
Top Tips for Supporting Your Brain Health
If you are noticing more brain fog, forgetting names, struggling to concentrate or simply thinking more about how to protect your brain as you get older, it can be difficult to know where to start.
There is certainly no shortage of advice. Take this supplement. Avoid that food. Do a daily crossword. Eat more blueberries. Buy a continuous glucose monitor.
But the best research tells a much less complicated story.
Brain health appears to benefit most when we look after several different areas at the same time: cardiovascular and metabolic health, nutrition, movement, sleep, hearing and vision, mental stimulation and social connection.
The 2024 Lancet Commission estimated that around 45% of dementia cases worldwide could potentially be delayed or prevented by addressing 14 modifiable risk factors throughout life.
That does not mean dementia is always preventable. Genetics, ageing and many factors outside our control remain important. But it does mean there are plenty of things we can do to create a healthier environment for our brains to age in.
Here are some good places to start:
1. Eat for Your Brain and Your Heart
One of the most consistent findings in brain-health research is that dietary patterns matter more than individual “superfoods”.
Mediterranean, DASH and MIND-style diets differ slightly, but they have far more similarities than differences. They tend to contain plenty of vegetables, fruit, beans and lentils, nuts, seeds, wholegrains, olive oil and fish, with fewer ultra-processed foods.
The evidence is not strong enough to say that any one of these diets prevents dementia. Instead, look at what these eating patterns have in common.
Try this: Aim to include vegetables or fruit at every meal, use extra virgin olive oil regularly, eat beans or lentils several times a week, include nuts and seeds, and choose minimally processed foods most of the time.
2. Look After Your Blood Sugar
The brain is highly energy dependent, but that does not mean it benefits from constantly high blood glucose.
Insulin resistance and type 2 diabetes are associated with an increased risk of cognitive decline and dementia. Diabetes is one of the 14 modifiable risk factors highlighted by the Lancet Commission, and the new WHO dementia risk-reduction guidance specifically recommends managing diabetes alongside other cardiovascular risk factors.
For day-to-day concentration, meals dominated by rapidly digested carbohydrates can also leave some people feeling hungry, tired or mentally flat a few hours later.
Try this: Build your meals around a good source of protein, plenty of vegetables and a sensible portion of fibre-rich carbohydrate.
For example, rather than toast and jam on its own, try eggs with wholegrain toast and vegetables, or Greek yoghurt with berries, seeds and oats.
You can read more about this in my article What is Causing my Brain Fog?
3. Don’t Forget Protein
We tend to associate protein with muscles rather than the brain, but maintaining muscle mass is an important part of healthy ageing.
Muscle is a major site of glucose disposal, so preserving muscle mass can support insulin sensitivity. Protein also provides amino acids required throughout the body for enzymes, hormones and neurotransmitter production.
This becomes particularly important from midlife onwards, when maintaining muscle can become more difficult.
Try this: Include a meaningful source of protein at each meal rather than leaving most of your protein until dinner.
Think eggs, Greek yoghurt, fish, chicken, tofu, tempeh, beans, lentils, cottage cheese or lean meat.
4. Eat Your Omega-3s Before Reaching for Supplements
DHA is an important component of brain-cell membranes, and oily fish is a regular feature of Mediterranean and MIND-style dietary patterns.
But supplements are not automatically better. The updated WHO guidance does not recommend omega-3 supplements specifically to reduce the risk of cognitive decline or dementia in people without a diagnosed deficiency.
That is an important distinction between supporting good nutrition and trying to treat or prevent disease with supplements.
Try this: Aim to eat oily fish regularly. Good options include salmon, sardines, mackerel, trout and herring.
If you do not eat fish, discuss suitable alternatives with a qualified practitioner rather than assuming you need a very high-dose supplement.
5. Eat More Colour
Blueberries often receive the “brain food” headlines, but they are not magical.
What is interesting is that berries, colourful vegetables, herbs, spices, tea, coffee, cocoa and extra virgin olive oil contain plant compounds called polyphenols.
Polyphenols interact with inflammatory signalling, vascular function, antioxidant defence and the gut microbiome. This is one reason researchers increasingly focus on dietary diversity rather than individual nutrients.
