Individualized IBS diets reduce symptoms better than placebo

Individualized elimination diets guided by leukocyte activation tests reduced symptoms of irritable bowel syndrome (IBS) better than a sham diet in a randomized controlled trial.

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Researchers concluded that this dietary strategy may enable patients with IBS to alleviate their symptoms with fewer food restrictions than those required by the low FODMAP diet, which could improve long-term adherence. “We didn’t expect results like this,” Ather Ali, ND, MPH, MHS, assistant professor of pediatrics and of medicine at Yale School of Medicine, said in a press release. “The people who consumed the diet consistent with the test did significantly better than people on the sham diet.” In a parallel-group, double-blind trial, Ali and colleagues analyzed blood samples from 58 adults with IBS (mostly white women) using a leukocyte activation test to measure immune response to individual foods. Then they randomly assigned participants to adhere to a diet restricting meals consistent with the test results, or to a sham diet restricting foods inconsistent with the test results, for 4 weeks.

An average of 13 foods was eliminated among all participants out of a possible 200 that were tested, the most common of which included strawberries and cinnamon (low FODMAP foods) followed by almonds, apples, onions and pears (high FODMAP foods). Additionally, overall diet adherence rates were statistically comparable, and patients reported no adverse effects related to the intervention. Patients on the individualized diet showed significantly more significant increases in IBS Global Improvement Scale (GIS) scores compared with those on the sham diet, which served as the primary endpoint. At 4 weeks, the mean difference in scores between groups was 0.86 (95% CI, 0.05-1.67), and at 8 weeks it was 1.22 (95% CI, 0.22-2.22).

Both groups showed significant improvements in IBS Symptom Severity Scale scores, but those on the individualized diet showed significantly higher reductions relative to the sham diet. At 4 weeks, the mean difference in score change from baseline between groups was –61.78 (95% CI, –4.43 to –119.14), and at 8 weeks it was –66.42 (95% CI, –5.75 to –127.09). Both groups experienced statistically comparable changes in mean IBS Adequate Relief and quality of life scores. Further analysis of plasma samples from strong responders showed that reduced levels of a single protein (neutrophil elastase) were associated with reduced symptoms.

The investigators concluded that this study provides novel data supporting the strategy of using leukocyte activation testing to develop individualized diets for IBS. “If these intriguing results can be replicated in larger and more diverse samples they can provide insight into another way to treat a condition that can often be very frustrating,” Ali said in the press release. “It can be debilitating, and patients are often looking for dietary approaches to it.” – by Adam Leitenberger

Adapted fromAli AWeiss TRMcKee D, et al. Efficacy of individualized diets in patients with irritable bowel syndrome: a randomized controlled trial. 

Daily Nutrition Nugget

Eating healthy on a budget can seem difficult…But it can be done! Many fruits, vegetables, and legumes (beans and peas) cost less than $1 per serving.

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Sometimes in life we just need a hug ... no words, no advice, just a hug to make you feel you matter.

 

 

Top 5 Detox Foods

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Even the most health-conscious among us can go a little crazy on snacks and drinks during the holidays and at springtime and during the summer months, and before we know it, we are back at the holidays. Really, where does the time go? If we are having fun with people we love and care about, then that may also be another reason for indulging in our favorite snacks and drinks. So, when is it not a perfect reason or season to fall victim of the snack trap?

Thankfully, you can kind of have your cake and eat it, too. It’s OK to indulge a little in the foods you love, as long as you know how to get your body back on track. One of the best ways to help your body feel like it’s working at an optimal level is to support the bodies natural detoxification. Your organs are already incredibly well-suited for detoxing things, such as heavy metals, pathogens, and other deleterious compounds from its system. However, sometimes, especially when it’s overloaded and working overtime, your body can use a little bit of detox support.

Eating these foods regularly will help you feel energized and clear-minded. You’ll also notice that side effects of chronic inflammation caused by toxins will disappear. For many people, common side effects are bloating, indigestion, and weight gain, so in a sense, these are “flat tummy” foods, too!

