One of the biggest challenges to eating a healthy, gut friendly diet is that healthy routines must be routinely do-able. It is now clear that a gut needs a diverse diet that provides the necessary proteins, essential fats, vitamins and minerals, as well as fiber-rich and fermented foods that support a healthy diverse microbial population.
That is- a gut-friendly diet is just the opposite of the Western Diet that most Americans eat. In fact, consumption of Western Diet is linked to all gut disorders, including food allergies and sensitivities, inflammatory bowel disorders (IBD), irritable bowel syndrome (IBS), and gastroesophageal reflux disease (GERD). The western Diet involves foods that highly processed and low in fiber, that are high energy (fats and sweets), convenient, and activate brain reward pathways.
So- a gut-friendly diet must also be convenient and rewarding, like the Western Diet. But it also needs to be flexible enough to accommodate cultural aspects of food that support personal and ethnic identity. And it needs to be easy enough to be routinely do-able. One way to achieve this is to adopt a “multivariate diet” approach.
A multivariate diet approach is based on base dishes such as salad, soup, casserole, and flatbread, which incorporate many different ingredients and can be mixed and matched to a set of ingredients based on, for example, seasonal availability of fresh vegetables and fruit, cultural preferences, or which items happen to be on hand.
The approach combines features of diet types (Mediterranean, vegetarian, vegan) that studies have shown improve inflammation, mood, and pain (Dragan 2020, Jacka 2017) symptoms in IBD (Caio 2021) and IBS. Thus, the multivariate diet approach relies on whole/intact grains when possible, incorporates green leafy vegetables (both in salads and main dishes) and reduces reliance on large servings of meat. Foods containing fiber, such as beans, grains, whole fruits and vegetables, and fermented foods, such as plain Greek yogurt help support diverse microbe population, especially the immune regulating “Old Friends” common in fermented foods (Wastyk 2021).
One key way to help reduce symptoms of gut disorders, including GERD, gastroparesis, and IBS is to avoid over-eating. But controlling appetite requires regulating emotions, and awareness of body signals such as satiety. The multivariate diet approach supports appetite-regulating strategies such as Mindful Eating and Intuitive eating by including many different ingredients with contrasting tastes and textures (such as nuts, intact grain, yogurt, citrus green leafy vegetables etc.) along with herbs and spices. This increases the complexity of the taste experience helping to slow down eating and enable awareness of satiety-related cues from the gut. It can also help make meals more emotionally satisfying too.
One key way to help reduce symptoms of gut disorders, including GERD, gastroparesis, and IBS is to avoid over-eating. But controlling appetite requires regulating emotions, and awareness of body signals such as satiety. The multivariate diet approach supports appetite-regulating strategies such as Mindful Eating and Intuitive eating by including many different ingredients with contrasting tastes and textures (such as nuts, intact grain, yogurt, citrus green leafy vegetables etc.) along with herbs and spices. This increases the complexity of the taste experience helping to slow down eating and enable awareness of satiety-related cues from the gut. It can also help make meals more emotionally satisfying too.
Finally, cooking is a “health behavior” (Farmer 2021) that can enhance emotional feeling of well-being and social connectedness.
Some tricks for instituting a multivariate diet:
Getting the extra sugar out of the diet
Sugar is everywhere and many of us have grown up eating sugary foods and beverages. But it has become quite clear that added refined sugars can dysregulate gut microbe populations (Moszak 2020) driving gut symptoms as well adverse health conditions including non-alcoholic fatty liver, diabetes, cardiometabolic syndrome, and Alzheimer’s Disease.
Reducing the amount of sugars in the diet can be a challenge, however, because of the potentially addictive qualities of sugary foods, as well as the near-ubiquity of added sugars in processed foods. Indeed, the addition of sugars to processed foods in a likely important contributor to the association of processed food diets to adverse health outcomes. Another problem with dietary habits of eating sugary foods is that the taste receptors for sweet can become desensitized with high exposure to the taste (Kinnamon 2013). This means that frequent consumption of sweet foods and beverages can make sugary foods seem less sweet over time, encouraging the addition of even more sugar. Fortunately, reducing sugar exposure can restore sensitivity of the receptors. Basically, the less sugar you eat, the less you need.
