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Is Your Gut Healthy? The Ultimate Guide for a Healthy and Happy Gut

Introduction

Healing your gut doesn't have to be difficult!

With our modern way of living and overwhelming demands on our bodies and minds, maintaining gut health is more crucial than ever.

Here’s everything you need to know about the importance of gut health, what to look out for, and how to improve it.

Understanding Gut Health

1. Why Gut Health Matters

Gut health refers to the balance of microorganisms living in our digestive tract. These microorganisms, collectively known as the gut microbiota, play essential roles in digesting food, absorbing nutrients, and protecting our bodies against harmful bacteria. A healthy gut microbiome can improve your immune system, heart health, and even mental well-being.

2. The Role of the Gut Microbiome

Our gut microbiome is a diverse community of over 100 trillion microorganisms that reside in our gastrointestinal tract, primarily in the colon. Comprising bacteria, viruses, fungi, and other microbes, the gut microbiome plays a vital role in maintaining our overall health and well-being, such as:

  • Digestive Function:

    One of the primary functions of the gut microbiome is aiding in the digestion and absorption of nutrients from the food we consume. Certain bacteria in the gut produce enzymes that break down complex carbohydrates, proteins, and fats into simpler molecules that our bodies can absorb. Additionally, these microbes help ferment dietary fibres that are indigestible by human enzymes, producing short-chain fatty acids (SCFAs) such as acetate, propionate, and butyrate. SCFAs serve as an energy source for the cells lining the colon and play a crucial role in maintaining gut health and keeping the gut lining tight and permeable.

  • Immune Regulation:

    The gut microbiome plays a significant role in regulating the immune system and protecting against pathogens. By competing with harmful bacteria for space and resources, beneficial microbes help maintain a balanced microbial community in the gut, known as microbial homeostasis. This balance is essential for preventing the overgrowth of pathogenic and opportunistic bacteria and reducing the risk of infections. Additionally, the gut microbiome interacts with the immune cells in the gut-associated lymphoid tissue (GALT), helping to train the immune system to recognise and respond appropriately to harmful invaders.

  • Metabolic Function:

    Recent research has highlighted the role of the gut microbiome in regulating metabolism and influencing various metabolic processes in the body. Gut microbes are involved in the metabolism of dietary components, such as carbohydrates, fats, and amino acids, contributing to energy production and storage. Imbalances in the gut microbiome, often referred to as dysbiosis, have been linked to metabolic disorders such as obesity, insulin resistance, and type 2 diabetes.

  • Neurological Function:

    Emerging evidence suggests that the gut microbiome can influence brain function and behaviour through the gut-brain axis, a bidirectional communication system between the gut and the brain. Gut microbes produce neurotransmitters, such as serotonin, dopamine, and gamma-aminobutyric acid (GABA), which play essential roles in regulating mood, cognition, and stress response. Moreover, microbial metabolites, such as SCFAs, can modulate the activity of the enteric nervous system (ENS) and the central nervous system (CNS), affecting brain function and behaviour. Dysregulation of the gut-brain axis has been implicated in various neurological and psychiatric disorders, including anxiety, depression, and autism spectrum disorders.

3. Signs of a Healthy Gut

Determining gut health can be tricky, but some signs indicate a well-functioning digestive system:

  • Regular Bowel Movements:

    Consistent and predictable bowel movements indicate a healthy digestive system.

  • Normal Stool Appearance:

    Stools are well-formed, neither too hard nor too loose, and easy to pass.

  • Absence of Abdominal Pain:

    Lack of persistent or severe abdominal pain or discomfort after meals.

  • No Excessive Gas or Bloating:

    Occasional gas is normal, but excessive bloating or flatulence may indicate digestive issues, even more so if these are painful.

  • Minimal Indigestion or Heartburn:

    Infrequent episodes of indigestion or heartburn, especially after consuming certain foods.

  • Healthy Appetite:

    Normal appetite levels without significant fluctuations in hunger or fullness.

  • Stable Weight:

    Maintaining a stable weight without unexplained fluctuations or sudden changes.

  • Satisfying Meals:

    Feeling satisfied and nourished after meals, without experiencing cravings or excessive hunger shortly afterwards.

  • Regular Hydration:

    Maintaining adequate hydration levels, which support digestive function and prevent constipation.

  • Absence of Food Intolerances or hypersensitivities:

    Being able to tolerate a wide range of foods without experiencing adverse reactions or discomfort.

