Whole food diet may help prevent colon cancer, other chronic conditions

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A diet that includes plenty of colorful vegetables and fruits may contain compounds that can stop colon cancer and inflammatory bowel diseases in pigs, according to an international team of researchers. Understanding how these compounds work on a molecular level could be an initial step toward finding treatments for people with cancer, they added. “What we are learning is that food is a double-edge sword — it may promote disease, but it may also help prevent chronic diseases, like colon cancer,” said Jairam K.P. Vanamala, associate professor of food sciences, Penn State. “What we don’t know is, ‘how does this food work on the molecular level?’ This study is a step in that direction.”

In the study, pigs that were served a high calorie diet supplemented with purple-fleshed potatoes had less colonic mucosal interleukin-6 — IL-6 — compared to a control group. IL-6 is a protein that is important in inflammation, and elevated IL-6 levels are correlated with proteins, such as Ki-67, that are linked to the spread and growth of cancer cells, said Vanamala, who also is a faculty member at the Penn State Hershey Cancer Institute. According to the researchers, who reported their findings in a recent issue of the Journal of Nutritional Biochemistry, eating whole foods that contain macronutrients, substances that humans need in large amounts, such as proteins, as well as micro and phytonutrients, such as vitamins, carotenoids and flavonoids, may be effective in altering the IL-6 pathway.

Vanamala said these findings reinforce recent research that suggests cultures with plant-based diets tend to have lower colon cancer rates than cultures with meat-based diets. Colon cancer is the second leading cause of cancer related deaths in the United States and a leading killer in many other Western countries, which tend to include more meat and less fruits and vegetables, he added. While the researchers used purple potatoes in this study, Vanamala said other colorful fruits and vegetables could prompt similar effects. Colorful plants, including the purple potato, contain bioactive compounds, such as anthocyanins and phenolic acids, that have been linked to cancer prevention.

“For example, white potatoes may have helpful compounds, but the purple potatoes have much greater concentrations of these anti-inflammatory, anti-oxidant compounds,” said Vanamala. “We use the purple potato as a model and hope to investigate how other plants can be used in the future.” Another advantage of using whole foods for cancer treatment is that it would benefit the agriculture industry and likely help small farmers around the world. “If this model works, we can see what works in other countries,” Vanamala said. “Instead of promoting a pill, we can promote fruits and vegetables that are very rich in anti-inflammatory compounds to counter the growing problem of chronic disease.”

The researchers fed the animals three different diets: a standard diet with 5 percent fat; a high-calorie diet, with 17 percent added dry fat and 3 to 4 percent added endogenous fat; and a high fat diet supplemented with purple-fleshed potatoes. The expression of IL-6 was six times lower in pigs that ate the purple potato-enhanced feed compared to the control group. Researchers used both uncooked and baked potatoes and found similar effects. Currently, anti-IL-6 drugs are used against certain type of rheumatoid arthritis and are being considered to treat other inflammation-promoted chronic diseases, such as colon cancer. However, these drugs are expensive and can cause side-effects, including drug tolerance.

Vanamala said that the pig model was used because the digestive system is very similar to the human digestive system, more so than in mice. The diet approach to cancer treatment has also shown similar promise in mice, however, he added.

Adapted from: Penn State. (2017, September 21). Whole food diet may help prevent colon cancer, other chronic conditions. ScienceDaily. Retrieved December 13, 2017 from http://www.sciencedaily.com/releases/2017/09/170921101727.htm

Nutrition Tip of the Day

Have a superfood! Most superfoods can be found in the produce aisle, they’re not fancy and they don’t even wear food labels. Add a fruit or veggie to each meal.

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Post-Workout Nutrition: What to Eat After a Workout

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You put a lot of effort into your workouts, always looking to perform better and reach your goals. Chances are you’ve given more thought to your pre-workout meal than your post-workout meal. However, consuming the right nutrients after you exercise is just as important as what you eat before. Below, is a detailed guide to optimal nutrition after workouts.

Eating After a Workout Is Important

To understand how the right foods can help you after exercise, it’s important to understand how your body is affected by physical activity. When you’re working out, your muscles use up their glycogen stores for fuel. This results in your muscles being partially depleted of glycogen. Some of the proteins in your muscles also get broken down and damaged.

After your workout, your body tries to rebuild its glycogen stores and repair and regrow those muscle proteins. Eating the right nutrients soon after you exercise can help your body get this done faster. It is particularly important to eat carbs and protein after your workout. Doing this helps your body:

  • Decrease muscle protein breakdown.
  • Increase muscle protein synthesis (growth).
  • Restore glycogen stores.
  • Enhance recovery

BOTTOM LINE: Getting in the right nutrients after exercise can help you rebuild your muscle proteins and glycogen stores. It also helps stimulate growth of new muscle.

Protein, Carbs and Fat

Protein Helps Repair and Build Muscle

These powerful macronutrients are involved in your body’s post-workout recovery process. As explained above, exercise triggers the breakdown of muscle protein. The rate at which this happens depends on the exercise and your level of training, but even well-trained athletes experience muscle protein breakdown. Consuming an adequate amount of protein after a workout gives your body the amino acids it needs to repair and rebuild these proteins. It also gives you the building blocks required to build new muscle tissue.

It is recommended that you consume 0.14–0.23 grams of protein per pound of body weight (0.3–0.5 grams/kg) very soon after a workout. Studies have shown that ingesting 20–40 grams of protein seems to maximize the body’s ability to recover after exercise.

Carbs Help With Recovery

Your body’s glycogen stores are used as fuel during exercise, and consuming carbs after your workout helps replenish them. The rate at which your glycogen stores are used depends on the activity. For example, endurance sports cause your body to use more glycogen than resistance training. For this reason, if you participate in endurance sports (running, swimming, etc.), you might need to consume more carbs than a bodybuilder.

