A growing interest in gut health

According to Tayag, there is a growing interest in improving gut health, with testimonials on social media claiming that it can help not only stomach issues, but also other health problems, such as low energy, acne, weight gain, and anxiety.

"Broadly, a healthy gut is one where the different segments of [the gut's microbiome]—numerous species of bacteria, fungi, and viruses—live in harmony," Tayag writes. "An unhealthy one implies a disturbance of the peace: One group may grow too powerful, or an invading microbe may throw things off-balance, leading to problems including gastroenteritis and a compromised immune system."

Recent research on the microbiome also suggests that the bacteria in your gut can impact your health. For example, a large study published in 2022 found that people with depressive symptoms had significantly elevated levels of certain bacteria. Another study published in 2023 found that a high-fiber diet could change people's microbiome in a way that promotes weight loss.

A person's diet can also have a significant impact on their gut health, as well as how they feel overall. "Food can have effects on the microbiome, which can then secondarily affect the host," said Purna Kashyap, a gastroenterologist at the Mayo Clinic.

Currently, there are several products that claim to support digestive health. Some of these products, like yogurt and kimchi, are "probiotic" foods that contain live bacteria that can affect your gut. Other foods, which often contain fiber, are considered "prebiotic" and feed the microbes already in your stomach. Having more fiber in your diet can improve regularity and support a more normal gastrointestinal system.

The benefits of gut health trends are still unclear

Although several food products have been promoted as being able to overhaul gut health, these claims are "a little bit premature," said Karen Corbin, an investigator at the AdventHealth Research Institute of Metabolism and Diabetes.

According to Corbin, a fundamental issue with people's current obsession with gut health is that "there's no clear definition of a healthy gut microbiome." Many factors, including genes, diet, environment, and even pets, can affect the makeup and balance of people's microbiomes. What works for one person may not work for another.

It's also unclear how much gut health can impact a person's health beyond their gastrointestinal tract. Although research has suggested that gut microbiomes are connected to other parts of the body, "the mechanisms underpinning them are largely unknown," Tayag writes.

There are "a lot of tall claims based on animal studies that the microbiome influences diabetes or obesity or whatever," but it's "really unlikely" that these findings translate to humans, said Daniel Freedberg, a gastroenterologist at Columbia University.

In general, unless you have been diagnosed with a gastrointestinal condition like IBS or Crohn's disease, "pursuing a healthy gut with food and supplements can be a nonspecific process with poorly defined goals," Tayag writes. "… Which bacteria, and how many of them, actually make it past the stomach into the colon isn't well understood."

Rather than relying on probiotic cookies or prebiotic sodas to improve gut health, health experts say that people who are concerned about their microbiome should eat a healthy diet with lots of fruits, vegetables, whole grains, and legumes while avoiding too much junk food. "In other words, a basic healthy diet is more than enough to achieve good gut health," Tayag writes.

Overall, "[m]uch more is known about the gut than in the days of Hippocrates, but [it's] still far less than the gut influencers on social media would have you believe," Tayag writes. (Tayag, The Atlantic, 2/20)

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