Is IBS a Gut–Brain–Microbiome Axis Disorder?

 

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Irritable Bowel Syndrome (IBS) is an extremely common gastrointestinal (GI) disorder that significantly reduces the quality of life. Treatment options for IBS have long been limited to symptom management. However, a new understanding of IBS has recently emerged, in which a dysfunctional gut–brain–microbiome axis is responsible for the development and progression of the disorder. Right now, you may be asking yourself “How does a dysregulated gut–brain–microbiome axis promote IBS and what therapeutic measures can be used to modulate this axis and reverse the course of the disease?” Well, let’s find out!

What is the gut–brain–microbiome axis?

IBS has an extremely high worldwide prevalence; it is estimated to affect approximately 10-25% of people in developed countries. Despite its vast influence, an understanding of the pathophysiology of this disorder has remained elusive for many years. In addition to abdominal pain, bloating, and abnormal bowel movements, IBS adversely impacts brain function and has been linked to psychiatric disorders such as anxiety and depression. Furthermore, research suggests that people with IBS have an altered gut microbiota compared to healthy individuals. These findings have led to the development of a new understanding of IBS, in which the interrelationship between gut symptoms, mental health, and the microbiome is mediated by the gut–brain–microbiome axis.

The gut–brain–microbiome axis connects the body’s central nervous system (CNS), which houses the brain and spinal cord, with the enteric nervous system (ENS) of the GI tract. This axis facilitates bidirectional neural, hormonal, and immunological communication between the gut and brain. The microbiome is the third key component of this axis. It serves as an intermediary between the gut and brain since the microbes it contains produce metabolites that relay messages to both organs. When the gut–brain–microbiome axis is in balance, the digestive system and brain function optimally. Conversely, dysregulation of this axis may initiate IBS and influence its progression and severity.

The microbiome is altered in IBS

Over the past several years, numerous studies have documented alterations in the gut microbiota of people with IBS relative to healthy people. This has led researchers to postulate that the microbiome may play a key role in the pathogenesis of IBS. In people with IBS, proportions of specific bacterial groups are altered and the diversity of microbial populations is reduced. Researchers have observed decreased levels of Lactobacilli and Bifidobacteria and an increased prevalence of pathogenic anaerobic organisms such as E. coli and Clostridia in fecal samples from IBS patients. In addition, IBS patients exhibit an increased Firmicutes-to-Bacteroidetes ratio.

There are several factors that may lead to microbiome disruption and the onset of IBS. These include antibiotic use, infection, diet, and stress. Stress is perhaps one of the more insidious factors that contribute to IBS; while dietary changes and treatment for gut infections can be relatively simple to institute, stress is an entirely different beast that must constantly be managed. However, the significance of stress and the psychological toll it creates in IBS cannot be understated, given our understanding of the gut–brain–microbiome axis.

The psychological toll of IBS

IBS sufferers have long understood the connection between their gut symptoms and mental health. Indeed, mental health issues such as anxiety and depression are a common comorbidity of IBS. However, this problem has only recently begun to receive the attention it deserves from the medical community, with the scientific discovery of neural links between the gut and brain in the gut–brain–microbiome axis. Further investigation into the psychological health of IBS patients has found that they exhibit a maladaptive stress response. This includes an exaggerated response to stress and an inability to appropriately shut down the stress response once the stressor is removed. IBS patients also demonstrate visceral hypersensitivity, a condition that increases the level of attention paid to gut symptoms, thus perpetuating anxiety about IBS. There is also evidence that people with IBS may experience stress-related deficits in cognitive function.

The enhanced stress response, anxiety, and altered cognition found in IBS patients may be due in large part to the influence of their gut microbes. There are several mechanisms by which gut microbes affect the gut–brain–microbiome axis. Via the axis, an altered gut microbiota can send neural signals from the gut to the brain, leading to the heightened stress response and increased visceral hypersensitivity characteristic of IBS. This promotes a sustained level of attention to the gut in IBS patients and an inability to “turn off” anxiety surrounding gut symptoms (I think this research is speaking to me 🧐). Gut microbes also alter the availability of tryptophan, an amino acid required to produce the mood-regulating neurotransmitter serotonin. Gut microbes influence the release of immune system mediators and glucocorticoids, which can heighten intestinal pain in IBS. Finally, pathogenic gut microbes can also initiate a proinflammatory state that increases intestinal permeability, resulting in the leakage of neuroactive metabolites from the gut into the CNS, where they have adverse effects on cognition.