  • Balanced Energy Levels:

    Consistent energy levels throughout the day, without experiencing extreme fatigue or lethargy.

  • Healthy Skin:

    Clear, radiant skin without frequent breakouts or skin issues related to poor digestion or nutrient absorption.

4. Signs of an Unhealthy Gut

Conversely, an unhealthy gut may manifest in various symptoms. Identifying signs of an unhealthy gut is essential (think food diary) for addressing potential imbalances and promoting gut health. Here are several indicators that may suggest an unhealthy gut:

  • Constipation or Irregular Stools:

    Difficulty in passing stools or irregular bowel movements.

  • Digestive Discomfort:

    Persistent digestive discomfort, such as bloating, gas, abdominal pain, and cramping, may indicate poor digestive capacities, low stomach acid and gut dysbiosis.

  • Irregular Bowel Movements:

    Constipation, diarrhoea, or alternating between the two can signal disruptions in gut motility and digestion.

  • Food Intolerances:

    Development of new food sensitivities or intolerances, particularly to foods that were previously well-tolerated, may indicate gut inflammation or permeability issues, and inflammation (and immune hyper-reactivity).

  • Chronic Fatigue:

    Persistent fatigue and low energy levels, even after adequate rest, may be linked to poor nutrient absorption and impaired energy metabolism in the gut.

  • Skin Issues:

    Skin conditions such as acne, eczema, or psoriasis may be exacerbated by gut inflammation and imbalances in the gut microbiome.

  • Mood Swings:

    Fluctuations in mood, including irritability, anxiety, or depression, may be influenced by alterations in gut-brain communication and neurotransmitter concentrations.

  • Brain Fog:

    Difficulty concentrating, memory problems, and cognitive issues, commonly or "brain fog," may be associated with gut inflammation and microbial imbalances.

  • Sugar Cravings:

    Intense cravings for sugary or processed foods may indicate an overgrowth of sugar-loving gut bacteria, leading to dysregulated appetite control.

  • Weight Fluctuations:

    Unexplained weight gain or weight loss, despite no changes in diet or exercise, may be linked to disruptions in gut microbiota composition and metabolic function.

  • Weak Immune System:

    Frequent infections, allergies, or autoimmune conditions may indicate impaired immune function, often attributed to gut dysbiosis and increased intestinal permeability.

  • Joint Pain:

    Chronic joint pain, stiffness, or inflammation may be associated with systemic inflammation triggered by gut dysbiosis and leaky gut syndrome.

  • Sleep Disturbances:

    Difficulty falling asleep, staying asleep, or waking up unrefreshed may be influenced by gut-brain axis dysfunction and disruptions in circadian rhythms.

  • Bad Breath:

    Persistent bad breath, despite good oral hygiene practices, may be indicative of underlying digestive issues, such as bacterial overgrowth in the gut or stomach.

  • Nutritional Deficiencies:

    Deficiencies in essential nutrients, vitamins, and minerals, even with a balanced diet, may suggest impaired nutrient absorption in the gut.

  • Chronic Inflammation:

    Systemic inflammation, characterised by persistent inflammation markers in blood tests, may be driven by gut dysbiosis and increased intestinal permeability.

  • Frequent Headaches:

    Recurrent headaches or migraines may be linked to gut inflammation and alterations in the gut-brain axis, affecting neurotransmitter levels and pain perception.

  • Unexplained Allergies:

    Development of new allergies or sensitivities, including seasonal allergies or environmental triggers, may be related to immune dysregulation stemming from gut imbalances.

  • Autoimmune Conditions:

    Autoimmune diseases, such as rheumatoid arthritis, lupus, or Hashimoto's thyroiditis, may be exacerbated by gut dysbiosis and leaky gut syndrome.

  • Chronic Stress:

    Persistent stress, anxiety, or mood disorders can disrupt gut function and microbiome composition, leading to a vicious cycle of gut-brain axis dysfunction.


In a nutshell: Signs of a Healthy Gut

1. Regular Bowel Movements

Maintaining a consistent pattern of bowel movements is a key indicator of gut health. While there is no strict rule for how often one should poop, a healthy range typically falls between three times a day and once a day.

Pooping during the day is considered normal, and nighttime bowel movements may warrant further investigation unless you eat a large dinner too close to bedtime.

