Go with your Gut

Many readers have asked for a user’s guide to improving gut health. Putting together all the research I’ve reviewed to date, here is my checklist for building a healthy gut. Obviously you can’t change how you were born or whether you were breastfed. The point of this overview is to show you there are many factors that contribute to a healthy microbiome and it’s never too late to improve your internal ecosystem.

To borrow from Reinhold Niebuhr, ‘God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.’


  1. Fingers crossed that your mother avoided stress and antibiotics during pregnancy.
  2. Have a normal vaginal delivery
  3. Breast feed
  4. Avoid antibiotics in the first 3 years of life.
  5. Throughout your life, use antibiotics only when absolutely necessary – not for minor coughs and colds.
  6. Try not to have your tonsils out before the age of 7 years. Our tonsils are a training ground for our immune system ie where friendly bacteria teach our immune cells what to attack and what not to attack. If your tonsils are removed early in life, it’s as if your immune cells have dropped out of school before graduating and they haven’t learnt everything they need to know later in life. This leads to an increased risk of autoimmune diseases and allergies. Tonsillectomy before age 7 is also linked to a higher risk of obesity.
  7. Try not to have your appendix removed unless the inflammation is life-threatening because the appendix is a storehouse for healthy bugs that are recruited in times of serious infection.
  8. Avoid taking antacids as they reduce stomach acid and promote growth of harmful gut bugs. Ask your doctor to educate you on the dietary and lifestyle factors that help alleviate heartburn and reflux.
  9. Avoid abuse, severe stress and trauma in the first 20 years of your life. Even a single exposure to social stress like bullying causes a negative change in gut microbiota. Our gut microbes want us to live harmoniously. Conflict continues to reduce microbial diversity throughout our lives but the effect is most profound early in life. Conversely, having meaningful, nurturing and supportive relationships strengthens our immune system, reduces the risk of heart disease and protects against developing dementia. The mechanisms through which positive relationships improve our health are complex and not yet fully understood.
  10. Don’t use antibacterial soaps at home. Do use antibacterial soaps in hospitals.
  11. Eat real whole food i.e. avoid food additives, preservatives, colourings and artificial sweeteners.
  12. Avoid processed foods with added sugar.
  13. Practise intermittent or overnight fasting – ideally 12+ hours – read my previous HEB for details.
  14. Avoid snacking (unless you’re a physically active, growing child who is genuinely hungry between meals).  The outdated advice to eat six small meals a day has done all of us a huge disservice. Our microbiota do not like to be bombarded with food every few hours.
  15. Eat fibre-rich foods like vegetables, oats, beans, unblanched nuts and unpeeled fruit. These are nature’s prebiotics.
  16. Eat fermented foods (known as probiotics) like unflavoured natural yoghurt, kefir, kimchi, kombucha and sauerkraut.
  17. Spend time in nature. 
  18. Get regular exercise – read my previous HEB.
  19. Manage stress effectively.
  20. Eat when you’re hungry and don’t eat when you’re not hungry. In particular, avoid eating when you’re stressed, angry or sad. Our emotional state influences our production of neurotransmitters and the activation of our gut nervous system.
  21. Listen to your gut about what to eat. One of the biggest things we’ve learnt from our microbiota is that one diet does not suit all. Discover your optimal diet by eating with awareness. Never eat while doing something else.
  22. If you have irritable bowel syndrome (IBS), try a low FODMAP diet as 74% of people find that it improves their symptoms.

* To read other HEB’s in the gut series click below:

  • John Stewart

    Another Gem Helena
    Beautifully written

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