Category: Food Sensitivities

Optimizing Digestive Function

4/20/2018

Food Sensitivities Explained Part III: Optimizing Digestive Function

Here’s a list-style overview of what we’ll be talking about relating to Optimizing Digestive FUNCTION:

Environment
Chewing
Stomach Acids
Digestive Enzymes
Intestinal Lining Health & Gut Microbiome
Hydration
Note on SIBO

We’ve previously visited the topic of RESTING the Digestive SYSTEM. Both resting of the system (via an elimination diet) AND optimizing digestive function must be happening at the same time if we’re going to heal the entire compromised digestive system and get back to eating most foods.

So when we talk about optimizing digestive function we’re mainly talking about nutrient absorption. Because you’re following an elimination diet followed by the re-intro phase your body is getting lots of good macro and micro nutrients.

YAY!

But what good do all those nourishing nutrients do for you if your digestive system can’t absorb them so that other body systems can use them? What other body systems? Literally everything that your body does. Nutrition is the foundation for maintaining health.

Think …

Organ Detox
Hormonal Balance
Cellular Function
Metabolism
Energy

It’s sort of like a car. You can put gasoline in it (the fuel that it needs to run) but if the fuel can’t be used to create mechanical energy then the car aint moving. Maybe the fuel pump isn’t functioning so the gas can’t get from the engine to the tank. It can’t “absorb” the fuel it’s been given.

Environment:
Let’s start with environment. How true are these statements of you:

When I eat I’m usually working or performing some other task at the same time like driving or housework.
When I eat I feel rushed
I end up having to eat around people I don’t really care for
When I eat there are usually loud noises and distractions all around me like TV & devices or bickering and arguments among the people I eat with

If any of these are true for you then you’re at least sometimes eating food under stress, whether you realize it or not. Remember when we’re talking about stress response we’re talking about physical processes in the body by way of the HPA Axis and the release of cortisol; essentially your body in “fight or flight” mode. And operating in fight or flight mode turns the body’s attention away from digestion. And instead concentrates on increasing your heart rate and your blood pressure.

Resolve right now to come up with ways, maybe with the help of a friend or a health coach, that you can create relaxing, calm, stress free environments while you eat.

WATCH THE VIDEO:

Chewing:
Research has found the evidence-based amount of times to chew hard foods (like nuts) is 40 times. Participants who chewed 40 times, their smaller particles of food were absorbed faster than those participants who chewed 10 or 25 times. Participants who chewed only 10-25 times, their larger particles weren’t absorbed at all, the body just eliminated them!

So, chew your food. 25-40 times. More like 40 for hard to chew foods like nuts.

Stomach Acids:
While the vast majority of nutrient absorption is in the small intestines, the stomach does play a role. And the stomach must be acidic enough for proper nutrient absorption during that stage of digestion. Low stomach acidity is called “hypochlorhydria”.

It can be caused by long term use of PPIs, genetic predispositions, stress, chronic pain, aging, drinking too much liquid with meals, and often it’s found in people with blood type A.

If you have weak or peeling nails, iron deficiency, or undigested food in your poop you may want to consider this issue. Natural sources to encourage appropriate stomach acid levels are:

Umeboshi plums or teas
Swedish bitters
Apple cider vinegar (1 TBPS in 8 oz water before meals)
Gentian root
Stress management

A more aggressive approach involves taking Bentaine HCL capsules with Pepsin to test your body’s response to this supplemental source of hydrochloric acid. Do NOT use this method with PPIs or antacids or if you have ulcers or ulcerative colitis.

Digestive Enzymes:
When food transitions from the stomach to the small intestines, the pancreas releases digestive enzymes to break down nutrients in this stage of digestion. To determine if you need supplemental digestive enzymes you can just try plant-based digestive enzymes and see how you feel. Here’s a link to a good one:

https://www.amazon.com/Designs-Health-Digestive-Vegetarian-Protease/dp/B000FGXL50

Or your functional medicine practitioner can order testing.