Try this: Instead of counting blueberries, count colours.
Across the week, include greens, reds, purples, oranges and yellows. Think broccoli, spinach, tomatoes, peppers, berries, beetroot, red cabbage, herbs and spices.
The more varied the plant intake, the broader the range of nutrients and plant compounds you are likely to consume.
6. Move Your Body and Pick Up Some Weights
If I had to choose between an expensive “brain supplement” and regular physical activity, the evidence would strongly favour movement.
Exercise research increasingly shows benefits for cognitive function, with aerobic, resistance and combined exercise all showing positive effects in older adults. Recent meta-analyses suggest resistance exercise may be particularly useful for several aspects of cognition.
Then there is the bigger multidomain evidence.
The Finnish FINGER trial combined nutrition, exercise, cognitive training and cardiovascular monitoring. More recently, the 2025 U.S. POINTER trial studied 2,111 older adults at increased risk of cognitive decline. Both lifestyle groups improved cognition, with greater benefit in the more structured intervention.
Try this: Combine everyday movement with both aerobic and resistance exercise.
Walk briskly, cycle, swim or dance, but also challenge your muscles two or more times each week if appropriate for you.
Your muscles are not separate from your metabolic or brain health.
7. Know Your Blood Pressure and Cholesterol
This is not as glamorous as buying nootropics, but it may be considerably more important.
High blood pressure and high LDL cholesterol are both recognised modifiable dementia risk factors. The 2024 Lancet Commission specifically added high LDL cholesterol in midlife to its list of factors associated with dementia risk.
What protects the blood vessels supplying your heart also helps protect the blood vessels supplying your brain.
Try this: Know your blood pressure, cholesterol and HbA1c, particularly from midlife onwards.
If they are raised, speak to your GP. Nutrition and lifestyle can support cardiovascular health, but they should complement appropriate medical management rather than replace it.
8. Take Sleep Seriously
We all know how poorly the brain works after a bad night's sleep. Attention, memory, decision-making and reaction times can all suffer.
The longer-term relationship between sleep and dementia is more complicated. Observational research links abnormal sleep duration and some sleep problems with increased dementia risk but cause and effect can be difficult to untangle because early brain changes may themselves disturb sleep.
One issue that should not be ignored is sleep apnoea.
Try this: Prioritise a regular sleep routine and speak to your GP if you snore heavily, stop breathing during sleep, wake repeatedly gasping or feel unusually sleepy during the day.
Better sleep is worthwhile for your brain now, even before we consider long-term risk.
9. Look After Your Hearing and Eyes
This is probably one of the more surprising brain-health recommendations.
Hearing impairment and untreated vision loss are included among the Lancet Commission's modifiable dementia risk factors. The new WHO guidance also recommends considering hearing aids as part of dementia risk-reduction strategies where appropriate.
September Herby Salmon with Roasted Tomato, Aubergine & Lentils This is a simple Mediterranean-style traybake using late-summer British produce. It combines oily fish, extra virgin olive oil, lentils and several colourful plants, giving you protein, fibre, unsaturated fats and a range of polyphenols in one meal. And this is great for brain health! The salmon provides high-quality protein and the long-chain omega-3 fat DHA, an important structural component of brain-cell membranes. The lentils add further protein alongside soluble and insoluble fibre, helping create a meal that should have a gentler effect on blood glucose than one based predominantly on refined carbohydrate. Aubergines, tomatoes, peppers, red onion, garlic and herbs provide a range of different polyphenols and carotenoids. Rather than chasing one particular antioxidant, eating a wide variety of colourful plants exposes us to many different bioactive compounds. Extra virgin olive oil provides predominantly monounsaturated fat alongside its own polyphenols. Importantly, this combination of vegetables, legumes, fish and extra virgin olive oil closely resembles the features shared by Mediterranean and other dietary patterns associated with better cardiovascular and cognitive health. And there is another benefit: you get around eight different plants in one dinner before you have even thought about the rest of your day! Serves 4 Ingredients To serve: Method Make it even more September Simply cook chopped apple and blackberries gently with a splash of water and cinnamon until softened, then spoon over thick Greek yoghurt and scatter with chopped walnuts. And if you're interested in further recipes, why not head to the Recipe Index to see what else you can cook?