There are ways to replicate the pleasurable aspects of sweet tastes. The first step is to avoid processed foods as much as possible. Baking at home means that you know exactly what is in your food, and you can experiment with ways to make just how you like it. One trick to reduce sugar in baked goods is to substitute baking spices such as cinnamon, ginger, cardamon, nutmeg or clove (Peters 2014, Peters 2018). Another trick is to add whole fruit. Although ripe fruit contains sugars, whole fruits contain fiber and possibly other things that can help slow the uptake of sugars into the body, reducing the risk of hyperglycemia. And whole fruit are key ingredients of a microbe friendly diet key to supporting gut health.
Diversifying protein sources
Dietary protein is important for many cellular functions, especially in the brain. Unfortunately, the main sources of protein that the Western Diet provides come from processed meats, especially beef and pork, that are linked to increased risk of conditions such as colo-rectal cancer (Wolk 2017). In contrast, Mediterranean and Multivariate Diet approaches rely on smaller amounts of animal protein, such as chicken, fish, seafood, or unprocessed beef and pork that is incorporated into dishes containing other gut-friendly ingredients, such as greens, grains, beans, or pasta. Meat-based protein can be substituted with plant-based protein sources, such as grains including quinoa, tofu, mushrooms, or fermented dairy such as plain yogurt and kefir. Plant based protein sources can have an added benefit of providing fiber that can help support healthy diverse microbial population. Notably, vegetarian and vegan diets are associated with reduced risks of cardiometabolic disease and with better cognitive function than the Western Diet (Morris 2018, Pearson 2016).
Adapting “traditional” cooking
Many traditional diets (such as the Southern diet) have been criticized because they rely on unhealthy cooking techniques such as excessive frying, starchy ingredients, too many saturated (animal) or trans fats, and may lack the variant of ingredients necessary for a healthy diet. Nonetheless, traditional diets support emotional meanings of food and may not be entirely “unhealthy” (Teicholz 2019). Such diets can be modified in ways that retain some key ingredients and flavors but provide more nutrition. For instance, the Southern diet traditionally relied on greens (such as collard and mustard), beans, sweet potatoes/yams, and corn. These are all nutritious ingredients. Rather than frying them in, for instance, bacon grease they can be roasted or sauteed in vegetable oils. Authenticity can be maintained by including traditional spices, such as cumin, curry, cardamon for South Asian foods, or Kan kan kan (a West African spice mix of peanut powder, chili powder, allspice, Maggi bouillon cubes mashed together) to enhance stews or soups.
Getting kids to eat a healthy diet
Children can be “picky” eaters, suspicious of foods that are new, have an unusual texture, or aren’t sweet. They need to outgrow this though, because poor eating in childhood can have lifetime consequences including diabetes and obesity, with the long-term consequences of those conditions. One way to get kids interested in fruits and vegetables is to get them involved in gardening (DaCosta 2017). As Ron Finley says (Finley 2013) “If kids grow tomatoes, they eat tomatoes”. In fact, “hands-on” programs, such as gardening and cooking, to improve eating behavior in children are substantially more effective than nutritional instruction (LaCosta). For instance, an elementary school intervention in which families were given healthy multicultural recipes led both children and parents to cook, appreciate, and eat more diverse foods (Chen 2014). The flexibility of the Multivariate Diet approach flexibility means that kids can be creative or experiment with different ingredients and spices.
The freezer is your friend
A common barrier to cooking “from scratch” is being too busy, especially mid-working week (Lavelle 2016). This particularly challenging in wintertime when it is harder to find fresh vegetables. We have found that in the Summertime, growing food or going to farmer’s markets often results in more produce than we can eat. So we freeze the extra in meal size portions in Tupperware-type containers (pro tip= put a date on it) in the Summer, and they are easily used later.