2. Gut Transit Time

The duration it takes for food to pass through the digestive tract, known as gut transit time, is another important aspect of gut health. A healthy transit time is neither too short nor too long, with an average duration of around 28 hours. Variations in transit time are normal but extreme deviations may indicate underlying digestive issues.

3. Characteristics of Stool

Observing the colour, shape, and consistency of stools can provide valuable insights into gut health. Healthy stool is typically medium to dark brown and has a smooth texture. It should form soft to firm sausage shapes passed in a single large or a few smaller pieces, sinking in the toilet bowl. Deviations from these characteristics, such as unusual colours or texture, or floating stools, may indicate digestive disturbances or medical conditions that require attention.

4. Comfortable Elimination:

Pain-free and effortless bowel movements are indicative of a healthy gut. Difficulty or discomfort during defecation, including straining or pain, may be suggestive of constipation, food intolerances, irritable bowel syndrome (IBS), or other gastrointestinal issues.

5. Gas and Bloating:

Gas production is a natural byproduct of gut bacterial fermentation and is considered a normal aspect of digestive function. Healthy gut activity typically results in passing gas approximately 10-20 times a day. While mild bloating and gas after meals are common, excessive or persistent bloating and discomfort may indicate underlying digestive imbalances or sensitivities.


Nourishing Your Gut: Foods and Supplements for Optimal Gut Health

Maintaining a healthy gut is essential for overall well-being, and incorporating gut-friendly foods and supplements into your diet can support digestive health and promote microbial balance. Here's a comprehensive guide to nourishing your gut:

  1. Probiotic Foods:

    Include probiotic-rich foods in your diet to introduce beneficial bacteria into your gut. Fermented foods such as yoghurt, kefir, sauerkraut, kimchi, and kombucha contain live cultures of probiotic bacteria that can help restore microbial balance and improve digestion.

    Start with a portion you are comfortable with then increase portion size to build up resistance. Decrease intake if symptoms start to appear or worsen.

  2. Prebiotic Fibre:

    Increase your intake of prebiotic fibre, which serves as fuel for beneficial gut bacteria. Foods high in prebiotics include bananas, onions, garlic, leeks, asparagus, oats, flaxseeds, and Jerusalem artichokes. These foods support the growth and activity of probiotic bacteria in the gut, enhancing gut health. Probiotic bacteria produce lactic acid, a repellent for pathogenic bacteria! They also produce short-chain fatty acids (SCFAs) that benefit overall health, the gut and the gut lining, keeping it tight and permeable.

  3. Fibre-Rich Foods:

    Incorporate plenty of fibre-rich foods into your diet to support digestive regularity and promote a healthy gut microbiome. Whole grains (Organic and non-GMO), legumes, fruits, and vegetables are excellent sources of dietary fibre, which helps bulk up stools, improve bowel movements, and nourish beneficial gut bacteria.

  4. Omega-3 Fatty Acids:

    Include omega-3 fatty acids in your diet to reduce inflammation and support gut health. Fatty fish such as wild salmon, mackerel, and sardines are rich sources of omega-3s, while plant-based sources include flaxseeds, chia seeds, walnuts, and hemp seeds. Omega-3s help maintain the integrity of the intestinal lining and reduce gut inflammation.

  5. Bone Broth:

    Sip on bone broth regularly to support gut health and repair the intestinal lining. Bone broth is rich in collagen, gelatin, and amino acids such as glutamine, which help heal and seal the gut lining, reducing intestinal permeability and promoting gut integrity.

  6. Digestive Enzymes:

    Consider supplementing with digestive enzymes to support efficient digestion and nutrient absorption. Digestive enzyme supplements can help break down carbohydrates, proteins, and fats, easing digestive discomfort and improving nutrient assimilation in individuals with digestive issues.

    You may also consider gluten-specific enzymes if you experience unwanted symptoms after eating gluten-containing foods.

    ALWAYS TAKE ENZYMES IN THE MIDDLE OF A LARGER MEAL, NEVER BEFORE OR AT THE END OF THE MEAL!

  7. L-Glutamine:

    L-Glutamine is an amino acid that plays a crucial role in gut health and intestinal integrity. Supplementing with L-glutamine may help repair the intestinal lining, reduce intestinal permeability, and alleviate symptoms of leaky gut syndrome. It also supports immune function and promotes tissue healing in the gut.

    Again, bone broth is rich in glutamine.