For pudding, serve warm British blackberries and apple with Greek yoghurt and walnuts.

Brain Health: What Does the Evidence Actually Show?
When people start worrying about their memory, it is tempting to look for one thing to fix it. A supplement. A “brain food”. A test. A strict diet.
But that is not really what the evidence shows.
The strongest research points in a different direction: brain health appears to be influenced by many interconnected systems, including cardiovascular health, blood sugar regulation, movement, sleep, hearing & sight, social connection, and the overall quality of the diet.
That is actually encouraging. It means we are not relying on one magic ingredient.
And one of the most exciting findings comes from the 2024 Lancet Commission on dementia. Its authors estimated that around 45% of dementia cases could potentially be delayed or prevented by addressing 14 modifiable risk factors across the life course. These include diabetes, high blood pressure, high LDL cholesterol, smoking, physical inactivity, obesity, depression, hearing loss, untreated vision loss, and social isolation.
Please don’t take that as dementia is always preventable, or that somebody who develops it has done something wrong. Genetics, ageing and factors, which are completely outside our control, remain very important. But it does tell us that the environment in which the brain ages matters.
The Brain Does Not Live in Isolation
This is where a Functional Medicine way of thinking can be useful. Rather than treating the brain as a separate organ, we can look at the systems that support it.
The brain needs an enormous amount of energy and a continuous blood supply. It relies on healthy blood vessels to deliver oxygen and nutrients. It needs insulin signalling to work effectively. It needs sufficient vitamins, minerals, fats and protein. It is influenced by inflammation, sleep, hormones, movement, and messages coming from the gut.
Therefore, which kind of internal environment helps the brain function well for as long as possible?
What Should We Actually Eat?
Let’s start with food. There is currently no single scientifically proven “dementia prevention diet”. But, dietary patterns associated with better cognitive and cardiovascular outcomes have a remarkable amount in common.
Mediterranean-style diets emphasise veggies, fruit, beans and lentils, wholegrains, nuts, seeds, olive oil and fish, with relatively little ultra-processed food. The DASH diet has similar foundations. The MIND diet combines elements of both and places extra emphasis on green leafy vegetables and berries.
A 2024 meta-analysis found that greater adherence to a Mediterranean dietary pattern was associated with a lower risk of dementia and Alzheimer’s disease. Observational studies of the MIND diet have also been encouraging.
But here is an important reality check. In a three-year randomised controlled trial involving 604 older adults at increased risk, the MIND diet did not produce significantly greater cognitive improvement than the comparison diet. Interestingly, both groups improved their diets and lost around 5kg.
For me, that is not evidence that healthy eating “doesn’t work”. It is a reminder that we should focus on the common characteristics of healthy dietary patterns rather than becoming obsessed with one named diet.
Think plants, fibre, healthy fats, adequate protein and minimally processed food.
Feed Your Blood Vessels and You Feed Your Brain
One of the clearest themes in dementia research is cardiovascular health.
High blood pressure, diabetes and high LDL cholesterol are all included among the Lancet Commission’s modifiable dementia risk factors. In fact, the Commission estimated that high LDL cholesterol in midlife could account for around 7% of dementia cases worldwide, which is a striking statistic.
The same habits that support good cardiovascular health help support the environment in which the brain operates: plenty of plants and fibre, replacing excess saturated fat with unsaturated fats such as olive oil, nuts and seeds, regular fish, movement, not smoking, and appropriate management of blood pressure, cholesterol and glucose.
This also links back to blood sugar. Insulin resistance and type 2 diabetes can affect the small blood vessels supplying the brain and are associated with higher rates of cognitive decline. I explored this in more detail in my previous article on blood sugar, inflammation and brain health.
Do Omega-3 Fats Deserve Their Reputation?
The Omega 3 fat DHA is an important structural component of brain-cell membranes, while EPA and DHA can influence inflammatory signalling.
