SALT LAKE CITY — November is National Diabetes Month, a month when Americans across the country join together to bring awareness to diabetes.
Learning more about diabetes, its risk factors and treatments is key to prevention, as well as improving outcomes. The American Diabetes Association lists many risk factors for diabetes — such as diet, lifestyle, genetics and environment — but what about your gut health? Let's look at what the research says, plus learn how you can improve your gut health.
Gut health 101
Gut health refers to how well your gut performs the various aspects of digestion. From that first bite of food to emptying your bowels, and everything in between, digestion encompasses simple processes, such as chewing, as well as other more complex processes.
When talking about gut health, you'll often hear the term "gut microbiome." This simply refers to the trillions of microorganisms and bacteria that call your gut home. These beneficial bacteria help your body with many different functions, including digestion and absorption of nutrients, supporting your body's immune system, protection against pathogens you may have consumed, making vitamins and other compounds, and eliminating waste products.
Studies, like this 2019 study out of South Korea, have shown when the number of bad bacteria outweighs the number of good bacteria in your gut, these intricate processes suffer. Oftentimes inflammation is introduced, followed by a number of possible health problems.
Prebiotics and probiotics
Prebiotics are components of nondigestible fibers (a carbohydrate) found naturally in many plant-based foods, including fruits, vegetables and whole grains. Sometimes they are also added to processed foods.
Prebiotics pass through the digestive system without being digested. As they move through your digestive tract they promote the growth and activity of "good" bacteria. In a nutshell, they are the food for probiotics.
Probiotics are the "friendly" or "good" bacteria in your digestive system. These are live bacterial cultures found in certain foods or supplements, such as yogurt with live cultures, aged cheeses and fermented foods. They live in your gut and perform specific functions, as mentioned previously, to help keep your gut healthy and functioning properly.
Additionally, some of your gut bacteria form vitamin K and short-chain fatty acids. Short-chain fatty acids are the main source of nutrition for the cells that line the colon. They build a strong gut barrier that helps keep out harmful bacteria, viruses and other substances. Research published by MDPI in 2011 shows this process also reduces inflammation, and a 2020 article in the journal Current Medicinal Chemistry says it may reduce the risk of colon cancer.
What does the research say about gut health and diabetes?
When there is a lack of beneficial bacteria in the gut, there is less fermentation of dietary fiber, resulting in decreased short-chain fatty acid production. A 2018 study published in the March issue of Science magazine examined the link between short-chain fatty acid production and Type 2 diabetes. Chinese researchers randomized patients with Type 2 diabetes to receive either traditional patient education and dietary recommendations (control group) or a high-fiber diet composed of whole grains, traditional Chinese medicinal foods, and prebiotics (test group).
Researchers found that in the high-fiber test group there were more bacteria that produced short-chain fatty acid through fiber digestion, resulting in better improvement in blood glucose levels when compared to the control group. These results suggest that reduction in short-chain fatty acids in the gut may be associated with Type 2 diabetes.
Additionally, 2017 research from the Finnish Diabetes Prevention Study found that people who had more fiber in their diets had more anti-inflammatory markers in their blood made by gut bacteria. They also had a lower risk of developing Type 2 diabetes.
While these findings suggest possible links between gut health and diabetes, there is still much research to be done in this area. More large, high-quality studies are needed to determine how and why diabetes is affected by the gut microbiome.
Tips to improve gut health
1. Eat a healthy, varied diet
It really is true that you are what you eat, or at least your gut health is what you eat. Consuming a variety of prebiotic- and probiotic-rich foods will help your gut bacteria thrive, allowing them to better perform their daily digestive functions.
Prebiotics are found naturally in many plant-based foods, including asparagus, chicory root, garlic, Jerusalem artichokes, leeks, dandelion greens and onions. Other sources include bananas, apples, peas, beans, sweet potatoes, flaxseed, oats, wheat bran, whole wheat and cocoa. Sugar alcohols — such as sorbitol, mannitol and xylitol — can act as prebiotics as well.
Probiotics are found in cultured yogurt, tempeh, miso, sauerkraut, kimchi, kombucha tea, kefir (both dairy and non-dairy), and non-pasteurized pickled vegetables. There are many different probiotic supplements available. However, there are many different strains and not enough specific research done on each. With that said, a few specific strains of probiotic bacteria, including Lactobacillus and Bifidobacterium, have been shown to be beneficial and effective for overall gut health.
2. Stay hydrated
Staying hydrated is a simple way to support a healthy gut. Water is pulled into the large intestine by fiber to create softer, bulkier stools, allowing things to keep moving along smoothly. Stay hydrated by drinking plenty of water each day and avoid too much soda, sports drinks, punch and other sugar-sweetened beverages.
3. Enjoy meaningful movement
Finding a form of physical activity you enjoy can have a beneficial effect on your gut health. Physical activity helps food move along our digestive tract, leading to more regular bowel movements. Exercise can also help manage symptoms of an irritable bowel, such as constipation and bloating.
4. Reduce stress
This is easier said than done, but taking steps to decrease your stress levels will go a long way in improving your gut health. In an article from the December 2015 issue of Nutrition in Clinical Practice, the Cleveland Clinic's Gail Cresci explains how stress has been linked to irritable bowel symptoms and overall decreased gut health.
Explore and find ways to manage your stress and practice them regularly. Some ideas include meditation, yoga, deep-breathing exercises, exercise, journaling or talking with a good friend.
5. Get enough sleep
Getting seven to nine hours of good-quality sleep each night helps improve mood, cognition and gut health. A 2019 study found that better sleep quality was associated with higher proportions of the gut microbiota.
If you don't get enough quality sleep, start by creating a routine of going to bed and getting up at the same time each day. Putting away cellphones and turning off the TV at least an hour before bedtime can help your body get ready for sleep, too.
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