Consuming 0.5–0.7 grams of carbs per pound (1.1–1.5 grams/kg) of body weight within 30 minutes after training results in proper glycogen re-synthesis. Furthermore, insulin secretion, which promotes glycogen synthesis, is better stimulated when carbs and protein are consumed at the same time. Therefore, consuming both carbs and protein after exercise can maximize protein and glycogen synthesis. Try consuming the two in a ratio of 3:1 (carbs to protein). For example, 40 grams of protein and 120 grams of carbs.

Eating plenty of carbs to rebuild glycogen stores is most important for people who exercise often, such as twice in the same day. If you have 1 or 2 days to rest between workouts then this becomes less important.

Fat Is Not That Bad

Many people think that eating fat after a workout slows down digestion and inhibits the absorption of nutrients. While fat may slow down the absorption of your post-workout meal, it will not reduce its benefits. For example, a study showed that whole milk was more effective at promoting muscle growth after a workout than skim milk. Moreover, another study showed that even when ingesting a high-fat meal (45% energy from fat) after working out, muscle glycogen synthesis was not affected.

It might be a good idea to limit the amount of fat you eat after exercise, but having some fat in your post-workout meal will not affect your recovery.

BOTTOM LINE: A post-workout meal with both protein and carbs will enhance glycogen storage and muscle protein synthesis. Consuming a ratio of 3:1 (carbs to protein) is a practical way to achieve this.

The Timing of Your Post-Workout Meal Matters

Your body’s ability to rebuild glycogen and protein is enhanced after you exercise. For this reason, it is recommended that you consume a combination of carbs and protein as soon as possible after exercising. Although the timing does not need to be exact, many experts recommend eating your post-workout meal within 45 minutes. In fact, it’s believed that the delay of carb consumption by as little as two hours after a workout may lead to as much as 50% lower rates of glycogen synthesis. However, if you consumed a meal before exercising, it’s likely that the benefits from that meal still apply after training.

BOTTOM LINE: Eat your post-workout meal within 45 minutes of exercising. However, you can extend this period a little longer, depending on the timing of your pre-workout meal.

Foods to Eat After You Workout

The primary goal of your post-workout meal is to supply your body with the right nutrients for adequate recovery and to maximize the benefits of your workout. Choosing easily digested foods will promote faster nutrient absorption. The following lists contain examples of simple and easily digested foods:

Carbs:

  • Sweet potatoes
  • Chocolate milk
  • Quinoa
  • Fruits (pineapple, berries, banana, kiwi)
  • Rice cakes
  • Rice
  • Oatmeal
  • Potatoes
  • Pasta
  • Dark, leafy green vegetables

Protein:

  • Animal- or plant-based protein powder
  • Eggs
  • Greek yogurt
  • Cottage cheese
  • Salmon
  • Chicken
  • Protein bar
  • Tuna

Fats:

  • Avocado
  • Nuts
  • Nut butters
  • Trail mix (dried fruits and nuts)

Sample Post-Workout Meals

Combinations of the foods listed above can create great meals that provide you with all the nutrients you need after exercise. Here are a few examples of quick and easy meals to eat after your workout:

  • Grilled chicken with roasted vegetables
  • Egg omelet with avocado spread on toast
  • Salmon with sweet potato
  • Tuna salad sandwich on whole grain bread
  • Tuna and crackers
  • Oatmeal, whey protein, banana and almonds
  • Cottage cheese and fruits
  • Pita and hummus
  • Rice crackers and peanut butter
  • Whole grain toast and almond butter
  • Cereal and skim milk
  • Greek yogurt, berries and granola
  • Protein shake and banana
  • Quinoa bowl with berries and pecans
  • Multi-grain bread and raw peanuts

Make Sure to Drink Plenty of Water

It is important to drink plenty of water before and after your workout. When you are properly hydrated, this ensures the optimal internal environment for your body to maximize results. During exercise, you lose water and electrolytes through sweat. Replenishing these after a workout can help with recovery and performance.

It’s especially important to replenish fluids if your next exercise session is within 12 hours. Depending on the intensity of your workout, water or an electrolyte drink is recommended to replenish fluid losses.

BOTTOM LINE: It is important to get water and electrolytes after exercise to replace what was lost during your workout.

Putting It All Together

Consuming a proper amount of carbs and protein after exercise is essential. It will stimulate muscle protein synthesis, improve recovery and enhance performance during your next workout. If you’re not able to eat within 45 minutes of working out, it’s important to not go much longer than 2 hours before eating a meal. Finally, replenishing lost water and electrolytes can complete the picture and help you maximize the benefits of your workout.

Adapted from: Arlene Semeco, MS, RD

Nutrition Tip of the Day

Chill out! Frozen foods, particularly fruits and veggies, can be just as nutritious as fresh produce and, in some cases, they may be even better.

Daily Inspiration 

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Nutrients for a Sharp Memory

Research supports a variety of nutrients and food components that protect cognitive function.

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Nearly everyone has walked into a room and forgotten what he or she went in there for, or has had trouble recalling an obvious word, and worried that his or her brain may not be as sharp as it once was. “My private clients, both young and old, express concern about preserving their memory,” says Jennifer McDaniel, MS, RDN, CSSD, LD, a spokesperson for the Academy of Nutrition and Dietetics. “I believe many underestimate the power of dietary choices in supporting brain health.” The brain, like the cardiovascular system, depends on good blood flow for optimal functioning. Heart-healthy lifestyle choices such as regular physical activity and a healthful dietary pattern are, therefore, good ways to keep the brain healthy and the memory sharp. “What’s good for the heart is good for the head,” McDaniel says. The heart-healthy Mediterranean-style eating pattern, for example, is linked to better cognitive function, memory, and alertness in numerous studies. The MIND diet, a variation of the Mediterranean diet that specifically targets brain health, adds an emphasis on certain foods such as green leafy vegetables and berries that have been linked (or contain components that in studies have been linked) with brain benefits, but what are some particular nutrients or food components that stand out for their brain-boosting powers? Research is inconclusive to date, but there is a few promising nutrients.

