The Good Gut Cookbook

A Healthy Diet

It’s perfectly acceptable to discuss heart disease and the foods to eat to avoid it. But the gastrointestinal tract, properly called the ‘gut’, is discussed much less, even though almost everyone will experience some gut problem at some stage in life.

This book has lots of delicious recipes to keep your gut, and the billions of microbes that inhabit it, healthy. It also tells you about the gut, how it functions, what can go wrong with it and what you should eat if you have a particular problem. We hope it will also sort out some of the confusion and conflicting advice about diet and gastrointestinal diseases.

With some gut conditions, it is vital to change your diet. For others, you need to make no specific dietary changes, apart from following a healthy diet. This means eating foods with a variety of types of dietary fibre and fewer junk foods, especially those high in added sugars or saturated fat – advice that applies to everyone.

The recipes in this book will help you put the principles of healthy eating into practice. They are designed to tempt your tastebuds while nourishing your body. Some, such as those marked as gluten-free (GF), are specially designed to suit particular problems. All are sources of dietary fibre and relatively low in saturated fat so they fit in with recommendations for a healthy diet to keep your whole body in top condition. We hope this book leads you further towards the discovery that healthy foods can taste good. We also hope you will learn more about the wonderful world that is within you.

There is nothing complicated about good nutrition. It is simply a matter of eating fewer junk foods, choosing from the range of healthy foods available and preparing them in such a way that you preserve their nutrients and flavour.

In a healthy diet, nothing need be forbidden, but some foods should have a more dominant role and others a much smaller part. The basic principles of a healthy diet are:

•Eat most of: plant-based foods including vegetables, legumes, fruits, wholegrain products, nuts and seeds.

•Eat moderately of: seafood, poultry, eggs, milk, cheese and yoghurt, and choose only small portions of lean meat.

•Limit: foods high in saturated fats, added sugars or salt, and also alcohol.

These basic principles provide a diet with the nutrients we need, as well as thousands of phytonutrients (‘phyto’ means ‘plant’) that are important for our health and also the health of the good bacteria that live in the gut.

Such choices also benefit heart health and – depending on the quantities of foods chosen – a healthy weight, which helps many other aspects of good health. However, a healthy diet should also be enjoyable and include a wide variety of foods. And let’s remember that the way we eat may be almost as important as what we eat. Taking time to relax, eating slowly and enjoying meals at the table is important for full enjoyment of food and also for good digestion.

Healthy eating patterns that can be used as a guide include Mediterranean diets and many Asian and Middle Eastern diets. These cuisines all include foods high in many types of dietary fibre and low in saturated fats. The total intake of fat, added sugars and refined starches is also an important consideration for good health and, especially, a healthy weight. Our recipes feature healthy fats such as extra-virgin olive oil, seeds and nuts, which provide flavour, nutrients and phytonutrients.

There are many ways to enjoy healthy meals and snacks. As an example, you might make your choices from:

BREAKFAST

•Fresh fruit

•A quality cereal that is high in dietary fibre and low in sugar with milk or yoghurt (choose one without added sugars)

•Wholegrain or wholemeal toast, bread or one of the home-baked recipes from this book

LUNCH

•Soups made with vegetables, legumes and grains

•Sandwiches, rolls, flat breads or toast – using wholegrain or sourdough breads

•Salads or vegetables

•Seafood, poultry or legumes such as beans, lentils or chickpeas, or a small serving of lean meat or cheese as an accompaniment to salads or vegetables

•Fresh fruit

DINNER

•Plenty of vegetables, with lots of variety

•Pasta or a wholegrain product such as cracked wheat, barley, brown rice or quinoa

•Seafood, poultry, a small serve of lean meat or a vegetarian alternative

•Dessert, preferably fruit-based

SNACKS

•Fresh fruit, or dried fruit occasionally

•Nuts

•Yoghurt (choose one that is made using bacterial cultures rather than thickeners or added sugars)

