Moving away from the theme of viruses – hooray! –  and talking to you today about the FODMAPS diet, specifically the low FODMAPS diet.
If you’re wondering what this word even means, it’s an acronym for terms describing certain carbohydrates (and their fermentable effect on digestion):  Fermentable Oligosaccharides Disaccharides Monosaccharides And Polyols.
Easy to understand why the acronym’s preferred.  Those carbs are quite a mouthful!

Fodmaps are found naturally in a wide range of foods.  They are different types of carbohydrates that are not easily absorbed in the gut, and which therefore can kick off IBS-type symptoms in some people.

Due to this diversity of potentially troublesome carbs it can be difficult to navigate the low FODMAPS diet, so here is a broad brush stroke of information to help you decide if you want to give it a go, either with a therapist, or on your own.

Let’s look a bit closer at this acronym.
Fermentables:  This is what happens when your gut bacteria ferments undigested carbohydrates.
Oligosaccharides: mainly found in wheat, rye, pulses but also garlic and onions..and more.
Disaccharides: mainly in dairy produce, including those yoghurts you might be eating daily because you believe they’re healthy (which they are for some, and perhaps for you, once you’ve been eating low FODMAP and introduced it later, in a small way; possibly only occasionally.  All very individual).
Monosaccharides:  these mainly cover fructose and include a variety of fruit plus honey – and corn syrups (do read labels when you go shopping!)
Polyols:  these are also found in different veg and fruit; also in articial sweeteners.

First thing to keep in mind when considering this diet is that you have to be dealing with IBS symptoms.  This isn’t a weight loss programme, nor is it a particularly healthy diet to keep in your life.  On the contrary.  As it excludes a lot of normally healthy prebiotic foods, this is an eating regime to do SHORT-TERM in order to reduce your IBS-ish symptoms.  Some prebiotic foods are included but not many, and you need these prebiotics for a healthy gut, for your diversely populated microbiome, hence this isn’t a diet for the long haul.

I normally suggest two to three weeks with clients, but if you’re feeling vastly better on it then an extra week or two is fine.  Monash university, which developed it in the first place years ago, and have an excellent app (more about that below), states you can follow it up to eight weeks.  Personally, I prefer clients to move back onto some of those ‘missed’ higher FODMAP foods earlier than that.

And this brings me to the next stage of the diet.  After your three or so weeks of ‘low’ eating, you then gradually introduce one higher FODMAP food, from one of the above groups, back into your menu to see how it feels, to check if you react and have symptoms.

This sort of challenge is what a lot of clients try out in order to identify ‘intolerance’ foods.  Exclude then reintroduce, one at a time, giving yourself days inbetween to allow some slower symptoms to emerge – or not.

With the FODMAPS approach – which is not about intolerance foods but about hard-to-digest carbs – once you’ve followed it for your two or three weeks, you then introduce a higher FODMAP food to your meal.  In a small way the first time, then building up slightly the following day.  On the third day you try a ‘normal’ (not huge!) amount of that food with your meal.

I recommend waiting a couple of days before you try another new higher FODMAPS food so that you’re not overloading your digestion, not challenging it too much.
Some people find their old gut symptoms return when they’re stepping up the amounts, so back off with that food, wait a couple of days and then try another higher FODMAP food.  Waiting those two days inbetween these trials gives pause for your digestion.

Always play it safe.  Stick to re-introducing one new food in one FODMAP group at a time.  Start small and gradually.
Everyone is different.  Some digestions are more sensitive or reactive than others, and this is one reason why it may help to work with a practitioner.
Another reason to work with someone:  You might be starting this diet because you feel you’ve “tried everything”.  Left out gluten then excluded that daily biscuit or sweet, reduced wine hugely, stopped the pizzas, left out some cheese.
This approach can often be too random, and if nothing else, there should be a logical and informed plan to how you go about changing your diet.  Some people may want the support of a nutritionist or naturopath with this plan.