Omega-3 Fatty Acids

The omega-3 family of polyunsaturated fatty acids (PUFAs) play several important roles in brain structure and function, and there’s clinical evidence suggesting that dietary deficiency in these PUFAs can have adverse cognitive effects. In addition, “There’s solid evidence from observational studies linking omega-3 fatty acid intake to cognitive benefits,” says Ondine van de Rest, MSc, PhD, an assistant professor in the division of human nutrition at Wageningen University in the Netherlands who’s done extensive work on nutrition and cognition. Numerous epidemiologic studies have found that high intake of PUFA-rich fish is associated with positive cognitive function and inversely associated with development and progression of dementia. In one study, elderly subjects who consumed fish or seafood even once per week exhibited a significantly lower risk of developing dementia in the seven-year follow-up period.

The long-chain omega-3 DHA, found in fish, shellfish, algae and especially prevalent in oily fish such as salmon, mackerel, herring, anchovies, menhaden, and sardines, is especially important to brain function. Since the body doesn’t make DHA efficiently, humans are dependent on dietary sources, and it appears the typical Western diet is falling short. According to one study, less than one-half of women consume the recommended dietary allowance. Despite these promising correlations, cause and effect has yet to be definitively demonstrated. “So far it has been hard to replicate these epidemiologic results in randomized controlled intervention studies, which are needed to establish a causal relationship,” van de Rest says. “Intervention studies to date show modest results, if any, and only in specific groups of mild cognitively impaired individuals, not in those who are still cognitively healthy.”

Research methodology may play a role in this discrepancy. “Some clinical studies that found no beneficial effects from omega-3 supplementation let participants in the control group eat up to three fish meals a week,” says Maggie Moon, MS, RDN, author of The MIND Diet: A Scientific Approach to Enhancing Brain Function and Helping Prevent Alzheimer’s and Dementia. “The amount of omega-3s in the fish would be enough to nullify any difference between the groups.” When it comes to brain health, avoiding saturated and trans fat may be as important as consuming polyunsaturated omega-3 fats. According to a 2014 review, laboratory, animal, and prospective epidemiologic studies support the hypothesis that high intake of saturated or trans fatty acids increases the risk of dementia. Additionally, the Chicago Health and Aging Project found that the people in the upper quintile for saturated fat consumption had a two-fold increased risk of Alzheimer’s disease compared with those in the lowest quintile. Not all studies are in agreement, but Moon again points to methodology as a likely confounding factor. “When you’ve got good methodology and control for the type of fat, the relationship between saturated fat and cognitive decline is clear,” Moon says. “They rise together.”

Lutein

Lutein is another nutrient found to aid in brain health and preserve memory. This nutrient is a yellow-pigmented carotenoid found in egg yolk, avocado, and dark leafy greens such as spinach and kale. Elizabeth Johnson, PhD, an antioxidant researcher with the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, has been involved in extensive research on lutein. “Lutein is selectively taken up into the macula of the retina, where it’s believed to be important for eye health,” Johnson says. “To get to the retina, it needs to cross the blood-brain barrier.” Research by Johnson and her colleagues found that lutein is the major carotenoid in the brain, and that brain tissue levels of lutein are related to cognition, including memory.

In a small, double-blinded placebo-controlled randomized trial, researchers gave supplements containing 10 mg lutein plus 2 mg zeaxanthin (another carotenoid found in the retina) per day to healthy older adults for 12 months and found improved cognitive function in the study population compared with the placebo group. “That’s the amount of lutein found in about 2 oz of cooked spinach,” Johnson says. “Unfortunately, the average American consumes only around 1 to 2 mg of lutein per day.” Notably, one study showed that even greater improvements in cognitive function were found when lutein was paired with the omega-3 fatty acid DHA. “No nutrient works in isolation,” Johnson says. “This study demonstrates that lutein and DHA are working together, and that’s how food works. When we promote better food selection, we promote better health.”

Vitamins

Epidemiological studies show that consumption of adequate vitamins and minerals (dietary or supplemental) are associated with lower risk of developing cognitive deficits. The B vitamins and vitamins E, C, and D specifically have been identified as playing important roles in maintaining normal brain function. Several of these vitamins, such as thiamine and vitamin E are constituents of neuronal membranes, and others, including B6, B12, and vitamin C, are implicated in tasks such as the synthesis and functioning of neurotransmitters. Members of the B vitamin family and vitamin C also are essential to energy production in the brain. The antioxidant power of vitamins C and E also may be important for reducing oxidation in the brain. Given their importance in neuronal function, these micronutrients have been studied as a way to help neurons cope with aging, with particular emphasis on vitamin E and the B vitamins.

Vitamin E

The antioxidant vitamin E is found in whole grains, nuts, seeds, dark-colored fruits, such as blueberries and blackberries, avocados, dark leafy greens, bell peppers, and vegetable oils. “Results of the research on vitamin E and the brain have been conflicting,” Moon says, “but controlling for initial serum levels of the vitamin clears up the discrepancy. A lot of the data on supplementation did not take into account baseline blood levels. People who start at a deficit do see improvement in brain-related symptoms and cognitive ability. For those already at an adequate level, adding more isn’t going to help.”

A study published in JAMA in 2014 found that, among patients with mild to moderate Alzheimer’s disease, those whose diets were supplemented with 2,000 IU per day of the vitamin E form α-tocopherol showed slower functional decline compared with the placebo group. Unfortunately, taking more than 1,000 IU of vitamin E supplements per day may be unsafe, particularly for people with CVD. Vitamin E supplementation is especially risky for those on blood thinners, and it also may increase prostate cancer risk. “There has been controversy around vitamin E supplements but never around vitamin E-rich food intake,” Moon says. Fortunately, it shouldn’t be difficult to get enough vitamin E from food, and doing so may provide additional benefits. “Food sources provide a mix of all eight forms of vitamin E, while supplements have just one or two,” Moon says. “Nutrients act synergistically in the body, and although we don’t know how the different forms of vitamin E interrelate, getting all eight forms in their natural concentrations is the best bet.”

