Leah:
Hello and welcome to The Ideal Nutrition Podcast. I’m Leah Higl and I am here with my co-host, Aidan Muir, and today we are talking strategies to manage bloating. So, bloating is a super common complaint that I get from my clients and kind of just generally see around. I think it’s important to acknowledge that some bloating is normal and a sign of a healthy functioning gut. It’s something that’s going to happen if you’re eating food, but when it’s excessive and uncomfortable, there are definitely strategies that you can utilize to reduce it and manage it to a more comfortable amount.
So, I’m sure everybody knows what bloating is, but let’s start off with a little definition. So, bloating is defined as the abdomen feeling full and expanded, and the cause of this is typically due to a build up of trapped gas or a disturbance of the digestive system. The reason we are kind of taking a second to define this is because it is often kind of piled in with things like weight gain and water retention and other things that might make us feel like, quote, unquote, “puffy,” I suppose.
But when we’re talking about strategies today, it’s really to address that trapped gas in terms of the actual definition of bloating and not just kind of chucking all these things together.
Aidan:
Yeah, I think I spent too much time reading comments on TikTok because people talk about bloating when it’s like not bloating.
Leah:
When it’s not bloating, yeah.
Aidan:
Yeah. So, I’m going to start off with the most boring aspect, but something that is underrated in terms of its effectiveness is eating slower and chewing more thoroughly. That’s really boring, but taking a second to reflect how many people actually do that.
Leah:
It could be a game-changer.
Aidan:
Yeah, that whole 20 chews concept, very few people would do that, and if you do that, maybe you digest your food a little bit better and maybe it reduces the impact of this. The only reason I start with that boring advice is because it means you don’t have to worry about stuff that is more difficult to implement or could have more downside in terms of either financial, whether it’s a supplement or whether it has involving changing your diet. So, it’s the simplest one to do. Other kind of simple ones are reducing the consumption of carbonated drinks. This extends to salt drink obviously, but it also extends to stuff like alcohol. If you have flat drinks rather than stuff that is carbonated, you can produce bloating then.
And the other common one is chewing gum, which is a double one for a few reasons, like one of them is sugar alcohols which we’ll talk about later, but then also a lot of people will consume air while they’re having chewing gum and this air is more gas to be trapped and everything like that to cause bloating. And then depending on the severity of the bloating of course, but in a lot of cases it’s worth looking to rule out other medical conditions. If it’s a quite severe bloating, you definitely want to be doing this to see if there’s another cause because that way you can look at stuff like whether it’s inflammatory bowel disease, celiac disease or anything like that, or you could also be looking for a diagnosis of IBS as well to rule out everything else and be like, “Okay, we’re looking at IBS here.”
Leah:
Yeah, I think it’s always important to rule out those more severe things that could actually impact your long-term health. Even if your symptoms are kind of moderate, it’s just good to check, be on top of it.
Aidan:
Yeah, because even if it’s a low likelihood, it’s just if you let those things go on unaddressed for longer, it could cause more issues.
Leah:
The next thing we’ll talk about is fiber. So, fiber’s a pretty big one when it comes to bloating. I feel like whenever we talk about gut health, gut stuff generally, the advice is to increase your fiber intake, and for most people that’s not the worst advice in the world. Most people can benefit from that, but it’s important to acknowledge that having a lot of fiber or increasing your fiber really quite high quite quickly or in a rapid way is likely going to cause bloating. You’re going to have some uncomfortable digestive issues and that build up of gas by increasing fiber intake too quickly. So, your body does adapt over time to an increase in fiber intake, but if you’re increasing fiber, just do it slow and steady.
And then another thing I want to mention in regards to fiber is really, really high fiber diets. Of course, I work in the plant-based space, so for me, a lot of my clients, we’ve reduced their fiber intake because they’re having 60, 80, sometimes a hundred-plus grams of fiber per day. So, regardless of their body adapting over time, it can adapt to a certain extent, but there’s just going to be bloating usually at such a high fiber level. So, potentially even reducing your fiber intake if it’s really high, and then on the flip side of that, if you’re increasing it, doing it slowly.
There are certain types of fiber that are more likely to cause bloating or to cause those uncomfortable symptoms. So, something like inulin or chicory root is a really common thing to add in high fiber products like Fiber One bars. It’s a great prebiotic source of fiber but also a common trigger for bloating. So, if you’re having a lot of these products with added inulin, that might be an issue for you and might be something you want to look at dialing back in order to reduce your bloating.
