Estimated read time: 7-8 minutes
People are no longer willing to blame common bouts of bloating, indigestion, and other digestive issues on an irritated stomach. Over the past decade, many Americans have started to realize just how important gut health is to their overall physical and mental well-being. And their search for products and treatments to promote a healthy gut has taken off.
"The most digestible piece of advice we have to offer for the public is fiber," says Amiko Uchida MD, a gastroenterologist and physician-scientist with University of Utah Health. "This is a nutrient that is dramatically lacking from the traditional diet, particularly in the United States and other developed countries."
Uchida is passionate about helping her patients and the public achieve better gut health. Often that starts with building their trust in the current science and research, like statistics that show up to 95% of Americans are not getting enough fiber in their diets.
Fiber is an essential part of sculpting and shaping the gut microbiota — the community of trillions of microbes, including bacteria, that live in your digestive tract. This gut microbiota is a major part of the human microbiome, which refers to all the microorganisms living in and on the body. These microbes play a vital role in digestion, nutrient absorption, and supporting the immune system.
Eating more fruits and veggies, a primary source of fiber, might sound like an easy fix. But accessing those foods can be a struggle for many people.
"With fiber, it is difficult, especially when we think about cities and communities that are food deserts," Uchida says. "In those places, nutrients in general can be hard to find while the foods that are available are highly processed or ultra-processed."
About 65% of the food available in the United States is ultra-processed, Uchida adds. "And the sticker price on fresh foods is higher. These are very important barriers that affect our entire country's health."
U of U Health initiatives are addressing this lack of access to fresh foods. "The U has a food pharmacy program that is in various stages of growing," Uchida says. "And there are a lot of providers and investigators at the university who would like to see the program grow into something even bigger, like a farm."
The importance of the microbiome
For people who can eat a balanced diet, reduce stress, and get enough exercise, the quest is still on to proactively care for their gut microbiome. Scientists are also studying the link between gut health and immunity, mental health, chronic diseases, and people's brains.
"It is important to think about the gut as a central location in our bodies," Uchida says. "It's a unique environment where foods are interacting with microbes, which are interacting with our own immune system and gut lining. They are all in an orchestra, producing different things like metabolites and hopefully working together. Those metabolites can be absorbed and travel to different places in the body, like the brain, and have beneficial anti-inflammatory effects."
The gut-brain connection
Mounting evidence connects the health of the gut microbiome and Alzheimer's disease. In his book, "Heal Your Gut, Save Your Brain," Partha Nandi, M.D., FACP, suggests gut care could drastically alter and transform the treatment and prevention of Alzheimer's.
"By targeting gut health, these patients and their families may have another means to address Alzheimer's with simple, effective principles that can impact the development of this neurodegenerative disease," Nandi writes.
Many ongoing studies are examining the link between gut health and cognitive decline, Uchida says. "People are looking at models, oftentimes using animals, to study if we modulate their diet and see less incidence of the 'mouse version' of dementia or this neuroinflammation that we think might predispose or eventually lead to things like dementia."
One of Uchida's colleagues during her fellowship at Massachusetts General Hospital is directing clinical investigations at Harvard Medical School into how the brain and gut communicate with each other.
Trisha Pasricha, M.D., a specialist in neurogastroenterology, focuses on gut health's connection to Parkinson's disease. In 2024, her lab published findings showing that damage to the upper lining of the gut was associated with about a 76% increased risk of developing Parkinson's in the future.
In a video released in December 2024, Pasricha said the goal of her lab's research "is to find an early biomarker of Parkinson's disease, and our hope is that we can find one in the gut."
She suggests it might be possible in the future to "Get your screening colonoscopy and be told that there is a sign you will progress to Parkinson's disease unless doctors intervene now."
At the center of Pasricha's research is the vast nervous system in people's guts, which can set off a variety of connections with the brain. In fact, the gut has often been referred to as a second brain — and there's a simple reason why.
"The second most abundant location for nerves, outside of the central nervous system in the brain and spinal cord, is the gut," Uchida says. "I think that resonates with people when they think about simple things like where they feel emotions."
She also points out that "The nerve endings in the gut are right there with the immune system in the gut. They are talking to each other, and that's why researchers are using basic science to try and understand these relationships."
Improving health through research
Uchida is in the midst of conducting clinical research at U of U Health into the link between gut health and its impact on allergic diseases like eosinophilic gastrointestinal (GI) disease and inflammatory bowel disease. Both conditions can lead to severe abdominal pain, diarrhea, vomiting and difficulty swallowing in patients.
In support of this kind of research, the University of Utah is also home to the Microbiota and Gastrointestinal Immunology Consortium (MAGIC), a leading hub for microbiome research. MAGIC brings together experts across disciplines to better understand how microbial communities influence human health and disease — from chronic illness to brain function.
It will take time, funding, and the support of the public for researchers like Uchida, Pasricha, and Nandi to make the best connections between gut health and a longer and healthier lifespan.
"One of the big messages that I hope to get across is that as a society, we really need to value science so that we can get better information and care for our patient population," Uchida says. "We continue to try our hardest and push forward to provide them with the best care possible by bringing together our clinical knowledge with new high-quality research."
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