BRAT Diet: Food List, Efficacy, and Alternatives

The BRAT diet is an acronym for Bananas, Rice, Applesauce, and Toast, and it is commonly recommended for managing acute diarrhea and gastrointestinal issues. While the BRAT diet has been a traditional recommendation, newer approaches emphasize a more balanced diet alongside probiotics and rehydration solutions.

A 2012 study published in Holistic Nursing Practice by Salvatore F. Salfi from the Christiana Care Health System in Smyrna suggested that the dietary limitations of the BRAT diet may need to be reexamined in light of new evidence supporting the role of probiotics in diarrheal management. Another study in 2013 published in the “Indian Journal of Pediatrics” by Parag Dekate from the Post Graduate Institute of Medical Education and Research in Chandigarh emphasized the management of acute diarrhea, stating it is the second leading cause of under-five mortality in India.

This study also recommended oral rehydration therapy as the cornerstone of management for dehydration caused by diarrhea. Notably, the BRAT diet is considered to be low in essential nutrients like protein and fat, making it less suitable for long-term use. The diet is usually recommended for a short period, often not exceeding 48 hours, to manage symptoms of diarrhea.

What is the BRAT diet?

The BRAT diet, which stands for Banana, Rice, Applesauce, and Toast (or Tea), is a dietary regimen traditionally recommended for managing acute diarrhea. Developed in the 20th century, the diet was initially based on the idea of “gut rest,” aimed at reducing stool output. However, this concept has been largely discredited, as studies, including randomized clinical trials, have shown that immediate refeeding after rehydration is more beneficial.

Debora Duro M.D., M.S., a Third Year Fellow in Pediatric Gastroenterology and Nutrition at Children’s Hospital Boston, Harvard Medical School, and her colleagues have scrutinized the diet’s efficacy and nutritional content. Their research indicates that the BRAT diet is lacking in energy, fat, and several micronutrients.

As of the 21st century, the standard of care for treating acute diarrhea has shifted toward oral rehydration therapy (ORT) and prompt feeding with age-appropriate food. Experts now consider the BRAT diet to be outdated and less effective than previously believed for treating acute diarrhea.

What is the history of the BRAT diet?

The history of the BRAT diet dates back several decades as it was once a popular recommendation for children with upset stomachs.

How does the BRAT diet help with diarrhea?

The BRAT diet is commonly used to manage acute diarrhea by offering a selection of bland, low-fiber foods that are easy on the digestive system.

How does BRAT diet work
How does the BRAT diet help with diarrhea?

According to a clinical study published in the journal Gastroenterology by G.H. Rabbani and colleagues from the Centre for Health and Population Research in Dhaka, incorporating the BRAT diet led to a significant reduction in the duration of diarrhea among 62 Bangladeshi boys aged 5–12 months. By the third day, 55% of children in the banana group and 59% in the pectin group showed no signs of diarrhea.

However, it’s crucial to note that while the BRAT diet may be effective for short-term management, it is not nutritionally complete and is deficient in energy, fat, and several micronutrients, according to experts like Dr. Duro. Therefore, the BRAT diet should be considered a short-term solution and supplemented with other nutrients for a balanced diet.

What are the health benefits of the BRAT Diet?

The health benefits of the BRAT diet are limited and primarily focused on short-term symptom relief for individuals with diarrhea or stomach illness. Some potential benefits include reducing nausea, diarrhea, and vomiting, as well as firming up stools, offering easy-to-digest foods, and being gentle on the stomach. 

  1. Reducing Nausea: The BRAT diet includes bland foods like bananas, rice, applesauce, and toast that are less irritating to the stomach. These foods can help minimize nausea symptoms by avoiding the stimulation of an already sensitive digestive system.
  2. Reducing Diarrhea: The low-fiber, high-binding qualities of the foods in the BRAT diet can help absorb excess liquid in the intestines, leading to firmer stools. This aids in controlling diarrhea by reducing the frequency and volume of loose stools.
  3. Reducing Vomiting: The simplicity and blandness of the BRAT diet foods can help calm the stomach, potentially reducing the urge to vomit. The foods are easy to digest, lessening the likelihood of triggering further vomiting episodes.
  4. Firming Up Stools: The starchy and binding components of the BRAT diet, such as rice and toast, work to absorb excess water in the digestive tract. This helps firm up stools, making them less watery and easier to control.
  5. Gentle on the Stomach: The foods in the BRAT diet are easy to digest, requiring minimal effort from the digestive system. This makes the diet gentle on an irritated or upset stomach, aiding in quicker recovery from stomach illnesses.

What are the health risks of the BRAT Diet?