Stress, in turn, has harmful effects on the intestinal microbiota. Stress increases intestinal permeability, allowing bacteria and bacterial antigens to cross the epithelial barrier into the bloodstream, inducing an immune response that alters the microbiome. Stress hormones, including epinephrine and norepinephrine, also increase the virulence of gut pathogens by enhancing the availability of iron, which the pathogens use to fuel their activities. Increased levels of gut pathogens may further exacerbate IBS.

Clearly, an imbalanced gut microbiome and an unhappy brain walk hand in hand. The complex relationship between the gut, brain, and microbiome in IBS creates a vicious cycle of intestinal symptoms, stress, and poor mental health. To break this vicious cycle, the gut–brain–microbiome axis must be repaired.

Repairing the gut–brain–microbiome axis to treat IBS

To successfully treat IBS, strategies must be employed that address each component of the gut–brain–microbiome axis. Modulation of the axis with dietary changes, prebiotics, probiotics, select antibiotics, and stress-reduction strategies offer a holistic means of treating IBS.

Diet and prebiotics

Significant positive changes can be induced in the gut–brain–microbiome axis through the implementation of dietary modifications and prebiotic supplementation. One dietary approach that has received substantial attention in the treatment of IBS is the low-FODMAP diet. Briefly, gut bacteria metabolize FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), which include various types of fermentable dietary fibers, into short-chain fatty acids (SCFAs). High levels of two SCFAs, acetic acid, and propionic acid, have been associated with GI symptoms, anxiety, depression, and reduced quality of life in IBS patients. Reducing dietary intake of FODMAPs can lower levels of these SCFAs and therefore alleviate IBS symptoms.

However, research on the low-FODMAP diet for IBS conflicts with other studies suggesting that prebiotics, a type of fermentable fiber, improve both guts- and brain-related symptoms of IBS. The regular consumption of fructooligosaccharides (FOSs) has been found to reduce GI symptoms and improve quality of life markers such as anxiety and sleep in people with functional bowel disorders. Prebiotics also offer brain-health benefits; the intake of galactooligosaccharides (GOSs) increases hippocampal levels of the brain-derived neurotrophic factor, a protein involved in normal brain function, and N-methyl-D-aspartate (NMDA) receptors, which regulate brain plasticity and memory. More research is needed to understand the divergent responses to low-FODMAP diets and prebiotics in IBS patients. Clinically, practitioners should encourage patients to experiment with FODMAPs and prebiotics and find what works best for them.

Probiotics

Probiotics are another promising treatment option for IBS since they modulate both the gut and the brain components of the gut–brain–microbiome axis. Supplementation with Bifidobacterium infantis has been found to improve gut-related symptoms of IBS by reducing abdominal pain and bloating and normalizing bowel movements, while also inducing antidepressant effects through the augmentation of plasma tryptophan levels, increasing levels of the “feel good” neurotransmitter, serotonin. Bifidobacterium animalis is effective for promoting intestinal motility and reducing abdominal discomfort in IBS-C (constipation) patients. Lactobacillus acidophilus supplementation reduces visceral hypersensitivity to IBS by activating opioid and cannabinoid receptors, thus ameliorating intestinal pain and reducing hypervigilance to GI sensations. Finally, probiotic strains that repair the intestinal barrier may reduce the leakage of neuroactive metabolites from the gut into the systemic circulation, protecting brain function.

Antibiotics

Mark Pimentel, a noted small intestinal bacterial overgrowth (SIBO) researcher, has found that up to 85% of IBS patients have SIBO. However, other research suggests that this may be an overestimation, due to the high false positive rate associated with the lactulose breath test used to diagnose SIBO. While not a cure-all, the eradication of SIBO using specific antibiotics, such as rifaximin, may benefit some cases of IBS.

Stress reduction

Chronic stress perpetuates the vicious cycle of IBS by altering the gut microbiota, increasing gut pathogen virulence, and promoting intestinal permeability. The implementation of stress reduction strategies is crucial for breaking the cycle and restoring health to the gut–brain–microbiome axis. While there are many stress-reducing practices to choose from, three in particular—yoga, exercise, and mindfulness meditation—have demonstrated IBS-specific benefits. Yoga has exploded in popularity in recent years and has become the subject of extensive scientific investigation. A recent study found that a yoga practice consisting of postures and breathing exercises beneficially modulates gut and brain function by reducing sympathetic nervous system activity and increasing parasympathetic activity, making it an effective remedial therapy for IBS.