  8. Probiotic Supplements:

    In addition to probiotic foods, consider taking specific probiotic supplements to support your gut. Look for high-quality probiotic supplements that contain a variety of strains, including Lactobacillus and Bifidobacterium species, and aim for a product with a high colony-forming unit (CFU) count to ensure potency and effectiveness.

  9. Digestive Bitters:

    Incorporate digestive bitters into your routine to stimulate digestive secretions and support optimal digestion. Bitter herbs such as gentian, dandelion, and artichoke can help enhance bile production, improve nutrient absorption, and alleviate symptoms of indigestion and bloating.

    These are also essential to support liver function and the release of bile. Taking bitters with a fatty meal may also reduce symptoms of maldigestion. Bile is also necessary to digest fat and absorb fat-soluble vitamins.

  10. Magnesium:

    Magnesium plays a crucial role in gut health and muscle function, helping to regulate bowel movements and maintain gut motility. Ensure an adequate intake of magnesium-rich foods such as leafy green vegetables, nuts, seeds, and whole grains, or consider supplementing with magnesium citrate or magnesium glycinate if needed.

  11. Apple Cider Vinegar:

    Apple cider vinegar contains acetic acid, which can help support digestion by promoting the production of stomach acid. Consuming diluted apple cider vinegar before meals may aid in digestion and reduce symptoms of indigestion.

  12. Colostrum:

    Colostrum, the first milk produced by mammals after giving birth, is rich in antibodies, growth factors, and immune-supporting compounds. Colostrum supplements may help support gut health by promoting the growth of beneficial bacteria and strengthening the intestinal barrier.

  13. Herbal Teas:

    Certain herbal teas, such as ginger tea, peppermint tea, and chamomile tea, have been used for centuries to soothe digestive discomfort and promote gut health. These teas can help relax the digestive tract, alleviate bloating and gas, and support overall digestive function.

    Beware of peppermint tea if you suffer from reflux, as it can make it worse.

  14. Resistant Starches:

    Resistant starches are a type of dietary fibre that can resist digestion in the small intestine and reach the colon intact, where they serve as fuel for beneficial gut bacteria. Foods rich in resistant starches include cooked and cooled potatoes, green bananas, legumes, and whole grains.

  15. Jerusalem Artichokes:

    Jerusalem artichokes are high in inulin, a prebiotic fibre that can stimulate the growth of beneficial bacteria in the gut and support digestive health.

  16. Aloe Vera:

    Aloe vera gel contains compounds that can soothe and support the lining of the digestive tract. Consuming aloe vera juice or supplements may help reduce inflammation in the gut and support overall digestive health.

  17. Turmeric:

    Turmeric contains curcumin, a powerful anti-inflammatory compound that can help reduce inflammation in the gut and support digestive function. Adding turmeric to your meals or taking turmeric supplements may help alleviate symptoms of digestive discomfort.

  18. Coconut Products:

    Coconut products such as coconut oil, coconut milk, and coconut yoghurt contain medium-chain triglycerides (MCTs) and lauric acid, which have antimicrobial properties and can support a healthy balance of gut bacteria.

  19. Psyllium Husk:

    Psyllium husk is a soluble fibre that can help regulate bowel movements and promote regularity. Taking psyllium husk supplements or adding psyllium fibre to your diet can support digestive health and relieve constipation. ENSURE TO DRINK PLENTY OF WATER WHEN TAKING PSYLLIUM.

  20. Apple Pectin:

    Apple pectin is a soluble fibre found in apples that can help promote regular bowel movements, support gut health, and aid in the removal of toxins and waste products from the body.

  21. Marshmallow Root:

    Marshmallow root contains mucilage, a gel-like substance that can coat and soothe the lining of the digestive tract. Consuming marshmallow root tea or supplements may help alleviate symptoms of digestive discomfort, such as heartburn and indigestion.

    Other foods rich in mucilage include chia seeds and flax/linseeds.

  22. Slippery Elm:

    Slippery elm bark contains compounds that can help soothe inflammation in the gut and support digestive health. Drinking slippery elm tea or taking slippery elm supplements may help relieve symptoms of gastrointestinal conditions, such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD).

    Slippery elm is also proven to be more effective than pharmaceutical drugs in reducing reflux and the sensation of heartburn.

