Specializing in science-based nutritioin for those who want to live a longer, healthier life
If you’re looking for a quick and delicious snack or meal, try this Strawberry Banana smoothie. It’s packed with flavor and protein and with just 4 ingredients it couldn’t be easier. It’s my favorite go-to quick drink! If you work the night shift, it’s a [Continue Reading]
Like many of you, my family and I are planning to eat more plant-based meals at our house. We decided to start with once a week, “Meatless Monday”. A recent Monday rolled around and we were considering what to make for dinner. It needed to [Continue Reading]
We hear so much about nutrition and fitness in the media. We are bombarded with information, but how do we know what is fact vs fad? Whose advice is reliable?
There is a continual influx of new diets and quick answers to losing weight, but in reality, most of these are not sustainable.
“In order to truly be beneficial, eating habits must be lifelong and timeless”.
Our bodies need the right fuel to function at its best. Eliminating any of the macronutrient groups such as carbohydrates, proteins, or fats may result in a short-term “fix”, but these are necessary components of a long-term healthy diet.
Carbohydrates are macronutrients that include sugars, starches, and fibers.
Sugars are the simplest form of carbohydrates and occur naturally in foods such as fruits, vegetables, and milk products.
Starches and Fiber are the more complex type of carbohydrates and are found naturally in vegetables, grains, and legumes.
Fiber passes through the body largely undigested, regulating the body’s use of sugars and starches. Fiber is also essential for optimal digestive health.
Carbohydrates have taken a bad rap, but they are necessary components of of our diet. Starches and sugars provide glucose, a necessary fuel for the brain, central nervous system, and all the cells in the body.
The brain depends on glucose for energy. Consequently, it uses glucose to feed the cells in the body to perform and function well.
While glucose cannot be replaced, it can be supplemented. For example, in the absence of glucose, the brain can use energy created by lactic acid. Lactic acid is a substance which is increased during intense exercise.
Or it can use ketones, which are byproducts of low carbohydrate or ketogenic diets. In the absence of carbohydrates, ketones become elevated as fats are used for energy. This is an example of our body’s “survival response” to starvation.
Ketones and lactic acid can be used for energy in the short run, however these are “second choice” fuels and not the preferred fuel over time. Our bodies run best on glucose.
Anyone following social media is familiar with the popular Keto diet. It is true, people are losing weight on it. BUT it is not a diet that can be sustained over a lifetime. And if it isn’t sustainable, is it worth it?
The Keto diet works by eliminating carbohydrates, causing “ketosis”, and thereby forcing fat to be utilized for fuel.
The Keto diet is comprised of about 75% fat, <5% carbohydrates and about 20% protein.
On the keto diet, there are no limitations on protein sources. You can consume all types of meats, fish, eggs, and poultry. You can eat bacon, hot dogs, and processed meats. Portions are not measured.
Since fats make up a huge part of the diet, the addition of oils, mayonnaise, lard, and butter are encouraged, as long as they are sugar free.
Cheeses and whole milk as well as nuts are also included on the diet.
Only extremely low carb veggies such as kale, spinach, cabbage, and mushrooms are allowed as well as a few lower sugar fruits such as blueberries and raspberries, and only in small amounts.
All grains, breads, and legumes are disallowed.
Eliminating carbohydrates, is reasonable for a short time and might bring about quick weight loss, however ketones are not the body’s preferred type of fuel.
Also, the extremely high fat content is contrary to what we know about the relationship between cholesterol and heart disease.
Aside from being arguably unhealthy, the Keto diet is “unbalanced” and impractical.
For instance, never eating pasta, bread or cereals is not likely to be a diet most people want to continue over time. Consequently, most revert to prior eating habits and weight is regained.
The ketogenic diet does have benefits. For example, it has been shown to be a viable treatment for drug resistant epilepsy, especially in children. The mechanism is not completely understood, and research in this area is continuing. Other neurological diseases such as Dementia, Parkinson’s and Multiple Sclerosis are also being studied.
Protein is another macronutrient and is found in all areas of the body.
It plays a role in maintaining muscles, bone and skin integrity and carries oxygen in the blood, to cells in the body.
Protein is another macronutrient and is found in all areas of the body. It plays a role in maintaining muscles, bone and skin integrity and carries oxygen in the blood, to cells in the body.
It is important that we include protein rich foods in our diet daily.
Protein from animal sources such as meat, fish, poultry, eggs, and dairy are complete proteins. In other words, proteins that contain all 9 essential amino acids that the body cannot make on its own. Amino acids are the building blocks that make up proteins.
