Heads up to plant eaters: Sugary foods and stress aren’t a good combo for your gut. Get the scoop on how these factors – and others – can put that gut out of balance, possibly driving you to have too much of a fungus called Candida.

Time for some truth-telling: While I follow a whole-food, plant-only diet, I’ve let my habits slip. As this pandemic has raged, so, too, has my sweet tooth, and even though everything I’m indulging in is vegan, I’ve nonetheless splurged more than normal. Add to that increased stress, which has caused numerous sleepless nights, and although I’m not battling any health woes, have maintained a normal weight, and am still an avid exerciser, I knew there would be consequences.

So I wasn’t surprised when a gut microbiome test (where you send an excrement sample through the mail to be analyzed) revealed the effects: The balance between my bacteria and fungi was off, and I was veering higher in a fungus called Candida. That left me wondering: How common is this, and what can you do if you suspect Candida is a problem?

What causes an unhealthy gut?

Although your gut is composed of trillions of microorganisms, all of which make up your gut microbiome, bacteria and fungi consist of the majority. “When they’re in balance, they work together to break down food, supporting each other while benefiting you as the host,” says Mahmoud Ghannoum, Ph.D., M.B.A., co-founder and chief scientific officer of BIOHMHealth, director of the Center for Medical Mycology at Case Western University in Cleveland, Ohio, and author of Total Gut Balance.

Beneficial bacteria (like Saccharomyces, Bifidobacterium, and Lactobacillus) act as a police officer, keeping bad guys or pathogens under control, producing small molecules that play a role in supporting your immunity and sending signals to the brain that aid in stress and mood. Meanwhile, fungi can support gut health by regulating immune responses throughout the body. When the two are in harmony, the bacteria outnumber the fungi so that you should have higher levels of ones like Saccharomyces and lower levels of Candida.

Yet when there’s an imbalance in your microbiome, what’s called dysbiosis, those bacteria and fungi still work together but against your detriment, Ghannoum says. The fungi gain the ability to invade their host (aka you) while the bacteria develop an antibacterial tolerance. The result? Unwanted gastrointestinal symptoms as well as inflammation.

While there are numerous fungi that might be out of whack, Candida is often the main one. “It’s responsible for the majority of fungal infections worldwide and is the third most common infection in hospitals,” Ghannoum says. Based on data from the BIOHM gut test, about 94 percent of individuals have Candida in their gut, and although studies to determine how common Candida overgrowth is are lacking, BIOHM data shows that 18.5 percent of people have Candida overgrowth.

What causes Candida and gut imbalances?

Numerous factors may contribute to gut imbalance, but the most impactful is sugar, especially when referring to Candida. “Candida overgrowth is most often triggered by excess sugar in the American diet,” says Jacob Teitelbaum, M.D., Hawaii-based board-certified internist and author of From Fatigued to Fantastic and The Complete Guide to Beating Sugar Addiction.

The average individual consumes 18 percent of his or her calories from sugar, eating a whopping 140 pounds of sugar every year. That sets up the perfect condition in your gut for yeast-like Candida to grow. “Yeast grows by fermenting sugar, leaving millions of people who have had their gut transformed to a fermentation tank,” Teitelbaum says.

And it doesn’t matter if the sugar occurs naturally or is in organic, junk, or even vegan food. You could be vegan and slug 36 ounces of soda a day, consuming 27 spoons of sugar, and your gut will still suffer. “If it’s fermentable, it increases Candida growth,” Teitelbaum says.

While eating a sugar-rich diet can lead to Candida overgrowth, there are other factors involved. Lifestyle habits like having elevated stress levels and not logging adequate sleep can cause an imbalance, Ghannoum says. Antibiotics, immune system problems, gut permeability issues, and vitamin deficiencies may even set you up for trouble.

How to know if you have gut imbalances

So how do you know if you’ve got issues in your gut balance? While you can undergo a stool test, Teitelbaum says the best way is to look for digestive symptoms. “If you have gas, bloating, diarrhea or constipation, that suggests a microbial imbalance in your gut,” he says, adding that Candida is the most common cause of these symptoms. In fact, if one of his patients has irritable bowel syndrome and/or chronic nasal congestion, which can happen in tandem, he’ll suspect Candida overgrowth until proven otherwise.