  23. Reduced Glutathione:

    Glutathione is a powerful antioxidant that plays a crucial role in detoxification and immune function. Taking glutathione supplements or consuming foods rich in glutathione precursors, such as sulfur-rich vegetables and fruits, can support gut health and overall well-being.

    Glutathione is also required to protect liver tissue from damage.

  24. Zinc:

    Zinc is an essential mineral that helps maintain gut integrity and support immune function. Consuming zinc-rich foods, such as oysters, beef, pumpkin seeds, and lentils, or taking zinc supplements can help promote gut health and reduce the risk of gastrointestinal infections.

  25. Licorice Root:

    Liquorice root contains compounds that can help soothe inflammation in the gut and support digestive health. Consuming liquorice root tea or supplements may help alleviate symptoms of gastrointestinal conditions, such as acid reflux and gastritis. Use caution if you have high blood pressure.

Improving Gut Health Naturally

1. Eat a Diverse Diet:

Consuming a wide variety of whole foods ensures that you receive a broad spectrum of nutrients and phytonutrients that support gut health. Include plenty of fruits, vegetables, whole grains, legumes, nuts, seeds, and fermented foods in your diet to promote microbial diversity in the gut.

2. Follow a Gut-Friendly Diet

A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) can help reduce gut discomfort. Foods high in FODMAPs, such as apples, pears, milk, and cabbage, can ferment in the gut and cause unpleasant symptoms.

DO NOT FOLLOW A LOW-FODMAP DIET FOR MORE THAN 90 DAYS!

3. Take Friendly Bacteria Supplements

Probiotic supplements can help restore balance to the gut microbiota, particularly for those with gut problems. These supplements can also support mood fluctuations linked to gut health.

ONLY PURCHASE FROM TRUSTED SOURCES WITH PROVEN STRAINS OF BACTERIA.

4. Exercise Regularly

Physical activity stimulates peristalsis, the muscle contractions that move stools through the gut. Regular exercise can improve gut efficiency and overall health. The UK government recommends 150 minutes of moderate aerobic exercise and strength training two or more days a week.

5. Reduce Fiber Intake (If Necessary)

Fiber-rich foods, such as fruits, vegetables, legumes, and whole grains, provide prebiotic fibre that nourishes beneficial bacteria in the gut. Aim to include a mix of soluble and insoluble fibre in your diet to support regular bowel movements and maintain a healthy gut environment.

While fibre is generally good for gut health, too much can overstimulate the gut, especially in individuals with sensitive digestive systems.

ALWAYS START SLOW AND LOW, AND BUILD UP YOUR RESISTANCE.

BEWARE OF CUTTING GRAINS OUT OF YOUR DIET AS YOU MAY LOSE A SIGNIFICANT SOURCE OF SOLUBLE FIBRE.

6. Gut-Focused Hypnotherapy

Research indicates that gut-focused hypnotherapy can significantly reduce symptoms in patients with gut issues. This therapy may make the gut less sensitive, decrease the strength of contractions, and alleviate stress and anxiety related to gut problems.

CONSIDER GUT-FOCUSED HYPNOTHERPAY IF YOU SUFFER FROM IBS.

7. Limit Processed Foods

Minimise the consumption of processed and ultra-processed foods high in added refined sugars, unhealthy (trans) fats, chemical additives, and preservatives. These foods can disrupt gut microbiota balance and contribute to inflammation and digestive problems.

8. Manage Stress

Practice stress-reduction techniques such as meditation, deep breathing exercises, yoga, tai chi, or mindfulness to help manage stress levels. Chronic stress can negatively impact gut health by altering gut motility, increasing inflammation, and disrupting the balance of gut bacteria.

STRESS IS A MAJOR CONTRIBUTOR TO IBS AND ITS SYMPTOMS.

9. Get Adequate Sleep

PrioritiSe getting sufficient sleep each night to support overall health, including gut health. Aim for 7-9 hours of quality sleep per night to allow the body to rest, repair, and regenerate.

Poor sleep habits can disrupt circadian rhythms and adversely affect gut microbiota composition and function.

POOR SLEEP PATTERNS AND CHRONIC LACK OF SLEEP OVERSTIMULATE THE HPA AXIS (THE STRESS RESPONSE) AND PARTICIPATE IN CHRONIC GUT ISSUES AND EXACERBATE SYMPTOMS.

10. Limit Alcohol and Tobacco

Reduce or eliminate alcohol consumption and avoid tobacco use, as these substances can negatively impact gut health and contribute to gastrointestinal disorders. Excessive alcohol consumption and smoking can instantly disrupt gut microbiota balance, increase inflammation, and damage the intestinal lining.