Naturally stimulate digestive enzymes with:

Turmeric
Mint
Ginger
Ajowan
Fennel
Coriander
Garlic
Onion

Intestinal Lining Health & Gut Microbiome:
We could talk about the gut and gut microbiota for days and days. For our purposes today let’s just highlight a few things:

Since most nutrient absorption happens in the small intestines it makes sense that the intestinal barrier or the “wall” of the intestines needs to be healthy and functional.
1. You’re already improving the intestinal barrier function using the elimination diet (resting the digestive system)
2. Inside the small intestine and the colon resides a community of organisms we call the microbiome or the microbiota or you may have heard it referred to as “good bacteria”. One of the many functions they serve is repair of the gut lining/wall. Community of these microbes = 10X the number of human cells!
  1. Probiotics and Prebiotics can give this community some support but we’ll save that for another discussion

It’s worth mentioning a few other notes:
1. Hydration is extremely important to the health of your digestive tract because the cells of the gut wall need to produce a protective lining of mucus. Which, it cannot do effectively without the presence of enough water. How much you ask? In general aim to drink ½ your weight in oz of water per day. Just not a bunch during a meal so that you don’t dilute your necessary stomach acids.
2. Small Intestine Bacterial Overgrowth (or SIBO) deserves further discussion, as there may be a link between it, IBS, and pelvic pain. Basically, the small intestine is housing either too many gut microbes or gut microbes that are misplaced (like they should be in the colon but not in the small intestine).
  1. We’ll definitely revisit SIBO but in the mean time, just know that there is a simple breath test to test for it. And there is an antibiotic that’s supposed to be effective without it disturbing the rest of the microbiome called Rifaximin. But it’s very expensive. There is some research on herbal therapies that may be effective.

To re-cap, to Optimize Digestive Function:

Eat in Stress-Free Environments
Chew Your Food
Maintain Adequate Stomach Acids
Maintain Adequate Digestive Enzymes
Support Intestinal Lining Health & the Gut Microbiome
Hydration!!

Until next time!

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Resting the Digestive System

4/9/2018

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Food Sensitivities Explained: Part II
Resting the Digestive System

Ok, so to hark back to last time, we decided if we’re having symptoms of food sensitivities, the best question for the moment is WHY is the digestive SYSTEM compromised (we’ll leave the HOW and the exact mechanisms to science for the time being). Go back and review the stressors that could be causing system compromise. And then focus on the short-term goal: REST the digestive system and OPTIMIZE digestive function. So that, we can get back to eating most foods.

We’re going to focus this time on resting the digestive system. And focus next time on optimizing digestive function. We have to do both at the same time in order to heal the compromised system. But in order to digest the information let’s approach them one at a time.

So, how do we take the stressors off the digestive system and rest it? The gold standard for resting the digestive is the elimination diet. The elimination diet is also the current evidence-based best practice for determining food sensitivities, not a laboratory test. Now, there are some tests available that have shown in the literature to be on the more reliable spectrum of reliability but still there is no one standard, reliable test. You may decide to take one of these tests under the direction of your physician to personalize your specific elimination diet. But you don’t have to have labs.

Research has found that it’s just as good as anything else to eliminate these 7: gluten, dairy, soy, eggs, sugar/sweeteners, peanuts, and shellfish. We’ll also avoid nightshades, alcohol and caffeine just to give the system a break from these as well. If you have a daily caffeine habit, wean off slowly and then start the elimination diet to avoid headaches and body aches. #beenthere

Hold On! Don’t quit on me just yet, that was the bad news and I know what a drag it is to know what you CAN’T have. So during the time of the elimination diet, you 100% focus on what you CAN have. Because just eliminating the main “culprits” without replacing them with nourishing foods will not be a time of rest for your digestive system. So I find what’s most helpful is to have a comprehensive list of what I CAN have. And that’s how I meal plan during my elimination diet.

Let’s talk about the food plan and then we’ll move onto the timeline. There are several therapeutic diets you could follow so feel free to go look them up and then pick one, adjusting it for your individual needs. Or, you can follow the pelvic pain elimination diet resource that I’ll provide for you, based on “Anti-inflammatory Nutrition for Endometriosis and Interstitial Cystitis” from the Integrative Women’s Health Institute. But please keep in mind that there is no protocol! It’s not like oh if you have IC you use this elimination diet or oh if you have vulvodynia you use this elimination diet or oh if you have IBS you use this elimination diet. Nope. Why? Because we are all individuals and we are all unique and because a protocol, with official diet “rules” and “procedures” according to a diagnosis, is not evidence based. K?

Paleo: Grain-free and dairy-free but would allow for eggs, nightshades, and some natural sweeteners so eliminate those as well.

Whole 30: Additionally this diet cuts out legumes and any sweeteners, even natural, but still allows for eggs and nightshades.

Ketogenic: Allows for dairy so be careful there, you’ll want to cut that out. It’s based on high consumption of healthy fats along with proteins and non-starchy vegetables.

