Constipation is such a common problem these days, and most people have experienced it at some point in their life. If you are young and don't have any other medical problems, it is unlikely that there is an underlying serious cause, but it can be a real problem to live with. There are many drivers of constipation ranging from a poor diet, dehydration, hormone imbalances, sugar, alcohol, and a dysbiotic gut. In this article I am going to discuss how we can use food-based interventions to support a healthy digestive system. I want to reinforce the fact that we are, quite literally, what we eat, and talk about the different food groups and how they can support a healthy microbiome. I will also give you my top 10 gut-friendly foods for constipation and why I love them. Hopefully some of these tips will help you to manage your symptoms through the festive period and kickstart your journey to digestive ease.
Food Groups and the Microbiome
Healthy Natural Fats
Good fats are rich sources of omega-3, butyrate, antioxidants, and energy that help to lubricate the gut and support healthy, regular bowel movements. They are found in plant foods, such as nuts, seeds, extra virgin olive oil and avocado, as well as meat, some dairy, and seafood. Oily fish is a great source, as well as coconut oil, butter, and ghee. Monounsaturated (nuts, avocado, olive oil) and omega-3 fats (hemp, flax, oily fish) are beneficial due to their anti-inflammatory properties. Coconut oil contains caprylic acid which has anti-fungal properties, and ghee/butter contains butyrate, a short-chain fatty acid that has many gut-healing benefits. I talk more about ghee later on in my ‘top 10 gut-friendly foods’.
Increasing your intake of healthy fats will also help to reset your metabolism and reduce blood sugar as they provide a steady source of energy that doesn’t stimulate the release of insulin (fat storage hormone).
Bad fats you should always try to avoid include trans and partially hydrogenated fats which are found in margarines and processed packaged foods such as biscuits, takeaways, and ready meals. They are also used in many restaurants as they are cheaper to use for cooking.
Dietary fibre encourages gut motility and peristalsis. It acts like a broom for the digestive system, helping the gut to push waste through the system. Fibre is made up of non-digestible carbohydrates and acts as a source of energy and nutrients for the good bacteria that live in your gut. Soluble fibre holds water and softens the stool, helping it to move through the intestines. Insoluble fibre doesn’t dissolve and brings bulk to the faeces, improving stool transit. All plant foods contain some form of fibre and of the two, insoluble fibre helps to relieve constipation and other bowel disorders, such as haemorrhoids. Current guidelines suggest a daily fibre intake of 30g which can be achieved by eating foods such as oats, lentils, root vegetables, asparagus, leeks, celery, prunes, figs, pears, apples, vegetables, beans, seaweed, and psyllium husks. Soluble fibre also contains inulin and Fructooligosaccharides, also known as prebiotics, and are important food sources for your microbiome, promoting the growth of beneficial bacteria. Through the fermentation of this fibre, these bacteria also produce short-chain fatty acids such as butyrate, which play an important role in gut health. I will talk more about the benefits of butyrate later in the article.
Polyphenols and phytonutrients
Polyphenols are antioxidants that are found in many plant-based foods containing fibre. They have anti-inflammatory properties and are supportive of good gut health, as well as for your brain and heart. Polyphenol-rich foods act as prebiotics, as they seem to increase the levels of good bacteria in the gut.1 The antioxidants are processed in your gut by microbes and help to support a healthy balance of gut bacteria. Good sources include herbs, spices, berries, nuts, seeds, dark chocolate, and green tea.
Phytonutrients (also referred to as phytochemicals) are compounds which give fruits and vegetables their colour. They evolved to help plants protect themselves from insects and disease, and in the same way can offer us some support. Research shows that by eating a variety of colourful fruit and veg rich in phytomchemicals, we can support a healthy microbial balance in the gut and reduce inflammation. So as we enter the indulgent festive season, remember to try and include as many different colours as possible in your meals.
Probiotics and prebiotics
Prebiotics are food sources of fibre that encourage the growth of friendly microorganisms in the gut. Probiotics are live microorganisms that support our whole inner ecosystem, and are found naturally in fermented foods, such as sauerkraut and yoghurt, and also come in supplement form. They increase the levels of friendly bacteria and drive down the numbers of harmful ones. Probiotics support the digestion of food and the absorption of nutrients, and their first use dates back to the 1950s when they were used to treat irritable bowel syndrome. They work by replacing the indigenous colonies missing from your ecosystem due to poor diet, antibiotics, medications, and stress. The most important facet to consider with probiotics is getting the right strain for the health condition in question, as there are many different strains and they all have different actions in the body. For instance, it has been shown in a randomised, controlled study2 by Banasiewicz et al. that certain key bacteria within the colon, such as Bifidobacterium and butyrate-producing colon bacteria, can speed up gut transit time and reduce pain associated with constipation.
