Most of us have experienced bloating at some time in our lives. Some of us endure it most days. If this is you, you probably know the feeling all too well – you wake up in the morning feeling slim, but as the day goes on you feel more and more uncomfortable. It’s not uncommon for women to report thinking that they look 6 months pregnant by bedtime! Wouldn’t it be great if you could get rid of this?
The first thing I must say is that persistent bloating that is not typical for you can be a symptom of ovarian cancer. Ovarian cancer is difficult to detect in the early stages, making late diagnoses more common, so it is important to report any symptoms which could be signs of ovarian cancer to your GP as soon as possible. It’s much more likely that your bloating is due to a benign cause, but it’s important to get checked out. For more information on the symptoms of ovarian cancer, follow this link.
That said, there are many less suspicious factors which can cause bloating. Sometimes all that is required to ease the symptoms might be changing the way you eat or making some lifestyle changes. In other cases you might need to dig a bit deeper to find the cause of your bloating and resolve it. Let’s have a look at some of the factors that might be responsible, starting with those that are easiest to address first. In this first part in a series of blog posts, we’ll discuss how the way you eat might contribute to bloating. In later parts we’ll look into lifestyle, digestion and gut health and specific foods that may be problematic.
That’s right, how you eat rather than what you eat might be to blame. I’ve written before about how at any one time the body is either in fight or flight mode or rest and digest mode (see “Stress: What’s nutrition got to do with it?”). The clue is in the name: in order for our digestive system to work optimally, we need to be in rest and digest mode. In simple terms, this means that we need to be relaxed.
When we are relaxed, the parasympathetic nervous system takes over. This directs blood to our gastrointestinal tract, ensuring the proper release of all the enzymes and digestive juices we need to digest and absorb our food. When we are stressed, on the other hand, blood is directed to our skeletal muscles (to help us to run away from danger) and away from our digestive system. This means that some food can be left partially digested in our gut, where it can ferment, resulting in the gas that is responsible for bloating.
Throughout our human history, mealtimes were traditionally a time when we slowed down, stopped our work and ate in the company of our family and friends – firmly in the rest and digest mode. Contrast this with the way many of us eat today: grabbing a sandwich at our desks whilst continuing to work, eating breakfast on the way to work or meals in front of the TV. Even if you are eating around the family dinner table, if there is an argument going on then you will be in the stress response.
Chew your food
Another consequence of eating in a rush is that we may not chew well enough. Digestion begins in the mouth and there are no teeth in our stomach! If our food is not adequately broken down before we swallow it, it places a strain on the rest of the digestive system. It might sound boring, but chewing your food until it is liquid before you swallow it can make a big difference to digestive problems, including bloating. I have seen this for myself in clinic.
Get those digestive juices flowing….
Did I say that digestion begins in the mouth? It’s true that this is where the process of food being broken down begins, but there is actually a phase of digestion that comes before this. It happens in our brain.
When we think about food, or smell it or see it, our brain receives a stimulus. The brain then transmits a signal to the gut (via the vagus nerve which connects the brain and the gut) telling it to prepare for food and the gut responds by secreting digestive juices. We know this happens – we salivate when we think about food – but it’s not just contained to the mouth. When our brain receives signals about food we also produce stomach acid, pancreatic digestive enzymes and hormones related to appetite (1). It is interesting that the response to sensory stimulation is lessened when the brain is distracted and not concentrating entirely on food.
Imagine spending time preparing a meal. You plan what you are going to cook, handle the ingredients, the aromas permeate your kitchen and you might even taste a little to make sure you have got the seasoning or spices just right. After all this, your brain really knows that food is on its way! Contrast this with grabbing a takeaway on the go or sticking a ready meal in the microwave. Your brain is much less prepared for the arrival of food, and your digestion might struggle to keep up as a result. Insufficient digestive juices can result in particles of food passing undigested into the colon, where bacteria can ferment them producing gas. The result? Bloating.
Leave some room
The Japanese island of Okinawa is one of the Blue Zones: areas of the world in which people live much longer than average. One of the practices common among Okinawan elders is Hara Hachi Bu which roughly translates as “eat until your belly is 80% full”. As well as being a possible contributor to the remarkable longevity of Okinawans, stopping eating before you are completely full makes sure that your digestive system is not overloaded and can deal with the food that is in it. It’s common to be more bloated as the day progresses and your digestive system has more food to deal with. Taking the pressure off by 20% at each meal may make a difference.
Tips for optimising how you eat
1. Spend some time before you eat thinking about what you are going to eat. If you are preparing the meal yourself, great – concentrate on what you are doing. If you will be eating a meal that someone else has prepared, spend some time thinking about what you will be eating. How will it taste?
2. Make sure that you are in the rest and digest mode before you eat. One easy way to get into this mode is to practise some deep breathing, concentrating on the out breath.
3. When you are actually eating, stop all other activities except socialising with the people sharing the meal with you. Don’t eat whilst walking, texting, replying to emails or doing your online shopping!
4. As far as possible, avoid arguments at the dinner table (being part of a busy family of 5, I know this is sometimes easier said than done!). Avoid eating while watching anything dramatic on TV that could put you into the fight or flight response.
5. Be mindful of what you are eating. How does your food smell, taste, feel in your mouth? If you’re not used to doing this, start by committing to do this for just the first 5-10 mouthfuls, until it becomes a habit.
6. Chew your food well, ideally until it is liquid before swallowing.
7. Eat slowly and stop when you are 80% full – Hara Hachi Bu!
In part 2 of this series, we’ll look at how changing a few simple aspects of your lifestyle might help with bloating.
1. Smeets, P.A., Erkner, A. and de Graaf, C. (2010). “Cephalic phase responses and appetite”, Nutrition Reviews, 68(11), pp643-655. Available at https://www.ncbi.nlm.nih.gov/pubmed/20961295 (Accessed 25 September 2019).