If you or your child has ever experienced a stomach bug or dealt with diarrhea, chances are you’ve likely heard of the BRAT diet. And as the winter season begets an increase of the flu, respiratory syncytial virus and other illnesses among children and families, many are turning to mom’s old cure for upset stomachs.
The BRAT diet — which stands for bananas, rice, applesauce and toast — had widely been used as the pediatrician’s go-to remedy for sick children who presented with stomachaches, nausea, vomiting or diarrhea. Because certain over-the-counter anti-diarrhea medications — specifically bismuth subsalicylate, the main ingredient in Pepto-Bismol — are not recommended for young children, a simple diet containing these four BRAT foods was often recommended to treat and relieve symptoms.
“These particular foods are selected due to their low-fat and low-fiber content,” says Stacy Cavagnaro, a registered dietitian with Cleveland Clinic’s Center for Human Nutrition in Ohio. “Therefore, they are easy to digest and absorb.”
These foods are also starchy, which can cause movement in the gastrointestinal system — like that caused by diarrhea — to slow down.
“The BRAT diet came to be many, many years ago,” explains Dr. Stanley Spinner, chief medical officer at Texas Children’s Pediatrics and Texas Children’s Urgent Care in Houston. “The supposition was when you have diarrhea, typically you want to give starchy foods or foods that are known to slow down the motility of your gut … and relieve the diarrhea faster.”
For a long time, this rationale made sense. However, the American Academy of Pediatrics, or AAP, changed its recommendation in the late 1990s after understanding that the BRAT diet lacked key nutrients — such as fiber, calcium, protein, fat and vitamin B12 — to help children recover. Instead, a healthy, well-balanced diet was better for recovery than the highly restrictive BRAT diet.
“When you get an intestinal infection, certainly with the lower GI with diarrhea, you’re going to usually get some inflammation or some damage to the lining of the gut. What’s necessary is for that to heal,” Spinner says. “The best way to do that is to nourish the gut and to have good nutrition. When you are using a very selective diet, we were able to understand that really wasn’t happening.”
During the first few hours of illness, it’s important to rehydrate with clear liquids and electrolytes first. After that, the AAP recommends parents resume feeding their children a regular, nutritious diet that includes complex carbohydrates high in fiber, fruits, vegetables and lean protein, such as eggs and chicken.
“You want to have as regular a diet as you can because you really want to nourish the gut well,” Spinner says. “The more you do that, the quicker your gut heals.”
Although these guidelines are geared toward children, they apply to adults, as well, experts say. The American Academy of Family Physicians encourages similar recommendations, in combination with over-the-counter anti-diarrhea drugs, for adults experiencing acute diarrhea.
[READ: 10 Reasons Your Stomach May Be Hurting.]
When and How to Follow the BRAT Diet
If you’re battling the stomach flu or dealing with diarrhea, you might find that eating the soft, bland foods that are part of the BRAT diet won’t upset your digestive system. But you don’t have to limit yourself to the four foods in the traditional BRAT diet. Instead, you’ll want to consume a mix of fruits, vegetables, lean meat, yogurt and complex carbohydrates, experts advise.
Before you consume any solid foods, health care professionals typically recommend giving your stomach a rest for the first six hours after vomiting or diarrhea by drinking small amounts of clear liquids — such as water or electrolyte drinks — to avoid dehydration.
“The following day, you can begin to incorporate foods from the BRAT diet and other bland foods, like crackers and oatmeal,” says Lana Nasrallah, manager of clinical nutrition at UNC Health, a not-for-profit integrated health care system based in Chapel Hill, North Carolina. “By day three, you can reintroduce soft foods, like soft-cooked eggs, white meat, chicken or fruit. Avoid using strong seasonings.”
After the third day, people can transition back to a normal, well-balanced diet as tolerated.
[SEE: Best Foods to Eat for an Upset Stomach.]
Foods You Can Eat on BRAT
Here are types of foods you can eat on the BRAT diet:
— Complex carbohydrates.
All vegetables should be cooked until they are soft, to the point you can cut them with a fork.
Lower-fiber options include:
— Cooked carrots.
— Green beans.
— Peeled zucchini.
As with vegetables, all fruits should be able to be cut with a fork.
Good fruit options include:
— Peeled and baked apples.
— Peeled peaches and pears.
— Mandarin oranges.
— Soft melons.
Many complex carbohydrates are good choices to settle an upset stomach.
— Instant oatmeal.
Some proteins are fine to consume, if they are bland enough.
— Lean white meat chicken.
— Lean white meat turkey.
— Flaky fish.
— Low-lactose dairy foods, such as Greek yogurt and kefir.
While incorporating some fat is needed for a well-rounded diet, it’s best to limit your consumption of them, Cavagnaro says.
Among the macronutrients your body needs — carbs, fat and protein — fat is the most slowly digested. Greasy foods typically contain high levels of fat, which slow the stomach from emptying and can cause bloating, stomach pain and nausea.
These fats, in moderate amounts, can be part of a BRAT diet:
— Almond butter.
— Coconut milk.
— Olive oil.
— Sunflower seed butter.
[See: What to Eat, Drink and Do to Relieve Constipation.]
Foods to Avoid on BRAT
In addition to consuming bland foods, there are certain types of foods that you’ll want to avoid for a while. For example, adults struggling with digestive issues should avoid consuming alcohol because it causes your stomach to produce more acid than it typically does. The additional acid can inflame the stomach lining and cause stomach pain, diarrhea and vomiting.
Foods to avoid on the BRAT diet include:
— Alcohol, caffeinated beverages and soda.
— Potato peels.
— Dairy products.
— Greasy or fried foods.
— Spicy foods.
— High-fat foods, including red and processed meats.
— Whole nuts, whole seeds, corn and popcorn.
“The BRAT diet can work as a temporary eating solution but wouldn’t be very good long term because it doesn’t provide enough nutrients,” says Lisa Jones, a registered dietitian based in Philadelphia.
It’s important to keep in mind that the BRAT diet may not remedy nausea, vomiting and diarrhea for some. If symptoms continue or worsen for more than a day or two, you should contact your health care provider for medical advice.
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What Is the BRAT Diet? originally appeared on usnews.com
Update 03/02/23: This story was previously published at an earlier date and has been updated with new information.