Whole grains are a great source of nutrients and certainly play a role in a well-balanced diet. Wholegrain varieties, such as brown rice, quinoa, oats, amaranth, and buckwheat offer valuable sources of fibre. However, certain gluten-containing grains can irritate the gut in certain people and so should be reduced or avoided. Modern diets contain too much wheat and the highly refined varieties found in white bread and pasta can cause digestive problems for some people as well as leading to rapid spikes in blood sugar levels. When working with digestive disorders, such as constipation, grains should be reduced to avoid fermentation of carbohydrates in the gut, as they are more difficult to digest if not prepared properly by soaking and sprouting. Instead, focus on carbohydrates from starchy vegetables, such as root veg, until your gut has healed.
Fermented dairy such as yoghurt and kefir drinks are an excellent source of protein and probiotics, which can support good levels of bacteria in the gut. However, dairy is low in fibre and contains the sugar lactose which is problematic for many people, causing symptoms such as bloating, cramps, diarrhoea, and constipation. Lactose intolerance affects up to 75% of the population and so may be the cause for some of your gut problems. I always recommend brief elimination diets with my clients to see if symptoms improve. If you are lactose intolerant, you may be able to tolerate homemade fermented yoghurt and kefir, butter and ghee, which are all low in lactose. Caesin is a protein found in dairy and can promote inflammation in certain people, resulting in irritation to the gut lining. Ghee contains no lactose or casein protein, and so is often more tolerable for people with lactose intolerance. It is also an excellent source of butyrate and vitamins A and D, all of which are important for gut healing.
Many people do not consume adequate protein for their body’s needs, especially if they require healing. When it comes to gut health, eating a variety of good quality protein is key, from sources such as pulses, beans, eggs, fish, poultry, tofu, nuts, seeds, and tempeh. Nuts are high in protein and fibre. Soaking or sprouting them can improve their digestibility, as they naturally contain substances that inhibit enzyme activity. Putrefactive fermentaion of animal sources of meat, especially red meat, can worsen symptoms of constipation, so stick to plant-based sources, oily fish and poultry.
Dehydration and a lack of fibre in the diet are the usual suspects for constipation, although a change in environment (such as travelling abroad), a sedentary lifestyle, stress, hormone imbalances, or a medical condition such as irritable bowel syndrome can all play a role. Diet is paramount to helping with constipation, and your first step should be to increase your fibre intake, of both soluble and insoluble fibre.
Probiotic supplements may be necessary for you if you are’t consuming enough fermented foods in your diet, or you have ongoing gut problems. Fermented foods don't exert therapeutic effects in the same way as a probiotic supplement, and this is because of the way that strain composition and stability varies between supplements. The probiotic strains used in supplements are standardised and well researched, meaning you can use specific strains to target your health conditions effectively. As I mentioned earlier, Bifidobacteria is a species that has been researched for its beneficial role in modifying gut transit time and can be used in place of a harsh laxative that often fosters dependency and doesn’t work in harmony with your gut.
OptiBac Probiotics ‘Bifidobacteria & fibre’ combines the extensively researched BB-12 strains to relieve constipation. Deficiencies in this particular species of bacteria can be a cause of ongoing sluggish stools, so it is worth trying a course to see if your symptoms improve.
Digestive enzymes are necessary to break down molecules like fats, proteins and carbs into even smaller molecules that can be easily absorbed. Without sufficient digestive enzymes, the body is unable to digest food particles properly, so they are another important factor in good gut health.
There are three main types of digestive enzymes:
> Proteases - break down protein into small peptides and amino acids
> Lipases - break down fat into three fatty acids plus a glycerol molecule
> Amylases - break down carbs like starch into simple sugars
Including foods rich in enzymes may help to ease some of your digestive symptoms. Here are four foods that will increase your levels of natural digestive enzymes:
Pineapples may provide a special boost to digestion, because they contain an enzyme called bromelain which supports the breakdown of proteins. Bromelain also has anti-inflammatory properties, so is great for calming and soothing the gut.
Add to kale smoothies to reduce the bitterness and strong flavour.
Avocados contain the digestive enzyme lipase. This enzyme is essential for the metabolism of fats and can reduce the discomfort of indigestion.
Add ¼ of an avocado to your smoothie or top your salad with cubed pieces.
Fermented vegetables are an excellent source of enzymes and probiotics to help boost your gut health.
Use 1-2 tsps with every meal to support digestion.
Chlorella is a type of algae and is a good source of vitamins, minerals, and digestive enzymes such as chlorophyllase and pepsin. It is also a good source of fibre and may increase your levels of Lactobacillus bacteria.
Occasional fasting can be beneficial for gut health if you are in general good health. It can be an effective way to rest your digestive system, encourage cellular healing, clear the body, and lower inflammatory markers. I encourage my clients to fast for 12-14 hours overnight, which means having an early dinner (no later than 7pm) and then breaking the fast between 7am and 9am the next morning. There is also the 5/2 method whereby you eat three normal meals per day for five days of the week, and then you restrict your calories by half for two days of the week. I also like the two day water/juice/broth fasts every three months. However, if you have poor adrenal function, blood sugar imbalances, and ongoing high stress levels, fasting may be harder and potentially not very beneficial for you.
