overall protein intake through plant foods such as nuts and seeds.
If you’re completely vegetarian or vegan, congratulations on what I think is a pretty incredible ethical and environmental choice. It’s also much more difficult to get a balanced diet, though. Keep in mind you will need to make your serving sizes much larger than the ones outlined above. Despite what the meme-of-the-moment might say about broccoli over beef, the truth remains that even the best plant sources of protein—nuts, seeds, pulses and legumes—are less concentrated than their animal counterparts, and you need to be really dedicated to make sure you’re eating plenty of them at every meal.
Balance your fats
Let’s face it: the most exciting discovery in recent years is that when it comes to health, fat is no longer the bad guy. We now know it’s not the one-stop-shop for lifestyle-related disease that we used to think it was. The fat debate has been going back and forth for years, swinging wildly between the fat-free products of the nineties, and the more recent revival of coconut oil, butter and even lard.
Our relationship with dietary fats has been a turbulent one, but the discussion that seems to be missing is that of balance. While fats certainly play an essential role in the body, that doesn’t mean it should be a free-for-all. Similarly, stripping your diet completely of fats isn’t the way to go.
Instead, a good rule of thumb is to use fats enough to ensure satiety, without going overboard. That is to say, a drizzle of your favourite oil over a salad, or a tablespoon of nut butter in a smoothie will help keep you feeling fuller for longer, especially while you get used to the reduction of starchy grain-based foods that I recommend in this book. Polyunsaturated fats such as those in fish, chia and flaxseeds in particular are beneficial, as they possess anti-inflammatory properties and may also act directly on nerve cells to improve their structure and function.
Eat lightly
I mean this literally. Try not to overburden your digestive system with enormous portion sizes and be conscious to eat slowly. Overwhelming your gut, even with healthy options, can result in digestive upset much like eating the wrong foods can. Just remember that your belly is loaded with acids and enzymes waiting to break down your food, but if bombed by too big a serving, they just won’t be able to keep up and there will be more opportunity for fermentation and digestive upset.
Don’t self-medicate if you don’t have to
On the topic of those enzymes, did you know we drastically reduce their activity, or erode the valuable gut lining, just by taking some over-the-counter medications? Antacids and non-steroidal anti-inflammatory drugs should be approached with a degree of caution, and only used when absolutely necessary.
On the topic of antacids in particular, I have a few herb nerd suggestions it may be worth keeping up your sleeve. Herbal medicines can be so effective for a range of digestive complaints, and we’ll explore the dried herbs you need to start your gut-health apothecary in the next chapter.
While we’re on the topic of self-medicating, we should address alcohol too. It’s hardly news that excessive alcohol consumption isn’t good for you, but sometimes we need a reminder. Instead of reaching for a glass of wine at the end of a stressful day, relax with herbal teas like those on pages 166 and 119.
A drink every now and again won’t hurt, but my recommendation is to keep it to one or two glasses of (preferably red) wine or the same number of standard serves of white spirits. And I recommend not drinking on more than two nights of the week. Too much or too often and you’ll disrupt sleep, negatively impact your liver function and disrupt your gut bacteria.
Hydrate, hydrate, hydrate!
Never underestimate the power of hydration. Every now and again, when I give this advice out, someone rolls their eyes. ‘Water is obviously good for us,’ they say, ‘tell us something we don’t know.’
The problem is that as much as we all know drinking enough water is important, so many people still don’t actually do it. The 2-litre rule is a good starting point, but I would add two extra 250-millilitre glasses for every coffee consumed or hour of intense exercise performed that day.
Love your food
In a world of gluten-free, low-FODMAP, dairy-free foods, I would like to suggest we start celebrating what is in our foods, rather than what has been taken out of them. Don’t get me wrong, there is a time and a place for all of the above—and they have all been catered for in this book—but we are losing sight of the fact that good nutrition is as much about increasing goodness and bolstering the nutrition in our food as it is about removing potential dietary irritants.