CERTAIN PATHOGENIC BACTERIA PRODUCE ALCOHOL AS A BYPRODUCT, INFLAMING THE LIVER AND CONTRIBUTING TO NON-ALCOHOLIC LIVER DISEASE. THIS IS IN ADDITION TO CONSUMING ALCOHOL, A SUBSTANCE THAT CONTRIBUTE TO THOSE BACTERIA THRIVING.

OTHER BACTERIA RELEASE ENDOTOXINS (LPS) THAT FURTHER INFLAME THE LIVER AND CONTRIBUTE TO GASTROINTESTINAL DISORDERS.

The Gut-Brain Connection

1. The Gut-Brain Axis

Our gut and brain are closely connected through the gut-brain axis (via the vagus nerve), a communication network that links the emotional and cognitive centres of the brain with peripheral intestinal functions. This connection explains why stress and emotional disturbances can lead to digestive issues like bloating and discomfort.

2. Impact on Mental Health

Emerging research suggests that the gut microbiota influences mental health through the production of neurotransmitters and modulation of the immune system. The fermentation of inulin and other prebiotic fibres by gut bacteria produces SCFAs, which can modulate neurotransmitter production and inflammation, potentially affecting mood and cognitive function.

The Final Say

Maintaining a healthy gut is essential for overall health and mental well-being.

By understanding the signs of a healthy and unhealthy gut, incorporating gut-friendly foods into your diet, and adopting healthy lifestyle practices, you can support your digestive health and enhance your quality of life.

Go back to the list given above and take notes if necessary.

Healing the gut doesn’t have to be difficult – with the right knowledge and habits, you can harbour a happy and healthy gut.


References:

Kechagia, M. Basoulis, D. Konstantopoulou, S. et al. (2013). Health benefits of probiotics: a review. ISRN Nutrition. 2013, 481651. doi:10.5402/2013/481651

Kim, YS. Song, BK. Oh, JS. et al. (2014). Aerobic exercise improves gastrointestinal motility in psychiatric inpatients. World Journal of Gastroenterology. 20(30), pp. 10577-10584. doi:10.3748/wjg.v20.i30.10577

Lazar, V. Ditu, LM. Pircalabioru, GG. et al. (2018). Aspects of gut microbiota and immune system interactions in infectious diseases, immunopathology, and cancer. Frontiers in Immunology. 9, 1830. doi:10.3389/fimmu.2018.01830

Li, Y. Hao, Y. Fan, F. et al. (2018). The role of microbiome in insomnia, circadian disturbance and depression. Frontiers in Psychiatry. 9, 669. doi:10.3389/fpsyt.2018.00669

Mashaqi, S. Gozal, D. (2020). Circadian misalignment and the gut microbiome. A bidirectional relationship triggering inflammation and metabolic disorders — a literature review. Sleep Medicine. 72, pp. 93-108. doi:10.1016/j.sleep.2020.03.020

Parkar, SG. Kalsbeek, A. Cheeseman, JF. (2019). Potential role for the gut microbiota in modulating host circadian rhythms and metabolic health. Microorganisms. 7(2), 41. doi:10.3390/microorganisms7020041

Rinninella, E. Raoul, P. Cintoni, M. et al. (2019). What is the healthy gut microbiota composition? A changing ecosystem across age, environment, diet, and diseases. Microorganisms. 7(1), 14. doi:10.3390/microorganisms7010014

Scaldaferri, F. Gerardi, V. Lopetuso, LR. et al. (2013). Gut microbial flora, prebiotics, and probiotics in IBD: Their current usage and utility. BioMed Research International. 2013, 435268. doi:10.1155/2013/435268

Wagner-Skacel, J. Dalkner, N. Moerkl, S. et al. (2020). Sleep and microbiome in psychiatric diseases. Nutrients. 12(8), 2198. doi:10.3390/nu12082198

Wang, L. Guo, MJ. Gao, Q. et al. (2018). The effects of probiotics on total cholesterol: A meta-analysis of randomized controlled trials. Medicine (Baltimore). 97(5), e9679. doi:10.1097/MD.0000000000009679

https://www.nhs.uk/live-well/exercise

https://www.nhs.uk/live-well/exercise/how-to-improve-strength-flexibility