From occasional constipation or diarrhea to chronic digestive conditions, like Irritable Bowel Disease (IBD) or Gastroesophageal Reflux Disease (GERD), there's more to managing your symptoms than food choices. A concept called "meal hygiene" offers non-food ways to support your gut health. 

What's in the GI Tract?

Our gut includes the mouth, esophagus, stomach, small and large intestines, and assistive organs like the gallbladder and liver. This system does two main things: digestion and absorption. Digestion is about breaking down food particles into smaller and smaller pieces, releasing carbs, fat, protein, water, vitamins, and minerals. Combined with digestive secretions - like stomach acid and bile - the gut now turns to absorption where these nutrients are moved from the gut to body cells where nutrients can be used for energy, building and repairing, and other body processes. 

Meal Hygiene

Try these tips about meal hygiene to support your digestion and absorption. These steps work together with nutritious food choices, but a gut and food choices blog is for another day.

1. Spacing meals. 

The human gut is designed for breaks between eating. We have a system called Migrating Motor Complex (MMC), which includes a series of muscle contractions that helps move food through the gut. It only happens where you have not eaten. If your eating style is grazing (or eating small bites every hour or so), your MMC cannot move digested food (and also bacteria and other microorganisms) through your gut effectively. The switch: focus on eating meals and snacks at least 2-4 hours apart. (Read more about drinks and digestion below.)

2. Chewing to applesauce consistency.

Digestion starts in the mouth with chewing. Swallowing pieces of minimally chewed food means your stomach and the rest of your gut has to work harder to digest what you ate. The switch: chew well - as close to applesauce consistency as you can get.

3. Speed of eating.

Fast eating often means you don't have time to effectively chew your food (see above). Since it takes time for your gut to communicate with your brain that you feel full, fast eating can lead to overeating and gut symptoms like bloating and discomfort. It takes practice and intention to eat slowly, particularly if you are used to eating in a time crunch. The switch: slow down.

4. Consistent meals.

Eating at regular points throughout the day gives your body energy to do all its body processes, including digestion and absorption. Irregular eating can look like eating one or two large meals each day, skipping meals, or eating at different times each day. The switch: eat regular meals and snacks throughout the day.

What can happen with irregular eating?

• One or two large meals per day puts a large volume of food into your gut. This can be challenging for your body to effectively digest, leading to symptoms like bloating and discomfort. 
• As for eating at irregular times each day, one long-term study showed an association with inconsistent mealtimes and higher rates of H pylori infection, a bacterial infection of the stomach that can lead to reflux and other symptoms. In another study, eating regularly through the day was associated with lower rates of irritable bowl syndrome (IBS).
• While research on how skipping meals impacts the GI tract or gut symptoms is mixed, skipping meals has been associated with heart disease and mental health challenges.

5. Tall posture.

Folding your shoulders and chest over your stomach while you eat compresses your esophagus and stomach. (Think peering over your smart phone so your head and shoulders move forward.) This can make it harder to swallow or put pressure on the muscles that allow food to pass between the esophagus and stomach. The switch: while eating, sit tall.

6. Liquids with meals.

Your stomach contains gastric acid which helps break apart foods, releases vitamin B-12 from protein foods, and help kill bacteria and other microorganisms. Research shows that drinking water increases pH of stomach acid (meaning it's less acidic). While no research has looked at the relationship between drinking water or other drinks on gut symptoms, it is assumed that drinking water with meals may dilute gastric acid and lead to less complete digestion of foods. In fact, many gut-health registered dietitians anecdotally recommend not drinking water with meals. The switch: avoid water with meals or take only small sips.

7. Liquids between meals. 

Let's come back to Migrating Motor Complex. Water and unsweetened coffee and tea do not activate MMC and are great to drink between meals while still allowing your gut to focus on digestion and absorption. However, drinks like juice, milk, sweetened coffee and tea, and sodas have carbs, fat, or protein - or energy/calorie-containing nutrients. When the body detects calories in food or drink, it triggers the MMC to stop - switching back to digestion, not gut movement. Research is still exploring how non-nutritive sweeteners (NNS) (or alternative or artificial sweeteners) impact MMC. The switch: choose water and unsweetened drinks between meals.

