A common question asked by the general public, whether when talking to their doctor, dietitian or “Doctor” Google is: my stomach hurts/I have a stomach ache, what I should and should not eat to ensure I am taking care of my gut health?

Considering the close relationship between what you eat and gastrointestinal symptoms—and that almost one third of the westernized population complain of some kind of gut-related symptoms—that is no surprise. Furthermore, most patients believe that specific foods are important triggers for their gastrointestinal symptoms.

Although digestive symptoms are not usually life threatening, they have a negative effect on an individual’s quality of life. With these problems preying so clearly on people’s minds, we decided to ask five gut health dietitians what constitutes a healthy gut.

Before we move on, let’s introduce them to you. Andrea Hardy is a registered dietitian from Calgary (Canada); Paula Crespo is a professor at the European University Miguel de Cervantes and dietitian at the Department of Nutrition and Dietetics at Hospital Campo Grande in Valladolid (Spain); Kate Scarlata is a Boston-based registered dietitian (USA) with a Master’s in public health; Megan Rossi is a registered dietitian and nutritionist based in England with a PhD in gut health, founder of The Gut Health Clinic; and Mariana Camarena is a nutritionist in Mexico City and director and founder of Nutrición Activa.


How would you define gut health?

Andrea Hardy: Gut health means optimizing the gut you were given. You can strive towards a healthy gut even if you have a functional or structural gut disorder. Rather than a specific definition or criteria, which we lack at this time, let’s focus on taking care of your gut by feeding your gut microbes, managing any gastrointestinal symptoms if you have them, and helping facilitate normal digestion. All of those things contribute to a healthy gut!

Mariana Camarena:  Gut health is a term increasingly used by doctors, health professionals and many people, while it is challenging to define because is difficult to be measured. It refers to a state of physical and mental well-being thanks to the absence of gastrointestinal complaints and many other symptoms that put the person in a state of discomfort that require the assistance of a health care professional.

Can you share 3 major criteria for a healthy or unhealthy gastrointestinal system?

Kate Scarlata: The top 3 indicators of a healthy gut include:

  • Effective digestion and absorption of nutrients.
  • No active gastrointestinal disease.
  • Favorable balance of gut microbiota.

Paula Crespo: The 3 major criteria and common signs of an unhealthy gut are:

  • An upset stomach: as bloating, gas, diarrhea, constipation, and heartburn.
  • Secondary food intolerances (without clear etiology): recent evidence has revealed that food intolerances may be caused by a high amount of poor quality bacteria and a reduced amount of good bacteria in the gut.
  • Unclear and non disease-associated general symptoms such as: unintentional weight changes, and sleep disturbances and constant fatigue without specific etiology.


Why is taking care of digestive health important for overall health and well-being?

Megan Rossi: Good gut health has been linked to the health of just about every other organ in the body, including the heart, skin and brain. One of the main reasons gut health is so key is that 70% of the body’s immune cells lay along the digestive tract. So for fewer sick days, lower risk of allergies and autoimmune conditions, it’s likely that having good gut health will support this. Our bodies also contain trillions of microbes—including bacteria—within the digestive tract that are incredibly powerful and perform thousands of functions for looking after us on a daily basis.

Paula Crespo: It has been widely shown that having a huge variety of good bacteria in the gut can enhance immune system function. These bacteria may also improve symptoms of depression and reduce obesity after previous failed efforts with hypocaloric nutritional intervention, while also reducing the inflammation in some chronic diseases. Moreover, the microbiota is involved in energy harvesting and storage, as well as in a variety of metabolic functions such as fermenting and absorbing undigested carbohydrates, which is necessary for the body to function properly.

“Good gut health has been linked to the health of just about every other organ in the body, including the heart, skin and brain.” Megan Rossi

Andrea Hardy: We know now that by way of the gut microbiota, your digestive health influences your immune system, the development of chronic disease, and even mental and emotional health. The gut barrier plays a key role in this by acting as a gatekeeper and preventing any harmful molecules from getting through or interacting inappropriately with the immune system. In research, we often see that the gut barrier is compromised during chronic disease, leading to inflammation and inappropriate activation of the immune system. A perfect example would be celiac disease, where the gut barrier is compromised and patients experience inappropriate activation of the immune system and inflammation. By taking care of your gastrointestinal system, you can improve gut barrier function and benefit from its protective effects.

Mariana Camarena: Gut health is the door to the integrity of overall health. As Hippocrates said more than 2,000 years ago, “Disease begins in the gut”. Taking that as a premise, added to the amount of studies about the correlation of many metabolic conditions and gut inflammation, I rank gut health at the foundation of treating almost any condition in my work as a nutritionist. This is because gut health covers multiple aspects of the gastrointestinal tract, from digestion and absorption of nutrients to an effective immune system and more.

“I rank gut health at the foundation of treating almost any condition in my work as a nutritionist”. Mariana Camarena

The gut is home to trillions of bacteria that affect your health, either in a good or bad way. It all depends on the type and amount of bacteria the gut hosts, commonly called gut microbiota, which is unique in every person. That is why if we talk about gut health, we have to talk about gut microbiota and the way it responds to diet, stress, medication, and many other factors that can manipulate the metabolism. That’s why we have to personalize every diet, prioritizing gut health in the treatment route.

In summary, taking care of your gut health means taking care of the health of just about everything in your body, ranging from your intestine to your immune system and mood. Despite its relevance, there is no single criteria for defining a healthy gut. According to the gut health dietitians we interviewed, a healthy gut can be seen as a peaceful gut, free from active gastrointestinal disturbances, unknown food intolerances and with a balanced gut microbiome and strengthened gut barrier that help keep your digestive symptoms at bay.


Note: original answers may be edited for style and length.