A generalized exercise program may also benefit the gut–brain–microbiome axis and reduce symptoms of IBS. Exercise increases GI motility, reduces intestinal gas retention, relieves stress, and increases the number of beneficial microbial species in the gut. Finally, mindfulness training is another beneficial stress reduction strategy for IBS. Mindfulness training (MT) promotes nonreactive awareness to emotional and sensory experiences, such as GI symptoms, and has been found to beneficially alter pain processing. An eight-week course of mindfulness training in women with IBS significantly reduced gut-focused anxiety and abdominal pain, thus breaking the vicious cycle of stress and intestinal symptoms.

A diagnosis of IBS no longer needs to be vague and frustrating for people. The newfound knowledge of the gut–brain–microbiome axis, and the variety of treatments that can be used to modulate it, offers IBS patients the possibility of a full recovery.

Adapted from: Chris Kresser (Kresser Institute)

Nutrition Tip of the Day

Serving size does not always equal portion size! Check the serving size and servings per container because what might seem like a typical portion could actually equal two or more servings.

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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.

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Is an Anti-Inflammatory Diet the Best for You?

Fans of anti-inflammatory diets say they can transform you inside and out. Is this another  “health” fad…or do we all really need to go AI?

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An anti-inflammatory diet=less pain, happy gut, more energy, and more! This diet may be buzzy, but the tenets of an AI diet; more plants, less sugar, no refined stuff, is far from a passing fad. “Who needs to eat a more anti-inflammatory diet? Everyone,” says Barry Sears, PhD, creator of The Zone diet, who has spent decades studying chronic inflammation. Here’s the lowdown on inflammation, and how to fight it with food.

What the heck is inflammation, anyway?

Believe it or not, inflammation starts as a good thing. It happens when your immune system sends out white blood cells and “warrior” compounds, such as eicosanoids to attack invading viruses, bacteria, or toxins. A classic example of normal inflammation: Pain, heat, redness, and swelling around a wound or injury (think of a tender sprained ankle). “There’s a separate response called ‘resolution’ that brings the dogs of war back to their barracks and heals your tissues,” says Sears. “The first phase of inflammation causes cellular destruction, and the second phase, resolution, begins cellular rejuvenation. As long as those phases are balanced, you stay well.”

However, for most of us, the balance never happens. That’s because sugar, refined grains, and saturated fat can also trigger an inflammatory immune response, notes Sears, and the typical Western diet is packed with them, meaning we’re inflaming our bodies over and over, every time we eat. Meanwhile, guess what the average American gets way too little of? Fruits, non-starchy veggies, and fatty fish. Fruits and vegetables are packed with antioxidants that help cool things down and reduce the intensity of the initial inflammatory response and fatty fish, a great source of omega-3 fatty acids, can help your body move into the resolution phase.

Air pollution and environmental toxins also trigger your immune system in the same way, but “most of the chronic, extra inflammation in our bodies is diet-related,” says Sears. In arteries, chronic inflammation can lead to heart disease. In the brain, it’s linked to anxiety and depression. In your joints, it causes swelling and pain. In the gut, inflammation throws off the balance of helpful bacteria and causes direct damage to the lining of the intestines, says Mark Hyman, MD, director of the Center for Functional Medicine at the Cleveland Clinic and author of The Blood Sugar Solution: 10-Day Detox Diet. This may contribute to IBS, food sensitivities, autoimmune diseases, and even obesity, research suggests.

In contrast, research shows that following a more anti-inflammatory style of eating may reduce the risk of heart disease, obesity, and some cancers and may even extend your life, says Frank Hu, MD, professor of nutrition and epidemiology at the Harvard T.H. Chan School of Public Health. Other claims about anti-inflammatory diets, such as reversing autoimmune disease (the goal of the Autoimmune Protocol, an extremely restrictive AI diet) or improve mental health, have less solid proof, he says.

How to spot an anti-inflammatory diet

There isn’t just one specific “AI Diet,” unlike Atkins or South Beach. Sears’s Zone diet and Dr. Hyman’s Detox are both highly anti-inflammatory, as is the soy-heavy plan from integrative medicine guru Andrew Weil, MD. Paleo and Whole30 diets are both AI, as well. However, the plan with the most research-backed anti-inflammatory credibility is the traditional Mediterranean diet, emphasizing fruits, vegetables, whole grains, legumes, fish, and olive oil. Several very large studies, including the famed Nurses’ Health Study, have found that people who follow a Mediterranean pattern of eating have lower levels of the inflammatory markers C-reactive protein and interleukin-6 in their blood compared with those who do not. This may be one reason the Mediterranean diet is linked to so many health benefits, from keeping weight down to slashing heart and stroke risk, notes Dr. Hu.