  1. Beets: The root veggie is available year round, but be sure to grab a few at the farmers market before your next summer cookout. Beets support healthy liver function and help it filter out toxins all thanks to something called betaine. This compound, unique to raw beetroot, encourages the liver to cleanse itself and promotes healthy bile production. Try wrapping beets in foil and throwing them on the grill next time you BBQ!
  2. Grapefruit: Juicy, sweet, and tart, grapefruits are good to keep on hand the morning after a heavy meal. The antioxidants in the citrus fruit protect cells from free radical damage. Grapefruit is also very high in fiber, which acts like a broom for your digestive system, sweeping out the gut and intestines until everything is clean and good as new.
  3. Dandelion Root Iced Tea: Not exactly something you can snack on, but still an excellent detoxifying ingredient to have in your pantry! Dandelion Root promotes the production of bile in the liver. In other words, it helps your liver break down and cleanse your internal organs. Make a big batch and sip on this stuff the morning after a night out.
  4. Asparagus: According to the Journal of Food Science, the amino acids and minerals found in asparagus protect liver cells. Because so much of detoxification happens in the liver, it’s important to support this critical organ however possible.
  5. Avocado: Next time you’re feeling a little woozy after one too many skinny margaritas, whip up some avocado toast. A study published in The Journal of Agricultural Food Chemistry found that of all fruits, avocado has the most liver-friendly benefits. It’s even able to reverse liver cell damage!

Daily Nutrition Nugget

Be an advocate for healthier kids! Insist on good food choices at school and childcare centers. Contact public officials and make your voice heard.

Daily Inspirational Nugget

Life is so ironic. It takes sadness to know happiness, noise to appreciate silence, and absence to value presence.

 

Like it or not: Broccoli may be good for the gut

For the broccoli haters of the world, researchers may have more bad news: the vegetable may also help promote a healthy gut.

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In a study, when mice ate broccoli with their regular diet, they were better able to tolerate digestive issues similar to symptoms of leaky gut and colitis than mice that were not placed on a broccoli-supplemented diet, according to Gary Perdew, the John T. and Paige S. Smith Professor in Agricultural Sciences, Penn State. He added that other vegetables, such as Brussels sprouts and cauliflower, may also have similar gut health properties. “There are a lot of reasons we want to explore helping with gastrointestinal health and one reason is if you have problems, like a leaky gut, and start to suffer inflammation, that may then lead to other conditions, like arthritis and heart disease,” said Perdew. “Keeping your gut healthy and making sure you have good barrier functions so you’re not getting this leaky effect would be really big.”

Good intestinal barrier function means that the gastrointestinal (GI) tract is helping protect the intestines from toxins and harmful microorganisms while allowing nutrients to pass into the system, he said. According to Perdew, the key to the process may be a receptor in the gut called Aryl hydrocarbon receptor, or AHR. The receptor helps the body regulate its reaction to certain environmental contaminants, as well as triggers other responses to toxin exposure. The researchers, who released their findings in the current issue of the Journal of Functional Foods, suggest that cruciferous vegetables, such as broccoli, brussels sprouts and cabbage contain an organic chemical compound called indole glucosinolates, which breaks down into other compounds, including indolocarbazole (ICZ) in the stomach.

When ICZ binds to and activates the Aryl hydrocarbon receptor (AHR) in the intestinal lining, it aids in maintaining a healthy balance in the gut flora and immune surveillance, and enhances host barrier function, according to the researchers. This may help prevent diseases, such as various cancers and Crohn’s Disease, caused by inflammation of the lining of the gut. According to Perdew, hyper-activating the AHR can cause toxicity, but using broccoli to activate the receptor locally, in the gut, rather than systemically might help avoid some of these problems. “Dioxin, for example, activates this receptor, and if you hyper-activate it with dioxin, it will cause toxicity,” said Perdew. “What we were interested in is: Could you locally activate the receptor naturally at a level that would cause only modest AHR activation in the gut, but not cause systemic activation, which could possibly lead to negative effects?”

The researchers used two genetic lines of mice in the study to focus on AHR. One line had a low ability to bind ICZ to AHR, while the other line had a high ability to bind ICZ to AHR. They added 15 percent broccoli to the diets of both groups of mice. After adding a substance that causes digestive problems, the researchers said that the mice with a higher ability to bind ICZ to the AHR were protected from a chemical that induced digestive problems, but the mice with the lower affinity suffered from the toxic insult.