Establishing healthy habits
To improve your gut health and digestion and reboot your biome it is also important to build healthy habits in to your daily routines. Ensure you keep hydrated, as water is essential for digesting and absorbing foods. Aim for 8 glasses per day and include broths, herbal teas, and homemade green juices and smoothies. Limit your intake of refined sugars and carbohydrates, as they are inflammatory and provide food for potentially harmful bacteria. Eat a diverse range of high-fibre fruits and vegetables, rich in colour and antioxidants, by buying seasonal produce that changes throughout the year. Your gut bacteria will thank you for it. They get 'bored' when you eat the same things over and over again - be adventurous in your cooking and try a new food every week to support diversity. And lastly, eat mindfully to promote healthy digestion. Good digestion is just as much about how you eat as what you eat. Focus on what’s on your plate and not whats on your screen! Put your phone away and reclaim your lunch break. Take your time, smell your food, and do not overeat.
Foods for constipation: 10 gut-friendly foods and why I love them
1. Magnesium-rich leafy greens
Magnesium is important in muscle function, particularly contraction and relaxation. The gastrointestinal tract is one long muscle, so consuming foods rich in this mineral will support gut motility and peristalsis. Good food sources include green leafy vegetables, fish, lentils, nuts & seeds.
2. Pickles and fermented foods
I recommend consuming 1-2 tbsp homemade pickles, sauerkraut or kimchi just before or with each meal, to stimulate your digestion. These foods have additional benefits in that they also boost the gut flora.
3. Bitter foods
Bitter greens and sour foods (chicory/rocket/watercress/dandelion/radicchio) help to stimulate digestive secretions. Use them in salads, smoothies or make a vegetable juice.
4. Live apple cider vinegar
If you suffer from low stomach acid, try adding 1-2 tbsp of raw apple cider vinegar in a small amount of warm or cold water before meals. Raw, unpasteurised apple cider vinegar contains probiotics that will top up your levels of good bacteria and support optimal digestion of food.
Turmeric contains at least 200 different compounds, including curcumin which has powerful antioxidant and anti-inflammatory properties, and is good at inhibiting the growth of bad bacteria which can lead to dysbiosis and sluggish bowels.3 Add 1/2 tsp ground turmeric (or grated fresh) to a cup of hot water, with 1/2 tsp cinnamon and a squeeze of lemon for a soothing, nutritious drink after meals.
Seaweed is both nutrient-dense and rich in fibre, and has also been shown to lower inflammation and increase insulin sensitivity. This means it is also good for blood sugar balance and weight loss.
7. Antimicrobial-rich foods
These foods will support good levels of commensal (friendly) bacteria in the gut and reduce overgrowth of yeasts, parasites and pathogenic bacteria. Good sources include garlic, clove, oregano, coconut oil, curcumin, olive oil, and liquorice.
Ghee is an excellent source of butyrate, or butyric acid, a short-chain fatty acid that plays a central role in gut health. Recent studies have found that butyrate stimulates mucus production and increases peristalsis in the colon, thus helping to propel food through the digestive tract. Butyrate is also produced by certain species of bacteria in the gut such as Bifidobacterium, through dietary intake of fibre. Selected strains of Bifidobacterium species are commonly used probiotics and are a good way of supporting good digestive health.
9. Zinc-rich foods
Your body needs sufficient levels of zinc for the production of stomach acid and optimum digestion of food. Low levels can also contribute to leaky gut. Food sources of zinc include seafood, beef, spinach, pork, chicken, red lentils, pumpkin seeds, cashew nuts, and raw cacao.
10. Rainbow fruit and vegetables
Fruit and vegetables contain lots of fibre and a wide range of phytonutrients that support a healthy gut biome. Research is demonstrating that a varied, colourful diet lowers inflammation and supports optimal diversity of good bacteria in the gut, by increasing certain species such as Bifidobacterium. Try to extend your range of fruits and vegetables beyond the five-a-day and add more colour to your plate to support a more diverse microbiome. The average number of foods consumed by people on a Western diet is just 20 per year compared with our ancestors who consumed up to 100. They may not have had access to supermarkets and superfoods from all over the world, but they ate seasonally and foraged for different foods as they moved across the land. We have access to an amazing array of foods but many people get stuck in food ruts and end up buying the same thing every week.
I hope some of my tips help you to combat your constipation. Have a happy and healthy festive period!
You may be interested in the following articles:
1Jin, J S et al (2012) Effects of green tea consumption on human fecal microbiota with special reference to Bifidobacterium species, 'Microbilogy and Immunology', [online] Vol 56:11, pp. 729-739 Available at: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1348-0421.2012.00502.x [Accessed:30/11/2018]
2 Pituch, A et al (2013) Butric acid in Functional Constipation, 'PRZEGLRD Gastroenterology', [online] Vol 8:(5), pp. 295-298 Available at:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4027827/ [Accessed: 30-11/2018)
3 Gupta, S C et al (2013) Therapeutic Roles of Curcumin: Lessons Learned from Clinical Trials 'The AAPS Journal', [online] Vol 15:1. pp. 195-218 Available at:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3535097/#CR37 [Accessed:30/11/2018)