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The BRAT Diet: Is It a Good Idea?

The BRAT diet is a bland, easily digestible diet.

For decades, it has been prescribed for adults and children
with gastroenteritis, an infection of the intestines commonly
known as the stomach flu.

However, the BRAT diet has been criticized for being overly
restrictive.

This article takes a detailed look at the BRAT diet and whether
it is appropriate during recovery from digestive illness.

Man with a Bunch of Bananas on His Shoulder

What Is the BRAT Diet?

BRAT is an acronym for
bananas
, rice, applesauce and toast. These are the main
foods that make up the BRAT diet.

Many people follow the BRAT diet when transitioning to normal
eating after illnesses involving vomiting and diarrhea.

It is intended to be followed for up to 48 hours after active
vomiting has resolved.

The BRAT diet has been prescribed for both children and adults
because the foods it contains are bland, easy to digest and may
be helpful for nausea.

Bottom Line: The BRAT diet contains bland,
easy-to-digest foods like bananas, rice, applesauce and
toast. It is often prescribed for people recovering from
illnesses that involve vomiting and diarrhea.

History of the BRAT Diet

Toasted Bread

Until fairly recently, it was believed that the intestinal
tract should rest during and after digestive illness.

Up until the 1980s, pediatric textbooks recommended a
clear-liquid diet for the first 48 hours of illness, followed
by gradual re-feeding with easy-to-digest foods (1).

The first mention of the BRAT diet was nearly a century ago, in
a 1926 report. The report described the diet’s use for children
with intestinal illness involving severe diarrhea and
dehydration (2).

Today, many people consider the BRAT diet the best way to
manage diarrhea in both children and adults.

However, despite its widespread use over the past century,
there has been very little research on the BRAT diet to support
its efficacy.

Bottom Line: The BRAT diet was first
mentioned in a paper in 1926 as a treatment for severe
diarrhea in children. It has been widely used in cases of
vomiting and diarrhea, despite a lack of evidence to support
its use.

Foods to Eat and Avoid on the BRAT Diet

The BRAT diet only allows a few foods and liquids, although
they can be consumed in unlimited quantities based on appetite.

Foods Allowed on the BRAT Diet

  • Bananas
  • White rice
  • Applesauce
  • Toast made from white bread
  • Soda crackers
  • Clear liquids including water, weak tea, broth, juice,
    electrolyte-containing beverages, such as sports drinks, and
    soda that’s flat and caffeine-free

Foods to Avoid on the BRAT Diet

  • Meat, fish and poultry
  • Eggs
  • Dairy products
  • Fruits other than bananas and applesauce
  • Vegetables
  • Nuts and seeds
  • Whole grains
  • Beans and legumes
  • Beverages that contain caffeine
  • Carbonated beverages

Bottom Line: The BRAT diet excludes most
foods other than bananas, applesauce, refined grain products
and clear liquids.

Advantages of the BRAT Diet

Apple Sauce in a Ramekin

The BRAT diet has certain advantages.

It consists of easy-to-digest foods that are unlikely to
irritate the gut or cause nausea during digestive illness.

Although there are no studies supporting the BRAT diet’s
ability to decrease diarrhea, there is research on certain
foods in the diet suggesting they may help.

Bananas may act as a binding agent and provide other
anti-diarrhea effects.

In a study of tube-fed, hospitalized patients, 57% of those who
received banana flakes in their feedings were diarrhea-free at
the end of the study, compared to 24% of patients who received
medical treatment instead (3).

It appears that green or unripe bananas are particularly
effective at reducing diarrhea. Green bananas contain resistant
starch
, which bacteria that live in your gut ferment into
short-chain
fatty acids
.

Research suggests that these short-chain fatty acids may
increase the gut’s ability to reabsorb water and nutrients,
which can be very beneficial during episodes of diarrhea
(4).

One researcher conducted several studies in children with
diarrhea and reported that including green bananas in their
diets consistently reduced the severity of diarrhea and led to
faster recovery (4, 5, 6).

One of these studies looked at more than 2,900 children with
acute diarrhea.

They found 80% of those who received green
bananas
experienced resolution of diarrhea within three
days, compared to 53% of children who did not eat green bananas
(6).

Rice has also been shown to provide anti-diarrheal activity.
Most of these studies looked at the effects of rice-based oral
rehydration solutions, which are used to treat diarrhea-related
dehydration (7, 8, 9, 10).