For humans, the amount in the experiment would be equivalent to eating about 3.5 cups of broccoli each day, according to Perdew. “Now, three and a half cups is a lot, but it’s not a huge amount, really,” said Perdew. “We used a cultivar — or variety — with about half the amount of this chemical in it, and there are cultivars with twice as much. Also, brussels sprouts have three times as much, which would mean a cup of brussels sprouts could get us to the same level.”

Because people with certain digestive conditions like colitis, are often warned to avoid too much roughage in their diets, future research may include determining the best ways for people to consume broccoli, or other veggies with similar effects, to receive the same health benefits, without causing any other associated digestive problems from the fibrous vegetables.

Adapted from: Troy D. Hubbard, Iain A. Murray, Robert G. Nichols, Kaitlyn Cassel, Michael Podolsky, Guray Kuzu, Yuan Tian, Phillip Smith, Mary J. Kennett, Andrew D. Patterson, Gary H. Perdew. Dietary broccoli impacts microbial community structure and attenuates chemically induced colitis in mice in an Ah receptor dependent mannerJournal of Functional Foods, 2017; 37: 685 DOI: 10.1016/j.jff.2017.08.038

Nutrition Daily Nugget

Try a meatless meal each week. Think vegetable lasagna or a portabella mushroom burger! Vegetables and beans can add protein, fiber, and other nutrients to a meal.

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5 Smart Carb Swaps

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Eating fewer carbs does not mean giving up everything you love. A few easy changes can make a big difference in how much you consume. Instead of choosing carb sources loaded with sugar, fat, and calories, opt for more nutrient-dense alternatives filled with fiber, heart-healthy fats, and whole grains. You’ll be surprised at much you love the alternatives below and how delicious eating low-carb can be.

1. BBQ Baked Beans

GOOD: Beans are full of fiber.

BAD: Lots of sugar in the sauce—13g for a total of 32g carbs.

BETTER: Black beans with sautéed red bell pepper, jalapeño, lime, and fresh cilantro. 10g fewer carbs and an additional 1.5g fiber.

2. Salad Dressings

GOOD: You’re eating salad!

BAD: Dressing choices, such as honey mustard (one of my favorites!!) and raspberry vinaigrette contain roughly 7g refined carbs per 2 tablespoons, all from sugar. And most light or fat-free dressings add sugar to make up for fat.

BETTER: Opt for oil and vinegar-based dressings instead; you’ll get zero carbs and lots of heart-healthy fats.

3. Apples with Low-Fat Caramel Dip

GOOD: You’re eating apples—25g balanced carbs and 4g fiber.

BAD: That caramel sauce has 26g carbs in just 2 tablespoons, all from sugar.

BETTER: Swap caramel for 1 tablespoon peanut butter. You’ll add 4g filling protein.

4. Cracker Jacks

GOOD: Whole grains and nuts.

BAD: The caramel adds 30g refined-sugar carbs per cup.

BETTER: Lightly salted oil-popped popcorn and nuts.

5. Mashed Taters

GOOD: More veggies.

BAD: No skin = 2g less fiber.

BETTER: Mashed butternut squash has just 47 calories, 12g carbs, and 4g fiber per ½ cup. Add a teaspoon of butter for 34 calories and 2.4g sat fat.

Not bad alternatives! And if you want to take your health goals to the next step, check out the challenge.

Nutrition challenge: If half of your daily grain intake is not 100% whole grain, I challenge you to “up-your-ante!” If this is old news to you, then what challenge will you take on?

Adapted from: Sidney Fry, MS, RD

Nutrition Daily Nugget 🍏

Get your kids in the kitchen! They’ll be more excited about eating healthy foods when they’ve been involved. Give them age-appropriate tasks and keep a step-stool handy.

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7 Foods to Improve Eyesight

Our eyesight is among the conditions underestimated by many people. Usually, people take care of their eyesight only when they start experiencing some problems. However, this should not be the case!