Protein from vegetable sources, such as legumes, nuts, tofu, and dark leafy greens are incomplete proteins and need a little “help”.
Quinoa and Amaranth are an exception. In other words, these plant-based foods are complete proteins.
Diets that eliminate animal products, run the risk of inadequate or incomplete protein. So how do vegetarians and vegans meet their needs?
The challenge of moving to a plant-based diet includes learning how to prepare new foods, as well as the art of “mixing and matching” to achieve high quality complete protein.
For example, combining incomplete proteins such as rice or whole grains with beans or other plant-based foods results in a complete protein.
Additionally, substituting quinoa for rice in any recipe adds high quality protein.
Find out more about Plant-Based Eating and suggestions for making the change.
Fat is a third macronutrient that is essential to our health. Fats provide essential fatty acids. Fatty acids function as energy storage and act as fuel when glucose is in short supply, as in the case of the ketogenic diet.
Fats in our diet help our body absorb fat-soluble vitamins. For instance, the fat-soluble vitamins A, D, and E can only be absorbed by fats.
In excess, just as with carbohydrates and proteins, when fat that is not used for energy it is stored as body fat and leads to obesity.
All fats are not the same. Trans or Saturated fats or bad fats are those that raise cholesterol and increase risk for heart disease
Saturated fats come predominantly from animal sources, such as meats, butter, cheese, and eggs. Palm and coconut oils, as well as coconut, are plant sources of saturated fats.
Additionally, saturated fats are often found in pre-packaged biscuits, cakes, and pastries. Look for hydrogenated fat, palm oil, and coconut oil, on the ingredient list.
Often unsuspecting foods have these “hidden” in the fine print. For example, you may find saturated fats in microwave popcorn, breakfast cereals and some crackers.
Unsaturated fats or good fats include oils from plants and oily fish. These include olive oil, corn oil, avocados, almonds, and peanuts. Additionally, sardines, salmon and mackerel contain unsaturated fats.
Evidence suggests replacing saturated fats with unsaturated fats can help to lower cholesterol and reduce risk of heart disease.
While we need some fat in our diet, it should be eaten in moderate amounts. For example, fat should not make up more than 15-20% of calories. For instance, on a 2000 calorie diet, fat should be limited to about 40 grams.
To give some examples, one egg has about 5 grams of fat and an ounce of cheddar cheese has about 9 grams of fat. A 6oz skinless chicken breast contains about 5.5 grams of fat.
Products claiming “low fat” must contain at least 30% less fat than the original product. Becoming familiar with and reading nutrition labels can help make wise eating choices.
A survey of nutritionists was taken to determine their idea of the “healthiest diet”. Hear what 61 of them had to say!
Walk every day. Strive for a daily goal of 10,000 steps or 250 steps each hour.
However, make sure to check with your doctor before starting an any exercise regimen.
Adding simple exercises will help burn more calories and accelerate weight loss!
Exercise also boosts metabolism and mood. Incorporate these into your daily routine to help keep you in shape.
Anemia itself is not an illness, but a symptom that is found in a variety of conditions. In other words, it is an indication there is an underlying problem. It means “lack of blood” and consequently results from a disruption in the way our bodies [Continue Reading]
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Starting at birth, our bones grow in size and strength. In childhood and adolescence bone growth outpaces bone loss. Bone density peaks in our 20’s. It remains stable until about the age of 30, at which time bone density begins to decline, and bone loss exceeds growth.
With increasing age, as bones thin, we become more susceptible to health issues. For example, a decrease in mobility, and an increase in pain, especially back, hip, and neck pain. Consequently, we are more inclined to have accidents or falls with fractures.
Osteoporosis means “porous bone” and is a disease that occurs when the body loses too much bone. It causes bones to be weak and prone to breakage. Osteoporosis is the number one cause of fractures as a result of a fall.
Women are the most susceptible to osteoporosis after menopause due to decreased estrogen. However, by about the age of 65, the bone loss for men and women is about the same.
“Osteoporosis is the most common bone disease in humans” as reported by the Surgeon General. “It is characterized by low bone mass, deterioration of bone tissue ….and an increase in the risk of fracture”.
It is estimated that “about one out of every two Caucasian women will experience an osteoporosis-related fracture at some point in her lifetime, as will approximately one in five men”.
Bone mineral density or BMD is the most commonly used characteristic for estimating the risk of bone fractures related to osteoporosis. It is an estimation of bone strength.
