Is the Brat Diet Spoiled? This Decades-Old Practice May Be Outdated
Many parents will find themselves mopping up a mess with one hand and comforting their child with the other at some point in life. An upset stomach – vomiting or diarrhea and sometimes both at the same time, is an unpleasant experience for all!
Children often feel weak and need nutrition after getting everything out, but what food can they eat that won’t further aggravate their stomach? Many of us parents have the BRAT diet ingrained in our minds as the go-to solution to feed our kids after a bout of the stomach flu.
But is BRAT, an acronym for the restrictive diet of bananas, rice, applesauce, and toast, post stomach illness, still the best way to introduce food back into the body? Although there are some benefits to eating bland foods like the ones suggested in BRAT, the American Academy of Pediatrics says it’s time to give BRAT the boot.
How Does the Brat Diet Help?
The BRAT diet dates back to 1926. However, the diet was simply a physician’s recommendation for re-feeding post stomach illness and is not an evidence-based diet. Still, widespread knowledge and use of the BRAT diet began in the 1940s to guide medical professionals and parents on what to feed children after experiencing vomiting or diarrhea.
So why has this decades-long practice of eating bananas, rice, applesauce, and toast been considered the best foods after having an upset stomach? Here is what this group of foods has in common:
Bland – Foods without a strong taste or smell, which likely won’t cause nausea.
Easy-to-Digest – The foods are considered non-irritating so they won’t cause vomiting.
Low Fiber and Starchy – The foods won’t cause diarrhea and may help runny stools start to bind.
By eating these types of bland foods suggested by BRAT after an upset stomach, the theory is that they will have a calming effect by reducing nausea and diarrhea.
Brat Diet Breakdown
The boost of potassium that your body will appreciate.
The potassium content acts as an electrolyte that helps the body maintain fluid and blood volume.
The fiber can bind and bulk up stools to help with diarrhea.
Bananas are easier to digest because they are high in carbohydrates. Also, it’s better to eat yellow, ripe bananas with an upset stomach than green ones because the resistant starches change to simple sugar, which can also be easier to digest.
White rice is low in fiber, unlike brown, black or red rice. White rice is also high in carbs, low in fat, and bland tasting on its own, which is why it is easier to digest. The low fiber content will not encourage bowel movements which is ideal when experiencing diarrhea.
Applesauce contains pectin, which is a soluble fiber. Soluble fiber can absorb liquid in the intestines and add bulk to stools; however, the process of cooking apples to make the sauce reduces the fiber content and makes it easier to digest.
Toast that is made with white flour is easier to digest. White flour is refined and processed to strip out any fiber, which is why white bread is lighter on the stomach than other types of bread like whole wheat and other grains.
Is the Brat Diet Effective?
There haven’t been many clinical trials conducted that test the effectiveness of the BRAT diet in treating gastrointestinal issues. However, rice and bananas have proven to have some positive benefits in treating diarrhea.
In a study of a small group of children fed a rice diet mixed with cooked green bananas, 59% stopped having diarrhea by the third day of experiencing an upset stomach. The study confirms that there is some benefit to including bananas in children’s diet with diarrhea.
Studies of rice-based oral rehydration solutions have also been beneficial in treating diarrhea. The rice-based hydration can reduce the volume of stools and duration of diarrhea in patients.
Children were also fed rice soup in another study, along with an oral rehydration solution. The study concluded that adding the rice soup was a very effective treatment in stopping diarrhea.
Disadvantages of the Brat Diet
1. It’s too restrictive
The BRAT diet is very restrictive in the array of foods available to eat and the vitamins and nutrients contained in the four foods. The foods in the BRAT diet are low in calories, fat, fiber, and protein. The BRAT diet provides approximately 300 calories per day less than a regular diet fed to a healthy toddler.
The BRAT diet can lead to deficiencies of essential nutrients and may not be the best course of action when restarting to eat after a stomach illness.
