In diastasis recti forums, women are swapping recipes for bone broth, recommending collagen supplements, and authoritatively advising on specific vitamin combinations.
They need to stop.
This advice is based on dietary myths, myths perpetuated by some of the foremost experts on the postpartum tummy.
The advice feels logical. If a diastasis is caused by damage to the linea alba, which is mostly collagen, then consuming collagen and “collagen boosting foods” should help it heal, right? If only biology were that simple.
Let’s Talk Collagen
Collagen is cool. And important. And everywhere in the body.
It is the main protein in skin, tendons, cartilage, bone, and connective tissue (thus, in the linea alba). In other words, collagen holds your entire body together.
Collagen is really strong, but also elastic. It has a lot of tensile strength, but not a lot of compressive strength. This means it stretches when pulled on (like a pregnant belly), but returns to its original position after the pull is removed. Conversely, it folds up easily when pushed on, which is why splinting is sometimes iffy.
Diastasis Recti and Collagen
Diastasis recti is caused by over-stretching the linea alba. In most women, the connective tissue recoils, but in women with lingering diastasis recti, this recoil doesn’t happen. Lucky us.
Often, appropriate movement will fix the issue, but sometimes surgery is the only way to bring the rectus abdominis closer together. Keep in mind, we don’t know exactly how the tissue shortens in some women, but we do know it can (it did for me).
This shortening has led some postnatal trainers and nutritionists to focus on the linea alba’s building blocks. They reason the best way to rebuild tissue connections is by consuming collagen, specific vitamins, and gelatin (a hydrolyzed form of collagen).
The Bone Broth Recommendation
For example, one popular postnatal authority posted on her blog that the best way to rebuild collagen in overstretched abdominals or torn pelvic floors is via animal proteins, “especially those from the skin, cartilage, and bones of other animals.”
She recommends women drink bone broth because it is “the absolute best food source for rebuilding collagen.” She also encourages women to supplement with gelatin via powders in smoothies, or to consume a protein powder made from beef.
It’s all very Paleo.
Why This Advice is Too Simplistic
The advice to make bone broth or take gelatin supplements is based on faulty logic and biologic myth:
How would consumed collagen know to beeline to your linea alba, rather than to your bones or cartilage or other connective tissue? Fortunately this anatomical dilemma is moot; consumed collagen does not automatically turn into collagen in your body.
Our stomach acid deactivates all proteins and our bodies break them down to their individual amino acids. As a protein, collagen/gelatin is not considered a good source, as it does not contain all the essential amino acids…The two amino acids collagen is known for, proline and glycine, are both non-essential amino acids that our bodies can make as long as it is getting adequate, complete protein.
To put this simply, consumed collagen is broken down, so it doesn’t magically turn into collagen in your body. Your body creates collagen from amino acids that your body makes, and these amino acids can be created from any source of complete protein. For example, dairy, eggs, and meat are all complete proteins. Although requiring more diligence, vegan sources can also provide this protein, as long as multiple types are eaten.
William Percy of the University of South Dakota’s Sanford School of Medicine sums the confusion up nicely:
Since we don’t absorb collagen whole, the idea that eating collagen somehow promotes bone growth is just wishful thinking.
Similarly, Scott Gavura writes in Science Based Medicine:
From a dietary perspective, your body doesn’t care (and can’t tell) if you ate a collagen supplement, cheese, quinoa, beef, or chick peas — they’re all sources of protein, and indistinguishable by the time they hit the bloodstream.
Collagen doesn’t promote bone growth, nor heal a linea alba. Therefore, bone broth is drastically overrated. This doesn’t mean you should shun bone broth if you really like it. By all means, drink up. It’s still protein, so consuming it won’t harm you—well, probably not…there is some concern about lead exposure.
Ultimately, whether you eat bone broth is a personal taste decision. If you don’t like it, abandon it. It isn’t necessary for healing a diastasis recti or pelvic floor tears, and it definitely isn’t “the absolute best food source for rebuilding collagen.”
My Beef with the Advice
I care about bad advice in the postnatal world because we moms are a desperate lot. If someone promises us that drinking bone broth and taking expensive supplements will give us our flat belly or function back, we’ll do it, usually no questions asked.
However, we should ask questions. We should ask for evidence. We should ask for biologic plausibility.
There is a cost to bad advice. Making bone broth takes time. Buying supplements takes money. Thinking about this stuff takes up mental space, space that should be stuffed with other concerns, like where did my kid hide all his underwear, and how did that poop get in the laundry…
What We Should Do Instead
The evidence for how to close a diastasis recti is confusing and inadequate. I go deep in the Primer, so please read that if you are the type of person who likes to jump into a topic.
Although the evidence is sparse, exercise and diet could help stretched out connective tissue and abdominal muscles. And in my experience, it has.
What is a Good Diet?
Even though I knock the bone broth recommendation, a good diet is still important. A good diet will provide the necessary building blocks for tissue repair, especially for pelvic floor tears and, perhaps, for a stretched out linea alba.
I define a good diet as anything that isn’t a bad diet. This means, unless you eat only junk, shun all protein, or starve yourself, you’re probably fine. Consuming more bone broth won’t speed up recovery or flatten your belly.
Adequate rest, exercise, and a balanced diet are your best bets for seeing improvement. If this doesn’t help, surgery might be necessary.
This advice is bland, yet less complicated than bone broth recipes, and less expensive than supplements. It probably tastes better too.
- MedicineNet.com, “Definition of Collagen,” http://www.medicinenet.com/script/main/art.asp?articlekey=2786 ↩
- Andrea D’ambrosia, “The Bone Broth Myth,” Dietetic Directions, 6 July 2015, http://dieteticdirections.com/the-bone-broth-myth/ ↩
- Quotes in Daniela Galarza, “The Bone Broth Trend Isn’t Going Anywhere,” Eater, 12 February 2015, http://www.eater.com/2015/2/12/8025027/what-is-bone-broth-and-why-is-everyone-talking-about-it ↩
- Scott Gavura, “Collagen: An implausible supplement for joint pain,” Science Based Medicine, 10 November 2011, https://www.sciencebasedmedicine.org/collagen-an-implausible-supplement-for-joint-pain/ ↩