A dual X-ray absorptiometry or DXA scan is a tool used to determine BMD. Most commonly DXA scans measure the bone density of the hip and spine. The result is called a T-Score. T-Scores are defined as the standard deviation (SD) from the peak bone density of an average 30-year-old adult. Osteoporosis is defined when a T-score lies between -2.5 and -4 SD. Pre-osteoporosis or osteopenia is illustrated with a score of -1 to -2.5 SD.
Calcium is one of the most abundant minerals in the body, found mainly in the bones and teeth. A diet that is rich in Calcium plays an important role in keeping bones healthy and helping to slow the progression of osteoporosis, thereby reducing the risk of fractures.
Calcium also plays an important role with muscle contraction and nerve function. And is essential for normal heart rhythm.
Unfortunately, most americans do not get enough calcium in their diets, thereby leaving them at a higher risk for osteoporosis and other health concerns.
The recommended calcium intake for adults over the age of 60 is 1200 mg/d.
| 10 Foods Highest in Calcium | Serving size | Estimated calcium in milligrams |
|---|---|---|
| Collard greens, frozen | 8 oz | 360 |
| Sardines, canned with bones | 3 oz | 325 |
| Ricotta, part-skim | 4 oz | 335 |
| Yogurt, plain, low-fat | 6 oz | 310 |
| Milk, skim, low-fat, whole | 8 oz | 300 |
| Yogurt with fruit, low-fat | 6oz | 260 |
| Mozzarella, part-skim | 1 oz | 210 |
| Cheddar | 1 oz | 205 |
| Greek yogurt | 6 oz | 200 |
| Cottage cheese | 4 oz | 125 |
| Feta cheese | 4 oz | 140 |
| Cottage cheese | 4 oz | 125 |
Calcium from dairy sources is the most easily absorbed. Cheese, yogurt, and milk contain significant calcium and are the major sources of calcium in our diets. Non-dairy sources of calcium contribute a smaller amount and aren’t as easily absorbed.
Most cereals and grains do not have much calcium unless they are fortified. Juices and some fruit drinks are available with added calcium.
Getting enough Vitamin D is just as important as calcium when it comes to bone health. That is to say, it is essential that we consume an adequate amount of both.
Calcium absorption is improved when there is adequate Vitamin D. In other words, Vitamin D enables our body to use Calcium more efficiently for increasing bone health. Vitamin D also helps improve muscle strength and consequently decreases the chance of falling and fracturing.
Vitamin D can be obtained by exposure to sunlight and from dietary sources. However, the amount of Vitamin D produced from sunlight varies.
For example, the time of day, where you live, and the color of your skin are all factors limiting the amount of Vitamin D you absorb from the sun. Elderly persons or those who are house-bound may not get outside often enough and consequently have limited sun exposure.
The recommended daily allowance for adults >70 years old is 800 iu/day.
| 5 Foods Highest in Vit D | Serving Size | IU Vit D |
|---|---|---|
| Codliver oil | 1 tbsp | 924 |
| Grilled Salmon | 3 oz | 284 |
| Grilled Mackerel | 3 oz | 352 |
| Tuna, canned in brine | 3 oz | 144 |
| Sardines, canned in brine | 3 oz | 184 |
In addition to the foods in the table above, some dairy products, such as milk and yogurt, and some orange juice brands, are fortified with Vitamin D. Fortifying foods adds to their nutritional value. Consequently, including foods fortified with Vitamin D increases the options available to meet your needs.
Exercise also plays a role in bone health. For instance, it increases muscle strength and improves balance and posture, thereby preventing falls. Weight-bearing exercises in particular, such as walking, dancing, hiking, climbing the stairs, playing tennis, and jogging. These are activities that work against gravity and have the most impact on muscle strength and reduce the risk of falls. Resistance exercises, such as weight lifting can also strengthen bones.
Exercise regimens should be tailored to the individual’s age and medical conditions and discussed with a physician prior to starting.
Fitness habits should be regular to be effective. “According to the Surgeon General, the optimal goal is at least 30 minutes of physical activity on most days, preferably daily”.
When meal consumption and appetite are poor, a dietary supplement may be needed. In other words, Calcium and Vitamin D needs may not be met, if dietary intake is inadequate.
Also, those who follow a vegan diet or are lactose intolerant and limit dairy products may benefit from taking a calcium and vitamin D supplement.
Not all types of calcium supplements are absorbed in the same way or contain the same percentage of elemental calcium. Elemental calcium is the actual amount of calcium usable by the body.
Some studies have shown Vitamin D3 to be more effective suggesting this it is related to its metabolism in the liver and kidneys. Other studies report no definitive difference between Vitamin D2 and Vitamin D3.