Eating oily fish – which is a good source of Omega 3 fats - is consistently associated with healthier cardiovascular outcomes, and many brain-healthy dietary patterns include fish regularly. Supplement research, however, is less straightforward.
A 2025 meta-analysis of 58 randomised trials suggested that omega-3 supplementation may produce modest improvements in some aspects of cognition, but the certainty of evidence varied and researchers concluded that longer, better-designed trials are still needed.
So rather than assuming that everybody needs a high-dose fish-oil supplement, a sensible food-first approach is to include oily fish regularly, such as salmon, sardines, mackerel, trout or herring. Supplements may be appropriate in some circumstances, but they should be personalised.
The Homocysteine Story Is Fascinating
Homocysteine is an amino acid produced during normal metabolism. Vitamins B12, B6 and folate help the body process it.
Higher homocysteine concentrations have been associated with cardiovascular disease, brain atrophy and cognitive decline, which has led researchers to investigate whether lowering homocysteine could help.
The VITACOG trial produced one of the more intriguing findings in nutritional neuroscience. In older people with mild cognitive impairment, high-dose B vitamins seemed to reduce homocysteine and slowed brain atrophy. A subsequent analysis found that the greatest effect was seen in participants who also had higher omega-3 status.
Again, this does not mean everyone should take high-dose B vitamins, however. Across trials, findings are mixed, particularly in cognitively healthy people. B12 and folate deficiencies should be identified and corrected appropriately, while homocysteine testing may be useful in selected clinical circumstances.
Your Muscles Are Part of Your Brain-Health Strategy
We often talk about exercise as though it is separate from nutrition, but metabolically they are deeply connected.
Muscle is one of our largest sites of glucose disposal. Maintaining muscle can therefore support insulin sensitivity as we age. Exercise also affects blood flow, cardiovascular fitness, inflammation and signalling molecules involved in brain plasticity. A 2024 systematic review of long-term exercise found benefits for cognitive outcomes in older adults.
But perhaps the most compelling evidence comes from studies where researchers changed several things at once.
The landmark Finnish FINGER trial combined dietary guidance, exercise, cognitive training and vascular risk monitoring. After two years, overall cognitive improvement was around 25% greater in the intervention group than in the control group.
Then, in 2025, came the U.S. POINTER trial. More than 2,100 older adults at increased risk of cognitive decline followed one of two programmes involving nutrition, physical activity, cognitive and social activity and health monitoring. Cognition improved in both groups, with greater improvement in the more structured programme.
That may be the biggest message of all: the evidence increasingly supports doing several sensible things together.
What About the Gut-Brain Axis?
The gut microbiome produces metabolites, including short-chain fatty acids, that can interact with immune, metabolic and nervous-system pathways. This makes the gut-brain axis biologically plausible and extremely interesting. Diets rich in diverse plant foods, fibre and polyphenols can support microbial diversity and the production of beneficial metabolites.
However, human evidence showing that manipulating the microbiome prevents dementia is not yet strong enough for such claims. So, I would recommend focussing on supporting the microbiome for overall health rather than buying expensive “brain probiotics”.
Seven Things You Can Do for Your Brain
Start with the basics rather than a supplement cupboard.
Perhaps the most reassuring message is that brain health is not about perfection.
The 2024 Lancet Commission describes dementia risk across an entire lifetime. FINGER and U.S. POINTER suggest that even later in life, changing several factors together can make a measurable difference to cognition. We cannot control every risk factor, and no lifestyle programme can guarantee that dementia will not occur.
But we can give the brain a healthier environment in which to age. And that means looking beyond the latest “brain food” and supporting the whole person instead. If you’re interested in knowing more, why not get in touch?

What’s Causing My Brain Fog?
Have you ever walked into a room and forgotten why you went there? Struggled to find a familiar word? Or reached the middle of the afternoon and felt as though somebody had quietly switched off your brain? Occasional lapses happen to everyone, particularly during periods of stress, poor sleep, or illness. However, ongoing brain fog, poor concentration and memory difficulties can understandably feel worrying, particularly if you have had relatives with dementia or Alzheimer’s disease.