Aidan:
And it’s rare for one thing to be the contributing factor, but I have worked with clients who’d have one, sometimes two of those per day, and just reducing that alone has been enough to tip things back in favor of not being bloated. It’s often multifactorial, but sometimes making some changes matter. And those Fiber One bars, they have about five grams of fiber per bar. From memory, when they first came out, they were higher fiber than that, and I’m quite confident that they reduced it because it was causing that. So, they tried to reduce it down to amount that wouldn’t commonly cause that. But what if you are more sensitive to inulin than somebody else? You might still get symptoms. What if you have two in a day? There was a reason they reduced the fiber.
Leah:
Yeah, that’s a lot.
Aidan:
Yeah, and it’s rare for people to be doing that, but I do see people doing that, and it is a common cause. Another common cause that I particularly see in the fitness space is sugar alcohols. So, sugar alcohols are added to a lot of low carb or low sugar products to help reduce the sugar content, and common examples of this are maltitol, erythritol, xylitol, and sorbitol, and they’re also notorious for causing bloating and other GI symptoms, particularly when consumed in large amounts. Once again, a lot of people in the fitness space could be consuming I know protein bars as well as say a Fiber One bar and a few other things that kind of adds up. Say you chew gum which has the sugar alcohols as well, and you have a low car protein bar and as a snack you have a Fiber One bar as well, you’re kind of stacking a few of these things together.
The research on sugar alcohols is interesting in terms of looking at the GI symptoms. I’ve seen research on maltitol showing either 25 grams or 50 grams which is quite a lot having relatively minor symptoms from a GI perspective in people, as in it’s not like you get a bunch of people and they all have massive symptoms from this. These bars are probably only having five to maximum 10 grams of maltitol in them, and it doesn’t a hundred percent line up based on what that research shows. But I would speculate that firstly, one, if you’re more sensitive to these sugar alcohols, you’re more likely to experience bloating. Two, as I said, it’s often a combination of stuff, it’s not just one thing. What if that research is just looking at it as an isolated variable and it’s not really showing this, but what if 10 grams of maltitol for you in the context of your day is enough to tip you over the edge towards being bloated and then you’ve got this stacking effect of other stuff as well?
I think it’s one of the easiest places to start. If bloating is a common thing for you and you look at your own diet and you’re like, “Oh, I actually do have quite a few of these products,” I’d just trial reducing them and seeing what happens. If it does nothing. Then this doesn’t matter. If it does something, then this probably does matter.
Leah:
I feel like it’s a really common thing in the fitness space as well when you’re having all these kinds of products. It could just be an easy win, just reducing it overall before you head into, I guess the next thing we’re going to talk about, and that’s FODMAPs which I feel like people are kind of starting to jump to a little early. They’re kind of pulling the trigger on, oh let’s go low FODMAP when they’ve not done this, these easier things that are more likely to be the cause of their symptoms. But FODMAPs is definitely one worth talking about. So, FODMAPs are fermentable forms of carbohydrates and includes sugar alcohols. This fermentation process in the large intestines, so this is what causes an increase in gas and the bloating. So, FODMAPs going to go through the digestive tract pretty well undigested and they get into the large bowel and they start to be fermented by gut bacteria creating gas.
Now, not all the FODMAP groups are going to cause that excessive gas in all people. Usually it is going to be just a couple of the FODMAP groups for a certain person, but also again, in the space that I work in with plant-based people, just looking at overall FODMAP load can be an issue. If you’re someone who’s eating a lot of plant-based foods that contain a really high amount of FODMAPs, that in itself, like fiber, could be causing an excessive amount of bloating that you might be looking at reducing your overall load of FODMAPs to manage.
But looking at the low FODMAP diet itself, it’s an elimination diet. So, if you’re wanting to go down this process and figure out whether your bloating is related to FODMAPs, the best and kind of gold standard way to do that would be to go on a strict low FODMAP diet for a period of time. If your bloating does go away or it’s reduced to a minimal level, you can then do a systematic reintroduction of these foods to find which FODMAP groups personally trigger your symptoms and then kind of go from there in regards to finding a personalized diet that limits those FODMAPs that you react to in a less restrictive way that still manages your symptoms.
Aidan:
Another thing to look at is food volume and how this ties in with all of the other things we’ve been talking about. So, the first obvious one is that eating a large amount of food can make you feel full, and although as we discussed that is separate to bloating, there can be an overlap in how you feel, look, or whatever, and maybe there’s a certain level of bloating and there’s a certain level of fullness, but that makes you feel more bloated overall. So, that’s one factor, but other factors are more food could mean more fiber, particularly if it’s more food volume into forms of fruits, vegetables, nuts, seeds, those kind of things, and more food could also mean more exposure to certain triggers such as FODMAPs or other food intolerances as well.
