Most people suffer from indigestion, heartburn, bloating and constipation at some point in their lives yet they rarely understand what causes these symptoms to recur.
The medical community frequently treats heartburn with prescription medications that decrease acid production or with over-the-counter medications that neutralize acid. The naturopathic community typically treats bloating and constipation with probiotics, elimination diets or digestive enzymes. Either of these approaches may effectively treat the symptoms or they may simply provide temporary relief. Other times, they will fix the root problem. But there is one major aspect of digestive health that is overlooked. I call it eating hygiene.
Many patients with insomnia are becoming increasingly familiar with the concept of sleep hygiene. This refers to the simple lifestyle changes involved in treating chronic insomnia. It includes things like sleeping and waking at regular times, avoiding caffeine after 3:00 pm, avoiding meals after 8:00 pm and avoiding phone or screen use thirty minutes before bed 1. If these precautions fail to control insomnia, pharmaceutical or naturopathic interventions are then explored.
Eating hygiene is implemented similarly except in this case it’s indicated for proper digestive function. It’s a relatively new concept that has yet to gain traction. Eating hygiene refers to proper lifestyle habits with respect to eating. If adopted, eating hygiene can treat the root cause of many digestive symptoms without any further interventions (pharmaceutical or naturopathic). But to understand the rules of eating hygiene, we must first understand the basics of physiological stress responses.
The “fight-or-flight” and “rest-and-digest” phenomena are common in many mammals. These expressions are essentially describing the sympathetic nervous system (SNS) and parasympathetic nervous system (PNS) respectively. Our bodies swap between these two modes—which are completely antagonistic—meaning the mechanisms of one shut down the mechanisms of the other 2. The SNS kicks in when the body is in a stressful situation and humans have evolved response for survival. Fight-or-flight is achieved by dilating the pupils for better vision, increasing the rate and contractibility of the heart for blood flow to muscles, dilating bronchioles in the lungs for more oxygen, dilating skeletal muscle blood vessels and constricting smooth muscle blood vessels to slow digestion and slowing digestive peristalsis 2. The point of these mechanisms is to give the most oxygen and energy to the skeletal muscles and the least energy allocated to things like digestion and reproduction, which are not essential to survive a stressful event. By comparison, the PNS kicks in when there is no stressful situation and the body can relax. It stimulates digestive enzymes to be released, urination and bowel movements as well as reproductive organs to function. These functions are all essential for survival but not for escaping an immediate stressful event.
While humans have evolved to survive stressful situations that involve brief intense events like outrunning a lion, today our stressful situations are commonly day-to-day inconveniences like being stuck in traffic on the 401 or staying up all night to meet a work deadline. These situations are much less intense but they also last much longer. As a result, our bodies have become accustomed to being in a chronic state of fight-or-flight. The SNS is powerful and ensures our survival as a species but it becomes maladaptive when we’re stuck in it for long periods. This phenomenon explains why stress can cause high blood pressure, infertility and insomnia.
Since the western lifestyle lends itself to high stress, most of us are stuck in a low but chronic fight-or-flight state. It’s no wonder why so many people suffer from chronic digestive conditions. They aren’t digesting properly because digestion is on hold in the SNS state. So how do we fix this? Turn off the PNS.
Exercising daily, fresh air, meditation, adequate sleep, taking vacations and partaking in regular social activities are all essential to switching from the SNS to the PNS. These steps are especially indicated for people at risk of heart attacks, insomnia, infertility and digestive disorders.
Eating hygiene can trigger the PNS to kick in and stimulate digestion. The following habits of eating hygiene should come before pharmaceutical or naturopathic interventions are considered:
- Respect your appetite and make time just for your meal. Even if you have to eat at your desk, allow a set time for you to focus on eating and not be busy doing anything else. Better yet, dine with a friend!
- Eat slowly! Take your time. This will allow you to get into the zone and enjoy your meal. Smell the odours and taste the flavours.
- Eat smaller bites by cutting food into smaller portions at a time. Don’t shovel huge portions into your mouth because that makes chewing more difficult.
- Chew thoroughly. It shouldn’t be a race. Chewing is really the first step of digestion because it mechanically increases the surface area of the food you’re eating. This will increase the contact between the intestine and the nutrients it will absorb.
- Sit down while you eat. This should really be a no brainer.
- Don’t eat on the go, especially full meals. If you have to grab a light snack, at least make sure you’re eating it while sitting down. The easier it is to digest, the better. So opt for things like fruit or nuts and avoid high protein or fatty snacks. Save protein and fats for mealtime.
- No distractions! Don’t eat while watching TV, doing work or reading the paper. Even if it doesn’t seem like it, these activities can stimulate the SNS, which is what we don’t want.
Many patients will find that implementing these habits will prevent the need for any interventions. For example, the lower esophageal sphincter (LES) is what separates the stomach from the esophagus. When it’s loose, a patient will experience heartburn or gastroesophageal reflux disease (GERD) 3. Many patients get put on antacid medication to control the symptoms of heartburn but what they really need is LES tone. The problem with using unnecessary antacid medication is that it decreases acid production, which then further impedes digestion. Since the PNS tones the LES while the SNS loosens it, stimulating the PNS can preclude the need for intervening with acid production at all.
Much like sleep hygiene, eating hygiene is a form of therapy that is free, practical and safe! There are really no downsides to trying it and patients with digestive dysfunction have everything to gain from trying it out before moving on to any pharmaceutical or naturopathic interventions.
- Physiology of the autonomic nervous system. The American Journal of Pharmaceutical Education. 2007, 71 (4): 78. Am J
- Central control of lower esophageal sphincter relaxation. The American Journal of Medicine. 2000, 108 (4a): 90S-98S.