Auto-Immune Protocol (AIP): Probably the most restrictive so, as with any others, make you sure you 100% focus on what you CAN have and nourish your body!

(Others exist, including the Wahls, low-FODMAPS, GAPS, and Low Oxalate. If you are vegan or vegetarian it’s hard, but not impossible, to ensure you get enough protein in your diet. Consider working with a functional medicine minded nutritionist, dietician, MD, or ND)

WATCH THE VIDEO:

You could even do a mixture of therapeutic diets out there, just making sure to stay away from the “avoid” list. To meal plan (and you’ll need to do lots of that: PLANNING) just type in Google “AIP meals” and “Paleo recipes” and “Ketogenic dinners” and seriously so much stuff with come up and if it includes something you can’t have just move onto the next one or substitute the ingredient if that’s possible.

Do some research and get a game plan. And it may help you to take a look at the elimination diet resource I provide.

So, speaking of game plan: how long is all of this going to take? You’ll need to fully commit to the elimination diet for 4 weeks or about 30 days. Because we know it takes about 23 days for any immune response from food to completely clear the system. Approach this like a scientific study: no “cheating” because you can’t gather reliable information that way. Keep a food journal starting from day 1 and record everything you eat plus an approximate portion size, even if you just use terms like “one handful”. There are apps you can download if you want to use technology instead of a written journal. Just be sure to read their privacy policies and terms of use so you know how they are using your data.

Also record daily in the journal: when did you poop and what number was it on the Bristol Stool Chart.

If you feel uncomfortable talking about poop, don’t worry I’m going to do a whole blog dedicated to poop and it will totally desensitize all your fears about the topic.

And record any symptoms you have that day and when: headache, stomachache or bloating, skin issues you notice, other areas of pain or inflammation, sinus problems, feeling in a fog, feeling sluggish. Also note any positive effects you notice in a day: clarity, energy, decreased pain, cleared up sinuses.

I know this sounds like a lot of work. It is. But this way you have a record of everything and you can go back over it and recognize patterns and draw some conclusions because let’s just admit it: aint none of us just going to ‘remember’. So we’ve got to record it.

If you notice somewhere near the end of week 3 and mid-week 4 that you’re still having symptoms of food sensitivities then it’s possible that you have sensitivity to something not among the “avoid list”. So for instance, you’ve substituted in lots of coconut in place of dairy but turns out you’re actually sensitive to coconut. At this point, if you’re frustrated and aren’t already seeing a practitioner, it’s time to find one that can help you navigate the waters, potentially with the help of some labs.

Let’s say, it’s been 30 days. And you’re feeling pretty good because you’ve RESTED the digestive system and you’ve OPTIMIZED the digestive function. Don’t forget that one… more on it next time! Now, you’re ready to “challenge” foods by putting them back into your diet to see if they trigger symptoms. We’ll call this the “Re-Intro Phase”. One at a time, that’s very important, one at a time you introduce a food back in. So just pick one, maybe something you really miss or something you’re just super curious about. Although, let’s make sugar wait last in line because you’ll want to in general only sparingly eat sugar moving forward anyway.

For example, eggs. While you continue to follow the rest of the diet, eat eggs for 3 or 4 days, about 2-3 servings a day. Then remove the eggs again and give any reaction to eggs 3 days to show up. Remember, food sensitivities are different than true allergies so reactions to them are usually delayed. It’s crucial to keep up on your journal: record what you eat and their servings plus your pooping and any symptoms you notice. If you get symptoms within those 3 days, you probably can’t tolerate the challenge food (eggs in this example) at least not right now. If no symptoms appear within 3 days then cool, you can tolerate eggs, incorporate it into your diet and then challenge the next food; maybe nightshades. Repeat until you’ve challenged everything on the “avoid list”. The Re-Intro Phase could take about 3 months. Worst-case scenario, there’s maybe 2-3 categories or foods you have to long-term avoid. And you may find that some things you can have in moderation without experiencing symptoms. (See my * below).

Don’t start this yet! First, join me next time to dive into OPTIMIZING digestive function during your elimination diet. See you there!

*I’ve found I can tolerate small amounts of dairy like a few tablespoons of cream a day or equivalent. Too much dairy and I’m sneezing and wheezing like I’ve been snorting hay. I have to avoid gluten 100%, though trace amounts don’t seem to cause issues. Gluten free & non-GMO grains and nightshades/legumes in moderation seem to be fine, I just can’t go crazy. If you’re reading this far into the post, then it’s likely your body will do best without gluten long-term because of its highly inflammatory properties. Best of luck!!