Both Vitamin D2 and Vitamin D3 are found in dietary supplements, however the most popular on the market, such as Nature’s Made, Nature’s Bounty, CVS, Caltrate, and Alive all contain Vitamin D3.
Supplements of Calcium and Vitamin D can be taken separately or in combination with each other.
A combination of Calcium 600 mg and Vitamin D 400 iu taken two times per day meets the minimum levels recommended by the Institute of Medicine‘s Dietary Reference Intakes.
There are some foods that hinder calcium absorption, these include caffeine, alcohol, and foods high in oxalic acid.
Caffeine hinders the absorption of calcium. One study showed, one or two cups of coffee per day results in a loss of 4-6 mg of calcium, however, the association with bone loss was not supported.
In another study, “bone density did not vary by lifetime coffee intake in women who reported drinking at least one glass of milk per day during most of their adult lives”.
Coffee intake may play a minor roll in calcium absorption and bone health as we age, bone loss but further studies are needed.
Alcohol consumption may hinder the absorption of calcium and our bone health as we age. One study showed that consuming 1-2 drinks per day resulted in a 1.34 times risk of osteoporosis. Consuming >2 drinks per day resulted in a 1.64 times risk when compared with non-alcohol drinkers.
Oxalates are natural substances found in some foods. These substances bind to calcium in the gut and are excreted, therefore hinder the amount of calcium available for absorption.
Oxalates that are not bound with calcium are excreted through the kidneys. If there is too much oxalate, crystals may form and develop into a kidney stone. Persons with kidney disease should limit foods high in oxalates.
Foods high in oxalate include nuts and legumes, rhubarb, spinach, and beet greens, chocolate, coffee, and beer.
while aging is inevitable, we can improve bone health and slow the progression of diseases such as osteoporosis,
First, by consuming a healthy diet, rich in calcium and vitamin D.
Second, by getting out to get sun exposure
Third, by engaging in walking or another form of weight-bearing exercise to improve muscle strength, thereby lowering the risk of falls and fractures.
Fourth, by limiting caffeine, alcohol, and foods high in oxalates.
The younger healthy eating and exercise habits are established, the better the outcome. But it’s never too late to start. Even making one change at a time will lead to a healthier you!
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Is the FODMAP diet the answer to your SIBO symptoms? Eating and food usually bring comfort and pleasure. But for some, it results in abdominal distress. For example, symptoms such as pain and bloating or diarrhea and cramping can result from a meal that seems simple and ordinary. Why is it causing discomfort? In other words, is something wrong?
SIBO is one of many irritable bowel syndrome (IBS) conditions that produce these symptoms.
With SIBO your gastrointestinal tract is not functioning properly. For example, bacteria from one area of the gut, usually the colon, is growing in the small intestine. Food does not move as quickly as it should through the small intestine into the colon. In other words, it gets “stuck” and allows for bacterial overgrowth.
SIBO is often difficult to diagnose clinically because the symptoms can be vague and mimic other IBS conditions. Your doctor may ask you to keep a food diary for a week or two. In other words, have you write down everything you eat and the symptoms that follow. Other more definitive methods of diagnosis may include medical tests such as the lactulose-hydrogen breath test (LHBT) or laboratory blood tests.
The LHBT measures the amount of hydrogen and methane gas produced after eating fermentable foods containing glucose or lactose, such as a food high in FODMAPs.
Laboratory or blood tests look for anemia, vitamin B12 levels, or prealbumin, thereby indicating signs of malnutrition. Vitamin K levels may be elevated due to increased bacteria.
If your doctor diagnoses your symptoms as SIBO you wonder what is the cause. Other conditions that interfere with normal food digestion such as celiac disease, Crohn’s disease, or diverticulosis can increase your chance of developing SIBO. Family history may also play a role. For example, if a parent or sibling have the disease, you may be more likely to have it too.
Celiac disease is an inflammatory disease caused by an intolerance to gluten-containing foods. This inflammation can also cause the destruction of the lining of the small intestine and lead to obstruction.
In Crohn’s disease scarring in the small intestine can cause an obstruction. This will slow transit time and allow for an increase in bacterial growth to occur. In other words, allowing for gas and bloat to develop.
Diverticulosis is a condition where tiny sacs form in the intestine allowing bacteria to multiply. Furthermore, these can become infected or inflamed. Consequently, producing abdominal pain and bleeding.
It is important that treatments not only address symptoms but also any associated nutritional deficiencies.
Antibiotic treatment is used to reduce bacterial overgrowth and is one option. To be successful the antibiotic must be able to target the specific bacteria causing SIBO. Therefore, broad-spectrum antibiotics such as Cipro and Amoxicillin are commonly chosen.