Another area that I think is interesting to think about how this plays a role is when you’re looking at, say, a calorie deficit versus a calorie surplus or maintenance calories. One of the most common experiences I probably find of a lot of clients is when we go into a calorie deficit, even if we haven’t talked about bloating or anything like that yet, they will often tell me that they feel less bloated when we go into a deficit, and sometimes when we go back to maintenance calories, they feel more bloated. That’s a bit of a frustrating thing because we can’t just live in a deficit. If you’re in a deficit, by definition you are losing weight, and we can’t just lose weight forever. By definition, we need to be at maintenance calories or higher for a decent majority of the time.
This is a problem that needs to be solved anyway, but it is interesting thing about it, particularly because when people go into deficit, they’re often also reducing carbohydrates. As we talked about, FODMAPs are fermentable forms of carbohydrates. Not all carbohydrates are FODMAPs, but a lot of carbohydrates are high-end FODMAPs as well. If somebody reduces their carbohydrates and they reduce their food volume, they’re likely going to be feeling less bloated. That doesn’t mean the calorie intake has any role to play in the bloating, but there is often overlap, and it’s worth thinking about how this factors into that.
Leah:
Totally. Ann easy win though could be peppermint oil. So, that’s something that I tend to use with a lot of my clients where we just want an easy win, we just want a little bit of reduction in bloating, and this could be a potential thing we use. So, having peppermint oil prior to meals does have pretty solid evidence for reducing bloating. So, looking at the research, on average, it improves IBS symptoms including bloating by around 44% according to a 2019 systematic review. And 44% from doing something as easy as taking peppermint oil capsules prior to eating, it just seems like a super easy win to me. So, if I’m working with a client, we don’t really want to kind of muck around with too many things, this is what we’ll go for. And the mechanism here is that it relaxes the intestines and allows the trapped gas to basically pass through.
So, something that I will use my clients is Mintec is a really common example of these peppermint oil capsules. Generally I don’t recommend specifically peppermint tea just because the amount of peppermint oil in that is probably not going to be enough to have the same relief as peppermint oil capsules, but either way, it’s such an easy win.
Aidan:
Another potential easy win, there’s a little bit less consistent, but it is in the same kind of category of easy wins is probiotic supplementation, and I suppose you could also add eating probiotic rich food into this category as well. But from a supplementation standpoint, there was a systematic review from 2013 that identified on average probiotics outperformed placebo for helping reduce bloating. That’s really the metric we care about because a lot of people say probiotics work, but it’s like let’s actually look at the outcomes, see does this actually help. Not every study is consistent, but that’s fair because it very much depends on the dosage and the strain and everything like that. That is a big topic by itself, but as a general rule, on average, probiotics likely help a little bit.
Leah:
So, final thing we’re going to touch on is constipation. So, constipation definitely can contribute to bloating since there is going to be some trapped gas in the intestines from the constipation itself. So, if you are experiencing constipation and that’s creating bloating, it’s really crucial that you deal with the root cause of that problem. So, whilst you can kind of focus on all of the previous things we’ve talked about and they may help a little bit, if you don’t deal with the constipation, not really going to deal with the bloating in its entirety. So, we did have a full episode on constipation, so if that’s something that you want to check out, it’s episode 11 and goes through all the different nutrition strategies that can be potential options for getting rid of constipation and having more regular bowel movements. So, if that is what is causing your bloating, definitely check it out.
Aidan:
Yeah, I think that one’s huge, even just because I’ve had experience working with so many clients who’ve used a tool like the low FODMAP diet or something like that, and in the first couple of days it’s helped their bloating, but then they’re still constipated, bloating comes back-
… and it’s just like, okay, that wasn’t the solution. You obviously need to address that. And sometimes those people will still clinging onto the low FODMAP diet because they’re like, “Well, it helped,” but it hasn’t solved the symptoms.
Leah:
Because there would’ve been some gas production that was limited through the low FODMAP diet, but it doesn’t stop the gas production from the constipation.
Aidan:
Exactly, yeah. So, it’s a tricky balance. You’ve obviously got to address the root cause. That mostly wraps things up for today. So, there’s definitely a lot of things you can do for bloating. This isn’t even a super detailed list. That’s even more than just this, but these are probably the first places we’d be looking at in a lot of cases. If you want a bit of a summary of this kind of stuff or look at any of the research we have mentioned, I encourage checking out the show notes. But apart from that, thank you for listening.