The BRAT Diet: All You Need to Know

The BRAT diet is a now-defunct diet that became popular in the 1920s for those recovering from stomach conditions such as diarrhea. The diet is named after the staple foods: Bananas, Rice, Apple sauce and Toast. These foods were aimed at introducing a variety of starchy carbs to the diet which would not be too “exciting” (I.e. very bland foods), in order to return the stomach to normal function and health.

Main Brat Diet Foods

The main foods, after which it is named, are high in starchy carbohydrates whilst being low in dietary fibre. These foods are supposed to return stool to a firm, “healthy” consistency. This is clearly not a diet for long-term purposes as an extended duration on any diet that intentionally reduces the intake of protein, fats or fibre will result in constipation [1].

Diarrhoea is an inconvenience to many of us nowadays – presenting as an incapacitating and embarrassing condition – but it has very severe health implications and has been linked to millions of deaths across history. This primarily involves loose stool, poor control over the timing and frequency of excretions and a severe dehydration.

The BRAT diet is also pertinent for those who are suffering from a stomach ache and vomiting: many of the symptoms attributed to diarrhoea above have analogues to sickness. The idea of the diet, then, is to increase the regularity, control and stability of the digestive tract.

How Does Brat Diet work?

BRAT diet foods

There has been a lot of discussion regarding the way that the BRAT diet works and the problems that it addresses. The main question is whether this diet actually improves the way that the digestive system works and whether or not there are any negative health implications associated with it. There are certainly some benefits associated with a diet that focuses on the reductions in volatile oils and fibre: these nutrients increase the speed of digestive function. When fiber and fats are consumed, they bind together to reduce digestion of various nutrients (such as glucose and fats) and speed them through the intestines and straight to excretion [2].

However, the reduction of dietary variety and the restriction away from a vast majority of food groups, foods and vague categories about which foods are acceptable all bring their own problems. Limiting oneself to foods that are “bland” doesn’t provide many practical guidelines for food selection or balancing the demands of a whole diet. The main criticism of this diet is that it unnecessarily restricts the diet in a way that is not necessarily productive to recovery. An effective diet should be characterised by variety, rather than restriction – an incredibly variety of nutrients is the foundation for the most effective long-term diet.

Taking a look at the main, titular foods of the BRAT diet – Bananas, Rice, Apple sauce and Toast – there are some clear issues. Primarily, the fact that these foods are entirely starches is the point but excluding fiber has a negative effect on the digestive processes surrounding diarrhea. Fiber acts to regulate bowel movements, both constipation and diarrhea [1], and should not be excluded from the diet. Whilst there are, obviously, times where solid foods are inappropriate for digestive health, fibrous foods should be among the first that are returned to the diet following a bout of severe digestive disruption. Those foods that have high insoluble fiber (such as broccoli or sweetcorn) can provide “bulk” to the stool without loosening it or adversely affecting the frequency or regularity of toilet visits.

Secondly, these foods are incredibly low in relevant nutrients for proper recovery. Whilst it is essential to return to maintenance calories as soon as possible, recovery from any illness is dependent on immune system health and function. The immune system is built on the basis of the vitamins and minerals that we consume through the diet [3]. Whilst many claim that bananas provide a variety of nutrients (most commonly mis-attributed is the idea that they are an excellent source of potassium, when they are far less effective than many vegetables), this diet is incredibly low in the essential vitamins and minerals that are necessary for immune function. For example, B and C vitamins are the main nutrients that ensure the proper health of the immune system: the banana contains only 38mg of Vitamin C per 100g and only trace elements of vitamin B. To suggest that this should be the most nutritious of the staple foods for a recovery diet seems ludicrous.

Practical Guidelines

When approaching the BRAT diet, it is important firstly to remember that it is a temporary diet and should only be used when there are no other options. The BRAT diet is the first step to recovery because, and only because, it is the first set of solid foods that we are likely to be able to eat. As soon as it becomes feasible to eat foods that are more nutritious and varied, we should do so. However, when we are looking to fix your digestive system, and return to proper health, it is important to realize that this is a process and we can’t skip it by eating more apple paste and toast. Returning to proper health should be the first priority when it comes to eating.

The best way to approach a BRAT diet is to modify it from the initial structure. The original diet contained a wide variety of foods that tend to be high in simple sugars – between Apple sauce, Bananas and Toast, the original diet does not achieve the health-related goals we might want to use it for. For example, a recovery meal of vegetable soup and coarse breads may provide a “bland” and reliable meal that we are able to keep down, this provides a wider variety of quality nutrients whilst also avoiding foodstuffs that would exaggerate the digestive problems of stomach instability or diarrhea. Leafy vegetables and others with “roughage” will provide the balance of nutrients and bulk necessary to address the problems associated with digestive illness.

In response to this, we’d amend the title of the diet to the better-researched but less-catchy SVOW diet: Soup, Vegetables, Oatmeal and Water. The addition of soups (especially chunkier soups with vegetables and legumes) will increase both hydration and nutrient intake. This will improve immune function and help us fight off the microbial causes of the illness, rather than just dealing with the symptoms [3, 4].

Vegetables play a similar role, increasing the quality and quantity of nutrients that our body can use to repair itself. Oatmeal is a fantastic carb source (far better than, say, apple sauce) because it has a low GI (reduces the spikes in blood sugar seen in the high-sugar BRAT diet), provides a large amount of dietary fiber and can be mixed with fruits such as raisins, sultana, banana, apple, etc. to improve taste, micronutrient intake and reintroduce “regular” solid foods. Finally, water is the most important aspect of a recovery diet – it is the best way to avoid the dehydration that occurs with digestive problems (both vomiting and diarrhea can cause severe dehydration) and will regulate the body whilst we attempt to fix the problem [5].

Closing Remarks

We aren’t big fans of the BRAT diet – the science has been against it for decades and it doesn’t seem to address how to get better. It may be the case that these foods won’t make you throw up, but that’s not huge praise. There are other foods, outlined above, that will promote stable digestive health whilst also providing nutrients and avoiding the sugar content associated with BRAT. Illness is no fun and nutrition might not be the top of our priority list when we’re feeling down in the dumps, but prioritizing nutrition and hydration can make the recovery process faster, easier and more pleasant!

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Reference

[1] Anderson et al (2009): ‘Health benefits of dietary fiber’. Nutrition reviews, 67(4), pp.188-205
[2] Anderson and Chen (1979): ‘Plant fiber. Carbohydrate and lipid metabolism’. The American journal of clinical nutrition, 32(2), pp.342-363
[3] Chandra, R.K. (2002): ‘Nutrition and the immune system from birth to old age’. European journal of clinical nutrition, 56 (supp.3), pp.73-76
[4] Mitchell et al (2002): ‘Effect of exercise, heat stress and hydration on immune cell number and function’. Medicine and science in sports and exercise, 34(12), pp.1941-1950
[5] Sueyoshi et al (1995): ‘An immunohistochemical investigation of porcine epidemic diarrhoea’. Journal of comparative pathology, 113(1), pp.59-67