The goals of an AI plan are simple: Cut back on foods that trigger an inflammatory response and eat more of the foods that heal damage. While there are some variations in what’s allowed and what isn’t, most AI plans share an emphasis on eating whole, minimally processed foods, non-starchy vegetables, monounsaturated fats, such as olive and avocado oil, colorful berries and other fruits, omega-3s from fatty fish (or supplements), and avoiding added sugar and refined grains. That said, your plate may look a little different from your friend’s or coworker’s, and that’s the way it should be, says Dr. Hyman. Some people thrive on a grain-free Paleo plan, while others would rather die than give up bread. Food sensitivities also play a role: “People react to foods differently, and if someone has a sensitivity to a particular food, it will lead to cytokine production and an increase in other inflammatory chemicals,” says Dr. Hyman. If you suspect you have a sensitivity, talk to your doctor or a dietitian, who can design an elimination diet to help ID the culprit.

What’s off the menu?

While all AI plans give a thumbs-up to veggies, fatty fish, and olive oil, the foods you can’t eat vary. Women with a history of eating disorders take note: “Restricting whole food groups can be triggering,” says Sonya Angelone, RDN. Here is what’s not allowed in four different diets:

Autoimmune protocol: Nightshade vegetables (tomatoes, eggplants,peppers), nuts, seeds, eggs.

Paleo: All grains, dairy, legumes, (chickpeas, lentils, beans, peanuts).

The Zone Diet: All refined grains, white potatoes.

Mediterranean Diet: Added sugar, refined sugar.

So what exactly do you eat?

You don’t have to follow any AI diet perfectly to make a big impact. A healthy body is built to handle the occasional onslaught of inflammation (like having a cupcake at a party); it’s the regular, consistent consumption (and overconsumption) of inflammatory foods, such as sugar and saturated fat that’s linked to serious disease, says Sonya Angelone, RDN, a spokesperson for the Academy of Nutrition and Dietetics. A 2012 study of nearly 2,000 people, for example, found that those who ate the most sweets over two years had significantly higher levels of interleukin-6 than people who ate more veggies, fruits, and whole grains. That’s why it’s more important to eat an overall “super” diet rather than focus on individual superfoods, says Angelone. “If you’re regularly eating a bunch of doughnuts along with a bunch of anti-inflammatory veggies, you’re still harming your body,” adds Dr. Hyman. Follow these AI guidelines on most days:

1. Aim for half to two-thirds of your plate to be nonstarchy vegetables. Greens of all kinds, mushrooms, summer squash, beets, cauliflower…the list goes on and on, as well as at breakfast, too, says Dr. Hyman. They’re packed with gut-balancing fiber and powerful antioxidants.

2. Limit added sugar and sweet drinks. That includes fruit juices and natural sweeteners, such as honey, says Dr. Hyman. In a small 2005 study, people who were fed a high-sugar diet for 10 weeks had significantly elevated blood levels of haptoglobin, an inflammatory marker that in high concentrations is associated with diabetes, heart attack, stroke, and obesity, compared with controls.

3. Eat fish. Especially fatty kinds, such as salmon, mackerel, herring, and anchovies, or take omega-3 supplements, at least 1,000 milligrams daily, says Dr. Hyman.

4. Nix white flour and limit other flour-based foods. Focus on whole, intact grains, such as quinoa, brown rice, and bulgur wheat instead of loading up on whole-grain crackers, breads, and tortillas. Even 100% whole-grain flour will cause a spike in blood sugar that exacerbates inflammation, especially for people with insulin resistance, metabolic syndrome (i.e., prediabetes), or diabetes, so use them moderately, says Sears.

5. Choose fats carefully. The most abundant saturated fats in our diet contain the same fatty acids as do fragments of the cell walls of many bacteria. No wonder our immune system sees a bacon cheeseburger as a threat! Limit saturated fats and skip vegetable oils that are high in omega-6 fats, such as safflower and corn oils. Opt instead for olive, avocado, or walnut oil. “It might sound tough, but if you think about it, it’s exactly how your grandmother probably told you to eat!” says Sears, and a diet endorsed by your nana? Now that sounds like a plan.

Yes, you might lose some weight

Going AI doesn’t automatically mean you’ll drop pounds, says Angelone, especially if your weight is in a healthy range to begin with. However, research does suggest that an AI diet packed with veggies and low in sugar and refined carbs can help with weight loss goals. “You feel fuller on fewer calories because the high-fiber foods have so much more volume,” she says. The healthy fats in an AI plan may also play a role: A large, five-year study published in 2016 found that people who ate a veggie-and fat-rich Mediterranean diet lost more weight than those who went on a low-fat plan.