Wholesome, healthy, whole foods are worth celebrating. They bring people together, give joy and nourish our bodies. It’s the main reason I tell anybody who will listen that one of the best things to do for your health is to learn to cook. I also recommend growing some of your food yourself—or at least introducing yourself to your greengrocer—as a way to enhance connection with your community, your environment, your food supply and ultimately your health.
Every now and again, forget everything I just said
You might have heard of something called the eighty-twenty rule, and it’s important. It basically means adhering to a set of dietary principles eighty per cent of the time and then throwing caution to the wind and just enjoying yourself for the rest of it.
To come full circle in this conversation about food as medicine, a healthy diet requires a healthy mindset. That means feeling positively about food, and enjoying the experience. So, every now and again, in the name of good mental health, cast aside the first nine guidelines and just indulge.
HERBAL REMEDIES
Both the digestive and nervous systems respond beautifully to herbal medicine, and so to complement the dietary measures explained in this book, I’ve compiled some of my favourite remedies to tackle imbalances of the gut–brain axis.
Among the recipes are teas to tackle anxiety and tinctures to reinvigorate a tired mind. Implementing herbal medicine measures alongside the nutritional aspects of good gut health will help fast track your results, as well as give you the skills to whip up a home remedy specifically targeted to whichever tummy trouble comes your way. For example, if you’ve got bloating that just won’t go away, check out the homemade tummy troubles tincture recipe on page 105, or if your heartburn has flared up, then the marshmallow latte on page 112 might be just what you need.
All of the remedies in these pages have been tried and tested, and are informed by modern research and a long tradition of use in herbalism. If, however, you find yourself struggling with ongoing symptoms, always get yourself down to the doctor for proper investigation. This book is certainly not intended to take the place of proper medical care, but rather provide gentle and effective remedies to take charge of your gut health—and in doing so, your mental and emotional wellbeing.
A truly holistic approach to wellness incorporates not only how we feed our bodies, but also how we use them. Regular exercise has been rigorously studied in terms of its effect on mood, and the results invariably show that it is an important consideration in the natural management of depression and anxiety.
In fact, exercise has been suggested to increase not only the production of serotonin—one of our ‘happy hormones’—but also its release for use in the brain. Aerobic exercise such as running, swimming or high intensity interval training is my recommendation. If you’re new to exercise or not able to train at that kind of intensity, a brisk walk is a nice place to start. At a minimum, you should be moving at a pace that lifts your heart rate slightly, brings on a light sweat after ten minutes or so and makes you breathe a little faster to the point where carrying on a conversation becomes difficult, but you are not completely out of breath.
I’d also suggest doing it first thing in the morning when our bodies are primed for activity. Cortisol, one of our stress hormones, is highest before midday and so we should be making the most of it and getting our workouts done early. Conversely, working out too late in the day can disrupt normal circadian rhythm and interrupt sleep.
But the toughest hurdle to overcome in terms of exercise might just be finding the time to do it. We all live increasingly hectic lives and so prioritising health can be difficult. But with exercise being one of our best weapons against lifestyle-related disease, it seems odd that it’s not prioritised as highly as our work and social lives.
The trick, then, is recognising that fitness is of equal importance as your other commitments. Learning to make exercise a priority, and not an afterthought, is key to creating healthy habits.
And let’s not forget that a sedentary lifestyle interrupts normal digestive processes, so for the sake of a healthy gut it’s essential to move your body every day. With perseverance, you will reap the rewards over time.
STRESS LESS
Easier said than done, I know. Stress creeps into every corner of our lives and there is no one single way to manage it. Dealing with the demands placed on your mind and body is an essential component of overall wellness, but how you achieve it will be a very personal experience. One thing is for sure, though: it can’t be ignored.
Firstly, to get a better understanding of stress, it needs to be said that not all stress is bad. Eustress, also known simply as ‘good stress’, is a physiological response controlled by the sympathetic nervous system, or the ‘fight or flight’ nervous system. Hormones like adrenaline and cortisol are also involved. Its purpose is to help you get things done. Whether it’s running away from a sabre-toothed tiger, hunting for your tribe or (perhaps more realistically) just meeting that deadline at the office, stress is often an unavoidable side effect of achieving the desired outcome.