But brain fog and cognitive decline are not the same thing. Brain fog is really just when we get a bit of forgetfulness, thinking more slowly than usual, or having difficulty concentrating. Whereas cognitive impairment involves actual measurable changes in abilities such as memory, language, reasoning, or planning.
Brain fog can still be debilitating though. And there are many reasons for feeling mentally less sharp. Lack of sleep, menopause or hormone imbalance, stress, sluggish thyroid, or deficiencies of iron, vitamin B12 or folate can all contribute. But what is particularly interesting is that research is increasingly suggesting that metabolic health also matters to the brain. The way the body manages glucose and responds to insulin may influence how alert we feel today, as well as some of the biological processes involved in cognitive ageing.
Don’t worry – this doesn’t mean that eating sugar causes dementia or that balancing blood sugar can guarantee protection from it! The relationship is far more complex. But getting our blood sugar under control can have a positive effect on the way we think.
Why Blood Sugar Matters for the Brain
The brain is an exceptionally energy-demanding organ. Even though it is only around 2% of our total body weight, it uses approximately 20% of our body’s energy at rest. That is significant.
Much of this energy is supplied by glucose circulating in the bloodstream. Brain cells need a continuous supply of energy to communicate, maintain their structure and support attention, learning and memory. However, before you start reaching for the biscuits, this doesn’t mean that more glucose is always better. The brain depends on the body keeping blood glucose within a carefully regulated range.
After eating carbohydrate-containing foods, glucose enters the bloodstream and the pancreas releases insulin. Insulin helps glucose move into muscle and other tissues, where it can be used or stored. Insulin also acts within the brain, where it is involved in communication between nerve cells, strengthening and forming connections, appetite regulation, and processes associated with learning and memory.
Problems may arise if cells become less responsive to insulin - known as insulin resistance. The pancreas initially compensates by producing more insulin, so glucose results can remain apparently normal for some time. This compensatory rise in insulin is called hyperinsulinaemia, and it means that the body is having to work harder to maintain glucose control, even though fasting glucose or HbA1c may still be withing range on a blood test.
Researchers have identified that disrupted insulin signalling within the brain may affect how nerve cells produce energy and communicate with one another. The hippocampus, a region involved in learning and memory, appears particularly sensitive to metabolic and vascular changes.
Inflammation, Insulin Resistance and Cognitive Function
Insulin resistance and inflammation can reinforce one another.
When cells respond less effectively to insulin, glucose and insulin may remain elevated for a longer time after eating. And over time, this may contribute to oxidative stress, altered fat metabolism, and the production of inflammatory signalling molecules.
Inflammation itself is not always harmful. It is an essential part of the immune response and helps us respond to infection and injury. The concern is more the persistent, low-grade inflammation that continues quietly over months or years. Visceral fat (or fat stored round the belly) may be one source of this inflammation. It can release inflammatory signalling molecules and is closely associated with insulin resistance. And it’s important to remember that people can develop metabolic dysfunction at many different body weights.
Inflammatory signals produced elsewhere in the body can communicate with the brain. They may affect the blood-brain barrier, the carefully regulated boundary controlling what passes from the circulation into brain tissue. They may also influence microglia, the brain’s resident immune cells. Microglia normally help defend the brain, clear damaged material and support tissue maintenance. However, prolonged activation may contribute to an inflammatory environment that disrupts communication between nerve cells.
Chronic neuroinflammation may also affect mitochondrial function. Mitochondria are the energy powerhouses inside cells. Brain cells have particularly high energy requirements, so impaired mitochondrial function may influence their ability to communicate, repair and remain resilient.
As we can see, inflammation affects many different brain processes. It may influence energy production, the strength of connections between nerve cells, the integrity of the blood-brain barrier and the clearance of cellular waste.
Blood vessel health provides another important link. High glucose, insulin resistance, elevated blood pressure and abnormal blood lipids can all affect the lining of the blood vessels. The brain requires a continuous supply of oxygen and nutrients. Damage to its larger or smaller blood vessels can reduce this supply and may contribute to strokes, small areas of tissue injury and vascular cognitive impairment.