Also important to be aware of is that a lot of gut distress can be due to overgrowths of yeasts or bacteria or parasites.  Stool tests would then be indicated, or other home test kits to rule out SIBO or gut permeability for instance.  Dietary changes alone won’t clear up an overgrowth of pathogenic gut bacteria, and eliminating sugars (& using a pessary) won’t resolve systemic candida.

Stress, too, can play a huge role.  In clinic, when talking about stress, often a client will say, ‘yes I’m stressed but isn’t everyone?’  Short-term stress, sure.  That’s part of life, and your body is wonderfully geared to coping with it.
Ongoing chronic stress, however, should never be considered the norm.  A low FODMAPS diet might relieve some gut symptoms but if underlying anxiety, stress, anger or insomnia are big in your life, the triggers to your digestive distress, then switching diets won’t be the magic bullet.  (Luckily there are lots of other magic bullets that can help you!)

All this low and high FODMAP food talk may sound like a pfaff but you can either work with a therapist or use something like the Monash University FODMAP app.  And if you don’t use apps there are some excellent online lists of food and recipes you can print off.

If working on your own, take your time to read about the FODMAP diet first.  Get your head around the aim of the diet, the foods and stages it involves so you are fully committed and have your kitchen stocked and those menu plans in place.  And don’t feel you have to eat a food just because it’s low FODMAP.  If you don’t normally want a banana, don’t eat it just because it’s ‘allowed’!

For those of you thinking life will be a vegetable misery for the weeks you’re on this diet you’ll be jumping for joy.  There are loads of fab veg which are low in FODMAPS.   Animal protein isn’t a problem, and there are good options for vegetarians like tempeh, eggs, quorn…

The above photo shows just a few vegetables I had at hand for some clients last month.  Instead of their regular follow-up, we had an extra hour of going through the foods together, then cooking a couple of dishes and eating the low FODMAP way.

Key points to remember:
First make sure this diet is right for you, that you’ve ruled out other players such as gut overgrowths, intolerance foods, stress….
Work with a therapist if you can, especially regarding the above issues you may not have considered.
If going it alone, I recommend downloading the above-mentioned Monash University app. There are other apps on the market – do take a look online – but this is the one I’m familiar with and which is specifically for tracking and working with FODMAPS and not overall diets.  Otherwise, google low FODMAPS diet and print off the food and menu lists.  Get your kitchen and your head ready for a couple of weeks of changed meals.

If you’d like any more information about the FODMAP diet I always offer 15 mins free calls.  And if you have any other worries about diet, health or well being do please contact me for a chat.

I’ve stopped 1:1 consultations during these times of social distancing, but skype, facetime and landline consultations work really well and have been part of my clinic for years.  Our voices and ears are in fine form and can side-step viruses to cross towns, counties and oceans via amazing technology.
How lucky we are for that!

It’s almost February, which seems so unlikely as the year only just began moments ago, surely?

In keeping with my new year’s resolution (which actually only dawned on me a week ago, well past new year, oops) I’m going to post more health info blogs on my website rather than just the short social media chat and occasional recipes.
This will keep me on my toes with some mindful research and deliberation, and will hopefully give you something to read and think about; a chance to make comments and suggestions as it’s all a learning game.  We are indeed unique, so our experiences will be very individual.

 

On this last day of the first month (and almost the eleventh hour! Been a long day…) I’m kicking off with the somewhat prosaic topic of high cholesterol.
Oh I know, it feels like we’ve been here, done that, however, in the last two days I’ve seen four clients who came for very different health reasons but all have alarmingly high cholesterol.  Scarily high LDL in fact (more about that below).
I took it as a sign to blog about some cholesterol facts and foods.
Apart from this coincidence – these four clients sharing more than they will ever know – the topic of cholesterol has become quite a controversial one; well worth having a chat about.