The 10 best foods for fighting inflammation

These are foods that research has shown to have exceptionally strong effects on inflammation:

• Berries

• Dark green Leafy vegetables (like kale, spinach, Swiss chard)

• Fatty fish

• Garlic and onions

• Green tea

• Ginger

• Turmeric

• Nuts

• Oranges

• Tart cherries

What are your thoughts on an AI diet? Can it transform you from the inside out?

Nutrition Tip of the Day

Cook vegetables in healthy ways that will help bring out their natural flavors, including roasting, grilling, steaming and baking. You’ll need less salt (if any) and may even turn the most anti-veggie kid into a fan!

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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.

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The Best Way To Help Your Child With Their Weight & Body Image + Chaos

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If you have kids in your life, you’re probably already aware that body image challenges start early. Numerous studies have shown that even elementary school children, especially girls, believe they need to change something about their body, whether it’s their weight, their hair, their freckles, or something else. It can be heartbreaking to watch the children we care about struggling with these issues, and so many grown-ups want to know what they can do to help. As it turns out, there IS one thing that we, as adults, can do to create an environment that truly supports our kids’ development of a healthy, positive body image. It’s something we actually have a lot of control over, and best of all, when we start doing this, it will immediately make our own lives better, too.

I would like to share my thoughts on the best way to help children with their weight and their body image. Though I do not have credentials behind my name….yet (another six months and I will!), I have struggled with anorexia nervosa for almost 20 years. I have been in recovery for four years so I give myself a bit of credibility when it comes to this subject. I also do a ton of research!

We live in a time when so many people, young and old, are experiencing an epidemic of body hate and body dissatisfaction. You can read the statistics. Nine out of 10 women polled are hitting on their bodies, and 40% of girls, three to six years old, are already dieting. They’re hating on their body. They’re wanting to change their body parts.

This is crazy! This is the kind of challenge that cuts me to the core….and I hope yours as well.

Hating our body, judging it, and believing that it’s unlovable in some way is the royal road to misery and an unhappy life.

Think about it. When we’re born into this world, watch a baby. They’re not sitting there worried about how they’re looking or running around naked or if they’ve got little bits of body fat here and there. Babies and infants are in love with their physiology. It’s just all one. It’s pleasure. It’s play. However, so many people are struggling in silence with self-defeating thoughts about their own physical form. We’ve got to change that.

An unhappy and unresolved body image keeps us small in our sense of self. It limits our personal growth. It stops our best creativity, and it leaves us far short of the beautiful potential that we are born with. Body hate shuts down the soul. It ruins us. It’s a soul crusher!

If you’re a parent or you have kids in your life and you really want to help the child, especially if you’re a parent, then you want to give them the best chance of a loving relationship with their body….OR at least I hope you do! An unhappy body image these days often starts at a young age. However, there is one strategy that will help you succeed in such a brilliant and beautiful way:

Heal your own relationship with your body!

That’s it. Work on you. Work on your relationship with your body. Get to a place, please, as fast as you can where you forgive your own imperfections and where you let go of your own self-criticism. Stop the fight. Just stop the war because your children, our children pick up on who we are. Children are brilliant observers. They’re not good interpreters, but they’re brilliant observers. They will observe mommy, daddy hating on their own body. They’ll feel it. They’ll absorb it through the airwaves.

In a way, this is the beauty of our young ones. They want to be like us, and they will be like us. Therefore, it is best to look in the mirror and start to work on SELF. It is going to save your kids so much heartache and unnecessary waste of life energy as they get older.

SO AGAIN!!…….the greatest gift you can give your kids is to do your own work and do it now and stop the nonsense in your own head! Here’s how you start: Call a cease-fire on self-attack, and mean it! Just wake up and say cease-fire! Consciously choose to begin to love yourself in small ways. It’s a practice. You’ve got to practice every day.

Every day practice gratitude in some way, shape, or form, for the body that you’ve been given. I know you’ve got complaints about it and this and that and all that. However, balance out all those crazy complaints with some gratitude. Find ways every day to affirm love for your body.

Honestly, it is as simple as that because when you do work on yourself, you save future generations from pain and suffering. However, I know for some…..it isn’t that simple. Your “leading by example” will uplift them in ways that they’ll never know, and when you do that, when you do your work on self so your kids don’t have to finish up that work, we create such a better planet and such a better environment for all of us to thrive in. This is the magic of the world!