But, unfortunately, we don’t just use the stress response for one-off tasks anymore. We flick the switch to ‘on’ and we never turn it off. We run errand after errand, always feeling like we’re struggling to get ahead. We juggle family commitments with professional ones, but totally overlook our need for rest and recovery. It’s this form of stress we are all more familiar with.
The main problem associated with operating in fight-or-flight mode all the time is that our parasympathetic nervous system never gets a chance to operate the way it should. As mentioned earlier in this book, the parasympathetic nervous system is also known as our ‘rest and digest’ nervous system, so you can imagine the problems that arise when we don’t make time to relax and let the parasympathetic take over.
Our gut is a very good indicator of what’s going on in terms of stress. When the sympathetic nervous system—that’s the fight-or-flight one—is activated, the body’s resources are diverted away from the gut and towards the brain and muscle tissues instead, to help us think and act quickly. Over time, our digestion suffers.
So, what’s the fix? As I mentioned earlier, there’s no one single approach. For some people, meditation is the answer; for others, cognitive behavioural therapy offers solutions. Yoga is another option, as it also provides the benefits of exercise that were mentioned earlier.
It may be as simple as making time to go for a walk in nature. The Japanese concept of shinrin-yoku or ‘forest bathing’ is the practice of spending as little as twenty minutes surrounded by nature, and has been shown to improve mood, reduce blood pressure and even strengthen immunity.
SLEEP
Sleep is another strong indicator of mental wellbeing, as well as a target for natural treatment to improve mood and energy. For overall wellness, it is essential to promote good sleep onset and maintenance—onset is how long it takes to fall asleep, whereas maintenance refers to how often you wake up throughout the night.
Along with the herbal remedies outlined later in the book, the first step to good sleep is to ensure what we call proper sleep hygiene. Despite the name, that doesn’t refer to clean sheets—although who doesn’t love fresh sheets?
Sleep hygiene is a set of habits that put you in the best position for a restful slumber. There is a simple set of rules that I follow to do this:
1 Charge your phone in another room overnight. This prevents distractions like checking emails or social media, which keeps your brain alert and prevents sleep onset.
2 Watch TV from the couch, not the bed. This goes for any other activities that involve bright screens. The light triggers your brain to remain alert and it’s better that you associate your bedroom with rest and relaxation rather than the frenzied activity of whichever series you are binge-watching.
3 Go to bed when you’re tired. Ideally, you should be aiming to go to sleep around 10pm. That is when a healthy body is hormonally primed for a restful slumber. But years of late nights, intense stress and disrupted daily rhythm can throw this awry. So, rather than putting yourself to bed at a certain time, stay in tune with your body and follow the wave of drowsiness. If you go to bed and don’t fall asleep within 20–30 minutes, get up and do something else until you feel ready to sleep.
4 Develop a ‘sleep ritual’. This may sound a little odd, but the process of training yourself to have a set of calming practices leading up to bedtime can make all the difference. It takes some discipline initially, but once you are in good habits, then the rest becomes much easier. For example, my sleep ritual looks a little like this: after dinner, I make myself a cup of tea (the recipe on page 119 is perfect) to mark the beginning of my wind down time. After that, I don’t allow myself to check social media or answer emails. During these few hours between my cuppa and bedtime, my home is a no-stress zone. I might take a bath or read a book, but nothing that will trigger my fight-or-flight nervous system and make me restless. If something is on my mind and I can’t shut it out, I have a dedicated notepad that I write it down in. Getting it out of my mind and onto paper gives me permission to forget about it until morning, when I can pick my problem back up again and work on a solution. But for now, it’s time to sleep.
NOTE: The recommendations in this book are not a replacement for proper medical care, and should be considered alongside the advice of your trusted healthcare professional.
6 Koloski, NA, Jones, M & Talley, NJ 2016, ‘Evidence that independent gut-to-brain and brain-to-gut pathways operate in the irritable bowel syndrome and functional dyspepsia: a 1-year population-based prospective study’, Alimentary Pharmacology & Therapeutics, vol. 44, no. 6, pp. 592–600
Limit your sugar intake