B Vitamins

Although supplementation with B vitamins has not been shown unequivocally to improve brain function or symptoms of memory loss, the important role these vitamins play in the brain raises some interesting possibilities. For example, deficiency in vitamin B12, found exclusively in animal products, is known to lead to dementialike symptoms, which can be reversed by raising B12 levels. Low levels of both B12 and folate together have been associated with a significantly increased risk of Alzheimer’s disease. One possible link between these vitamins and dementia is their role in the metabolism of the amino acid homocysteine. Clinical research shows that people with cognitive impairment have significantly higher plasma levels of homocysteine, and insufficient levels of B6, B12, folate, thiamine, and riboflavin are implicated in high homocysteine levels and cognitive deficits.

Many studies on the role of B vitamins in brain health to date are inconclusive and conflicting, but numerous methodological issues come into play. “Some studies aren’t very sensitive or fail to take into account baseline levels of the vitamin,” Moon says. It may be necessary to consider how nutrients work together rather than studying them in isolation. Recent preliminary research, for example, suggests that B vitamin treatment is effective in slowing cognitive decline only when omega-3 fatty acid levels are normal. “You can’t fix something that’s not broken,” Moon says. “If someone has low vitamin status, raising those levels through diet or supplementation could be beneficial.”

Polyphenols

Many bioactive compounds found in plants have been examined for their role in brain health. The class of compounds known as polyphenols, in particular, is associated in population-based studies with better performance in cognitive abilities and lower risk of cognitive decline in older persons. Found in fruits, vegetables, tea, wine, juices, and some herbs, polyphenols have antioxidant properties and may have other beneficial effects in the brain, including neuroprotective and anti-inflammatory actions. Much has been written about the positive effects of berries on brain health, largely due to their high concentration of polyphenol flavonoid compounds called anthocyanins. Research on other compounds from this class of phytochemicals also is yielding promising results.

Curcumin

The polyphenolic compound curcumin lends its yellow pigment to turmeric. Preclinical studies suggest curcumin has antioxidant, anti-inflammatory, and neuroprotective effects. “India has one of the lowest rates of Alzheimer’s disease,” McDaniel says. “The curcumin in their traditional curries has been shown to help reduce inflammation in the brain and reduce oxidative stress.” A large population-based study found that healthy elderly Asians who frequently consumed curcumin-rich curries scored significantly better on tests of cognitive function than those who ate curries infrequently. While a six-month, randomized placebo-controlled double-blinded clinical study of curcumin in persons with progressive cognitive decline and memory issues did not show improvements in brain function scores, another study that provided supplementation with 400 mg curcumin found both short- and long-term positive effects on memory and mood in healthy older adults. A 2017 review in the journal Neural Plasticity concludes that, while curcumin may benefit the brain and cognitive function during aging, no clinical trials to date provide conclusive evidence that long-term curcumin consumption is effective for prevention or treatment of cognitive decline with aging. The review authors point to limited bioavailability as a significant limitation in studies and interventions of this promising phytochemical.

Resveratrol

A polyphenolic compound found in grapes, wine, peanuts, and some berries, resveratrol has significant free radical scavenging capabilities. Animal studies have suggested that resveratrol might be beneficial for brain health, but few clinical trials have been completed. One small-scale, randomized placebo-controlled double-blinded trial that added concord grape juice to the diets of older adults with memory decline (but not dementia) for 12 weeks found significant improvement in a measure of verbal learning. A double-blinded placebo-controlled study in which researchers gave healthy older adults 200 mg resveratrol supplements daily with 230 mg quercetin for six months found improved memory performance. As with curcumin, low bioavailability is a major drawback to resveratrol, which is readily metabolized and eliminated.

Catechins

Also known as flavan-3-ol monomers, potent antioxidant and anti-inflammatory catechins constitute 30% to 42% of the solid weight of brewed green tea. They’re also found in white, oolong, black, and Pu-erh tea, which all come from the leaves of the same plant. Various epidemiologic studies (which don’t prove cause and effect) have associated long-term catechin intake with improved language and verbal memory and lower risk of cognitive impairment and decline. A small interventional study in healthy volunteers found an increase in brain activity on functional MRI scans after consumption of green tea.

For RDN’s

Fear of losing cognitive function is very real for many people. “I see some clients who are more scared of losing cognitive ability than just about any other condition,” Moon says. “It helps to let them know how easy and practical a brain-healthy diet can be. There are no special foods to buy. A plan, such as the MIND diet is flexible; it doesn’t recommend a lot of red meat or butter or hard cheeses, but there is room for them. Just eat them less often.” Moon works with clients who have favorite recipes and are looking for small ways to make them a little bit more healthful. “Use olive oil in place of butter; swap out refined grains for whole grains, or do a 50:50 mix, like adding barley or farro to a pearl couscous dish,” Moon says. Emphasizing richly colored fruits and vegetables and cooking with herbs and spices can boost vitamin and phytochemical intake. “Our goal is to recommend these dark colored fruits and vegetables since these are naturally rich in phytochemicals that reduce oxidative stress and protect the brain from inflammation,” McDaniel says. “I also tell my clients to keep their spices visible and easily accessible and to add them to food on a regular basis. Herbs and spices make foods flavorful and add beneficial phytochemicals like curcumin to the diet. I personally add a little turmeric to my morning green smoothie.”