•Wholegrain bread, toast, raisin or fruit loaf

•Crisp raw or cooked vegetables, or soups

•One of the snack food recipes in this book

WHEN TO EAT

Most people need to eat three times a day. Children and those who are very active may need to eat more often, but few adults are active enough to need to eat between meals. The length of time food takes to be digested varies according to what you have eaten. Fruit eaten on its own, or a meal with little protein such as rice and vegetables, will be digested rapidly. Such meals will leave you feeling hungry soon after eating and that can lead to a desire for a quick and unhealthy snack. Foods that have more dietary fibre, protein or slowly digested carbohydrates (found in legumes and wholegrains) take longer to be digested and so satisfy you longer. On the other hand, eating too much, and especially too many fatty foods, will delay the emptying of the stomach so much that you may feel uncomfortably full for many hours. An average-sized meal takes up to four hours to leave the stomach and from there it passes to the small intestine where most of the digestion occurs. Many small children cannot sit at a table long enough to eat sufficient food to last more than a few hours and may therefore need something to eat between meals. Children also need plenty of nutrients for growth so what they eat between meals should be a healthy choice such as unsweetened yoghurt, milk, wholemeal bread with peanut butter, or fruit. Avoid getting children into the habit of eating packaged snacks as they are usually high in added sugars, fat or salt.

Diets that include alternate days of semi-fasting are popular and may suit some people. Long term, these diets do not produce better results for weight loss than modest meals eaten each day.

DIETARY MODIFICATIONS

Except in unusual circumstances, most therapeutic changes to a regular eating pattern should fit in with the basic principles of a healthy diet. However, if you need to avoid certain foods because of a specific medical condition, you may need to eat more of other foods to provide the missing nutrients. Supplements are not usually necessary unless there are whole classes of foods you cannot eat.

VARIETY

Foods are complex and the best way to ensure a good diet is to enjoy a variety of healthy foods. Many components of fruits and vegetables, for example, have only recently been found to have important functions. Restricting your choice of foods, and especially cutting out whole food groups, could deprive your body of some valuable food components. These include different types of dietary fibre that benefit the healthy bacteria that grow and live in the gut. The solution is to include lots of different foods to supply the vitamins, minerals, amino acids, various types of dietary fibre, essential fatty acids and many other food components needed for good health.

Supplements are not the answer. Foods contain hundreds of valuable components whereas supplements are always limited and often unbalanced. Some food components also function best in combination in foods. Isolating them into supplements does not always give the same benefits.

Myths about Food

FIBRE – MORE THAN ROUGHAGE

‘Roughage’ is an old-fashioned term that refers to cellulose, one type of dietary fibre, which is not digested to any extent in the human bowel and so passes through the gut largely unchanged.

Dietary fibre is much more than ‘roughage’ and includes many substances, including a range of pectins, gums, hemi-celluloses, mucins and lignin. Most types of dietary fibre are totally broken down by helpful bacteria in the large intestine, producing valuable by-products that help more beneficial bacteria to grow. As well as some types of dietary fibre, the spent bodies of these helpful bacteria make up the bulk of the stools we pass.

The old idea that including bran, an apple and a green salad will provide a high-fibre diet is not correct. It’s also wrong to think we can get all the dietary fibre we need from fruits and vegetables.

Foods such as wholegrains, vegetables, legumes, nuts, seeds and fruit are all important sources of dietary fibre. Some foods also provide a kind of starch that resists the usual digestion in the small intestine and enters the large intestine where, like dietary fibre, it is broken down by helpful bacteria and helps them populate the large bowel.

Dietary fibre is not always visible and not all foods with visible fibre contain the all-important dietary fibre. For example, peas have a high content of dietary fibre, even though they don’t look obviously fibrous; celery has much less dietary fibre, even though it appears ‘stringy’; and meat has no dietary fibre at all, even though it may have visual fibres.

The total amount of dietary fibre consumed is important to prevent constipation, but it’s the variety of different types of dietary fibre and resistant starches that is most important in encouraging healthy bacteria to dominate the large bowel. When these bacteria break down some types of dietary fibre, they produce short-chain fatty acids that not only nourish the cells lining the bowel but are absorbed and can influence blood levels of cholesterol and glucose.

UNPROCESSED BRAN FOR FIBRE?

