The C Word

The lockdown block-up is something that UK-registered dietitian Annabel Alder has been exploring in great detail. Annabel worked in the NHS for 15 years across a range of specialities, including renal disease, diabetes, gastroenterology and ICU, but now studies her craft in the rather more relaxing setting of Majorca.

Photo by Giorgio Trovato on Unsplash.

Annabel explains: “Most of us have experienced a very sudden upheaval in our day-to-day life which has undoubtedly affected our activity levels and what we’re eating. This can have major repercussions on our body’s ability to process what we put in it and how easily it comes out. Anyone who’s spent a length of time in hospital will be familiar with this feeling. But, before you reach for a laxative, it’s worth considering the obvious culprits for clogging you up.

“Now is a good moment to point out that there is no such thing as ‘normal’. Whether you are a four-times-a-week or a twice-a-day kind of person is irrelevant, what we’re looking for is a deviation from your ‘normal’. And, don’t compare yourself to others; your genes, gut microbiome and level of lockdown upheaval are entirely unique to you.

“Lack of physical activity is an obvious place to start. If you eliminate the usual walk to work or trip to the playground, and add in a hefty temptation to relax on the sofa, many of us are missing out on basic exercise which helps stimulate the rippling motion of muscles in our digestive tract known as peristalsis. Even some simple stretching and twisting will help; Google ‘yoga poses to relieve constipation’ to find some positions that suit your abilities. Oh, and while we’re on the subject of exercise, a quick word of warning about living in gym gear during lockdown. If the elastic’s too tight, it will put pressure on your tummy and can make digestive matters worse.

“Diet is the next place to look, especially fibre. Some of us may be grazing on low-fibre snacks in lieu of our usual more balanced menu, so let’s reinstate that fibre and revert to a more regular mealtime routine. Wholegrains, fruit, vegetables, pulses, nuts and seeds, especially linseeds, are all great sources of fibre. Others, however, may have stockpiled lentils and chickpeas, just because everyone else did, and have doubled their usual fibre intake overnight. This would come as a shock to any system. The best advice here is not to overdo it and drink more water. Don’t forget that fruit comes with its own handy water supply.

“On the subject of water, just a small deficit each day compared to your normal intake can cause dehydration. Likewise, a small excess of alcohol each day compared to your normal intake can exacerbate this dehydration. Something to bear in mind, although this is no time for preaching.”

Annabel said she could bore you witless about gut microbiomes, but the main takeaway is that gut health plays an essential role in the body’s immune response to infection - perhaps more than any other organ. A diverse microbiome is a healthy microbiome, and it’s begging for a wide range of high-fibre plant-based foods rather than ultra-processed junk with high levels of sugar, salt and additives. The Mediterranean diet promotes healthy gut bacteria (good news for those of us who reside here), while the current trend for fermented food and drink such as kefir, kombucha, kimchi and sauerkraut is a good one for happy bowels.

“Another thing our tummies adore is routine,” continues Annabel. “Our bodies work to their own wonderful rhythm across the day and night and, if we suddenly change our sleeping or eating patterns, we fall out of sync with our digestive systems.

“Finally, our mental health. Chronic niggling anxiety means we could be stuck in constant fright or flight mode. It’s an automatic response, where the sympathetic nervous system diverts blood and energy away from our gut to our brain and limbs so we’re keenly alert to protect ourselves from imminent danger. If we are permanently set to ‘on’, our digestion suffers. Similarly, stress can alter that gut microbiome allowing less healthy species to invade and take over. Now is the time to Google ‘relaxation techniques’ and practise breathing or meditation, or try a long bath with a chillout playlist.

“Perhaps you’re facing a different type of anxiety, a touch of stage fright. Maybe you can no longer access your preferred venue for a number two, or excitable home-schooled children are interrupting your usual quiet moment, and you’re having to ‘hold it in’. Don’t. This just creates time for the body to reabsorb valuable liquid leaving you with, literally, a harder task to deal with. Grab a magazine and make a polite but firm request for some space and time.

“If none of the above works, it might be time for a spot of gentle abdominal massage to wake the bowel muscles up. Again, Google will be your friend here. Just don’t try it if you’ve had recent abdominal surgery or suffer from any other more serious digestive issues. Or, if all else fails, take advantage of a trip to the pharmacy for some medical supplies of a laxative variety - at least it’s an excuse to get out of the house.”