The final word on nutrients and brain health is evolving. “It can be tempting to get caught up in research about one particular brain-boosting nutrient or food,” McDaniel says. “But it’s the consumption of a variety of brain-boosting foods, or dietary patterns, that makes a real difference. The good news is, we’re already providing dietary advice for preserving brain health when we counsel our clients on ways to promote heart health.” Moon agrees: “There’s enough research to suggest that dietary patterns like the MIND diet may be of benefit to brain health, but, regardless, we know it will be heart healthy and good for general health,” Moon says. “There’s not a lot of risk, and there’s potential for benefit.”

Adapted from: Judith C. Thalheimer, RD, LDN

Nutrition Tip of the Day

Indulge without bulge! Comfort foods in the right amounts and at the right times will provide what you’re looking for – comfort. Excessive amounts; however, could lead to discomfort and unnecessary weight gain. Avoid portion distortion.

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The Connection between Leaky Gut, Gluten Intolerance, and Gallbladder Problems

As Hippocrates once said, “All disease begins in the gut.” Researchers have indeed found that many diseases are linked to changes in gut microbes or gut function.

 

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Do you have trouble digesting fatty foods? Back pain or nausea? A sluggish gallbladder may be to blame. Recent evidence suggests that inflammation in the gut is closely related to gallbladder function, but how about the gut-biliary connection, gluten, and all those things flowing, and how are they involved and how do they connect? Well, let’s check it out!

Meet your biliary tract

The biliary tract, or biliary system, refers to the liver, gallbladder, and bile ducts, which work together to make, store, and secrete bile. After production in the liver, bile travels via the common bile duct to the gallbladder for storage. When dietary fats enter the small intestine, they are sensed by enteroendocrine cells, which release the hormone cholecystokinin. Cholecystokinin, in turn, stimulates contraction of the gallbladder and the release of bile into the small intestine.

Try placing a single drop of oil in the center of a glass of water. The oil remains in one spot and doesn’t reach the edge of the glass, right? Add some dish soap, however, and the detergent encapsulates the oil, forming an emulsion and making the oil drop soluble in water. This is exactly how bile works in your small intestine.

Bile is made up of 97 percent water, with the remaining 3 percent consisting of a mixture of bile acids, cholesterol, phospholipids, bilirubin, inorganic salts, and trace minerals. Bile acids act like a detergent, helping to emulsify lipids in food. A lipid droplet from food does not mix well with the rest of the contents of the intestinal lumen. For the droplet (oil) to be absorbed, it must first be encapsulated by bile acids (detergent) to form a micelle. This micelle is then soluble in the luminal contents (water) and able to diffuse from the center of the lumen to the intestinal epithelium (edge of the glass) for absorption. Without bile, these lipids go undigested, resulting in fatty stools, a condition called steatorrhea. Bile is also crucial for proper absorption of cholesterol and the fat-soluble vitamins A, D, E, and K, all of which are transported to the epithelium in micelles.

(All too) common gallbladder diseases

Gallbladder disease symptoms can be steady or occur in acute episodes. Though symptoms will vary slightly depending on the exact disease, pain is usually located in the upper abdomen and may be accompanied by features such as jaundice ( a yellowing of the skin), nocturnal onset, nausea, vomiting, and radiation of pain through to the back and neck. The most common gallbladder diseases are:

Cholestasis: The backup of bile flow in the liver or in the biliary ducts.

Gallstones: Stones formed in the gallbladder from the components of bile. About 20 to 25 million Americans (10 to 15 percent of the adult population) are affected by gallstones. Gallstone disease is the leading cause for hospital admissions related to GI problems, yet over 80 percent of individuals with gallstones never experience biliary pain or more serious complications.

Cholesystitis: A complication of prolonged cholestasis and gallstone disease characterized by inflammation of the gallbladder tissue due to cholestasis and lack of blood flow. About 6 to 11 percent of patients with gallstones develop cholecystitis.

Cholangitis: A serious infection of the bile ducts that sometimes occurs as a complication of cholestasis or gallstones, when the flow of bile is blocked. The infection can also spread to the liver, so quick diagnosis and treatment are very important.

Gallstone pancreatitis: In rare cases, a blockage of the pancreatic bile duct by a gallstone can cause inflammation of the pancreas. This occurs at the sphincter of Oddi, a small round muscle located where the bile duct opens into the small intestine. Similar to cholangitis, this is a dangerous condition, and prompt treatment is crucial.

Risk factors for gallbladder disease

Those who are overweight, female, and over the age of 40 have an increased risk of gallbladder disease. In fact, females are almost twice as likely to develop gallstones, and 25 percent of those who are morbidly obese have gallstones. Underlying diseases such as inflammatory bowel disease, liver disease, and cystic fibrosis, as well as a number of prescription medications, can contribute to gallbladder disease.  Pregnancy, oral contraceptives, and antibiotic use have all been associated with the onset of cholestasis.

Lifestyle factors also play a role. Reduced physical activity is associated with a higher risk for gallbladder surgery. Gallstones have also been associated with a Western-type diet high in processed foods and sugar. Curious about the role that gluten might play in gallbladder disease? Well, see below!

Leaky gut affects the biliary system

When intestinal barrier function is compromised, also known as “leaky gut”, gut bacteria that are normally confined to the intestinal lumen can cross the gut barrier and enter the bloodstream. The immune system sees these microbes and their microbial products as foreign invaders, and quickly launches an immune response. This can affect the biliary system, as the resulting inflammatory signaling from such a microbial invasion has been shown to alter the gene expression and function of key transport systems involved in bile uptake and secretion in the liver.

The connection between microbes and biliary function has been known since early 1901. In his classic textbook, The Principles and Practice of Medicine, Sir William Osler reports that pneumonia can lead to jaundice: In this form there is no obstruction in the bile-passages, but the jaundice is associated with toxic states of the blood, dependent upon various poisons which either act directly on the blood itself, or in some cases on the liver-cells as wellWe now know that these “toxic states of the blood” are due to the presence of microbes in the bloodstream (sepsis) and that the “various poisons” Osler describes are inflammatory signaling molecules called cytokines, which affect transporters on liver cells.