The health risks of the BRAT diet include nutrient deficiencies, calorie insufficiency, lack of protein and fat, potential for malnutrition with prolonged use, limited fiber intake, and inadequate variety of nutrients. Following the BRAT diet for an extended period (over 2 days) can result in undernourishment and low energy levels. The American Academy of Pediatrics does not recommend the BRAT diet for children with diarrhea due to its restrictive nature and potential risks.

  1. Nutrient Deficiencies: The BRAT diet is limited in the variety of nutrients it provides, lacking essential vitamins and minerals. This can lead to deficiencies that may impact overall health, especially if followed for an extended period.
  2. Calorie Insufficiency: The foods in the BRAT diet are low in calories, which can lead to insufficient energy intake. A lack of adequate calories can result in fatigue and low energy levels, hindering the body’s ability to heal.
  3. Lack of Protein and Fat: The BRAT diet is low in protein and fat, which are crucial for tissue repair and immune function. The absence of these macronutrients can slow down the recovery process and weaken the immune system.
  4. Potential for Malnutrition: Prolonged use of the BRAT diet increases the risk of malnutrition, as it lacks the comprehensive nutrient profile needed for a balanced diet. Malnutrition can result in a host of health issues, including weakened immunity and slowed healing.
  5. Limited Fiber Intake: The BRAT diet is low in fiber, which is necessary for regular bowel movements and a healthy digestive system. Extended reliance on this diet can disrupt normal digestive function.
  6. Inadequate Variety of Nutrients: The BRAT diet is restrictive and does not offer a well-rounded nutrient profile. This lack of variety can result in imbalances that may lead to health issues over time.
  7. Undernourishment and Low Energy Levels: Following the BRAT diet for an extended period can lead to undernourishment, characterized by insufficient nutrient and calorie intake. This can result in low energy levels and hinder the body’s ability to function optimally.

How does the BRAT diet affect metabolic rates?

The BRAT diet is not specifically designed to affect metabolic rates, but its low caloric and nutrient content can lead to metabolic deficiencies if followed for an extended period. There is no scientific evidence to suggest that the BRAT diet has a direct impact on metabolic rates, but its nutritional inadequacies could potentially slow down metabolic processes if used long-term.

How to start the BRAT Diet?

To start the BRAT diet, follow the 13 steps outlined below.

How to do BRAT diet
How to start the BRAT Diet?
  1. Consult with a healthcare professional or a registered dietitian to determine if the BRAT diet is appropriate for your specific condition or situation.
  2. Begin the BRAT diet by gradually introducing bland and easily digestible foods into your diet.
  3. Start with small portions and slowly increase the amount as tolerated.
  4. Start with bananas as they are a key component of the BRAT diet.
  5. Choose ripe bananas that are easy to digest. It is recommended to eat them plain or mashed.
  6. Incorporate rice into your meals.
  7. Choose plain white rice and cook it thoroughly. Avoid adding spices, sauces, or fatty ingredients.
  8. Include applesauce in your diet, choosing unsweetened and plain varieties.
  9. Avoid adding sugar or other sweeteners.
  10. Introduce toast made from white bread into your meals.
  11. Choose lightly toasted bread and avoid adding butter or high-fat spreads.
  12. Stay hydrated by drinking clear liquids such as water, herbal tea, or diluted fruit juices without pulp.
  13. Avoid carbonated beverages, caffeinated drinks, and sugary beverages.

What foods can you eat on the BRAT diet?

On the BRAT diet, you can eat bananas, rice, applesauce, and toast.

foods to eat on the BRAT diet
What foods can you eat on the BRAT diet?

These foods are low in fiber and are considered easily digestible, making them suitable for individuals with gastrointestinal issues or after surgery. However, it’s important to note that the BRAT diet is not synonymous with a bland diet with a broader range of allowed foods.

What foods can you eat on the BLAND diet?

On the bland diet, you can eat easily digestible, low-fiber, cooked foods that are gentle to the gastrointestinal tract. This includes the following foods.

  • Low-fat dairy products
  • Eggs
  • Broth
  • Pudding
  • Fruit juices
  • Cream of wheat
  • Tofu, lean meat
  • Bland vegetables
  • Tea

What foods are restricted from the BRAT diet?

The BRAT diet restricts foods that may irritate the gastrointestinal tract and worsen symptoms, typically including fried and fatty foods, whole grains, spicy foods, and high-fiber foods.

Is toast allowed on the BRAT diet?

Yes, toast is allowed on the BRAT diet.

What are the calorie counts for foods on the BRAT diet?

The calorie counts for foods in the BRAT diet are generally low. One medium-sized banana has approximately 105 calories, a cup of cooked white rice contains around 205 calories, one cup of applesauce has about 100 calories, and a slice of toast can range from 60 to 80 calories depending on the type of bread used. In total, a single round of all four BRAT diet components would provide roughly 470 to 490 calories.