 

Chaos: Emily Rosen

 

Nutrition Tip of the Day

Enjoy fish high in omega-3 fatty acids. Oily fish such as salmon, mackerel, trout and albacore tuna are good choices!

 

Daily Inspiration 

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Why You Need Fermented Foods in Your Fridge, Stat!

Be honest… when’s the last time you ate sauerkraut? Unless you’ve been firing up brauts on the barbecue this holiday season, you probably haven’t eaten it recently. So, what’s the scoop with fermented foods? 

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Fermented foods – like kraut – are officially “a thing,” and here’s why. The hard reality is many of the processed foods we eat today have half the nutritional value of their raw forms. You could opt to get your nutrients by chowing down on raw veggies, which isn’t a bad option; however, there are huge health benefits to eating them fermented. Simply put, it all comes down to the amount of healthy bacteria found in fermented food. So, check out the details below and how to incorporate these yummies into your diet.

Your gut with thank you, your taste buds will say “whoa, wow!” and you’ll be pleasantly surprised at how easy and delicious fermented foods are.

So, why all the hype about fermented foods?

Fermentation is nothing new. The Ancient Greeks wrote about the health benefits of fermented cabbage, and the Romans found that cabbage fermented in acid prevented and treated intestinal infections. The renewed interest today comes, in large part, from an increased awareness that our eating habits (i.e. decades of processed foods) have damaged the balance of bacteria in our guts. Our digestive systems have paid the price for our dietary choices and at least part of the answer to fixing the problem lies in probiotics.

There are plenty of mass-produced probiotic supplements available now, but fermented foods actually offer a cheaper and tastier way to balance the “good bacteria” in your stomach. Naturally incorporating probiotics into your diet not only promotes healthy digestion but may also prevent a host of illnesses. Now that’s a win-win!

Bacteria: The good, the bad, the ugly

Fermentation 101: When a food is fermented, it’s placed in a contained environment and exposed to healthy lactic-acid producing bacteria. By ingesting these good bacteria, you’re helping create a more acidic environment in your stomach, which aids in digestion and the production of more good enzymes. The result is a healthier digestive tract. If you’re facing any of the health problems listed below, you probably need some good bacteria in your tummy….and most of us do!

Constipation

If you’re finding it hard to digest certain foods, or maybe anything at all, you probably don’t have enough acetylcholine in your bloodstream. Acety-what?? In science speak, acetylcholine is a neurotransmitter that aids in sending out nerve impulses. It can increase the movement and responsiveness of the stomach which aids in digestion and relieves constipation. Lucky for you, acetylcholine is naturally produced in the fermenting process and can be ingested through any fermented food.

Diabetes

The good bacteria found in fermented food may also increase pancreatic function. In addition, because organic matter that sits in lactic acid is partially digested already, vegetables and other fermented treats are easier for your body to process and put less strain on your pancreas; something no other food can do.

Weakened Immune System

If you find you’re getting sick all the time, you might be able to help your body combat the bad bacteria it’s exposed to through fermented foods. We still don’t know why many pathogens are sensitive to acidic environments, or what exactly fermented foods contain that combat the bad bacteria… but they’re doing something right.

DIY fermented foods

Alright, so you are now convinced of the health benefits, but how about another great benefit: Cost. Fermented foods are typically cheap to make and you can do a lot of it at home!

A few ideas to inspire you:

  • Sauerkraut is easily made with sliced cabbage, salt, and caraway seeds. Grab a mason jar and make your own sauerkraut tonight. If you’re looking to spice things up, many gourmet dishes feature kraut in them as well!
  • Kimchi is a variety of kraut that’s deliciously spicy. Relying on lacto-fermentation and a whole lot of chili, kimchi is the perfect way to dress up traditional kraut.
  • Pickled vegetables of any kind can be made with some whey protein, sea salt, dill, and garlic for taste. Ordinarily vinegar would be used to can vegetables, but to get the full probiotic potential of your fermented vegetables, rely on the bacteria on the surface of their skin to do the work for you.
  • Kombucha is a traditional fermented drink that’s easy to make at home, and even possible to carbonate! If you would prefer drinking your probiotics, fermenting milk and juices may be more up your alley. There’s a whole world of fermented drinks available to you so go crazy!
  • Fermented cranberry sauce may sound a little unconventional, but it’s an easy way to incorporate some probiotics into dinner or any holiday meal.

Fermented foods incorporate numerous benefits into your diet, while also supporting a healthy immune system and digestive tract. Cheaper than over-the-counter probiotics, homemade slaws, krauts, and pickles are an easier, more natural way to sustain your body and make gourmet food from home. Go kraut crazy!