The takeaway:

Healthy gut → microbes remain in the colon → proper gallbladder function

Leaky gut → microbes leak into the blood → gallbladder dysfunction and disease

Bile helps maintain gut barrier function

Like many interorgan networks, the gut–biliary connection is a two-way street. As mentioned earlier, leaky gut and microbes entering the blood can lead to gallbladder disease and a backup of bile. However, a lack of bile entering the intestine can itself cause leaky gut and an alteration in gut bacteria. How do we know this?

Researchers found that when they induced acute liver injury in animals, they rapidly showed evidence of increased intestinal permeability. Notably, these changes in the gut barrier preceded any changes in the gut microbiome. Another research group using a mouse model of cholestasis found that stimulating certain receptors in the gut with bile acids resulted in less gut inflammation and improved gut barrier function. This may occur by stimulating host production of antimicrobial properties at the intestinal barrier.

The takeaway:

Healthy gallbladder → bile acids reducing inflammation → proper gut barrier function

Gallbladder disease → less bile entering the small intestine → leaky gut & dysbiosis

The gluten connection: leaky gut, leaky bile duct?

Gliadin, a protein in gluten, can increase the production of zonulin, a toxin that breaks down the tight junctions between epithelial cells in the gut. This causes gaps between intestinal epithelial cells and allows microbes and dietary proteins from the gut lumen to “leak” into the bloodstream. Hepatocytes (liver cells) and cholangiocytes (the cells that line the bile duct) are also connected by tight junctions, forming a selectively permeable barrier between the blood and the biliary system. Research has shown that zonulin is associated with the tight junctions in virtually all mammalian epithelia. In other words, if gliadin compromises the intestinal barrier and gets into the bloodstream, it can also wreak havoc on other epithelial barriers, including the blood–biliary barrier.

Sure enough, research has linked gluten intolerance and celiac disease to increased prevalence of gallstones and biliary cirrhosis. There is also a high prevalence of celiac disease in patients with autoimmune hepatitis. One study found that 42 percent of adults with celiac disease had abnormal levels of liver enzymes. Adherence to a gluten-free diet for one to 10 years normalized liver enzyme levels in 95 percent of these patients.

Intestinal villi, the fingerlike projections on epithelial cells responsible for nutrient absorption in the small intestine, are typically shortened and damaged in celiac disease. This may impair the sensing of incoming dietary fatty acids by enteroendocrine cells, resulting in reduced release of cholecystokinin and insufficient contraction of the gallbladder. Studies have shown that this too can be reversed with a gluten-free diet.

Cholecystectomy

Cholecystectomy, the complete removal of the gallbladder, may be unavoidable in some people with late-stage gallbladder disease. In this procedure, the biliary tract is rerouted, so that bile flows directly from the liver to the small intestine via the common bile duct. Gallbladder removal should be avoided whenever possible, as it has several unintended consequences and significantly alters physiology. Even in the absence of the gallbladder, the liver continues to produce bile.

Without a storage organ, intrahepatic cholestasis, the accumulation of bile in the liver, may occur. Altered bile secretion into the small intestine has also been shown to affect gut microbes and gut function. Additionally, even if a patient has undergone cholecystectomy, he or she may still continue to produce gallstones in the liver or bile ducts if the underlying pathophysiology has not been addressed.

Treating gallbladder disease: the functional way

There really is no conventional treatment available for gallbladder disease other than invasive surgery. Conventional medicine usually only advocates a low-fat diet. While this may alleviate symptoms over the short term, long-term reduction of fat intake only prevents the stimulation of gallbladder contraction by cholecystokinin. This can lead to more sluggishness and an increased risk of gallstones, which is what we are trying to avoid in the first place.

In contrast, a high-fat diet has been shown to protect against gallstone formation, especially during weight loss. On the other extreme, many natural health websites are promoting gallbladder flushes. However, research is limited on flushes as a treatment recommendation so it may be better to look more at addressing the underlying cause (a goal of functional and integrative nutrition/medicine). Recommendations for approaching a gallstone issue include:

Get tested: Markers of impaired gallbladder function include high ALT, AST, bilirubin, LDH, GGT, ALP, and 5ʹ-nucleotidase. Relative levels of these markers can also help narrow down which gallbladder disease you are dealing with.

Change your diet: Many people resolve their gallbladder issues simply by changing their dietary habits. Removing inflammatory foods, such as gluten, processed foods, and sugar can substantially improve gallbladder health.

Heal the gut: While it’s a bit of a chicken-or-the-egg situation as to which comes first, leaky gut and biliary disease certainly go hand in hand. It’s important to address both simultaneously in order to break the cycle of gut inflammation → biliary stasis → lack of bile → more gut inflammation.

Stimulate bile flow: Bitters, such as curcumin, dandelion, milk thistle, and ginger are well known for their ability to stimulate bile flow. These can be taken as supplements, included in meals, or consumed as tea.

Dissolve gallstones: Beet root, taurine, phosphatidylcholine, lemon, peppermint, and vitamin C have all been shown to reduce the impact and even dissolve gallstones.

Consider supplementing with bile: If you’re having trouble with fat digestion, you can also consider supplementing with bile itself from a bovine or ox source until your bile flow is restored.

Adapted from: Chris Kresser 

Research articles and references highlighted in blue

Nutrition Tip of the Day

Be good to your gut! Include Greek yogurt, sauerkraut, kefir or foods high in fiber in your diet.