Unprocessed bran is a concentrated source of some types of dietary fibre, mainly cellulose and lignin. It is deficient in other types of dietary fibre. This argument is similar to believing that oranges equal vitamins. Just as an orange contains vitamin C but is not a complete source of vitamins, so unprocessed bran contains dietary fibre but cannot meet the needs for all kinds of dietary fibre.

LAXATIVES AND WEIGHT

Laxatives can reduce the amount of water reabsorbed from the large bowel, producing loose stools. This causes a loss of water from the body which may show up as a temporary (and useless) weight loss on the scales. Laxatives do not affect body-fat levels and may have adverse effects on the body’s retention of some nutrients.

LOW CARB DIETS – YES OR NO?

Low carb diets are popular. As well as banning all types of sugars, these diets place stringent restrictions on all grains, potatoes, milk and yoghurt, some legumes, and many types of fruit and vegetables.

In spite of claims these diets are superior for weight loss or for people with diabetes, analyses of studies that have compared a low carbohydrate to a more balanced diet for weight loss over periods up to two years show no benefits for weight loss, blood pressure, LDL, HDL and total cholesterol, triglycerides or fasting blood glucose levels for subjects with or without type 2 diabetes.

Short-term weight loss in the first few weeks may be higher with a low carb diet because so many foods are restricted and so total energy intake is low.

The restrictions imposed on food choices for many low carbohydrate diets lead to constipation because many valuable sources of dietary fibre are banned or severely limited. The lack of different types of dietary fibre may also interfere with the development of healthy gut bacteria.

WHEAT IS TOXIC – TRUE OR FALSE?

A spate of diet books claim that we should avoid all wheat products. This is certainly the case for those with coeliac disease (estimated to be about 1 per cent of the population) and anyone with an allergy to wheat protein. However, for most people, wheat is a nutritious food. Dietary guidelines recommend most grains should be wholegrain. For wheat products this equates to wholegrain or wholemeal bread, wholewheat breakfast cereals and wholemeal pasta. Note, however, that regular pasta is made from high-protein wheat flour and is also a nutritious choice, providing it is served in appropriate quantities and with healthy sauces. Italians love their pasta and have the second lowest incidence of obesity in the developed world (Japan has the lowest).

Claims that modern varieties of wheat have inferior nutritional qualities to ancient grains is not true. However, much of the wheat crop throughout the world is refined with the germ and bran removed. This does have adverse impacts on the overall nutritional value of the resulting wheat flour, which has less dietary fibre and lower levels of several minerals and vitamins than the wholegrain wheat recommended.

Claims that wheat has only been grown for 10,000 years and is therefore a major reason for excess weight ignore the fact that excess weight was uncommon for the first 9500 years when wheat was widely consumed.

ALKALINE DIET – GOOD FOR YOU?

A current fad claims to be able to cleanse the body and help us resist disease, including cancer. The diet promotes vegetables (but not legumes), fruits, nuts and seeds, and recommends apple cider vinegar, an acidic product that is claimed to leave an alkaline residue. Grains, sugar, dairy products, alcohol and caffeine foods are out. Meat and eggs are severely limited.

Promoters of this diet have little understanding of acidity, alkalinity, or the nature of the digestive system. In fact, the pH of the stomach is highly acidic as enzymes begin the digestion of protein. When food moves into the small intestine where most digestion occurs, however, the digestive juices are alkaline. The kidneys and lungs maintain an exact pH in the bloodstream and even a small deviation from a blood pH of 7.4 is enough to cause death. Measuring the pH in urine is not indicative of the pH of the blood. No studies support the idea of any benefits from an alkaline diet.

COCONUT OIL – HEALTHY FAT?

Over the last few years, coconut ‘oil’ has been promoted by some popular chefs and actors as a superfood. Proponents claim that its saturated fat is not harmful because it’s composed of medium-chain triglycerides (MCTs) which raise ‘good’ HDL cholesterol. This theory involves several misconceptions. MCT oil was a water-soluble form of fat originally developed for people who lacked the normal enzymes needed to digest regular fats. The laboratory-manufactured MCT oil consisted of