What is the 21-day BRAT diet food list?

The 21-day BRAT diet food list consists of bananas, rice, applesauce, and toast, which are bland foods that are easy to digest.

Is it safe to follow the BRAT diet for 21 days?

No, it is not safe to follow the BRAT diet for 21 days as this type of diet is mainly used for short-term relief of diarrhea and may not provide adequate nutrition for an extended period of time.

How long should adults stay on the BRAT diet?

Adults should generally stay on the BRAT diet for a short period of 24 to 48 hours to help alleviate symptoms of diarrhea. After this period, it is advised to gradually reintroduce regular, nutritious foods to avoid nutrient deficiencies and other health risks.

Why is the BRAT diet no longer recommended in some cases?

The BRAT diet is no longer universally recommended for treating acute diarrhea due to its significant nutritional shortcomings. A study using Food Processor SQL Version 9.9 found it provides 300 fewer calories than a healthy toddler’s daily requirement and is deficient in key nutrients like fat, fiber, protein, vitamin A, B12, and calcium.

A case report published in the Journal of Pediatric Gastroenterology and Nutrition in July 1998 by Susan S. Baker, MD, Ph.D. from the Medical University of South Carolina, highlighted that hypocaloric oral therapy like the BRAT diet can lead to severe malnutrition, including conditions like kwashiorkor. The American Academy of Pediatrics now advises against overly restrictive diets like the BRAT diet, advocating instead for a balanced diet that meets the Dietary Reference Intakes (DRI) for micronutrients. Therefore, while the diet may have short-term benefits in managing diarrhea symptoms, its long-term use can be nutritionally detrimental.

What are some alternative diets to the BRAT diet?

The following list outlines the alternative diets to the BRAT diet.

  1. CRAM Diet
  2. Rice Diet
  3. Bland Diet
  4. Bread Diet
  5. Banana Diet
  6. Oral Rehydration Therapy (ORT)

1. CRAM Diet

The CRAM diet consists of cereal, rice, applesauce, and milk, aiming to provide more protein and fat compared to the BRAT diet. While it offers more nutritional diversity, it may not be suitable for individuals who have milk or gluten sensitivities.

2. Rice Diet

The Rice Diet focuses on consuming rice to help bind the stool and provide easily digestible carbohydrates. It is effective in reducing stool volume, but it can be nutritionally limited, lacking in protein and other essential nutrients.

3. Bland Diet

The Bland Diet involves foods that are soft, not very spicy, and low in dietary fiber. While it’s easy on the digestive system, it may lack essential nutrients and vitamins, making it less ideal for long-term use.

4. Bread Diet

The Bread Diet comprises mainly bread, aiming to solidify stool. It provides a binding effect similar to rice but lacks a balanced nutrient profile, making it unsuitable for extended periods.

5. Banana Diet

The Banana Diet focuses on the consumption of bananas, which are rich in pectin and help absorb liquid in the intestines. Bananas are nutritious and easy to digest, but a diet solely based on them can lack protein and other essential nutrients.

6. Oral Rehydration Therapy (ORT)

Oral Rehydration Therapy involves the administration of fluid with specific amounts of sugar and salts, often through a pre-formulated oral rehydration solution (ORS), to prevent or treat dehydration. While ORT is highly effective in rapidly replenishing lost fluids and electrolytes in cases of acute diarrhea, it does not offer the nutrients or calories necessary for full recovery and long-term well-being.

How is the BRAT diet different from the Rice Diet?

The BRAT diet is a bland diet often recommended for individuals with gastrointestinal issues like diarrhea or vomiting. In contrast, the Rice Diet focuses exclusively on rice-based foods, potentially supplemented with ingredients like soya bean oil, glucose, and egg whites, as indicated in a study by the International Centre for Diarrhoeal Disease Research, Bangladesh.

While the BRAT diet offers a limited range of foods that are easy on the stomach, the Rice Diet may be more specialized for nutrient absorption and is particularly studied for its effectiveness in managing persistent diarrhea.

How does the BRAT diet compare to the Bread Diet?

The BRAT diet focuses on bland foods like Bananas, Rice, Applesauce, and Toast to manage short-term gastrointestinal symptoms like diarrhea. In contrast, the bread diet, particularly with Tritordeum-based foods, aims to improve long-term gastrointestinal health by reducing intestinal permeability and lowering markers of inflammation, as indicated by research from the National Institute of Gastroenterology “S. de Bellis” Research Hospital in Italy.

Is the BRAT diet generally regarded as a healthy diet?

No, the BRAT diet is not generally regarded as a healthy long-term diet due to its limited nutritional value. It is primarily recommended for short-term use.