Brain Fog and Energy Crashes
Blood glucose fluctuations can contribute to brain fog in some people. A meal or snack dominated by simple carbs can cause glucose to enter the bloodstream quickly. The body responds by releasing insulin. Glucose may then fall relatively rapidly, which can coincide with tiredness, hunger, irritability or difficulty concentrating. This is the familiar afternoon “crash” which can reflect what’s going on for you in your life - a combination of blood sugar imbalance, lack of protein, low hydration, too much caffeine and stress, or too little sleep. No wonder our brains don’t feel at their best!
Average glucose is only part of the picture. HbA1c (which is often on GP blood tests) estimates average glucose exposure over the preceding two to three months, but it does not show every post-meal rise or fall. Researchers are increasingly interested in glucose variability, meaning the size and frequency of fluctuations throughout the day. Repeated large changes may contribute to oxidative stress and blood-vessel dysfunction, although the long-term significance of glucose variability in people without diabetes is not yet fully understood.
Responses to the same food can also vary. Meal composition, sleep, stress, activity, muscle mass, hormones and the order in which foods are eaten can all influence the glucose response. This is one reason why a single food should not automatically be labelled either good or bad for the brain.
Hormones, Stress and Sleep
Many women first become concerned about memory and concentration during perimenopause. Word-finding difficulties, forgetfulness and feeling mentally slower are commonly reported during this stage.
Changing oestrogen levels may affect brain signalling, temperature regulation, mood and sleep. At the same time, the menopause transition can be accompanied by changes in body composition and insulin sensitivity. These factors may overlap, making it difficult to attribute brain fog to one single cause.
Experiencing brain fog during perimenopause does not mean that somebody is developing dementia. However, symptoms that are new, persistent, worsening or interfering with daily activities should be discussed with a GP.
Sleep and stress can also influence both cognition and metabolic health. Even a single poor night’s sleep can affect attention and memory the following day. Repeated sleep disruption may reduce insulin sensitivity and increase inflammatory signalling.
Chronic stress can affect concentration directly, while stress hormones may alter glucose regulation and sleep quality. Blood sugar therefore cannot be considered in isolation from the wider circumstances in which symptoms occur.
If you’d like to find out more, why not book in a call?

Summer Berry and Nut Smoothie
Fresh berries are one of the best things about summer. They are naturally colourful, require very little preparation and provide vitamin C, fibre and a wide range of plant compounds.
However, a smoothie made from fruit and juice alone may not keep you satisfied for very long. This version combines berries with protein, fibre and healthy fats to create a more complete breakfast or post-exercise option.
It is thick, creamy and not overly sweet, with no fruit juice, syrups or flavoured yoghurt required.
Why Berries Support Skin Health
Berries contain polyphenols, including the anthocyanins responsible for many of their deep red, blue and purple colours.
Anthocyanins and other polyphenols are being studied for their interactions with antioxidant defence, inflammatory signalling, vascular function and the gut microbiome. Human research has linked berry consumption with favourable effects on several cardiometabolic markers, although outcomes depend on the type and quantity of berries, the study population and the wider diet.
And their real advantage is that they make it easy to add several useful nutrients and plant compounds to an everyday meal.
Strawberries and blackcurrants are particularly rich in vitamin C. Vitamin C contributes to normal collagen formation for the normal function of skin and contributes to the protection of cells from oxidative stress. Collagen is one of the main structural proteins in the skin. The body needs vitamin C alongside amino acids from dietary protein to form and stabilise collagen fibres.
Using a mixture of berries also increases dietary variety. Frozen berries are just as practical as fresh berries and allow you to make this recipe throughout the year.
Serves one
Ingredients
To serve, optional:
Method
Frozen berries will create a colder and thicker smoothie.
Protein and Fibre Additions
The yoghurt provides most of the protein in this recipe. Greek yoghurt will usually contain more protein than standard natural yoghurt, although the amount varies considerably between brands.
Unsweetened soya yoghurt is generally the most protein-rich plant-based alternative. Coconut yoghurt usually contains very little protein unless it has been specifically fortified or blended with another protein source.
For a higher-protein smoothie, particularly after resistance training or when appetite is low, you could add:
Choose a protein powder without added sugar, additives or preservatives. A simple whey or pea protein can work, depending on personal preference and tolerance.