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Our eyes are extremely important and they help us to see the everyday beauty that life offers us, so we should take constant care of them, doing everything in our power to protect them. The care related to our eyes is pretty complex, and our diet is one part that plays an important role in it. The food we consume can help us to protect our eyesight and to prevent numerous health issues related to it.

These are the best foods that can improve your eyesight:

1. Carrots

Carrots are the most beneficial food for the good condition of your eyes. They are abundant with vitamin A that can prevent night blindness and essential for the health of your eyes. Carrots can reduce the risk of macular degeneration and Cataracts due to their rich content of antioxidants, beta-carotene, lycopene, and lutein.

2. Salmon and sardines

To protect your eyesight, you should regularly consume fish. It is a great source of omega-3 fatty acids that can improve the health of your eyes. The regular consumption of omega-3 fatty acids can protect the tiny blood vessels in your eyes. Make sure to consume fish, such as salmon, sardines, or herring, twice a week.

3. Broccoli

It is a well-known fact that broccoli is extremely beneficial for our overall health. Broccoli can significantly improve the health of your eyes. It is rich in antioxidants and vitamins and can supply your body with the essential nutrients. By consuming broccoli, you will intake vitamins A, E, and C, all of which work together to protect your eyesight.

4. Spinach

This green plant contains carotenoids, such as beta-carotene, lutein, and zeaxanthin. Moreover, it is a great source of vitamins E and C which can prevent macular degeneration and night blindness.

5. Eggs

Maybe you will not believe it, but eggs can improve the health of your eyes. They contain vitamin A, vitamin B complex, essential fatty acids, and zinc. It doesn’t matter how you consume them as long as they are included in your diet, so make sure to regularly consume them for your breakfast….or whenever you like to eat eggs!

6. Almonds

Almonds are a great source of vitamin E which can slow down the development of problems that occur as a result of aging. Moreover, they can prevent cataracts.

7. Strawberries, blueberries, raspberries

These fresh and delicious fruits are abundant with antioxidants which are known to reduce the risk of many eye problems. They are also packed with vitamin C which can significantly protect the health of your eyes. Other foods recommended for improving your eyesight: Milk, avocados, lemons, oranges, dark chocolate, papaya, pumpkin, tomatoes, onions, cabbage, and apricots.

Our bodies depend on us to choose the right fuel sources!

Nutrition Tip of the Day

Enjoy fruit for dessert most days and limit traditional desserts to special occasions. Try a delicious smoothie, a mixed berry and yogurt parfait, or a baked spiced apple or pear!

Daily Inspiration 

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Gluten intolerance appears largely undiagnosed in Canada

Research on a large sample of Canadians suggests that most people with celiac disease don’t know they have it.

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Ahmed El-Sohemy, a professor of Nutritional Science at the University of Toronto, and his colleagues studied the bloodwork of almost 3,000 Canadians and found that one in 114 (or almost one per cent) had elevated antibodies that indicate they suffered from celiac disease, which causes gastric distress and other symptoms. However, the vast majority, almost 90%, were unaware they had the disease. The data was collected about a decade ago, just before public awareness about the potential problems with gluten skyrocketed. The study, published in the journal BMJ Open, is the first to screen for celiac antibodies in a Canadian population. It confirms previous research suggesting that Caucasians are more susceptible to celiac disease than other ethnocultural groups. Although the number of South and East Asians screened in the Canadian study was small, none were found to have the disease. Intriguingly, though, a genetic variant that puts people at high risk for celiac disease was almost as high in the South Asian samples as the Caucasian ones, suggesting that other factors could play a role in who goes on to develop the disease.

“This hopefully should just raise awareness that despite the gluten-free craze there are a lot of people who still don’t know they have celiac disease,” says El-Sohemy. “It’s important for people to understand that celiac disease is not a single clear symptom — it manifests itself in different ways. Symptoms could be fatigue, gastro-intestinal, or other problems. These symptoms are so diverse that doctors have a difficult time pinpointing the cause. Gluten intolerance is not usually the first thing that comes to their mind.”