Contrary to conventional medical thinking these past decades, many studies now show that high cholesterol is NOT the be-all and end-all of CV risk.
A big statement, some may think, however these studies are proving that the measure of cholesterol is not always relevant.
Some people have a high ‘bad’ LDL cholesterol but are living to a healthy heart-attack-free age because, in part at least, their equally rising ‘good’ cholesterol has been offering them protecton.  Studies are also showing that when high cholesterol IS relevant to a person’s heart health, it’s not the only ‘measure’ that plays a significant role.  As I said, it’s not the be-all and end-all of CV disease.
This is not to say we ignore it altogether.
There is a place on the heart health table for trying to keep high cholesterol in check; certainly if there are other contributing negative factors gathering around that table.  Factors such as eating the wrong foods, chronic stress, insufficient exercise, overall body inflammation, smoking, weight gain (obesity is inflammatory and, like stress, it worsens all conditions), familial history of strokes and heart attack, and age (we remove excess cholesterol less efficiently as we get older).

What is cholesterol anyway?
A waxy fat-like substance that’s surprisingly important to our health.  It helps make our hormones, converts sunshine (when it’s around!) to vitamin D, is necessary for digestion and brain function, and assists in the absorption of fat-soluble nutrients.  Vital in fact for all our cell membranes, so we really don’t want to have too little of it.

When we talk about cholesterol we’re actually talking about the lipoproteins that carry cholesterol around our bloodstream.  These are fat on the inside and protein on the out and come in various forms, the two most relevant being, LDL (low-density lipoprotein, the so-called ‘baddie’ of the two, but yes there’s more to it than that regarding particle size and actual ‘badness’; too involved to go through here but there are excellent sites to read about these).  And secondly, HDL, the high density lipoprotein which is the ‘good’ cholesterol as it’s protective in that it takes excess cholesterol back to the liver where it’s then used or excreted. (It’s the efficiency of this disposal which can slow down with age, as mentioned above).  By removing excess cholesterol the build-up of fatty plaque in your arteries is avoided;  a build-up which is associated with low density lipoprotein, LDL and which can then lead to narrowing of the arteries and atherosclerosis.

When you have your cholesterol measured it’s the ratio of these two – LDL and HDL – that’s important to be aware of, not just the total number.

A large proportion of cholesterol that’s circulating in your blood is produced by the liver and intestines; the rest is from diet.  This may explain why some people with high cholesterol haven’t had the huge improvement – reduction – in ‘numbers’ that they expected after radically changing their dietary habits.

Nonetheless, for many people the effectiveness of dietary change regarding high cholesterol is extraordinary.  I’ve seen it in clinic;  one reason I wanted to write this post.  It’s an easy and very successful first port of call.  Together with getting off your sofa!

So, what are the foods that will make a difference, which will help you avoid taking medications, those statins that can have side effects and which are so very controversial?

Take a look at the photo accompanying this blog.
Eat more of these foods, the likes of flax seeds containing plant sterols that are shown to significantly lower cholesterol.  And oats with their soluble fibre.  More leafy green fibre such as spinach, chard, kale, radicchio, romaine lettuce, fennel, dandelion, spring greens, rocket, chicory… the list is endless!  And more cruciferous veg like broccoli, cauliflower, cabbage.
Also tocotrienols – found in the Vit E family and in the likes of walnuts and virgin olive oil which have shown improvement in arterial health.
And turmeric, always!  It’s not just a way of lowering inflammation but it improves vascular function in coronary artery disease and can suppress early atherosclerotic lesions (similar to lovastatin).

Eat far less meat, less overall saturated fats, less ‘whites’ (rice, potatoes, sugar, flour), less fried foods, far less sugars and salt.
Give up smoking, hooray!
And try to get stress levels down, down….

Last but by no means least, get moving.
Exercise will help rebalance your body, move your blood, shift stagnation, drop some kilos, soften the stress in your life, improve energy and alertness, increase happy hormones – and will most definitely help lower your high cholesterol.