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Some Like It Hot! Spicy Food Is Insanely Good for You

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There are few things in the food world that evoke stronger opinions than spice. Do you go for the mild salsa, the medium, or the three-alarm hot version? Fortunately for people who do love spice (and not just the fiery spice from capsaicin found in chili peppers), science is in your favor. Spices, such as cinnamon, turmeric, garlic, ginger, and cumin, as well as chili, host many health benefits.

If you’re an agnostic or simply don’t like the heat, here are five compelling reasons to reconsider adding a little spice to your day.

1. Spicy food has longevity benefits

Eating spicy food six or seven days a week, even just once a day, lowered mortality rates by 14 percent, according to a large 2015 study by Harvard and China National Center for Disease Control and Prevention. (Sadly, the benefits are even larger if you skip the margarita or Corona with your spicy taco.)

2. Spicy food speeds up your metabolism

Data across numerous studies indicates that certain spices, such as cumin, cinnamon, turmeric, peppers, and chilies, can raise your metabolic resting rate and slow down your appetite. One study also found that turmeric suppressed fat tissue growth in mice. The effect is mild, so putting cinnamon on your roll probably isn’t going to aid in weight loss. However, if you’ve reached a plateau in your weight loss journey, spicing it up may be just the thing to try. Although cinnamon is not really spicy (regarding taste), the health benefits are there!

3. Spices combat inflammation

Curcumin, a compound in turmeric, may reduce inflammation in the body. In Ayurvedic medicine, the anti-inflammatory properties of ginger and garlic have been used for centuries to treat a range of conditions, such as arthritis, autoimmune disorders, and even headaches and nausea.

Spices may even help fight cancer cells…Caution Note!

Capsaicin, an active component of chili peppers, has been shown to slow and destroy cancer cells. A UCLA study found that capsaicin inhibited the growth of prostate cancer cells in mice while leaving healthy cells unharmed.

Caution! Capsaicin, the fiery substance found in chili peppers, can elicit intense short-term symptoms, such as stomach pain, diarrhea, and vomiting in those who consume extreme amounts. This occurs due to overstimulation of the nervous system. The good news is no permanent damage is done to the intestinal lining. Though it was previously believed that spicy foods could lead to ulcers, current evidence now confirms that capsaicin provides protection against the ulcer pathogen, H. pylori. Capsaicin also acts as a pain reliever when applied topically or ingested. That said, if you’re new to eating spicy foods, increase your intake slowly to minimize undesirable symptoms.

5. Spices help kill bacteria

Cumin and turmeric have been shown to have powerful antioxidant and antimicrobial properties. This means they can be used against harmful bacteria in the body.

Bottom line

No matter your preference, sweet or savory, spices can be incorporated into any diet. The result is a satisfying and healthy addition. They can even increase two feel-good chemicals in the body, endorphins and dopamine. This may also explain that spicy food craving you can’t seem to kick. Spices can also help you cut down on the amount of unhealthy fats and sweets that are too easily added as a quick fix for taste.

In short, ditch the sugar and add some spice to improve and extend your lifestyle and culinary horizons.

Adapted from: Lindsey Dodge Gudritz

Nutrition Tip of the Day

Eat when you eat! Try not to do simultaneous activities such as typing, watching TV or driving when you eat. You’ll appreciate each bite even more.

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Can Carb Cycling Help You Lose Weight?

Carb cycling for weight loss is gaining popularity; however, there may be a healthier way to reap the same benefits! 

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You’ve heard plenty of mixed reviews for low-carb diets, but what about carb cycling? The trendpopular with body builders and some athletesis generating buzz as a weight loss method. Here’s the lowdown on how carb cycling works; its potential benefits; and a more simple, less strict alternative.

What is carb cycling, exactly?

While there isn’t one standard protocol, carb cycling typically involves alternating lower-carb days with higher-carb days. Typically fat intake increases on lower-carb days, and decreases on higher-carb days; while protein intake remains consistent. Many advocates recommend this regimen: On days when you do strength training, consume a higher amount of carbs (say 200 grams), a low amount of fat, and a moderate amount of protein. On days when you do a cardio workout, eat a moderate amount of carbs (about 100 grams), protein, and fat. On rest days, eat fewer carbs (30 grams), a higher amount of fat, and a moderate amount of protein.

Another approach involves keeping both protein intake and fat intake fairly consistent, and modifying only your carbohydrates. With this method, lower-carb days are also lower-calorie days.

What are the benefits?

Proponents of carb cycling claim that the eating pattern helps increase muscle mass, decrease body fat, and improve fitness performance. However, research on the diet is limited. One 2013 study, published in the British Journal of Nutrition, looked at the effects of intermittent carb and calorie restriction in 115 overweight women aged 20 to 69, all of whom had a family history of breast cancer. The women were randomly assigned to one of three groups for three months. The first group consumed a calorie-restricted, low-carb diet two days per week. The women in the second group followed the same diet, but were allowed to eat unlimited amounts of protein and healthy fats (such as lean meat, olives, and nuts) on the low-carb days. The third group followed a standard, calorie-restricted Mediterranean diet seven days a week.

Researchers found that the women in both low-carb groups had better results: They lost roughly 9 pounds on average, compared to about 5 pounds in the Mediterranean group. Insulin resistance also decreased by 22% percent among the standard low-carb dieters; and 14% percent among those allowed extra protein and fat on low-carb dayscompared to just 4% among the Mediterranean dieters. (The results were particularly significant for the study participants, as losing weight and lowering insulin resistance may help prevent breast cancer.) While this study didn’t involve the same carb cycling approach used by body builders and athletes, it does offer some insight into the potential benefits of limiting carbs part-time, but is doing so practical? Slashing carbs, even a few days a week, needs to be sustainable in order to generate lasting results.

The authors of that 2013 study also found that a higher percentage of women on the low-carb diets experienced constipation, headaches, bad breath, light-headedness, and food fixation. These unpleasant side effects parallel with many who severely restrict their carb intake. The side effects also result in many low-carb dieters, giving up the diet or wind up binging on forbidden foods.