Adding to the diagnostic confusion, reactions to gluten are not often immediate and acute, El-Sohemy says. “It’s not like lactose where you feel bad within a day after consuming it. Gluten causes damage to the intestinal lining, which results in malabsorption of vitamins and other nutrients, and the effects of those nutrient deficiencies are quite varied.” El-Sohemy believes people with a genetic susceptibility to celiac disease should consider blood tests to determine whether they have the disease if they present with any of the disease symptoms. His analysis of blood samples from Canadians of South Asian heritage suggests that genetic predisposition is only one piece of the celiac puzzle. Future research may focus on the timing of exposure to gluten as well as the role of gut bacteria.

As for why so many non-celiac sufferers feel better after giving up gluten, El-Sohemy speculates the real issue is “because they stopped eating heaping servings of pasta, white bread and other sources of processed carbohydrates.”

Adapted from: Joseph Jamnik, Christopher R Villa, Sirbarinder Bryn Dhir, David J A Jenkins, Ahmed El-Sohemy. Prevalence of positive coeliac disease serology and HLA risk genotypes in a multiethnic population of adults in Canada: a cross-sectional study. BMJ Open, 2017; 7 (10): bmjopen-2017-017678 DOI: 10.1136/bmjopen-2017-017678

Nutrition Tip of the Day

Let your heart be the guide when grocery shopping! Look for foods with the American Heart Association’s trusted Heart-Check mark to make smarter food choices.

Daily Inspiration 

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Guilt-Free Ice Cream Is Trending, but Is It Actually Healthy?

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In a perfect world, ice cream would have the same nutritional properties as broccoli. However, this isn’t a perfect world, and ice creams marketed as “zero guilt” or “healthy” aren’t exactly selling the right message. Alongside a $2 billion valuation, Halo Top’s been getting all of the consumer attention lately, outselling legends, such as Ben & Jerry’s this summer. It doesn’t hurt that Halo Top’s trendy packaging speaks to the eye. Clean lines, a touch of color, and unique, flashy tops egg on customers to add this yummy goodness to their grocery cart.

This brand, which didn’t exist before 2012, isn’t the only ice cream claiming to be healthy. Others, such as Arctic Freeze, Thrive, Wink, and Enlightened have slick marketing campaigns that target everyone from athletes to health nuts. Personally, I do not like the flavors of Artic Zero. I have tried three flavors and was completely dissatisifed with them all….I stopped purchasing after the third one. No one’s denying Halo Top’s rise to fame. However, we might want to question its validity, and that of other trendy ice creams, as a “health” food.

The biggest difference between real ice cream and ‘healthy’ ones

Halo Top and Enlightened both use real cows milk, while others, such as Arctic Zero and Wink must be labeled a “frozen dessert” because of its minimal dairy content. A product has to have a minimum of 10% dairy fat to be labeled ice cream, according to the U.S. Food and Drug Administration (FDA). Halo Top also contains the sugar alcohol erythritol and stevia. These sugar substitutes are considered “safe” options with minimal health impact when consumed in moderation (~50 grams/day). However, eating an entire carton of Halo Top as advertised means consuming 45 grams of sugar.

Other “healthy” frozen dessert brands contain alternative sweeteners, which have been shown to cause side effects, such as changes to gut bacteria, increased risk for cancer, obesity, diabetes, and an increase in sugar cravings. An Italian study conducted in 2005 revealed that aspartame, the most common artificial sweetener, resulted in diagnoses of lymphomas, leukemia, and tumors in rats.

Ice cream will never be a health food

According to Elizabeth Shaw, MS, RDN, CTL, a nutrition expert who’s worked with Arctic Zero and is developing recipes for Halo Top, the FDA is currently in the process of “redefining the legal definition surrounding the term healthy.” That means brands claiming to sell healthy products, when they’re actually filled with artificial ingredients, will be restricted. What does that mean for these frozen desserts or “healthy” low-calorie ice creams that are filled with artificial or highly processed ingredients? Many will have to re-image their marketing campaigns that focus on guilt-free, whole pint consumption because it’s “healthy.”

The side effects of eating healthy ice cream

These ice creams may be marketed as healthier, but if you went ahead and followed their guilt-free motto (because who stops eating at one serving?), your gut health might be in for a surprise.

