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(anaemia) and osteoporosis. People with coeliac disease, which is incurable, are required to follow a gluten free diet to heal the intestines and manage symptoms under medical supervision. Dr Belobrajdic says gluten free is often seen as the ‘go-to’ diet for improved gut health among non-coeliac individuals, but no evidence supports this trend. Such a trend has been evident during the COVID-19 pandemic, with experts imploring shoppers not to unnecessarily buy the gluten-free foods required for people with coeliac disease. He says a growing dialogue has emerged around the avoidance of bread and cereal-based wheat products containing gluten – in efforts to reduce bloating or cramping, for instance. “However, it may be other components of these foods impacting gut health, rather than the gluten or wheat itself, and caution should be applied when avoiding these foods without health professional diagnosis and/or support,” Dr Belobrajdic said. “Avoiding gluten unnecessarily can also impact overall health and wellbeing, with many gluten free products being lower in fibre, higher in added sugars and fats and also lower in key nutrients.” This is why Dr Belobrajdic advises people to seek medical advice from their GP, who may refer them to a gastroenterologist and/or accredited practising dietitian for diagnosis, symptom management support and appropriate testing and medical advice. Critical role of dietary fibre Dr Belobrajdic says that to prevent constipation through regular bowel function, it’s advisable that women consume 25g of dietary fibre a day, and men 30g – a level that many Australians aren’t achieving. Furthermore, if someone has a chronic disease such as type 2 diabetes or heart disease, the fibre requirement increases to 30-35g a day, he adds. He underscores that the easiest way for people to consume more fibre is through more plant-based foods, such as fresh fruit, vegetables and wholegrain cereals and legumes, as these provide a variety of fibre well fermented by the “good bugs” in the large bowel. “These good bugs produce short- chain fatty acids such as butyrate that contribute to the proper functioning of your large bowel and are linked to reducing risk of colorectal cancer,” Dr Belobrajdic said. Evidence is also mounting that products of the good bugs, together with dietary fibre, help control blood sugar levels and influence how full a person feels at subsequent meals. Accredited practising dietitian Geraldine Georgeou, author of the popular book The Australian Healthy Skin Diet, which many regard as a handbook for healing skin through simple diet changes, also emphasises the importance of adequate dietary fibre. She tells Retail Pharmacy that following “crazy” diets with little to no fibre results in an imbalanced gut DIGESTIVE HEALTH 67 microbiome and “even having bugs like bacteria or parasites in the gut, which need to be medically addressed”. Alternatively, Dr Belobrajdic says, people turn to dietary fibre supplements, which may alleviate constipation in the short term, but which are often not well fermented by microbes in the gut. An example, he says, is psyllium, a soluble fibre effective in helping people become more regular in their bowel movements, but which has little effect on fermentation in the large bowel, as the bacteria cannot break it down easily. Wheat bran is another example of a good bulking agent that is poorly fermented. Dr Belobrajdic says the CSIRO’s research has shown that resistant starch, a type of dietary fibre fermented throughout the large bowel, increases the abundance of beneficial bacteria and the amount of short-chain fatty acids, including butyrate. Good dietary sources of resistant starch, he adds, include beans, chickpeas, lentils, green (slightly unripe) bananas and barleyMAX, a barley variety developed by the CSIRO. Other resistant starch-containing ingredients to consider include potato starch, chickpea flour, green banana flour and freekeh, he says. The CSIRO Healthy Gut Diet, written by nutritional scientists and dietitians at the organisation, was published to provide guidance on food and recipes that promote gut health. TO PAGE 68 For the lasting relief of frequent heartburn and stomach acid complaints due to gastro-oesophageal reflux disease. Available in 7 & 14 pack Available to order via all major wholesalers, your Sales Representative or call 1300 9 27769 ALWAYS READ THE LABEL. FOLLOW THE DIRECTIONS FOR USE. IF SYMPTOMS PERSIST, TALK TO YOUR HEALTH PROFESSIONAL. RETAIL PHARMACY • JUL 2020