Gut Health Basics: Fibre, Fermented Foods and When Probiotics Actually Help

"Gut health" is everywhere now, usually attached to an expensive powder. But the basics are cheap, and most Indian kitchens already have them.

What your gut bacteria do

Your large intestine holds trillions of bacteria. They break down fibre you can't digest, and in the process make short-chain fatty acids such as butyrate, which feed the cells lining your gut and may help with inflammation and blood sugar control. A more varied community of bacteria is generally linked with better health, though the science is still young.

Fibre: the part most people miss

Your gut bacteria eat what you don't absorb, mainly fibre. Most guidelines suggest roughly 25 to 40 g a day for adults, and many urban Indians eat well below that as diets lean toward refined atta, maida and white rice.

Easy ways to add more:

• Swap some white rice for brown rice, millets like jowar, bajra or ragi, or mix them in.

• Keep the chokar in your atta, or add a spoon of besan.

• Eat whole dals, rajma and chana, not just washed dals.

• Have a fruit whole instead of juice.

• Add vegetables to everything, from poha to parathas.

Raise fibre slowly over a couple of weeks and drink more water. A sudden jump causes gas and bloating.

Variety matters too. One study from the American Gut Project found people eating 30 or more different plant foods a week had more diverse gut bacteria. Spices, nuts, seeds and herbs all count.

Fermented foods: the Indian advantage

Curd, buttermilk, idli, dosa, dhokla, kanji and home pickles are all fermented. A Stanford study found that eating more fermented foods for 10 weeks increased gut microbe diversity and lowered some markers of inflammation.

A caveat: cooking kills live bacteria, so idli and dosa don't carry live cultures, though fermentation still changes the food in useful ways. Fresh curd, buttermilk and traditional kanji do. Shop-bought pickles in vinegar or heavy oil usually aren't fermented.

When probiotics actually help

A probiotic is a specific strain of bacteria at a specific dose. Results depend on the strain, so "contains probiotics" on a label tells you very little.

Areas with reasonable evidence:

• Antibiotic-associated diarrhoea. Certain strains, such as Lactobacillus rhamnosus GG and Saccharomyces boulardii, may lower the risk.

• Some cases of IBS, though results vary by strain and person.

• Acute infectious diarrhoea in children, where some strains may shorten it slightly.

For a healthy person with a good diet, there's little proof that a daily probiotic adds much. If you want one, pick a product that names its strains and CFU count, and ask your doctor which strain fits your problem.

When to see a doctor

Blood in stool, unexplained weight loss, ongoing diarrhoea or constipation, severe pain, or symptoms that wake you at night need medical attention, not supplements.

This article is for general information only and is not medical advice. Supplements are not meant to diagnose, treat, cure or prevent any disease. Speak to your doctor before starting anything new, especially if you are pregnant, breastfeeding, on medication or managing a health condition.

References

1. Makki K, et al. The impact of dietary fiber on gut microbiota in host health and disease. Cell Host Microbe. 2018.

2. McDonald D, et al. American Gut: an open platform for citizen science microbiome research. mSystems. 2018.

3. Wastyk HC, et al. Gut-microbiota-targeted diets modulate human immune status. Cell. 2021.

4. Goldenberg JZ, et al. Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children. Cochrane Database Syst Rev. 2017.

5. Hill C, et al. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014.