By Hallie Levine
We've all been there: days when you feel as bloated as the blow-up Shrek in the Macy's parade. Okay, sometimes you know that having that third helping of your sister's peach cobbler wasn't the best idea. But when you're eating right and exercising regularly but still can't zip up your skinny jeans, what gives? "One of the main causes of bloat isn't how much you eat; it's eating certain foods that are difficult for your stomach and intestines to digest," explains Christine Gerbstadt, MD, RD, a dietitian in Sarasota, Florida, and spokesperson for the American Dietetic Association. "These substances then pass into your colon, where bacteria feed on them, producing the gas bubbles that make your stomach swell up." About 20 percent of adults experience bloating, according to one study from the University of Utah in Salt Lake City, but "anecdotally that number is much higher. Most women I see in my practice complain about bloat at one time or another," Dr. Gerbstadt says. "The good news is that with some simple diet and lifestyle changes, you can reverse that bloated feeling, fast." Start with these smart tips, which can help you flatten your belly for good.
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If your waistband feels snug after dinner, head outside for a brisk 10-minute walk. Physical activity helps air bubbles pass through your digestive tract quicker, explains Dr. Gerbstadt, so that bloated feeling will disappear faster than if you lounge on the couch. In fact, one of the worst things you can do on "fat" days is skip your workout: Moderate exercise, like biking for 30 minutes three times a week, significantly improved bloating and other symptoms in people with irritable bowel syndrome in a new Swedish study.
Pop a probiotic.
Sometimes bloating can be caused by an imbalance of the bacteria in your intestines, especially if you have been taking antibiotics to treat, say, a urinary tract infection or sinus infection, explains Sita Chokhavatia, MD, a gastroenterologist at Mount Sinai School of Medicine in New York City. Probiotics can help restore the bacterial balance, but not all brands have proven that they work: Bifidobacterium infantis is the only probiotic strain that studies show relieves GI symptoms, such as bloating, a Northwestern University review found. Dr. Chokhavatia recommends trying a two-week course to see if it helps.
Divide your dairy.
More than one in 10 adults are lactose intolerant, and bloat is a common side effect, according to a 2009 Baylor College of Medicine study. But if you suspect that milk, yogurt, and other dairy products are causing your belly bulge, you don't have to worry that you'll miss out on their benefits, namely lots of calcium and protein. Lactose-intolerant people can handle at least 12 grams of lactose (the amount in a cup of milk) with minor or no symptoms, researchers at the National Institutes of Health say. "For people with lactose concerns, I recommend they spread their dairy intake throughout the day -- say, a half cup of milk with their breakfast cereal, and cheese with crackers in the afternoon," says Tara Gidus, RD, a nutritionist in Orlando, Florida. "Choose dairy that comes from yogurt and hard cheeses, such as cheddar and provolone, which are digested more easily." If even small amounts of dairy cause stomach upset, switch to lactose-reduced or lactose-free products.
If you've ever had an urgent need to find a bathroom before a big race or presentation, you're no stranger to the internal effects of stress. "When you're anxious, your body releases cortisol and adrenaline, hormones that stimulate your digestive system," explains Yuri Saito, MD, assistant professor of medicine at the Mayo Clinic in Rochester, Minnesota. The result: You experience more gas, bloating, and even the runs. Compounding matters, stress causes many people to overeat or eat the "wrong" things, Dr. Saito notes, adding extra fuel to their overstimulated digestive system. If you can't eliminate the stressful circumstance, you may be able to manage it through cognitive behavior therapy or hypnotherapy; these two mind-body techniques are surprisingly effective in treating symptoms of irritable bowel syndrome, including bloating, a 2009 Canadian review found. Meditation or simple mindful breathing can also offer some relief. Practice it at home for a few minutes every day: Sit in a quiet space, close your eyes, and inhale through your nose for a count of 10. Focus on breathing deep and sitting tall. Exhale through your mouth in a controlled, purposeful fashion for 10 counts. Repeat 10 times.
Fine-tune your fiber.
A lot of cereals are advertised as being high in fiber, which should be good for your digestive system, right? Not always. Certain products add fiber in the form of chicory root, or inulin, which is harder to digest, says Kristin Kirkpatrick, RD, a wellness manager for the Cleveland Clinic Lifestyle 180 program. In fact, people who eat large amounts of inulin (10 grams) at one time end up experiencing more gas and bloating than those who eat less, researchers at the University of Minnesota in Saint Paul found. Your best bet: Get your fiber from fruits and vegetables and whole-grain rice, pasta, and bread rather than from packaged high-fiber products. And check the labels on your favorite cereals, cookies, and granola bars: If they contain chicory fiber, they most likely have inulin.
Switch your birth control.
Oral contraceptives contain estrogen, which causes your adrenal glands to produce fluid-retaining hormones, explains Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology, and reproductive sciences at the Yale School of Medicine. The experience is highly individual: Some women don't notice an increase in bloating, while others feel themselves puffing up within days of starting a new pill. If you fall in the second camp, talk to your ob-gyn about trying another brand. Both Yasmin and Yaz contain the hormone drospirenone, which may ease bloat, since it's also a diuretic. Of the 70 percent of women in a recent study in the journal Contraception who reported abdominal bloating while taking birth control pills, about half said their symptoms were gone after six months of switching to Yasmin. One caveat: Because drospirenone can increase levels of potassium in the body, women who frequently take other medications that increase potassium (such as NSAIDs and ACE inhibitors) aren't good candidates for this type of oral contraceptive.
Go easy on diet drinks.
