BRAT Diet for an Upset Stomach 7 Important Research Benefits

What is the BRAT diet?

• The BRAT diet is a short-term dietary approach that is often recommended for individuals, especially children, experiencing gastrointestinal issues such as diarrhea, nausea, and vomiting. BRAT stands for Bananas, Rice, Applesauce, and Toast, which are the main components of the diet.
• The BRAT diet is intended to be easily digestible, low in fiber, and gentle on the stomach.
• However, it is important to note that the BRAT diet alone may not provide all the necessary nutrients for a well-balanced diet, so it is typically recommended for a short period of time until gastrointestinal symptoms improve.
• The BRAT diet is a bland food diet that is often recommended for adults and children.
• This diet was first in discussions in the year 1926.

What does BRAT stand for?

BRAT stands for 

• Bananas: Bananas are easily digestible and contain essential nutrients like potassium, which can help replenish electrolytes that may be lost due to diarrhea or vomiting.
• Rice: Plain white rice is a bland and easily digestible carbohydrate source that can help firm up stools during diarrhea. It provides energy and is less likely to irritate the stomach compared to high-fiber foods.
• Applesauce: Unsweetened applesauce is another easily digestible food that can provide some carbohydrates and vitamins. It is low in fiber and can help soothe the digestive system.
• Toast: Plain toast made from white bread can be included in the BRAT diet. It provides a mild source of carbohydrates and can be easily tolerated by individuals with gastrointestinal upset.

What are the Benefits of the BRAT Diet

The BRAT diet can help you recover from an upset stomach or diarrhea due to its potential benefits

1. The role of dietary fiber in diarrhea has been proposed to reduce the duration of liquid stools. In vitro research studies proved that rice may possess anti-secretory properties.
2. BRAT diet also reduces the bioavailability of some micronutrients.
3. Banana is rich in amylase-resistant starch, which has been postulated to protect the gastrointestinal mucosa in animals and improve symptoms of non-ulcer dyspepsia and peptic ulcer in humans.
4. One mechanism by which fiber may improve gastrointestinal mucosa healing is by the generation of short-chain fatty acids (SCFA) in the colon.
5. These are potent stimulators of colonocytes, providing energy, enhancing absorption of water and electrolytes, and inducing a trophic effect in the colonic and small bowel mucosa
6. BRAT Diet includes “binding” foods. These are low-fiber foods that can help make your stools firmer.
7. It includes bananas, which are high in potassium and help replace nutrients your body has lost because of vomiting or diarrhea.

If you have recently had an upset stomach or diarrhea, your doctor may suggest that you limit your diet to bland foods that won’t irritate your stomach.

Hence BRAT diet is a diet that has been advised for people suffering with vomiting or diarrhea (gastroenteritis).

It is recommended that all people, regardless of age, drink plenty of fluids to prevent dehydration, along with oral rehydration solutions to replace the depleted electrolytes and avoid salt imbalance.

Severe, untreated salt imbalance can result in “extreme weakness, confusion, coma, or death.”

When should I follow the BRAT diet?

After you have diarrhea or vomiting, follow this diet to help your body ease back into normal eating. This diet may also help ease the nausea and vomiting some women experience during pregnancy.

You can add other bland foods to the BRAT diet. For example, you can try saltine crackers, boiled potatoes or clear soups. Don’t start eating dairy products and sugary or fatty foods right away. These foods may trigger nausea or lead to more diarrhea.

The classic BRAT diet (limiting food intake to bananas, rice, applesauce, and toast) has been the standard diet protocol in the past because this diet was thought to be well tolerated by the patients.

Most of the emergency department discharge instruction sheets contain dietary recommendations ideally for this kind of diet.

The principal aim of this Brat Diet is to reduce the volume and also the frequency of the stools.

Another reason physicians always prefer to advise their patients a BRAT diet may be the fear of inducing lactose intolerance, leading to osmotic diarrhea. 

When should I avoid the BRAT diet?

Solid foods, like those in the BRAT diet, are not recommended for adults or children who are actively vomiting  .

