It is clear that the gut plays an important role in health. Beyond digestion and absorption of nutrients, the intestine acts as a barrier and a filter, selecting for the good and eliminating the bad. Recent research has shown the importance of the gut microbiota for gut health, and diet remains one of the most powerful ways to influence this gut microbial balance.
Therefore, it’s no surprise that intestinal health was on the agenda at the 40th edition of the European Federation of Dietitians Association (EFAD) congress in September 2018 in Rotterdam. Indeed, dietitians are uniquely positioned to act as ambassadors for gut health – a field that lies at the intersection of medicine, nutrition and lifestyle. However, many questions remain unanswered, as indicated by Christina Katsagoni, head of EFAD’s European Network of Specialized Dietitians (ESDN).
Some of these outstanding questions include:
- How can patients be empowered to improve their gut health?
- What role should dietitians play, and how can dietitians become ambassadors of gut health?
- What do we know about the role of food (including prebiotics and probiotics) in the management of gastrointestinal disorders?
- How can we translate this scientific evidence into everyday practice?
- How do we identify evidence-based scientific information and differentiate it from erroneous information?
- What is the best way to deliver messages on the importance of gut health to patients?
Maria Gustafsson (Sweden) and Kevin Whelan (UK) addressed some of these questions during their presentations.
Maria Gustafsson, dietitian consultant specializing in nutrition and health, reminded the audience that we are all subject to a number of factors that impact our health and the state of our gut microbiota. Although we have little or no control over some of these factors such as birth modalities (cesarean section), antibiotics, stress, and aging, we do have the opportunity to act on our lifestyle and diet – factors that are guided by our own choices. “A varied diet is a traditional and natural way of ensuring optimal bowel function, “said Gustafsson, who noted that eating foods containing prebiotics and/or probiotics may help maintain the balance and resilience of the gut microbiota.
“A varied diet is a traditional and natural way of ensuring optimal bowel function,” says Maria Gustafsson.
Professor Kevin Whelan, Head of the Department of Nutritional Sciences at King’s College London gave a presentation on probiotics, prebiotics and a low FODMAP diet for irritable bowel syndrome (IBS). This talk focused on the role of diet and the gut microbiota in IBS. IBS presents a significant public health problem in the UK, affecting the quality of life of 5%- 10% of the population. In scientifically based nutritional interventions, probiotics and fiber are considered first-line treatment. As a second-line treatment, the low FODMAP diet, which is low in fermentable carbohydrates, seems to be effective for eliminating IBS symptoms, but also reduces the abundance of health-promoting Bifidobacteria in the gut. A combination of probiotic/prebiotic supplementation and a low FODMAP diet could be a way to reduce symptoms while maintaining the diversity of the gut microbiota, but this remains to be demonstrated.
Several medical and scientific organizations are in agreement that probiotics should be recommended for conditions related to the digestive tract and the immune system. Dietitians should play an important role in making personalized recommendations for people seeking to improve their gut health through diet, lifestyle, and probiotic/prebiotic supplementation.