 

Recently I saw two new clients who are having serious problems eating food.  People with allergies and intolerances are frequent clients, however both these people have quite extreme issues going on.
One has been on such a restrictive diet for the past year he’s now frightened to try anything new, or for that matter anything old.  He saw his doctor in January who said he had IBS and reflux; he was given antacids and told to watch what he eats.
All year this man has been watching his food, to the point that there isn’t much now left on his plate to watch.  After seeing his doctor back in January, he began searching online, trying out too many different hypo-allergenic diets, gradually eliminating so many foods that he’s now left with a sad and paltry selection; some quite bizarre.  He’s tired all the time, he tells me, and has lost too much weight.  “My joints hurt. I don’t know what to eat coz everything gives me heartburn”.  As he talks his leg jiggles the table between us.

Another new client the day after was a woman eating a reasonably healthy diet.  After hearing, however, about her regular reactions that are verging on anaphalaxis, I was surprised – in awe! –  at the variety of food she’s actually coping with.
Her allergy consultant has prescribed steroids which she takes when she has these severe reactions, worse and more frequent in recent times:  A tightening in her chest and throat, swollen lips, breathlessness, sometimes a sudden drop in blood pressure.  Scary stuff indeed.  She’s had to swap meds several times as she reacts to those as well (no surprise).
“What can I eat?” she asked.  Such an upbeat smiley woman, I would’ve loved to have given her an instant answer.

So, what to recommend when food becomes the enemy?

It may sound simplistic, or like some grandmother’s proverb but the logical start is, heal the gut.  These words are repeated around the globe every day by most nutritional therapists I’m sure!  And not just when food intolerances or bloating, flatulence, reflux and the like have become issues.  Given that 70% of our immune system is in our gastrointestinal system, we should all be wanting our digestion to be as happy as possible.

Healing the gut might mean different things for different people.  Removing certain gut microbes that shouldn’t be there, or are running rampant; increasing beneficial gut bacteria, strengthening the gut wall junctions, improving bile flow, increasing low levels of digestive enzymes or gastric acid a.o.  Some or all of the above; depends on the individual.
At the same time, too, expanding that digestive picture to include other important players linked to the health of our GI tract –  like the endocrine and nervous systems.

Food naturally will come into it, has to be part of the equation.  Not just because we have to eat to survive, or because that’s why people seek out a nutritional therapist, to find out which foods they should eat.
More due to that well-worn saying, we are what we eat – so true (just a shame it’s lost its impact with over-use). 

Food is a big part of healing the GI tract, of reducing chronic inflammation, of sustaining energy and improving well being.  Some foods have the potential to scupper digestive, or overall health – just think how sugar can spike everything into chaos in the body when it takes over every meal and isn’t treated with caution, kept to just an occasional treat.
Other foods have the nutrients, the astonishing ability to improve our immune health.  Those superpower foods, the likes of turmeric, green tea, fish oils, rainbow plant-based and fermented foods.  Or simply eating a balanced diet with healthy fats and quality protein (not to mention the humble green leafy veg, my fave… I’ll stop there, lol!)

After this posed question – what can I eat? – a dialogue begins. Discussing family history and other current health issues;  peeling back the layers and connecting as many dots as possible.  Trying not to overwhelm with too much information – that can be hard.  Working through food diaries and the results of lab tests. Seeing some of the puzzle pieces come together.
More often than not, the first step will focus on that healing of the gut as well as making careful changes to diet and invariably to lifestyle as well.  Suggesting people change habits they may rely on because they are part of their history, or convenient, needs to be considered.  The process has to be manageable and not too unfamiliar or threatening.

Removing, replacing, healing and restoring.  Adapting to the individual, to that person’s specific needs.  It’s a process, one step at a time.  A sharing of knowledge where it’s important to respect the difficulties in play.  Showing how food can be such a powerful medicine – as well as something delicious to eat!  And always with the aim of helping clients make food their friend and not the enemy. 

Appleaday’s Xmas gift this year, a 10% discount on first consultations – skype or 1:1 – during the month of Feburary 2020.  Email or message me on social media for available dates & times.

(Please note: the two clients above gave me permission to use some of their information.  I’ve kept it as general and vague as possible for privacy reasons).