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FOOD SENSITIVITIES EXPLAINED

3/22/2018

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First, let’s have ultimate clarity on what we’re talking about. Food ALLERGIES and Food SENSITIVITIES are different. Allergic reactions to food are modulated by Immunoglobulin E (or IgE) which are antibodies produced by the immune system. Symptoms of allergic reaction are typically seen very quickly after exposure to what the immune system has determined to be an allergen, say peanuts for instance. So rather immediately you notice itching, rashes, hives, and in extreme cases even swelling of the throat & tongue which can restrict your breathing and is life threatening, requiring emergency room care.

Food sensitivities or intolerances on the other hand are a whole other discussion. It’s a controversial topic among the medical community in general because we don’t yet understand the mechanisms behind it. Several theories have been researched, including the possibility of a different class of Immunoglobulin, IgG, that may modulate food intolerance responses. But evidence for this theory is still lacking in the literature. So, as of this moment in history, we don’t really know. But I’m sure science will eventually answer that question for us.

In the meantime, we do know by why of observation that food sensitivities and intolerances exist. They can be tricky to track down because unlike allergies, symptoms often appear much later, typically 48-72 hours after exposure. So pinpointing what exactly you’re reacting to can be difficult.

WATCH THE VIDEO:

Let me just take a time-out real quick and touch on lactose. Lactose is the sugar molecule in milk. And in order for the body to break it down and absorb it, the enzyme lactase is required. Some people don’t make enough lactase to fully digest lactose in the small intestines. Therefore, undigested lactose passes into the large intestine where it is fermented. Fermentation = gas. So you end up with the typical signs of lactose intolerance: bloating, cramping, etc.

Dear Lactose & Lactase, Thank you for being so straightforward. Sincerely, Everyone

However, maybe we can learn something about other sensitivities from lactose/lactase? After all, the lactase enzyme is produced by the cells that line the wall of the small intestine. And we know that when the tight junctions between the cells of the lining or “wall” of the small intestine becomes compromised that the intestines “leak”. In other words, particles that aren’t supposed to pass back and forth through the wall now do. And as a result, some of these particles are recognized by the immune system as antigens or invaders and an attack against them is mounted. And this is the basis for at least some autoimmune related reactions in the body.

Anyway, all of this to say: maybe the question for the moment isn’t: HOW do we explain food sensitivities? But instead: WHY is your body’s digestive SYSTEM compromised?

So if you’re having symptoms of food sensitivities which could include:

Runny nose / Sinus congestion
Stomach aches
Headaches / Migraines
“Brain fog” or inability to concentrate
Joint pain and inflammation
Skin issues like acne and dermatitis

Then consider taking a systems approach to RESTING the digestive system because clearly the whole system is under stress and needs rested. The question is: Why? Why is this happening? The answer is in both your physical and your emotional stressors. For instance, did you know that blood sugar imbalance is stressful on your systems? If you eat the standard American diet it is quite likely that your blood sugar is often dysregulated and that is stress on your body. Poor and inadequate sleep is a physical stressor. If you’re emotionally stressed out and constantly rushing, constantly “doing”, you’re up-regulating your central nervous system and spending life in “fight or flight” mode. All of this stress is contributing to the dysregulation of your Stress Response System (the HPA Axis), which increases cortisol. And we know that cortisol breaks down the lining of the small intestines! Other things that damage or break down the lining of the small intestines:

Dehydration
Over exercising
Proteins in gluten
Genetic Modification of food
Pesticides

Etc.

So the goal is: take the stressors off the digestive system while optimizing digestive function. Then, get back to eating most foods. (Break out in Dance or the Hallelujah Chorus). That’s right! The goal is to go back to eating most foods. Take for instance, lectins. Lectins are antinutrients found in a number of foods: grains, beans, nuts, and nightshade vegetables (like tomatoes and peppers and eggplant). And our bodies should have the capacity to break them down. But in a compromised digestive system, we maybe can’t. So after resting the system AND optimizing digestive function, you can reintroduce or “challenge” lectins. And it’s possible that you can then tolerate all or least some lectin-containing foods.

How does one rest the digestive system while optimizing digestive function? Join me next time and we’ll dive into it!

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Optimizing Digestive Function

Food Sensitivities Explained Part III: Optimizing Digestive Function

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Food Sensitivities Explained: Part II
Resting the Digestive System

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Food Sensitivities Explained Part III: Optimizing Digestive Function

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Food Sensitivities Explained: Part II
Resting the Digestive System