8. Eating less stressed.

The parasympathetic nervous system (PNS) of the brain is active when we are less stressed. It is colloquially referred to as “rest and digest.” Efficient digestion and absorption happen in this state of relaxation. In contrast, there is the sympathetic nervous system (SNS) - also called "fight or flight" - which slows digestion. When we are feeling stressed or busy, we may be in a "fight or flight" state when we come to eat. Being in a place of "rest and digest" can support your gut health. The switch: take several deep breaths before your first bite.

9. BONUS - Undistracted eating.

How often are you eating while watching a video on YouTube or reading a magazine? This bonus tip is an anecdotal story from my gut health journey. I focused on eating one meal per day without any distractions, like my phone. This forced me to do many of the things above: I ate more slowly, I chewed really well, I focused on my posture, I ate with minimal stress. Yes, I spent a lot of time feeling bored and noticing cobwebs on the ceiling, but after three or four months, I felt I had a good foundation on using meal hygiene steps. And my gut symptoms were better. Do I still do this? Not as often as I did, but I still practice meal hygiene every time I eat. Your journey won't be like mine, but if you try out some of these non-food methods, let me know what was helpful. 

Resources:

• Bavani, NG. et al. (2022). The relationship between meal regularity with Irritable Bowel Syndrome (IBS) in adults. Eur J Clin Nutr, Sep;76(9):1315-1322. doi: 10.1038/s41430-022-01108-3.
• Browning KN, Travagli RA. Central nervous system control of gastrointestinal motility and secretion and modulation of gastrointestinal functions. Compr Physiol. 2014 Oct;4(4):1339-68. doi: 10.1002/cphy.c130055.
• Deloose E., et al. (2012). The migrating motor complex: control mechanisms and its role in health and disease. Nat Rev Gastroenterol Hepatol, Mar 27;9(5): 271-85. doi: 10.1038/nrgastro.2012.57.
• Karamanolis, G. et al. (2008). A glass of water immediately increases gastric pH in healthy subjects. Dig Dis Sci, 53(12): 3128-32. doi: 10.1007/s10620-008-0301-3.
• Kwak, Y. & Kim, Y. (2017). Association between mental health and meal patterns among elderly Koreans. Geriatrics & Gerontology International. 18(1):161-168.
• Lim, S., et al. (2013). Irregular Meal Timing Is Associated with Helicobacter pylori Infection and Gastritis, ISRN Nutr. doi: 10.5402/2013/714970.
• Migrating Motor Complex. ScienceDirect. Accessed 11/14/2023
• National Institute of Diabetes and Digestive and Kidney Diseases
• Spencer, M. et al. (2016). Artificial Sweeteners: A Systematic Review and Primer for Gastroenterologists. J Neurogastroenterol Motil. 22(2): 168–180. doi: 10.5056/jnm15206.
• Sun, Y. et al. (2023). Meal Skipping and Shorter Meal Intervals Are Associated with Increased Risk of All-Cause and Cardiovascular Disease Mortality among US Adults, JAND, 123(3): 417-426. doi: 10.1016/j.jand.2022.08.119.
• Takahashi, T. (2013). Interdigestive migrating motor complex -its mechanism and clinical importance. J Smooth Muscle Res, 49: 99–111. doi: 10.1540/jsmr.49.99.
• Zaribaf, F., et al. (2018). Empirically derived dietary habits are associated with irritable bowel syndrome. Eur J Clin Nutr 72, 1537–1547. doi: 10.1038/s41430-018-0109-y.

About the Author: Caitlin Mellendorf is an Illinois Extension Nutrition and Wellness Educator serving DeWitt, Macon and Piatt Counties in Central Illinois. She is a Registered Dietitian and her work focuses on helping community members gain the knowledge, skills and tools to live healthier, more nutritious lifestyles. This includes providing programs and answering questions about heart health, diabetes, food safety, food preservation, grocery shopping and cooking. You can reach Caitlin by email at chuth2@illinois.edu or call 217.877.6042.