This is Part 4 of my Kids’ Nutrition Series
So far in our Kids’ Nutrition Series, we’ve covered nutrients kids may be missing and getting too much of as well as why fat is an important part of their diet. Now we are moving on to a more complex topic — one that is growing in popularity but poorly understood: gut health.
The gut consists of digestion and absorption of nutrients, immune function, and the elimination of wastes. It’s the first line of defense for the body, and acts as a protective barrier, as potential toxins and harmful bacteria are ingested. It plays a larger role in the immune system than most people realize, and in different ways than expected.
I want to clear up the confusion about gut health for you and your family. And in order to do so, we must start with a quick review of the good and bad bacteria that reside in the gastrointestinal (GI) tract.
Gut Health 101
A major component of a healthy GI tract is the presence of microbes (bacteria) that take up residence. These microbes can be found to a lesser extent in the stomach and upper part of the small intestine but as you move to the lower small intestine their numbers increase (1,000,000) with the most in the colon (1,000,000,000,000). It has been estimated that there are more than 400 different species of bacteria in the gut alone!
The microbes that reside in the GI tract can have positive, negative, or neutral health effects. It is beneficial, according to research, for the GI tract to contain more favorable microbes such as Lactobacilli, Bifidobacteria, and Streptococcus than unfavorable ones such as Clostridia, Bacteroides, E. Coli, toxins, and cancer metabolites.
This is where the term “probiotics” comes into play — taking in beneficial bacteria helps “crowd out” the not-so-helpful fellows. And certain types of fiber (prebiotics) are also beneficial as they provide fuel for healthy microbes to grow.
Probiotics are live microorganisms that, when consumed in adequate amounts, confer a health benefit on the host.
Prebiotics are nondigestible food ingredients that stimulate the growth and activity of beneficial bacteria in the colon. In other words, they are fuel for good bacteria.
Synbiotics are food products that contain both pre and probiotics.
Microbiotica is referred to an individual’s unique set of gut microbes.
The Microbiota Finger Print
In the womb, fetuses have very little exposure to bacteria — and when babies are born their GI tract is considered sterile. The baby’s first exposure is when they make their way down the birth canal and are initially colonized with the mother’s bacteria. After birth, kisses, holding, and feeding mean more bacteria are transferred to little ones.
It is known that breastfed infants have different microbiotica than formula-fed infants including more Bifidobacteria and Lactobacilli, which have beneficial effects on the immune system and intestinal function. One key reason is human milk contains oligosaccharides (prebiotic), which fuel the growth of good bacteria (bifidobacteria).
“Most people don’t realize there are probiotics in our guts naturally,” said Jo Ann Tatum Hattner, MPH, RD author of Gut Insight: Probiotics and Prebiotics for Digestive Health and Well Being. “The baby that is vaginally birthed and breastfed has the healthiest gut.”
Hattner goes on to explain how the first two years of life are vital for producing what researchers refer to as The Microbiota Finger Print, explained in this excerpt from her book:
As you grew, you were exposed to more bacteria and by about your second birthday, you developed an identifiable population of microorganisms in your gut known as your microbiota. Some researchers refer to this resident population as your microbiota fingerprint as they believe it is an individual pattern which defines you for a lifetime. Researchers theorize that both genetics and the environment contribute to the fingerprint’s makeup.
Guilt Alert! Don’t berate yourself if you weren’t able to have a vaginal birth or breastfeed, as these things don’t always work out. But if you have the chance, try your best for both of these goals — that’s all a mom can do. Read on for more you can do to maximize your child’s gut health NOW.
Maintaining good GI health
In children and adults, the body works to keep the microbiotica fingerprint although certain circumstances such as infections, antibiotic use, pathogens ingested from food, and poor diet can have negative effects. One way to enhance a child’s GI tract with more beneficial bacteria is the daily consumption of prebiotics and probiotics in food.
“Normal, healthy kids don’t need supplements, ” said Hattner. “Fermented dairy products and plant foods that contain prebiotics are enough.”
In her book, Hattner discusses how probiotic microorganisms stimulate the immune system and increase the acidity of the gut so undesirable bacteria can’t grow. Research also demonstrates that probiotics can improve in lactose digestion, diarrhea in infants, constipation, tolerance to antibiotic therapy and reduce symptoms of respiratory infections.
Probiotic foods available include yogurt (soy yogurts are also available) and specialty yogurts such as Dannon Activia, DanActive, and Yoplait Yo Plus, smoothies such as flavored drinkable dairy yogurts (both regular and light varieties) and soy probiotic drinks. Kefir, a cultured milk, can be bought plain or flavored (there is also Kefir soy). Yakult, a cultured dairy drink, contains a proprietary bacterial strain, Lactobacillus casei Shirota. Other non-dairy sources include probiotic wellness bars includingAttune bars.