Adapted by: Corinne Keating; medically reviewed by Natalie Olsen, RD, LD, ACSM EP-C

Nutrition Tip of the Day

When you cook at home you have more control over ingredients and portion sizes. Aim to cook at home more often than eating out!

Daily Inspiration 

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Remarkable Benefits of Cinnamon (& 12 Ways to Use It More) + Sneak Peek at “Read it Before you Eat it”

Practically everyone has cinnamon in their spice drawer but some may not know all of its many health benefits and uses. This pleasant-tasting herb has a long history both in natural medicine and as a culinary favorite.

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Cinnamon: A Spice for the Ages

From the Old Testament to the ancient Egyptians, many ancient cultures used cinnamon for anointing, preservation, and consumption. Cinnamon was so highly prized in the Middle Ages it was considered a luxury commodity and a status symbol. At one time, it was even more valuable than gold! Ancient Chinese medicine has long relied on this spice as a warming and cleansing agent to treat the heart, lung, and bladder. (Chinese medicine uses Guizhi, made from the twigs of the cinnamon tree as opposed to the familiar cassia spice made from the inner bark.)

Today, this spice still enjoys incredible popularity and resides in just about every spice cabinet. Just a mention of it probably brings to mind warm, comforting images, such as freshly baked muffins, apple pie, oatmeal, or mulled apple cider. The awesome part is, it has benefits beyond being sweet and spicy!

The Many Benefits of Cinnamon

Looking at the long list of proven benefits it’s no wonder this delicious spice has such a long history of use. Cinnamon fights against digestive trouble, kidney infection, colds, flu, hypertension, and even shows promise in fighting some types of cancer.

Regulates Blood Sugar

Perhaps the most well documented benefit is cinnamon’s ability to regulate blood sugar. More study is needed as to what role the herb can play in pre-diabetic or diabetic treatment, but research shows hypoglycemic benefits from ingesting about 2 teaspoons a day.

Anti-inflammatory

Studies show that the bark of the cassia variety strongly counteracts the enzyme responsible for inflammation. Add a pinch (or two or three) to drinks, recipes, or smoothies to get more anti-inflammatory benefits.

Anti-microbial

Cinnamon bark oil is an especially effective antibacterial agent and has long been known to disinfect and preserve. It has even been shown effective against E. coli, as well as its ability to kill the bacteria responsible for tooth decay.  The store bought brand OraWellness, explains why they include cinnamon in their mouth rinse: Recent research conducted in New Zealand demonstrated that the essential oil of cinnamon has the greatest antimicrobial potency against Streptococcus mutans, the bacteria responsible for tooth decay, and Lactobacillus plantarum, one of the bacteria responsible in gum disease. The research study concluded “that there may be a role for essentials oils in the development of novel anticaries (anti cavity) treatments.”

Anti-fungal

Certain species of cinnamon are effective against fungal infections, and it has even been used to treat oral candidiasis (a common symptom in HIV patients).

Anti-viral

Cinnamomum cassia bark has been shown effective against viral respiratory illness, flu, and colds.

Antioxidant

Can we fit any more “anti” in here? Yes! Cinnamon also exhibits antioxidant influence on free radical cells. The C. zeylanicum species shows the most potent antioxidant effects, but Ceylon or the more common Cassia varieties offer these benefits as well.

Lowers Blood Pressure

Since many compounds that help with insulin and blood sugar levels also lower blood pressure, cinnamon has benefits here too. In a study with rats, regular consumption lowered systolic blood pressure in hypertensive rats fed a high-sucrose diet almost down to the normal level of the non-sucrose consuming rats.

For the Brain

Exciting new research shows that cinnamon may block a protein called tau in the brain. This is important because tau buildup is found in the brain of people with Alzheimer’s. The exact mechanism isn’t clear yet, but this may be a promising use.

Ceylon Cinnamon vs. Cassia Cinnamon

Many people do not realize that there are multiple types of this spice. The two main types are ceylon and cassia. Both are considered healthy, but it is important to know the difference when using cinnamon as a remedy. The smell and flavor in cinnamon comes largely from a compound called cinnamaldehyde. Cinnamaldehyde is responsible for many of the health benefits of cinnamon as well but the dose makes the remedy in this case. Too much cinnamaldehyde can be harmful. But not to worry, there are safe cinnamon options that do not contain high amounts of cinnamaldehyde.

