Bloating is a common condition experienced by people worldwide, but the precise definition is somewhat vague. It is described as a full or gassy feeling in the abdomen that is uncomfortable.
One cause of bloating could be when food is not absorbed properly, and the bacteria in the digestive tract produce gases which lead to bloating. Bloating can also be accompanied by a visible increase in abdominal girth.
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The prevalence of bloating is high all over the world, with the USA (15-30%) and Asia (15-23%) showing similar results. Evidence shows that women typically have higher rates of bloating than men; this may be because of hormonal effects, especially during a woman’s menstrual cycle.
A typical Western that is low in fiber and omega-3 fatty, acids and is high in red meat, saturated fats, sugars, alcohol, salt, and refined grains could contribute to bloating.
A Western diet can have detrimental effects on our gut microbiota and is associated with an increased risk of bloating and functional digestive conditions such as irritable bowel syndrome (IBS). In IBS, patients experience abdominal discomfort with bloating or distention despite having no evidence of intestinal pathology.
What causes bloating?
Changes in dietary habits are a major cause of altered gut microbiota. In normal conditions, the microbial population present in the gut is stable, but the microbiota can be altered by multiple factors such as diet and drugs, which ultimately changes the host’s physiology.
The excessive volume of intestinal gas leads to bloating and distension. In the fasting state, only 100 ml of gas is distributed evenly throughout the gastrointestinal tract, but the volume is increased by about 65% after consuming food.
Intestinal gas is also dependent on the number of fermented foods that enter the colon (by bypassing absorption through small intestine) and alters the composition of colonic flora.
The type of food consumed plays an important role in bloating. Increased dietary fiber is recommended for patients with irritable bowel syndrome to decrease the discomfort associated with bloating. Fiber improves gastrointestinal motility and can regulate the microbiota in the intestinal tract.
Lactose intolerance may also contribute to bloating. In normal conditions, intestinal enzymes split disaccharides into monosaccharides which are then absorbed by the body. If the process of digesting disaccharides is not completed, the disaccharide reaches the colon, which results in the formation of carbonic acids and gases.
FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are a group of fermented carbohydrates that are osmotically active and rapidly fermentable. FODMAPs foods include wheat, rye, legumes, fruits like mangoes, and sweeteners such as honey and agave nectar, vegetables, onion, milk, yogurt, and soft cheese.
Low FODMAP diets, including almond, coconut, rice, and soymilks, bananas, bell peppers, carrots, cucumbers, grapes, oats, potatoes, rice, spinach, kale, and tomatoes, are recommended by some experts to treat IBS.
However, many high FODMAP foods are very healthy and a low FODMAP diet is only recommended for patients with IBS who are symptomatic. Low FODMAP diets can actually be associated with nutritional deficiencies if not undertaken carefully, often under the guidance of a dietician.
As per a study published by Vangay P in the journal Cell, migration from a non-Western country to the U.S. is associated with immediate loss of gut microbiome diversity and function. The study found that immigration was associated with alteration to the gut microbiome. There was a loss of microbial diversity, loss of native strains, loss of fiber degradation capability, and shifts from Prevotella dominance to Bacteroides dominance.
The researchers concluded that these alterations may be due to dietary changes, from an eastern to western diet. The popularity of western foods will continue as the world becoming increasingly globalized; however, this scenario may put the people at an increased risk of widespread bacterial loss, which may ultimately lead to serious consequences.
How to tackle the harmful effects of the western diet?
Consuming a well-balanced diet may help improve gut microbiota. A Mediterranean diet can help to keep the microbe well-nourished and healthy. A Mediterranean diet is one of the dietary plans recommended by the Dietary Guidelines for Americans to promote health and prevent chronic disease.
The Mediterranean diet is also recognized by the World Health Organization as a healthy and sustainable dietary pattern. A Mediterranean diet mainly includes plant-based foods, healthy fats (e.g. olive oil) and lean protein from fish and poultry.
Apart from dietary changes, living a physically active life can also help by improving gut motility. Increased use of antibiotics can also lead to changes in the gut microbiota; hence, avoiding the unnecessary use of antibiotics can combat some of the harms on the gut microbiome.