Many sugar-free beverages, candies, and gum contain the sweetener sorbitol. Though it's a great calorie cutter, sorbitol isn't digestible, so it sends stomach enzymes into overdrive, Gidus says. When patients with abdominal bloating were put on sorbitol-free and sugar-free diets, nearly half saw their symptoms disappear, one study found. Although the FDA requires companies to put a warning label on products that "may result in a daily consumption of 50 grams of sorbitol," experts note that as little as 10 grams can trigger stomach trouble. Sorbitol can add up quickly: One piece of sugar-free gum has about 1.25 grams, for instance.
Trim the fat.
You ate fried onion rings on Friday night, but now it's Saturday afternoon and you swear they're still hanging out in your belly. It's possible: High-fat foods delay the emptying of the stomach, which may lead to bloating and an overall feeling of fullness. A study in Australia found a direct correlation between bloating and the amount of fat in women's diets. "I've seen many women who assumed they were lactose intolerant because they felt bloated after eating a bowl of ice cream; it turned out it wasn't the milk but the fat that was the culprit," Kirkpatrick says. Don't eliminate fat: "Foods rich in heart-healthy fats, such as avocados, olive oil, and nuts, are actually low-gas producing," Dr. Gerbstadt says. "The key is to focus on these good fats and pair them with lean protein, such as chicken or fish, which aids in their digestion."
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Eat broccoli every day.
It sounds counterintuitive, but regularly eating foods that are likely to cause gas, like beans, broccoli, brussels sprouts, cabbage, and onions, helps your body adjust and learn to break them down efficiently. "I've seen women run into problems when they eat these foods infrequently, say once a week," Kirkpatrick says. "Their digestive tract isn't used to them, so they produce a ton of extra gas and bloating."
"A lot of my clients are busy working moms who are eating food either in their car or walking to the office," says Jeannie Gazzaniga-Moloo, PhD, RD, spokesperson for the American Dietetic Association. "The problem with eating on the go is that you take big bites of food and don't chew properly, so you end up swallowing a tremendous amount of air." Her advice: Take 15 to 20 minutes to eat each meal -- yes, even if you're munching on the run. "Take a deep breath after each bite and chew with your mouth closed. This forces you to breathe through your nose, which relaxes and slows you down." While you're at it, if you're sipping on the go, opt for a cup, not a straw: The latter promotes ingestion of gas.
Choose supplements carefully.
If you take a calcium supplement, know which compound is in it. One that contains calcium carbonate, like Tums or Os-Cal, is more likely to cause gas and bloating because it's harder for your stomach to break down than one with calcium citrate, such as Citracal, according to the National Institutes of Health. Either way, taking a supplement with an acidic drink, such as orange or grapefruit juice, will help you absorb calcium. Many women also experience bloating if they use an omega-3 supplement, Gazzaniga-Moloo says. "Put it in the refrigerator and have it cold; this seems to help reduce the burping and bloating that often come with taking such a supplement," she says.
Cut back on the sweet stuff.
Fructose, the simple sugar found in syrup, honey, and soft drinks, may be the source of some of your tummy troubles: Three out of four people with unexplained GI symptoms, such as bloating, had fructose intolerance, according to a University of Iowa study. Like lactose intolerance, this condition can be diagnosed with a simple breath test. The good news: Being fructose intolerant doesn't mean you have to swear off this healthy, sweet diet staple. "Most people are fine with actual fruit, especially if they spread their servings throughout the day, but you may need to steer clear of processed foods or soft drinks made with high-fructose corn syrup, like sweetened drinks or soft drinks," Dr. Saito says. Juice may also trigger a reaction, since it's more concentrated.
Get checked for allergies.
If your bloating is accompanied by nasal congestion, allergies may be the surprising reason. "When your nose is stuffed up, you end up primarily breathing through your mouth, which means you swallow a lot of air, which could cause bloating," Dr. Saito says.
Be takeout savvy.
"Steamed veggie plates seem like a smart option if you're ordering Chinese food, but if you're prone to bloating, you should realize that many of the vegetables, like bok choy, can produce tons of gas," says Jackie Keller, a celebrity nutritionist in Los Angeles.
Skip the salt.
You've heard it before, and we'll say it again: Salt causes your body to retain fluid. That's good news if you're training for a marathon. Bad news if you're trying to squeeze into a new dress for your friend's wedding. The biggest culprit? "Sauces and salad dressings," Keller says, "especially at restaurants." To play it safe, order dressings and sauces on the side, or season lightly with olive oil and vinegar.
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When It's Time to See a Doctor
Sometimes bloat can be the sign of something more serious. Three conditions to rule out:
IBS (irritable bowel syndrome)
Characterized by abdominal pain, bloating, and chronic diarrhea and/or constipation, IBS affects up to 15 percent of people in the United States, and about two-thirds of them are women, according to the International Foundation for Functional Gastrointestinal Disorders. "A lot of women aren't aware they have it," says Spencer Dorn, MD, an IBS specialist and gastroenterologist at the University of North Carolina at Chapel Hill. "Only about half of people with IBS see a doctor about it." Treatments include prescription meds and lifestyle and diet changes.
About one in 133 people in the United States suffers from celiac disease, otherwise known as gluten intolerance. "When people with CD eat gluten, the tiny hairlike projections in the small intestines that absorb nutrients from food are damaged, causing abdominal pain, gas, and bloating," says Dr. Chokhavatia. The disease, which is diagnosed with a simple blood test, is easily missed because its symptoms closely mimic those of conditions like lactose intolerance; it takes patients 10 years, on average, to be diagnosed, according to the Celiac Sprue Association.
Bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, and frequent urination can be signs of ovarian cancer, according to the Foundation for Women's Cancer. "Ovarian cancer is rare in younger women, but these symptoms should always be checked out," says Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology, and reproductive sciences at the Yale School of Medicine.
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