Left-overs are a blessing
One of the most effective strategies our family has used is to prepare enough food to generate left-overs. It is really nice to come home after a long day of work and have a nice pot of chile or soup that just needs to be reheated, and soups and stews often taste even better the next day. It is less work to double the amount of ingredients to put in a casserole than to make two separate meals. The left-overs can be quickly heated in a microwave or oven.
Anyone can cook!
Many people fear of cooking “from scratch” (Lavelle 2016) especially if they did not learn how to cook as children. People who think they can’t cook often think that because they tend to over-cook things and they don’t use many herbs or spices in the dishes they make. They may also feel overwhelmed by recipes than contain long lists of ingredients that might be hard to obtain, or ones that require complicated cooking techniques. The multivariate approach, however, relies on simple cooking techniques that use minimal heating times (to avoid oxidation of ingredients). A flexible array of possible ingredients can be “just thrown together”. Recipes have an easy basic structure that can encourage experimentation.
Organizing features of the multivariate approach
There are some features which chefs have noticed form the bases for attractive and tasty dishes that can be thrown together quickly after work (for instance) or can served as part of a sophisticated meal. Here are four important features:
Color– Humans are visual creatures, and much of what we consider appetizing is based on visual appeal. So, for instance, gray foods are not usually considered attractive. But foods with color catch our eyes. Red and yellow peppers, tomatoes, and blueberries (for instance) add a visual pop to a dish, as does white cheese. This is particularly important for salads because they are often cold, and therefore don’t give off strong aromas, which also drives motivation for food. Importantly, color in fruits and vegetables is associated with anti-inflammatory and anti-oxidant capabilities.
Texture– Dishes are most rewarding to eat when the ingredients provide a complex chewing experience. So, a salad with just one kind of lettuce will be less interesting than one that has multiple varieties, or some of the lettuce is chopped. Add crunchy things like walnuts, pine nuts, pistachios, sunflower or pumpkin seed, or chewy things, such as dried fruit. Dried fruit, especially cranberries or tart cherries give a splash of color as well and can give a salad a nice bit of fruity tang. Similarly, for casseroles, nuts can add crunch and Mediterranean olives add a briney tang. Gourmet soup recipes often call for “processing” and straining soups before serving, but leaving skins (such as tomato or peppers) in the soup increases the nutrition and contributes a more interesting texture.
An acid- That nice little tang is provided by foods that contain acids, such as acetic acid (vinegar) or ascorbic acid (vitamin C). Foods with tang include citrus (lemons and limes), red peppers, tart fruit, and sharp cheese. Balsamic vinegar works well to complement flavors of vegetables and tangy fruit.
A protein-In order to make a dish feel satisfying and be nutritious, it needs some protein in it. There are many high protein ingredients that work well with a multivariate approach, including cheeses, tofu, fish (such as tuna and salmon), chicken, mushrooms, and shredded pork or beef.
Liberal use of herbs and spices– Changing diets usually means getting used to new flavors or textures. Western Diet foods are characterized by sweet or salty tastes, with smooth oily textures (high fat). Low-sugar, -salt or -fats foods can be perceived as less appetizing (Peters 2014, Peters 2018, Haldar 2018) and this is one likely barrier to changing eating behavior. However, such low-salt and low-fat foods can be made more attractive by adding spices, such as curry mixes, turmeric, garlic, oregano, basil, chile pepper (peters 2018) and baking spices such as cinnamon, ginger, nutmeg, cardamom, or cloves, can improve hedonic perceptions of low-sugar desserts (peters). In addition, foods containing herbs and spices seem to contribute to satiety. People who consumed the same foods with, and without herb and spices reported that they felt fuller, more satisfied, and less motivated for more food when they had just eaten the spiced food (Halder 22018). In this way, spices in food can make food both more appetizing and more satisfying.
Basically, the multivariate diet approach involves combining a variety of different ingredients to create healthy dishes that are emotionally satisfying to eat.
Nice!