There is a comprehensive list of prebiotic food sources in Gut Insight including the star players: bananas, onion, garlic, Jerusalem artichokes, asparagus, chicory root (inulin), whole wheat, barley, and rye. Other potential prebiotic sources include berries, raisins, tomatoes, greens and legumes, oats, buckwheat, and brown rice.
Hattner suggests being creative at meals such as mixing Kefir with orange juice (this is really good!!), making yogurt a regular fixture at meals like breakfast, using yogurt as a base in dips like ranch, and trying some of the flavored specialty drinks.
But when happens when the GI tract goes awry with food allergies, constipation or antibiotic associated diarrhea? Hattner says most of the research for food allergies points to prevention — doing what you can to strengthen the gut in the early years — with studies mixed on the treatment of food allergies with probiotics. And giving a probiotic supplement when kids receive antibiotics makes sense, as antibiotics kill bad and good bacteria in the gut.
Hattner says when it comes to supplements: “discuss with a physician as too much may have GI symptoms such as gas and bloating.” And according to US Probiotics.org, make sure any probiotic supplement you are taking has research behind it. Without research, you have no way of knowing if a supplement has enough, or the right microbe strain (there are 400, remember!), to treat the GI side effect you or a family member may be experiencing.
Looking for a probiotic supplement? Hattner relates two with the best research behind them: Culturelle and Florastor. Most supplements contain Lactobacillus or Bifidobacterium although other strains are sometimes used. Look for the research!
The Proof is in the Poo
Still not sure your child’s gut is healthy? There’s one way to tell: analyze his or her bowel movements. This may not be realistic with older kids but when they are younger parents have ample opportunity.
In Hattner’s book, she explains that daily bowel movements are ideal although every two to three days is okay if the stool is soft and there is complete evacuation Model stool is bulky, soft, and easy to pass with a uniform shape (torpedo-like). Too hard (pebbles or many pieces) or liquid stool is not good.
So there you have it — simple ways to improve your family’s gut health. Any comments, questions, or concerns?
For more on kids’ nutrition at every stage and age, check out Maryann’s book Fearless Feeding: How to Raise Healthy Eaters from High Chair to High School
Of course, I have to ask a question about poo…
I read early on in a newborn book about how green stool is a sign the body has quickly digested food. My son is 2 and I would say most every day’s stool is green (with occassionaly brown mixed in). Should I be worried? He is in a low percentile for height and weight but the pediatrician has assured me it is not a worry. He eats a lot, is very active, eats a good variety of foods (although less veggies than I’d like).
I am a huge proponent of probiotic supplements. About 5 years ago I had a virus that paralyzed part of the nervous system to my stomach. I had horrible side effects, had to eat a very restricted diet, and was diagnosed with gastroparesis. Taking special order, high count probiotics got my stomach back in perfect working order. I keep them handy for weeks my stomach feels off, or if we travel and fast food makes up some of our meals.
Jo Ann says
Thank you for writing. I am so pleased to read you have had a good experience using probiotics. Regarding your child and the green stool question. In my book Gut Insight : Stool Gazing Alerts I discuss green stools associated with loose stools as being a concern. If this is the case with your son then I would again discuss this with his physician. If the stools are not loose check to see if it is correlated with eating naturally green foods or with iron supplementation as these can also associated with green stools. Jo Ann Hattner MPH RD
The Healthy Hostess says
I love your blog and read it regularly! Keep up the great work! I just wanted to say hi!
Maryann Tomovich Jacobsen, MS, RD says
Thanks so much. I appreicate it!
We had really good luck with probiotics clearing up my daughter’s eczema. we think her eczema was caused by dairy because it significantly reduced when she stopped eating dairy, but it didn’t entirely go away. I started giving her a probiotic (for other reasons) but it had the added bonus of clearing up all of her eczema and it has never come back. Same thing with my 2nd daughter too.
Maryann Tomovich Jacobsen, MS, RD says
Glad to hear probiotics worked for your family. What kind did you use?
I used Culturelle.
M. Hopson says
Since my siblings and I like yakult so much, is it good to drink more than a bottle per person? The bottle is just too small that we finish it in 3 or 4 gulps. Also, I’ve read that it’s advisable to get probiotics when into an antibiotic treatment, but it didn’t work for me that well because I had stomachaches and diarrhea. it’s probably because the probiotics dose that I had weren’t enough. anyway, I also want to share a good video about probiotics, some of its sources and why they’re good/bad : http://www.youtube.com/watch?v=neHbUI2JiPw
Maryann Tomovich Jacobsen, MS, RD says
Thanks for sharing the video! You might want to consider one of the supplements I mention in the article next time you are on antibiotics.