What is the point of eating?

You might eat with the intention that what goes into your mouth will end up in your body. You break your food down into nutrients, and then absorb them to use for all the things you need.

Ideally, that’s the way it works. Unfortunately, a lot can go wrong between the eating and the getting the nutrients part of this process. Problems like gut dysbiosis can wreak havoc this whole system and prevent key nutrients from being absorbed.

Got gas? Bloating? Constipation? Diarrhea? You might be trying to fix one (or more) of these problems with a supplement, but unfortunately almost everyone seems to have a different opinion about what supplement to take. There are a few common digestive support aids that are often taken to provide relief – whether there is research to back the claim or not

Fermented Foods

The Claim:

The probiotic bacteria in fermented foods support the colonies of probiotic bacteria naturally found in the human intestine. This is beneficial for pretty much everything, since the gut flora affect so many different systems.

Fermented foods are not the same as probiotic supplements, because they also contain other food components that may interact with the probiotics, e.g. the fiber in sauerkraut or kimchi, or the proteins in yogurt.

The Research:

There’s strong evidence that consuming probiotic foods is indeed good for gut health (not to mention everything else).

There are significant benefits in consuming fermented dairy products specifically.

Fermented foods can have a marked impact and provide benefits to mental health.

Kimchi (Korean fermented cabbage) specifically, has been shown to have multiple beneficial qualities including help with constipation.

The Bottom Line:

There’s strong evidence that fermented foods are good for you, but not everyone does well on them. If you have a bacterial overgrowth problem (e.g. SIBO), fermented foods might not be wise until your gut has healed.

Probiotics

The Claim: 

Taking probiotic supplements (if you’re interested in probiotic foods, see “fermented foods” above) will help improve gut flora composition.

The Research:

There’s fairly strong evidence that probiotic supplements are effective for antibiotic-associated diarrhea (in other words, the antibiotics mess up your gut flora, but probiotics can put them right again).

This review found that probiotic supplements were effective for constipation, especially in older adults.

There is research indicating the effectiveness of   probiotics in treating symptoms of Irritable Bowel Syndrome (gas, constipation, diarrhea, bloating, and related problems)

The Bottom Line:

A good probiotic can be very useful as a therapy; just make sure to get a high-quality one. It is also worth noting that in the case of SIBO, a probiotic can be worse than useless: if you think you have a bacterial overgrowth, talk to a doctor before trying a probiotic.

Apple Cider Vinegar

The Claim:

Taking apple cider vinegar daily or before a meal improves digestion, ease constipation, and improve glucose tolerance.

The Research:

There are no studies evaluating apple cider vinegar for digestion or constipation.

Some research has found that apple cider vinegar does delay stomach emptying and improve glucose response to carbohydrates in diabetics. Interestingly, the research also cites evidence that vinegar in general has this effect on most people, regardless of the type of vinegar.

The Bottom Line:

Raw apple cider vinegar might have benefits for digestion because it’s a probiotic food, but this has not been studied. There’s some evidence that it improves glucose tolerance when eaten with carbohydrates. That being said, if you find it helpful and supportive as a part of your diet, there is no evidence that you even have the slightest risk of harm.

Digestive Enzymes

The Claim:

Help speed digestion, alleviate constipation and bloating, and reduce that feeling of food sitting undigested in the stomach.

The Research:

There’s a reasonably good amount of research that adding digestive enzymes may be helpful – I have written about this previously

The Bottom Line:

Digestive enzymes might help people, especially people who are having trouble digesting and absorbing their food.

Betaine HCl

The Claim:

Helps alleviate heartburn.

The Research:

Searching PubMed for studies on betaine HCl and heartburn only turns up one study, which found that a supplement containing melatonin, l-tryptophan, vitamin B6, folic acid, vitamin B12, methionine and betaine was helpful. As exciting as that may be, with so many different things in one supplement, it’s impossible to pin down the benefits to just one part of it.

The Bottom Line:

Betaine HCl may or may not help. There is no evidence that would back this claim however many do experience positive effects when taking it.

Fiber

The Claim: 

Adding more fiber will bulk up your stools and make them easier to pass.

The Research:

Fiber supplementation and the myths around needing fiber are pervasive. Research has shown that the use of fiber for “functional bowel disease” (namely, anything without an obvious physical cause) is not actually very well supported, and fiber type matters.

The Bottom Line:

Whether or not fiber is helpful for digestion really depends on what type of fiber you are talking about. In general, fiber supplements are a short-term band-aid at best. You can get all the fiber you need from whole foods. If your diet is rich is real, unprocessed food, you won’t find a supplement helpful on top of that.

Gelatin

The Claim:

Gelatin helps ease gastrointestinal symptoms because it’s very soothing to the digestive system.

The Research:

There’s some research indicating that gelatin is good for the gut. None of it is terribly definitive, and there’s a lot more to do, but it does seem to be helpful.

The Bottom Line:

Broth rich in gelatin has been a traditional gut-healing food for thousands of years, but broth also has a lot more than just the plain gelatin. On the other hand, it’s fun to make desserts out of gelatin powder, there’s nothing dangerous about it, and it may be helpful: there’s certainly no harm in experimenting.

Prebiotics

The Claim: 

Prebiotics feed the gut flora, which allows your own flora to grow healthier and stronger.

The Research:

Research has shown some evidence of the positive impact of prebiotics both on the gut flora generally and on the symptoms of Irritable Bowel Disease. Overall, the balance of the evidence is slightly positive, but there simply are not very many trials.

The Bottom Line:

Prebiotic supplements are a mixed bag: some people do really well on them and other people can’t tolerate them at all. If you do want to experiment, start very low and up the dosage gradually to minimize potential side effects. It’s also worth noting that for some people, prebiotics actually make digestive symptoms worse, especially for people sensitive to FODMAPs.

Do You Need Digestive Supplements?

Many people might think that they can both break down and absorb all the food they are eating quite efficiently, no outside help required. After all, that’s how humans have been functioning and thriving for millennia! As “unnatural” as it might be to take supplements in whole food or pill form, the point is really whether it helps or not. If it helps you, that’s the most important consideration. Humans do plenty of “unnatural” things every day (like reading these words on your computer, for example). If your digestion is not quite where you would like it to, targeted supplementation can be a safe and quick way to get things moving along more smoothly.