Ceylon Cinnamon

Ceylon is considered “real cinnamon.” It comes from the inner bark of the Cinnamomum verum tree and grows in Sri Lanka and parts of India. It has a milder flavor than Cassia due to its lower cinnamaldehyde content. This also makes Ceylon a safer cinnamon for use as a remedy. Some also prefer Ceylon in culinary uses as well since it has a slightly milder flavor.

Cassia Cinnamon

This is the cinnamon you’ll find in most grocery stores. It comes from the Cinnamomum cassia tree and originates in China. Cassia is a cheaper variety but over 90% of its oils come from cinnamaldehyde. This makes it great for using in recipes since a little goes a long way. Many experts warn against using this variety as a remedy though due to the high cinnamaldehyde content.

Cassia also contains high levels of coumarin. This substance can cause liver damage in high amounts. In fact, the government of Denmark recently started regulating cinnamon use in bakeries to make sure that people aren’t consuming too much coumarin. Ceylon does not contain high levels of coumarin.

Is It Bad to Eat Too Much Cinnamon?

Like anything, too much of a good thing can be harmful. This is true with water and it is certainly true with this spice as well. Experts agree that culinary use is almost always safe (as long as you aren’t adding 1/4 cup to a smoothie), but there are some important cautions with using it as a remedy. Studies have looked at diabetics using up to 6 grams of cassia cinnamon a day for blood sugar management. They found improvements in fasting blood glucose and other measurements (compared to placebo) and did not report any adverse side effects.

Cassia is traditionally used in studies, probably because it is more widely available, but many experts recommend Ceylon for the benefits without the coumarin and high levels of cinnamaldehyde. That said, all the available research I found indicates that small amounts of 1-2 teaspoons a day of either type are likely safe for those without a medical condition. Of course, anyone under the care of a doctor or taking a medication should check to make sure there are no contraindications or interactions before taking large amounts of anything.

How Much Cinnamon to Eat?

Research shows that up to 6 grams per day (for adults) seems to be safe and it is recommended using only a high quality Ceylon variety and also cycling on and off for best results. This also holds true for supplements. For example, only consuming cinnamon supplements during the week and resting on the weekend to give the body a break and to not become acclimated to the supplement.

12 Ways to Use Cinnamon

So with all these benefits, how do we safely work this spice into daily life?

  1. In the Morning: Add a pinch to a cup of hot tea for a boost of energy (and sweetness) to start the day. Or, add some to your coffee!
  2. For Colds and Flu: Take up to a 1/2 teaspoon in a cup of tea with lemon juice and honey, or add it to elderberry syrup.
  3. For Coughs: This herbal cough syrup is another immune-boosting way to use cinnamon.
  4. In a Tincture: Add cinnamon to a homemade tincture to increase absorption of the herbs and improve flavor.
  5. In Fish Oil: Surprisingly, cinnamon makes a dose of fish oil taste much better (great for kids!).
  6. As a Digestive Remedy: Add a 1/2 teaspoon to water, tea, or capsule form after a meal out when you have consumed foods you normally wouldn’t eat.
  7. In Oral Products: Cinnamon’s oral health benefits are well documented (see above).
  8. In Savory/Spicy Meals: Curry and jerk seasoning blends often feature cinnamon, or try making your own.
  9. For Weight Loss: Used to soothe late night sugar cravings and boost metabolism.
  10. For Vaginal Health: Use cinnamon tea, tincture, or powder externally on vaginal infections to speed healing.
  11. As a Skin Soother: Mix some ground cinnamon with honey and apply to insect bites.
  12. In Makeup: Yup! Cinnamon is used in some DIY makeup recipes. 

Or Just as a Spice…

Of course there’s nothing wrong (and everything right) with getting this spice the traditional way in recipes, such as muffins, cobblers, and pancakes, or in drinks, such as chai tea, wassail, teas, and eggnog.

Other Uses and Precautions

Pregnant women should not use large amounts (culinary uses or under 1/2 tsp day is fine) or the essential oil as it can cause contractions. As always, check with a doctor or medical professional before using this or any other herb medicinally. There is some evidence that the coumarin content of this herb can be harmful in large doses. Ceylon cinnamon has a much, much lower amount of coumarin, making it safer to take in large doses or during pregnancy or breastfeeding. It also has a much milder taste, making it suitable for children.

Check out a preview of Read it Before you Eat it by Bonnie Taub-Dix, RDN

Nutrition Tip of the Day

Read food nutrition labels! Pick healthy foods that provide nutrients, such as vitamins, minerals, and dietary fiber but limit sodium, added sugars, saturated fat and trans fat.

Daily Inspiration 

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……Although it seems like it at times!