The BRAT diet, an acronym for Bananas, Rice, Applesauce, and Toast, has long been a popular recommendation for managing diarrhea, stomach flu, and other gastrointestinal complaints. The theory behind the BRAT diet is that by consuming only bland, easy-to-digest foods, people can reduce the symptoms of a stomach illness. These symptoms typically include nausea, diarrhea, and vomiting. While it was once a go-to solution, especially for children, many health professionals now advise against relying solely on the BRAT diet due to the potential for nutrient and calorie deficiencies. This article delves into the BRAT diet, examining its purported benefits, associated risks, and more effective alternatives for treating diarrhea.
Understanding the BRAT Diet
The BRAT diet consists of bananas, rice, applesauce, and toast. The foods in the BRAT diet are low in protein, fat, and fiber, which makes them easy to digest for most people. This simplicity was thought to provide relief to an irritated digestive system by reducing the workload and minimizing further aggravation.
Supposed Benefits of the BRAT Diet
Some people believe that following the BRAT diet can provide several benefits for those with an upset stomach and diarrhea. The supposed benefits include:
- Firmer stools: The foods in the diet are starchy and low in fiber, which may cause loose and runny stools to bind more easily.
- Gentle on the stomach: The foods are low in fat and protein, meaning that they may be less likely to irritate the stomach and put stress on the digestive system.
- Reduced nausea: Due to their bland flavor and lack of strong smells, people theorize that BRAT foods do not tend to cause nausea or vomiting.
Historical Context and Evolution of Recommendations
The BRAT diet was originally introduced in the mid-20th century as a way to manage gastrointestinal issues, particularly diarrhea and vomiting, in both children and adults.
- Mid-20th Century Origin: Pediatricians developed the BRAT diet in the 1920s-1940s as a gentle, low-fiber regimen for patients experiencing gastrointestinal distress.
- Widespread Adoption: By the 1960s, the BRAT diet had become a common recommendation among doctors and healthcare providers for managing acute gastroenteritis, particularly in children.
- Scientific Criticism: In the early 2000s, medical professionals began questioning the effectiveness of the BRAT diet.
- Current Usage: Today, the BRAT diet is still sometimes recommended, but it’s often combined with more balanced, nutrient-rich options.
Risks and Drawbacks of the BRAT Diet
Despite its perceived benefits, the BRAT diet is not without its drawbacks. The most significant concern is its limited nutritional value. However, these foods do not have varied enough nutrients to warrant the long-term use of this diet. Prolonged use of the BRAT diet may lead to malnutrition and low energy because it contains too few calories and not enough of the following vital nutrients:
Read also: Risks Associated with the BRAT Diet
- protein
- fat
- fiber
- vitamin A
- vitamin B12
- calcium
Due to its risks and restrictive nature, the American Academy of Pediatrics do not recommend the use of the BRAT diet for children with diarrhea.
Scientific Evidence and Research
Although people have been recommending the BRAT diet for decades, no recent clinical trials have looked at whether the BRAT diet is effective as a treatment for diarrhea or gastrointestinal illness. While the diet may relieve symptoms in some people, doctors do not recommend that they follow this diet. Other, more nutritionally balanced eating plans may be preferable.
However, some researchers have investigated the potential roles of bananas and rice in treating diarrhea.
- Bananas contain pectin, a starch that is beneficial for the digestive tract. One systematic review from 2019 detailed several studies that found that green banana pulp may reduce both diarrhea and constipation in children.
- Additionally, a 2023 study found that cooked green banana can help to treat diarrhea in children under 5, alongside standard management therapies. An older 2016 study showed that rice in the form of a soup could effectively treat diarrhea in children who consumed it alongside a prescribed oral rehydration solution.
However, the possible effects of individual foods on diarrhea do not give an accurate picture of how eating a diet that contains only those foods can affect the body. Some nutritional deficiencies could make diarrhea worse.
Alternatives to the BRAT Diet
Given the limitations of the BRAT diet, healthcare professionals often recommend a more balanced and less restrictive approach to managing diarrhea and stomach upset.
Read also: Diabetic BRAT Diet Guide
The Bland Diet
The BRAT diet is restrictive and does not offer a variety of nutritional foods. The bland diet, however, has more variety but still focuses on eating foods that are gentle on the gastrointestinal system. This can help to avoid undernourishment.
The IFFGD provides a list of bland foods, including:
- yogurt
- noodles
- rice
- white bread
- cream of wheat
- lean meat
- bananas
- boiled or mashed potatoes
- small amounts of smooth peanut butter
Those who wish to follow the BRAT diet for a limited time may add other bland foods to their diet. Other bland foods include:
- saltine crackers
- clear broth
- potatoes without added butter, cream, or cheese
- sweet potatoes
- steamed, baked, or grilled skinless chicken without fat
- oatmeal
- watermelon
Fluid Intake and Hydration
As diarrhea can lead to dehydration, it is important that people drink enough fluids. A person with diarrhea can drink a range of liquids, including:
- water
- clear broths
- herbal teas, especially ginger and peppermint
- coconut water
Homemade oral rehydration solution to prevent dehydration: 1 Liter of clean or boiled water, mix in 1/2 teaspoon of salt and 6 teaspoons of sugar and stir until both salt and sugar are completely dissolved.
Read also: BRAT Diet: A Guide
Oral Rehydration Products
People can purchase oral rehydration products over the counter at a pharmacy. They are available as a liquid, popsicle, or powder to mix with water. Oral rehydration therapy can help treat diarrhea in adults and children with mild-to-moderate dehydration. People should take care to follow the instructions on the packaging.
Probiotics
Certain beneficial bacteria, known as probiotics, may shorten the course of diarrhea. However, the research is inconclusive as other studies have not shown probiotics to be effective. Probiotics may help to relieve symptoms of diarrhea associated with antibiotic treatment.
For those who wish to try probiotic-rich food, some options include:
- low fat natural yogurt
- kefir
- fermented vegetables
- sauerkraut
- miso soup
- kombucha
Foods to Avoid
Some foods are more likely than others to trigger nausea, vomiting, or loose stools. These include:
- milk and other dairy products, such as cream, cheese, and ice cream
- legumes, including chickpeas, lentils, peas, and vegetables belonging to the cabbage family
- caffeine
- alcohol
- meats that are high in fat, such as marbled meats and bacon
- sugar-free gum and mints
- large amounts of nut butters or nuts
- foods that are high in fat, such as fried foods
- dried fruits
- prune juice and other fruit juices
- black licorice
Avoid milk and dairy products for three days.
When to Seek Medical Attention
Following the BRAT diet for a limited time is unlikely to cause significant harm, but people should avoid using the diet in the long term. People should consult a doctor if diarrhea:
- persists beyond 7 days, or 2 days for vomiting
- is frequent, recurrent, or severe
- accompanies rectal pain or bleeding
Similarly, people should seek medical care for symptoms of dehydration, which include:
- reduced urine output
- dry mouth
- thirst
- feeling light-headed, dizzy, or weak
- sunken
Parents or caregivers should take infants and children to see a doctor if they cannot produce tears, have sunken soft spots (fontanelles), or exhibit any of the symptoms above.
Call your doctor if you:
- have a dry mouth
- have excessive thirst
- stop urinating as frequently
- feel tired, or have weakness or dizziness
- have dark urine
Also call your doctor if you have:
- severe abdominal or rectal pain
- bloody or black stools
- a fever over 102°F (38.8°C)
- blood or bile in vomit
With small children and babies, you should call their doctor if vomiting or diarrhea persist for just 1 day.