1. Higher risk for obesity from alternative sweeteners

While Halo Top doesn’t have artificial sweeteners, many other brands that advertise themselves as “sugar-free” may. Ingredients, such as sucralose, aspartame, and acesulfame potassium may confuse the brain and cause people to eat more. They also eventually cause upset stomachs, nausea, and diarrhea. “These ingredients have demonstrated to exhibit undesirable effects on the gut microbiota and can cause stomach pain, loose bowels, or diarrhea in some individuals,” says Shaw.

On the other hand, alternative sweeteners aren’t free from the link to obesity, either. Research suggests that sweetener alternatives, including stevia, do little for weight loss. Another 2017 study looked at 264 college freshmen and found an association between erythritol and weight gain. Ultimately, frozen dessert brands that suggest a pint is the “ultimate single serve” aren’t really promoting a healthy lifestyle. They’re just promoting themselves.

2. Bloating, constipation, or diarrhea

Though not considered artificial, sugar substitutes, such as erythritol, an ingredient found in Halo Top and Enlightened, can cause nausea when in doses above 50 grams/day, since your body doesn’t carry the enzymes to break it down. Most erythritol eventually exits via urine. Most of these frozen desserts offer themselves as a “healthy” alternative to ice cream because of their high protein content. However, if you indulged in an entire pint, you’d be consuming 20 grams of fiber, which is more than half your daily fiber intake and more than likely, you are not deficient in protein. The result? A wildly upset stomach.

For many of these frozen desserts, labeling themselves different and a “perfectly guiltless pleasure” is due in part to its prebiotic fiber. Prebiotics are a dietary fiber that help produce nutrients for digestion. Vegetables, such as garlic, leeks, and onions are all naturally high in prebiotic fibers. Many of these frozen desserts promote their natural ingredients; among them are GMO-free fiber ingredients, such as chicory root or organic agave inulin.

The problem is that there’s no real health reason why prebiotic fibers are added to these treats. Instead, they’re added to maintain the creamy texture of ice cream, since erythritol has an inclination to form ice crystals. So, it’s not really that these additions are healthy, it’s just another platform these brands can use to market themselves. In the end, it’s better to get your fiber from whole foods rather than ice cream, anyway.

3. Cost on your wallet

With all these ingredient facts in mind, you might not actually be getting your scoop’s worth. “Healthy” ice creams cost about four to five times more than a Target-branded ice cream and contain far more artificial and processed ingredients. If you’re able to stick to portion size, buy traditional, natural ice cream, even the boutique stuff from your local creamery (for those who can tolerate dairy). They’re made with just a handful of ingredients and could be better for your wallet and gut.

Health comes down to the serving size

Everyone is human, and even registered dietitians and nutritionists (RDNs) have been known to indulge, says Shaw (We definitely are not perfect!). Rather than focus on consuming products labeled “healthy” but are highly processed, turn to wholesome, original ingredients that you love and recognize. Just remember to practice moderation! “Healthy is about balance and learning to appreciate the facts,” says Shaw. “All foods can fit in a balanced diet,” she adds.

As a reminder: Even nutrient-rich fresh fruits and vegetables can cause stomach pain and bloating when consumed in excess. Knowing your limits and serving size can go a long way. Halo Top provides 60 calories per 1/2-cup serving, compared to traditional ice creams and custards that provide 130 to 250 calories per 1/2-cup serving. While this is undoubtedly appealing to many customers, it’s still a processed food product, despite its simpler ingredient list and safer sugar substitutes.

Most experts agree to just go for traditional ice cream with minimally processed ingredients and limit artificial sweeteners, stabilizers, and gums. They also agree to stop when you hit a serving, not the bottom. Minimizing distractions and mindfully eating any meal or dessert, whether it’s marketed as healthy or not, is the best way to maximize pleasure with smaller portions and avoid the habit of overeating.

 

Adapted from: Meaghan Clark Tiernan and medically reviewed by Natalie Butler, RD, LD

Nutrition Tip of the Day

Vegetables and fruits are loaded with nutrients and fiber, and typically low in calories and sodium. Fresh, frozen or canned produce can all be healthy choices, but compare food labels and choose wisely.

Daily Inspiration

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