Is there a more sustainable approach?

One of the main philosophies behind carb cycling is limiting carbs when the body doesn’t need them as much. In a nutshell, carbs serve as fuel (like gasoline in your car) to help cells perform their jobs. Eating a large amount of carbs on days when you’re not very active doesn’t make much sense, because your body requires less fuel (much like how your car needs less gas for a ride across town compared to a road trip). Carbs that are not burned for fuel create a surpluswhich can prevent weight loss, or lead to weight gain.

On the flip side, a carb limit of 30 grams is very low, even on less active days. That’s the amount of carbs in one cup of broccoli, one whole apple, and five baby carrots. For a better balance, practice “carb matching, “or aligning your carb intake with your energy needs, which may vary from day to day, or morning to afternoon. This approach essentially involves eating larger portions of clean, whole food carbs to support more active hours; and curbing carbs when you expect you’ll be less active. For example, if you’re planning to do a morning workout, have oatmeal topped with a sliced banana for breakfast beforehand. However, if you’re headed to the office to sit at a desk for several hours, a veggie and avocado omelet with a side of berries would be a more appropriate a.m. meal.

Carb matching helps with weight loss and improves fitness performance, while supporting all-day energy and a wide range of nutrients, so it makes sense. Many pro athlete, who train or perform several hours a day, require more carbs than “office” athletes, who may fit in a morning workout, then sit in meetings the remainder of the day. Carb matching also involves aligning your carb needs with your age, height, ideal weight, sex, and occupation. After all, a young, tall man with an active job and an ideal weight of 185 pounds is going to have a higher carb requirement than an older, petite woman with a sedentary job and an ideal weight of 135 pounds.

While carb cycling involves drastic shifts, carb matching is all about creating balance; not too little, and not too much. If you’ve tried carb cycling, and it either hasn’t worked for you, or doesn’t seem like a strategy you can stick with, try moderating your carb intake based on your activity level instead. Regardless of which approach you try, stick with these two important rules of thumb:

1) Always make quality a priority by choosing fresh, whole foods. (And remember not all carbs are created equal.)

2) Listen to your body! It’s cues are pretty good at guiding you toward a “just right” balance.

Adapted from: Cynthia Sass, MPH, RD

Nutrition Tip of the Day

Shake the salting habit! Replace salt with lemon, herbs and spices.

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Banana Zucchini Chocolate Chip Muffins (Vegan)

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YIELD: About 11 medium/large muffin

PREP TIME: 10 minutes

COOK TIME: About 18 minutes, note reduction in oven temp after 10 minutes

TOTAL TIME: About 40 minutes + cooling

Baking with zucchini keeps everything so soft, moist, and you can’t taste it. The muffins taste like banana bread……though not like my mama’s! The one-bowl, no-mixer muffins are vegan and healthy. No butter, no eggs, the chocolate chips are solely sprinkled on top, and they’re made with coconut oil. It adds a nearly imperceptible undertone that’s sweeter and more fragrant than canola or vegetable oils, but substitute if you’d like. Between the softening powers of coconut oil, the creamy bananas that add tenderness, and the moisture-enhancing powers of zucchini, these are some of the softest and moistest muffins. The continue to get softer as the days pass, and the flavors marry tougher and tasted better the second day. You’ll never complain about eating your veggies after these muffins!

INGREDIENTS: 

3/4 cup granulated sugar

1/3 cup coconut oil, melted (or substitute with vegetable or canola)

1/4 cup light brown sugar, packed

2 tablespoons unsweetened vanilla almond milk (or substitute with coconut, soy, rice, cow’s)

2 teaspoons vanilla extract

1 teaspoon cinnamon

1 cup ripe mashed bananas (about 2 small/medium naners)

1 1/4 cups shredded zucchini, measured loosely laid in cup (not packed in or squeezed; about 1 medium zucchini, to peel is up to you)

1 1/2 cups all-purpose flour

1 tablespoon baking powder

pinch of salt, optional and to taste

About 11 teaspoons mini semi-sweet chocolate chips divided, about 1 teaspoon for each muffin (regular sized chips can also be used)

DIRECTIONS:

  1. Preheat oven to 400F. Spray a non-stick 12-cup regular muffin pan very well with floured cooking spray or grease and flour the pan; set aside (use liners if you choose).
  2. To a large bowl, add the first 6 ingredients, through cinnamon, and whisk to combine.
  3. Add the bananas and whisk to combine.
  4. Before adding the zucchini, put it in a paper tower and squeeze tightly for about 10 seconds to remove moisture. After squeezing, you should have about 3/4 cup of compacted shreds. Add zucchini to bowl and stir to incorporate.
  5. Add the flour, baking powder, optional salt and stir until just combined; don’t overmix.
  6. Using a large cookie scoop, 1/4 cup measure or spoon, turn batter out into prepared pan, noting that the recipe yields 11 muffins. Adjust accordingly to your size muffin pans. Each cavity should about 3/4 full; do not overflow.
  7. Sprinkle the top of each muffin generously with chocolate chips, about 1 teaspoon each.
  8. Bake at 400F for 10 minutes, reduce oven temp to 350F and bake for 8 minutes, or until muffins are set, domed, golden, and a toothpick comes out clean or with a few moist crumbs, but no batter. Allow muffins to cool in pan for about 10 to 15 minutes, or until they’ve firmed up and are cool enough to handle. It’s normal for muffin tops to flatten as they cool. Muffins will keep airtight at room temperature for up to 1 week, or in the freezer for up to 6 months. They also tend to soften over time and taste better on days 2-3 after the flavors married.

Adapted from: Averie Cooks

Nutrition Tip of the Day

Cook with your kids! Don’t think of this interaction as cooking lessons. Rather, realize that teaching your kids to put together a meal is a lesson they can use for the rest of their lives.

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