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However, a large analysis of 13 studies found that, although
these rice-based solutions majorly reduced diarrhea in children
and adults with cholera, they had less of an impact on those
with non-cholera diarrhea (10).

Bottom Line: Studies have found that green
bananas and rice-based solutions may help reduce the duration
and severity of diarrhea.

Disadvantages of the BRAT Diet

Bowl of Steamed Rice

The BRAT diet’s main disadvantage is that it does not provide
the appropriate nutrition that people recovering from illness
need.

These individuals are already nutritionally depleted due to
vomiting, diarrhea and poor appetite.

This is especially concerning for children and the frail
elderly, who are more likely to become malnourished and are at
greater risk of repeated illness than strong, healthy adults
are.

The BRAT diet is very low in protein,
fat and other nutrients that are needed for proper healing.

In one study, researchers analyzed the nutritional content of
the usual diet of a two-year-old versus the nutrition of the
BRAT diet. They reported the following (11):

  • Calories: 300 fewer calories on the BRAT
    diet
  • Protein: 70% lower on the BRAT diet
  • Fat: 80% lower on the BRAT diet

The BRAT diet also provided far less than the Reference Daily
Intake (RDI) for key nutrients involved in healing:

  • Vitamin A: 12% of the RDI
  • Vitamin B12: 0% of the RDI
  • Calcium: 12% of the RDI

Although the BRAT diet is intended to be followed for no longer
than two days, there have been reports of children remaining on
the diet until diarrhea resolves, which may be considerably
longer.

In 1998, researchers reported the case of two young children
who followed the BRAT diet for two weeks and developed severe
malnutrition due to insufficient protein and calorie
intake
(12).

The nutritional inadequacy of the BRAT diet has been
acknowledged by the American Academy of Pediatrics, the
European Society of Paediatric Gastroenterology Hepatology and
the European Society for Paediatric Infectious Diseases.

These organizations now recommend that children resume a
normal, age-appropriate diet within 24 hours of getting sick,
which includes lean meat, yogurt, eggs, fruits and vegetables
(13, 14).

Bottom Line: The BRAT diet does not provide
enough calories, protein or key nutrients to ensure proper
healing from digestive illness in children and the elderly.
Extending the diet beyond a few days may lead to
malnutrition.

Alternative Dietary Strategies for Digestive Illness

Here are some ideas for you to try during and after digestive
illness, instead of following the BRAT diet:

  • Take probiotics or eat probiotic-rich
    yogurt:
    Certain
    probiotics
    can help reduce diarrhea, including
    Lactobacillus reuteri, Lactobacillus GG and
    Saccharomyces boulardii (15, 16, 17, 18).
  • Take prebiotic fiber: Prebiotic
    fiber
    feeds healthy gut bacteria. In one study, diarrhea
    resolved significantly faster in children and adults given
    prebiotics, compared to those given a placebo (19, 20).
  • Begin a regular diet within 24 hours of illness, as
    tolerated:
    Foods rich in protein, vitamins and
    minerals provide nutrition needed for proper recovery. Add
    small amounts of meat, fish, eggs, yogurt and cooked
    vegetables first.
  • Avoid foods that worsen diarrhea: These
    include milk, sugar, fried foods, spicy foods and caffeinated
    beverages. You can add them back into your diet gradually
    after a few days.
  • Include BRAT foods: Including bananas and
    rice as part of a balanced diet may help firm up loose
    stools. Bananas can also help replenish potassium lost during
    sickness.
  • Drink electrolyte-rich fluids: Bone broth,
    chicken broth or beef broth are good options to replace water
    and electrolytes. For children, oral rehydration solutions
    like Pedialyte are recommended (21).

Bottom Line: Taking probiotics and
prebiotics, consuming a balanced diet and rehydrating can
help promote recovery from intestinal illness.

Take Home Message

Pediatricians and other experts now believe the BRAT diet is
unnecessarily restrictive for digestive illness.

It may even hinder recovery because it doesn’t provide enough
calories, protein or important nutrients.

For healthy adults, following the BRAT diet for a few days is
unlikely to cause problems, but there is no evidence it will
help resolve your symptoms more quickly.

For children and the elderly, resuming a normal
diet
as soon as possible is recommended to regain strength,
ensure proper healing and prevent malnutrition.

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