The chia seeds, ground flaxseed, berries and nuts contribute fibre. Soluble and viscous fibres can slow the movement of food through the digestive system and may help moderate the glucose response to a carbohydrate-containing meal.
Easy Variations
You can explore the connection between digestion, the microbiome, acne, eczema and rosacea in Could Your Gut Be Influencing Your Skin?
Find more balanced breakfast and snack ideas in my recipe index.

Could Your Gut Be Influencing Your Skin?
Have you noticed that your skin sometimes becomes more troublesome alongside changes in your digestion? Perhaps acne flares during a period of constipation or bloating. Eczema worsens after illness, antibiotics or stress. Rosacea appears alongside reflux or abdominal discomfort.
This does not prove that the gut caused the skin problem. Skin conditions are influenced by genetics, hormones, immune activity, medication, skincare, UV exposure, stress and the microbes living directly on the skin. However, the digestive system and skin communicate through immune pathways, the nervous system, hormones and microbial metabolites. Researchers call this network the gut–skin axis.
The science is interesting, but it is often overstated. Acne is not simply a sign of an unhealthy gut, eczema cannot automatically be cured by removing foods and rosacea does not mean someone has bacterial overgrowth. A more accurate message is that the gut microbiome may influence the environment in which some skin conditions develop or flare. Nutrition can support that environment, but it should complement rather than replace appropriate medical and dermatological care.
What Is the Gut–Skin Axis?
The gut microbiome is the community of bacteria, viruses, fungi and other microorganisms living mainly in the large intestine. These microbes help break down parts of food that we cannot digest ourselves. In doing so, they produce compounds that interact with the intestinal lining, immune system and wider metabolism. One important group is the short-chain fatty acids, including acetate, propionate and butyrate. Gut bacteria produce these when they ferment certain fibres and resistant starches. Butyrate, in particular, is an important fuel for cells lining the colon. It also participates in immune regulation and helps maintain the intestinal barrier.
The gut barrier must allow nutrients to pass through while limiting the movement of microbes and unwanted material into the circulation. The skin performs a similar role externally, protecting the body from water loss, irritants and microorganisms.
Both barriers are inhabited by microbes and communicate closely with the immune system. Both are influenced by diet, stress, medicines, hormones and the wider environment.
Possible routes linking the gut and skin include:
Gut Health, Inflammation and Skin Symptoms
Researchers have found differences in the gut or skin microbiomes of people with several inflammatory skin conditions.
The important word is differences.
An association does not prove that particular microbes caused the condition. Diet, age, geography, medication, hormones, illness and the skin condition itself can all influence microbial composition. There is no single ideal microbiome shared by everyone.
Even so, research is helping us understand how microbial and dietary factors may be relevant to individual conditions.
Acne and the Microbiome
Acne is a chronic inflammatory condition involving sebum production, blocked follicles, altered skin-cell turnover, immune activity and interactions with Cutibacterium acnes. C. acnes normally lives on healthy skin. Acne appears to involve an altered relationship between certain strains, the skin environment and the immune system rather than simply having “too many bacteria”. Studies have also reported possible differences in the gut microbiomes of people with acne, but much of the evidence is observational and inconsistent.
High-glycaemic diets can produce rapid increases in glucose and insulin. This may increase signalling through insulin-like growth factor 1, or IGF-1, which can influence sebum production and skin-cell growth. Some trials have found improvements in acne with lower-glycaemic dietary patterns, although the evidence is not uniform.
Dairy, particularly skimmed milk, has been associated with acne in some observational studies. This does not mean everyone with acne should remove dairy. Dairy foods also provide protein, calcium, iodine and vitamin B12, and an association cannot establish individual causation.
A useful starting point is a balanced pattern containing protein, vegetables, fruit, legumes, wholegrains and healthy fats, while reducing the extent to which sugary drinks and highly refined foods dominate the diet. Persistent, painful, cystic or scarring acne needs medical treatment. Nutrition may complement a wider plan but should not delay effective care.