2. Oral rehydration should come first
Diarrhea can cause dehydration. Treatment for dehydration accounts for an estimated 220,000 hospitalizations per year in the United States. Oral hydration is the therapy of choice for helping children with acute diarrhea heal before re-feeding. The American Academy of Pediatrics actually recommends focusing on dehydration prevention first and foremost and then continuing a regular diet with adequate fluids.
It’s best not to introduce solid foods after a bout of vomiting until a person can hold down liquids for several hours first.
Fluids that can help with hydration include:
- Electrolyte/sports drinks (low sugar)
- Clear broth
- Fruit juices (diluted or low sugar)
- Coconut water
3. More vitamins are needed for healing
The BRAT diet provides low amounts of the following vitamins and nutrients:
- Vitamin A
- Vitamin B12
- Dietary energy
Prolonged use of the BRAT diet can result in serious vitamin deficiencies and malnutrition. The American Academy of Pediatrics no longer recommends the BRAT diet alone unless the foods included in the BRAT diet are part of a child’s regular diet.
A healthy vitamin routine is a great way to help your body function its best.
Other Food Options
Eating fried, greasy, or spicy foods can be heavy on the stomach and worsen diarrhea because they are hard to digest. However, a little fat in your diet can actually help ease diarrhea due to the slow digestion of fats by the body. Consider adding small amounts of fat sources to your diet when reintroducing food such as:
- Lean meats
- A pat of butter
If suffering from diarrhea, you will want to focus more on foods higher in soluble fiber instead of insoluble fiber. Soluble fiber foods absorb water in the intestines and make stools firmer, whereas foods higher in insoluble fiber may cause stools to pass quickly through the intestines. High soluble fiber foods to consider are:
- Peeled fruits
- Cooked vegetables
- Some varieties of beans such as black beans and black-eyed peas
The human gut contains naturally occurring, beneficial bacteria. In the case of a disturbance in the gut microbiome, such as diarrhea, certain strains of microorganisms found in probiotics can help with a quicker recovery.
Eating a good quality natural probiotic yogurt with live bacteria such as lactobacillus acidophilus can help digestion and recover from diarrhea faster. A study found that yogurt containing another probiotic called Bifidobacterium lactis BB-12 worked more than a placebo at maintaining the good bacteria in the colon. So eating probiotic yogurt can protect against harmful changes in the gut microbiome, such as diarrhea. Other probiotic-rich foods include:
- Fermented vegetables like Kimchi
- Miso soup
Foods To Avoid
Although medical professionals recommend going back to your regular diet once the vomiting and diarrhea have safely ended, there are still some foods that can trigger the feeling of nausea and upset the stomach again:
Some Dairy – Other than dairy products with probiotics like yogurt and kefir, avoid milk and other dairies.
Fried, greasy and spicy food
Non-lean meats – like beef, fried fish, chicken with skin on it, pork, salmon, and sardines.
Raw vegetables – like cabbage, cauliflower, and broccoli which can cause gas and bloating.
Some fruits – avoid citrus fruit like oranges, grapefruits, and pineapple. Also, avoid tomatoes, cherries, and grapes.
High sugar foods– like cakes, cookies, sodas, candy and chocolate, and sugary drinks. Artificial sweeteners like sorbitol and sucralose can also worsen diarrhea symptoms.
Alcohol or caffeine – they can be diuretic.
Don’t Just Depend on the Brat Diet
Bananas, rice, applesauce, and toast in the BRAT diet are no longer the only way to restart eating after a gastrointestinal episode. Evidence suggests that early re-feeding after rehydration with a regular diet of various foods and even milk doesn’t prolong diarrhea. Continuing a regular diet may even reduce the duration of diarrhea by approximately half a day as it restores the nutritional balance. Continue to consume bananas, rice, applesauce, and toast if you wish to; just reintroduce more vitamin-rich foods back to the stomach sooner.