There are so many factors to consider when you are treating your SIBO. From antimicrobial protocols to dietary restriction to vagus nerve exercises, it can be a lot to juggle. One factor that is often lost in the sauce is physical activity.
Modern life with our desk jobs and Netflix binge sessions (guilty) can leave us sedentary for most of the day. When I was deep in the midst of my SIBO, I was always a little frightened of physical activity and exercise, because I was struggling to keep weight on.
Prior to my hardcore gut issues, I was inclined to exercising too hard. I would do long distance strenuous running about 5-6 days a week. I would also do really intense interval workouts.
As I will highlight in this blog, not all physical activity is good for your gut function. My pre-SIBO workouts likely contributed to the decline of my gut function over time.
But, incorporating the appropriate frequency and intensity of physical activity is imperative in optimizing gut function. I failed to strike that balance swinging from hyper activity to inactivity.
Like with SIBO diets there is a sweet spot with exercise. It took me a long time to figure that sweet spot out.
“Just do(ing) it” may be disastrous for your gut!
Nike and Under Armor commercials always have flawless athletes preaching to all of us sitting on our couches that we just need to run a little bit faster, train more and push ourselves to our physical limits. But, is this popular message that more exercise is always better really true?
I would argue absolutely not! Going to hard training in the gym, running or cycling can really do a number on your gut and your health as a whole!
Strenuous exercise has been shown to increase intestinal permeability (leaky gut). Endurance training and strenuous exercise can reduce blood flow, oxygen and nutrients to the gut as the body needs these resources to be used instead by the muscles.
Without proper blood flow to the gut, mucous lining becomes thin, free radical production increases and the gut barrier starts to breakdown. This leaky gut effect leads to toxins, bacteria and food to seep into the blood stream and overstimulate our immune system leading to a systemic inflammation. The graphic below is a great depiction of what happens along the intestinal lining:
The rise in core body temperature and dehydration seem to also play role in the increase in permeability of the gut lining during intense exercise.
Strenuous exercise can also lead to elevated cortisol levels and HPA axis dysfunction. Exercise is an added stress on the body. This stress can be good or bad depending on a number of factors.
When exercise is done right, the stress from exercise will have an overall positive effect because it prompts your body to build resistance to that stress. Your muscles grow and your body produces an overwhelming amount of anti-inflammatory compounds in response to the stress. A proper exercise and training regimen will have a hormetic effect (a minor stressor that promotes a much greater anti-inflammatory response and positive growth and repair).
When exercise becomes too strenuous, the stress becomes too much for your body to handle. Your body can not repair and grow, but instead remains inflamed. The elevated cortisol levels that are prompted from chronically over exercising can wreak havoc on the gut (check out this post to learn more how stress negatively effects the gut).
Here is a good graphic that highlights both how strenuous exercise negatively effects the gut and stress hormones:
When you have SIBO, you are even more intolerant to the extra GI stress that can follow an intense boot camp or competitive 10K. Taking a step back from intense training can be an important aspect of the healing process. It only takes like 20 minutes of intense exercise to promote intestinal permeability.
Why the right physical activity is important for healing from SIBO?
While too much strenuous exercise can be a problem, remaining active is critical to beating SIBO. Optimizing gut function requires us to get up and move!
The focus of physical activity when you have SIBO or other gut issues should be on moving more rather than training/exercising hard. Good physical activities when you have SIBO include walking, yoga, tai chi, light jogging/cycling and/or strength training (weights or resistance). You should probably avoid endurance sports, boot camps and high intensity interval training (if you are doing them longer than 10 minutes).
There are 4 main reasons that exercise can help gut function….
Physical Activity has been shown to increase bile output
Dave theorizes that coupling physical activity with feeding primes your digestive function. He highlights an interesting study that showed that 30 minutes of physical activity increases bile acid output into the small intestine by a factor of 10 when compared to being sedentary. That is a huge increase in bile output.
From an evolutionary perspective, we always used to rely on physically activity to forage and hunt for our food. Modern life has taken away our need to be physically active for our dinner.
Why is increased bile acid important?
- Increases digestion and absorption of nutrients
- Enhances gut barrier function
- Increases motility
- Antimicrobial effects of bile can help modulate bacterial populations in the GI tract. Bile is one of our bodies mechanisms to keep bacteria from overgrowing in the small intestines. Without enough bile, the environment is ripe for SIBO to develop.
Physical Activity keeps your brain healthy (crucial for brain-gut axis communication)
As I have highlighted in past posts, a healthy brain is needed for optimal gut function. Most people with SIBO have brain-gut axis issues that are hindering their digestive function.
Exercise increases the synthesis of a protein called BDNF (Brain Derived Neurtropic Factor). This protein is responsible for maintaining healthy neurons and creating new neurons. This increase in BDNF is suggested as the reason why exercise has been shown to drastically reduce inflammatory brain conditions like depression and anxiety.
In addition to the increase in BDNF, physical activity will also increase blood flow to the brain and optimizes brain function. Keeping the brain well nourished and healthy will improve digestion.
Physical activity can help regulate cortisol levels (when done properly)
I mentioned that pushing your body too hard with intense work outs can raise cortisol. But when done at the right amount and at the right intensity, physical activity can actually help increase your stress tolerance and lower cortisol levels.
So you may be wondering….what is the right amount and intensity? That really is going to vary based on each individual case. If you are still dealing with a lot of gut dysfunction and/or hormone imbalance, it is probably best to stick to low intensity physical activity like walking, yoga, tai chi and other more relaxing forms of exercise.
If you enjoy more high intensity exercise, it is imperative that you first heal your gut and hormone issues before returning to these activities. It can be an uphill battle when trying to fix your gut if your exercise routine is driving cortisol up. Cortisol has some really disastrous effects on the gut.
A good rule of thumb to figuring out the right dose of physical activity is really to gauge how you feel after you exercise. If the hours and days following your work out, you feel run down and really low energy, then your workout is too much for your body to handle. Your physical activity should leave you feeling more energized, not less.
Beneficial shifts in your microbiome
We always hear how important a diverse and nutrient dense diet is to building the optimal microbiome. But, physical activity is a key player in modulating the bacteria in the gut.
While the research is still ongoing, physical activity appears to increase microbial diversity, which is key to a healthy microbiome. Exercise also appears to have positive shifts in microbial composition. The increase in bile output that we previously discussed may also have an influence on these compositional changes in the gut microbiota.
Blood sugar regulation
Many of my clients have blood sugar instability. When blood sugar is too high, it damages the nerves in the gut. The enteric nervous system is responsible for blood flow, motility and enzyme release in the gut. You need these nerves to be healthy for optimal digestion.
Coupling a walk or work outs with carb containing meals will blunt blood sugar swings.
Find your physical activity sweet spot. Focus on finding enjoyable and relaxing ways to get moving to optimize your gut function. Be careful not to go overboard with strenuous exercise, because that will be counter productive!