Instead, stick to clear liquids at first and wait until you can eat solid foods without vomiting. If you have been vomiting or have diarrhea, drinking an electrolyte beverage can help protect against dehydration. Use these products according to your doctor’s instructions.

Scientific Research Facts about the BRAT diet

• Rabbani, et al performed a double-blind controlled trial in Bangladeshi boys (n = 62), age 5–12 months randomly assigned to a diet of rice only or rice mixed with either cooked green banana or with pectin for seven days.
• The authors measured the duration of illness and characteristics of stools in these two treatment groups compared with rice only.
• Children receiving pectin or banana-containing diets had overall better outcomes than children receiving the rice diet alone.
• They observed a significant reduction in stool weight, by the third day in both groups, 55% and 59% of children stopped having diarrhea compared with only 15% in the rice diet group.
• Also both groups were observed to require less ORS (p < 0.05), intravenous fluid (p < 0.05) and a reduced frequency of vomiting (p < 0.05) compared to the group receiving rice alone.

There is a large body of literature about a variety of nutrients and their role in protecting the GI mucosa from chronic or severe inflammatory diseases; these include micronutrients (e.g., vitamin A and zinc), amino acids (e.g., glutamine and arginine), and proand prebiotics.

Very few studies, however, have been performed about which, if any, specific foods might help in this regard.

As with many dietary habits, there are social and cultural beliefs about what foods should be given to sick or ill children. Many traditional diets for children with diarrhea are restrictive in one or many macro- or micronutrients.

Review of the literature from the limited data which address the safety and efficacy of diets with bananas, rice, and other dietary components in treating diarrhea are performed.

Morover, the study of this literature review identified that the nutritional content of this restrictive diet found that it is lacking in energy, fat and several micronutrients.

Prompt feeding and age appropriate food should continue as the standard of nutritional care during acute diarrhea.

Is the BRAT Diet recommended for Acute Diarrhea in Children ?

Yes, the BRAT diet is one of the dietary management tools used by many pediatricians and the parents around the world during acute diarrhea in Children.

Here is the data from a research study which represents a comparison of a regular toddler’s diet based on a 2-year-old, 12 kg boy/girl with a BRAT toddler’s diet in regards to Vitamin A, Vitamin B12, Calcium and Dietary Reference Intake (DRIs)

Diet Type	Vitamin A (IU)	Vitamin B12 (mcg)	Calcium (mg)
BRAT toddler diet	180	0	130
Regular toddler diet	11210	2.3	1220
DRIs	1500	0.9	500

Table Source: Practical Gastroenterology• JUNE 2007, The BRAT Diet for Acute Diarrhea in Children: Should It Be Used?

Rice is commonly used in the diets of children with diarrhea.

Research studies from in vitro data suggest that rice may possess anti-secretory properties. Rice-based oral rehydration solutions (ORS) have also been shown to reduce the volume of stools and duration of diarrhea in patients with cholera.

In addition to the potential anti-secretory effect of rice, ricebased ORS may provide additional glucose moieties for sodium-glucose co-transport, thus leading to optimal rehydration during severe diarrhea.

In non-cholera diarrhea, rice-based ORS is no more effective than standard glucose-based ORS. A recent study reported on the efficacy of rice based ORS in a group of 189 Mexican children age three to 24 months with acute diarrhea.

They were randomly assigned to receive rice-based ORS or glucose-based ORS. Although stool output was not different between the groups treated with rice-based ORS compared to glucose-based ORS, there was a reduced need for intravenous fluids in the rice group.

An advantage of rice-based ORS may be lowered osmolarity, which has been associated with less vomiting, less stool output, and reduced need for unscheduled intravenous infusion compared with standard ORS in children during infectious diarrheal episodes.

It is important to remember that the BRAT diet is meant to be a temporary solution and should not be followed for an extended period of time. Once gastrointestinal symptoms improve, it is essential to reintroduce a wider variety of foods to ensure a balanced and nutritious diet. If symptoms persist or worsen, it is advisable to consult a healthcare professional for further evaluation and guidance.