Eczema and the Microbiome
Eczema, or atopic dermatitis, is a chronic inflammatory condition involving an impaired skin barrier and altered immune responses. The skin barrier helps retain moisture and keep irritants, allergens and microbes outside the body. In eczema, it is less effective, leaving the skin dry, itchy and vulnerable to irritation. Genetics are important. Variants affecting filaggrin, a protein involved in skin-barrier structure, increase susceptibility in some people.
The skin microbiome also changes during flares. Greater colonisation by Staphylococcus aureus is commonly observed, particularly in more severe eczema. This concerns the skin microbiome and does not prove that a bowel problem caused the condition. Probiotic studies have produced mixed results. Outcomes vary by bacterial strain, dose, age and timing, so probiotics should not be treated as one universal eczema therapy.
Food allergy and eczema can coexist, especially in children with moderate or severe eczema, but indiscriminate food removal is not recommended. Removing dairy, gluten, eggs, soya and other foods without a clear indication can lead to nutritional deficiencies and unnecessary anxiety. Suspected food allergy requires appropriate medical assessment. Nutritional support should sit alongside emollients and any treatment prescribed by a GP or dermatologist.
Rosacea and the Microbiome
Rosacea commonly causes facial flushing, persistent redness, visible blood vessels and, in some people, spots or thickening of the skin. Its causes are complex and may involve vascular reactivity, immune signalling, genetics, UV exposure, skin-barrier changes and microorganisms living on the face.
Demodex mites have received particular attention. They are found on healthy skin but may be more numerous or trigger a different immune response in some people with rosacea. Researchers have also reported associations between rosacea and gastrointestinal conditions, including coeliac disease, inflammatory bowel disease and small intestinal bacterial overgrowth. Possible links with Helicobacter pylori have also been investigated. These findings do not mean everyone with rosacea has a digestive disorder. Testing and treatment should be based on symptoms and medical assessment.
Common rosacea triggers include UV exposure, heat, hot drinks, alcohol, spicy food, stress, vigorous exercise and certain skincare products. These often provoke flushing through vascular or nervous-system mechanisms rather than by harming the gut. There is no universal rosacea diet. A short symptom and trigger diary may be more useful than removing every food mentioned online.
The Role of Diet Diversity
A varied range of plant foods supplies different fibres, resistant starches and polyphenols for gut microbes. Rather than chasing a perfect weekly number, look at repetition. Could you rotate berries, grains, beans, herbs or seeds instead of eating the same few plants every week?
Increase fibre gradually. A sudden increase may cause bloating, particularly in people with IBS or an already sensitive digestive system.
Diet diversity may support the microbiome, but someone’s eczema or acne has not persisted because they failed to eat enough plants. Diet is one influence within a much larger picture.
Nutrition Strategies That Support Both Gut and Skin
The most useful approach is not a restrictive skin detox. It is a varied diet that supplies fibre, protein, healthy fats and micronutrients while supporting digestive tolerance.
Aim to:
Where a food genuinely appears to trigger symptoms, use a structured and time-limited process rather than removing several food groups at once.
A Gut–Skin Reality Check
The gut–skin axis is a credible and developing area of research. It helps explain how microbes, immune regulation, nutrition and barrier health may connect different parts of the body. But it is not evidence that every skin condition begins in the bowel.
Acne is shaped by hormones, sebum, follicular changes, inflammation and the skin microbiome. Eczema involves genetic susceptibility, immune activity and an impaired barrier. Rosacea involves vascular, immune, environmental and microbial factors.
The most sensible approach is to support both systems without making unrealistic promises. Eat a varied diet, include sufficient fibre, protein and healthy fats, address genuine digestive symptoms and avoid unnecessary restriction. Continue appropriate skincare and medical treatment.
Book a Gut and Skin Health Consultation
If digestive symptoms and recurring skin flare-ups seem to overlap, personalised nutritional support can help you explore the wider picture without resorting to unnecessary restriction. Would you like to know more? Book a free call.
Persistent, severe or worsening acne, eczema or rosacea should be assessed by a GP, pharmacist or dermatologist. Seek prompt medical advice for infected or weeping eczema, eye symptoms associated with rosacea, rapidly worsening rashes or acne that is painful, cystic or causing scarring.
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