Probiotics are living organisms that help improve or restore normal gut flora. There are many different types of bacteria in the intestine. Therefore, a single probiotic is not likely to be effective. For example, choose a probiotic with at least two or more species to see the most benefit.
According to research, probiotic species containing Lactobacillus and Bifidobacterium have the best potential to restore normal flora. Therefore, these are better able to help manage the symptoms of SIBO and IBS.
There are several foods that contain beneficial bacteria and have probiotic qualities.
Diet plays an important role in reducing the symptoms of SIBO. Simple sugars and short-chain carbohydrates are poorly absorbed in the small intestine. Consequently, these become food for bacteria and cause gas and bloating.
Foods known as FODMAPs or Fermentable, Oligo-, Di- and Monosaccharides And Polyols, exhibit these characteristics.
FODMAPS foods pull water into the intestinal tract and are usually not digested well. These foods then provide food for the overgrowth of bacteria. Consequently, this results in symptoms of bloating and gas as well as diarrhea or constipation.
While FODMAPs do not cause disorders, they may cause the symptoms. Therefore avoiding them is not a cure, but will improve the way you feel.
There are inconsistent methods of measuring FODMAP content in foods. In other words, the cut-off levels are not clearly defined.
Therefore, foods are listed based on clinical observation and feedback from patients who have identified them as triggers. Also, foods are listed based on their make-up. In other words, based on their fructose or lactose content, for example.
There are several Low FODMAP cookbooks available. Here are three written by dietitians:
Here are some simple low FODMAP snacks to try:
Pay attention to and AVOID high-fructose corn syrup. This is usually found in many prepared items, such as:·
Gluten-Free grains do not contain wheat or rye and are low in FODMAPs. There is an increasing number of gluten-free items in the market every day. Consequently making it easier to find a large variety to choose from. For example, look for bread or cereal made from oats or oatmeal. Also, cornbread, grits, and corn puffs are gluten-free and low FODMAP.
Water is the best way to stay hydrated. Hydration is important to keep your body functioning as normally as possible. It helps replenish fluids lost from frequent bowel movements or diarrhea. Try to consume at least 8-10 glasses of water each day. Also, increase your intake during times of flare-ups or illness.
Take a multivitamin and mineral supplement to meet your estimated recommended dietary intake (RDI) of vitamins and minerals. When foods are not digesting properly, nutrients are not absorbed well. Consequently, you run the risk of becoming deficient.
After a four to six-week trial period on the low FODMAP diet, try re-introducing a high FODMAP food. Begin with one food at a time and only in small amounts. If symptoms return, eliminate that food from your diet. Wait at least 3 days before trying a second new food. This will allow you to determine if a particular food is a trigger for you. In other words, a food or group of foods that make you feel ill.
There are also Low FODMAP apps you can download to make meal planning easier:
Everyone is different and you may find that one or more foods you tolerate are not one tolerated by others. Also, you may find you tolerate food in a small quantity and not in a larger portion. Unfortunately, there is no easy answer. Therefore, it is a trial and error practice that takes patience and commitment.
You may find that one or two or a combination of treatment options work for you. Also, the same treatments may be helpful now and not in the future.
I hope you have gained some helpful information from this article and found some useful tips to minimize your SIBO symptoms.
References:
Therapeutic Advances in Chronic Disease, 2013 Sep; 4(5): 223-231Gastrointestinal bacterial overgrowth: pathogenesis and clinical significance. Amit H. Sachdev and Mark Pimentel.
Journal of Gastroenterology and Hepatology Research, Vol 2, No 6, 2013. Celiac Disease presenting as idiopathic terminal ileum obstruction. Chee-Kin Hui.
Crohn’s and Colitis Foundation.
Verywell Health, Digestive Health, Irritable Bowel Syndrome, Managing both IBS and Diverticulitis. Barbara Bolen, Ph.D., Dec 11, 2019.
Healthline, Probiotics 101: A Simple Beginner’s Guide, Kris Gunnars, BSc, Nov 13, 2018
Staudacher, HM Whelan, Altered gastrointestinal microbiota in irritable bowel syndrome and its modification by diet, probiotics, prebiotics, and the low fodmap diet. Proc Nutr. Soc, 2016; 75:306-318.
Stanford Hospital and Clinics, Digestive Health Center and Nutrition Services, The Low FODMAP Diet.
The FODMAPs Approach-Minimize consumption of fermentable carbs to manage functional gut disorder symptoms, Kate Scarlata, RD, LDN. Today’s Dietitian, Vol. 12, No. 8, P. 30