You can also use the dysbiosis risk checklist provided by Ghannoum (see the bottom of the article). Note that it’s not meant to diagnose an issue and just because you’re at higher risk doesn’t mean you have it now. “You may have suffered from microbiome imbalance in the past that’s now resolved,” he says. For instance, if you were born by C-section and were on antibiotics as a child, you may have not have had as diverse or robust a microbiome, but if you’ve lived healthy for many years, you may have overcome that microbiome imbalance.

If you don’t get this type of overgrowth under control, you can suffer yeast-related health issues like athlete’s foot, thrush, and vaginitis. Candida can also cause or worsen many other health issues like antibiotic-associated diarrhea, IBD and possibly IBS, Candida arthritis, allergies, inflammation in the gastrointestinal tract, and serious infections like those on the skin and in the kidneys, Ghannoum says.

How to improve your gut health

Because so much of Candida overgrowth depends on what you put in your mouth, making dietary changes is your first step to getting that gut in balance. The obvious switch? Cut your sugar intake and avoid fruit juices, which have similar amounts of sugar as soda, Teitelbaum says. Instead of drinking the fruit juice, eat the whole fruit so choose oranges over orange juice, for instance.

Along with all sugar (although Ghannoum notes that maple syrup and honey may have benefits for the gut), avoid alcohol. And if you’re not yet fully plant-based, ditch high-fat red meat, processed meat, and full-fat dairy products.

Then load your diet with polyphenols, which you can find in vegetables, fruits, nuts and seeds. “Polyphenols feed the bacteria that keeps Candida under control,” Ghannoum says. At the same time, increase plant-based proteins and fats and make sure you’re eating plenty of anti-inflammatory foods, especially cruciferous vegetables. Ginger, turmeric, deglychrrhizinated licorice, and marshmallow root can also help fight inflammation.

Foods to boost microbiome health

What Ghannoum calls “microbiome power foods” should also be part of your diet. They include green tea, sweet potatoes, pistachios, onions, brown rice, mushrooms, and fermented foods. Just don’t overdo the carbohydrates or excessive carbs could wind up feeding Candida. Instead, stick with one serving of whole-food carbs at each meal.

Supplements may even help. Ghannoum recommends three: A multivitamin; probiotic with S. boulardi, a fungal strain that works to balance Candida levels and support overall microbiome health; and anti-fungal supplements, notably those that include garlic, polyphenols and grapeseed extract.

And of course, you’ll need to make some lifestyle changes. Get that stress under control, and while it’s impossible to avoid all antibiotics, avoid unnecessary ones, which can open the door for Candida excess, Ghannoum says. Although you shouldn’t go against your doctor’s advice, always ask if an antibiotic is truly necessary.

With all of these strategies in place, you can expect to see changes in any symptoms you’re having within two to four weeks.

Dysbiosis (gut bacteria imbalance) risk checklist

Use this checklist created by Ghannoum to determine if you’re at greater risk for dysbiosis. The more questions you answer 'yes' to, the higher your risk for dysbiosis may be. As always, consult your healthcare professional to learn more.

  1. Were you a C- section baby?
  2. Were you ever hospitalized as a child?
  3. Were you fed with a bottle rather than breastfed?
  4. Did you have colic as a baby?
  5. Did you take antibiotics multiple times as a child?
  6. Did you grow up in a home without any animals?
  7. Did you grow up in an exceptionally clean, hygienic environment?
  8. Did your family always use a dishwasher rather than washing dishes by hand?
  9. Have you taken antibiotics multiple times as an adult?
  10. Did you ever have a C. difficile infection?
  11. Do you or did you ever have asthma and/or allergies?
  12. Do you have a diagnosed autoimmune disease, such as Crohn’s disease, ulcerative colitis, rheumatoid arthritis, lupus, psoriasis, or celiac disease?
  13. Are you or were you ever very overweight?
  14. Do you eat a high-sugar diet?
  15. Are you under a lot of stress for prolonged periods of time?
  16. Would you describe yourself as mostly sedentary during the day (like working at a desk or spending many hours at home sitting)?
  17. Are you over 50 years old?


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