Diet
#13956 - 07/14/03 01:58 PM
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Heather
Reged: 12/09/02
Posts: 7799
Loc: Seattle, WA
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All articles related to diet and digestive health research should be posted here.
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Journal of the National Cancer Institute, Vol. 95, No. 12, 914-916, June 18, 2003
© 2003 Oxford University Press
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BRIEF COMMUNICATION
Glycemic Load, Carbohydrate Intake, and Risk of Colorectal Cancer in Women: A Prospective Cohort Study
Paul D. Terry, Meera Jain, Anthony B. Miller, Geoffrey R. Howe, Thomas E. Rohan
Affiliations of authors: P. D. Terry, T. E. Rohan, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY; M. Jain, Integrated Policy and Planning Division, Ontario Ministry of Health and Long-Term Care, and Department of Public Health Sciences, University of Toronto, Toronto, Canada; A. B. Miller, Department of Public Health Sciences, University of Toronto, and Division of Clinical Epidemiology, Deutsches Krebsforschungszentrum, Heidelberg, Germany; G. R. Howe, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
Correspondence to: Paul D. Terry, Ph.D., M.P.H., National Institute of Environmental Health Sciences, Epidemiology Branch, P.O. Box 12233 MD A3–05, Research Triangle Park, NC 27709–2233 (e-mail: terry2@niehs.nih.gov).
ABSTRACT
Mounting evidence suggests that high circulating levels of insulin might be associated with increased colorectal cancer risk. The glycemic effects of diets high in refined starch may increase colorectal cancer risk by affecting insulin and/or insulin-like growth factor-I levels. We examined the association between dietary intake and colorectal cancer risk in a cohort of 49 124 women participating in a randomized, controlled trial of screening for breast cancer in Canada. Linkages to Canadian mortality and cancer databases yielded data on mortality and cancer incidence up to December 31, 2000. During an average 16.5 years of follow-up, we observed 616 incident cases of colorectal cancer (436 colon cancers, 180 rectal cancers). Rate ratios for colorectal cancer for the highest versus the lowest quintile level were 1.05 (95% confidence interval [CI] = 0.73 to 1.53; Ptrend = .94) for glycemic load, 1.01 (95% CI = 0.68 to 1.51; Ptrend = .66) for total carbohydrates, and 1.03 (95% CI = 0.73 to 1.44; Ptrend = .71) for total sugar. Our data do not support the hypothesis that diets high in glycemic load, carbohydrates, or sugar increase colorectal cancer risk.
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Eating Food Too Fast Speeds Heartburn - Slow Eating Cuts Acid Reflux Risks
By Jennifer Warner
WebMD Medical News
May 23, 2003 - Fast eating, not just fast food, can increase the risk of acid reflux after meals, according to a new study. Researchers say people who eat their food quickly are more likely to suffer from gastroesophageal reflux disease (GERD).
GERD occurs when stomach acids wash up into the esophagus and cause symptoms such as chest pain and heartburn. If left untreated, the condition can lead to more serious problems, such as narrowing of the esophagus, bleeding, or a precancerous condition known as Barrett's esophagus.
Several lifestyle factors are known to affect the risk of GERD, such as a person's weight and the type of foods they eat. But in this study, researchers looked at whether the speed alone with which a person eats a meal may contribute to the risk of acid reflux and GERD.
Researchers asked 10 healthy volunteers to eat a normal, 690-calorie meal in either five or 30 minutes on alternate days and then monitored them for two hours after the meals for signs of acid reflux and GERD.
The study showed that the speedy meals induced a total of 15 GERD episodes compared to 11.5 GERD episodes triggered by the more leisurely meal. Acid reflux episodes were reported a total of 12.5 times after the five-minute meal versus 8.5 times after the 30-minute meal.
The results were presented this week at Digestive Disease Week in Orlando, Fla.
"Since rapid food intake produces more [GERD], eating slowly may represent another life-style modification aimed at reducing [GERD]," write Stephan M. Wildi of the Medical University of South Carolina in Charleston, and colleagues. "In other words, 'Your mother was right.'"
SOURCES: Abstract, Digestive Disease Week, May 17-23, Orlando, Fla.
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CardioSource 3 May 2003, Volume 361, Issue 9368 Pages 1496-1501
Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study
Sheila A Bingham a, Nicholas E Day b, Robert Luben b, Pietro Ferrari c, Nadia Slimani c, Teresa Norat c, Françoise Clavel-Chapelon d, Emmanuelle Kesse d, Alexandra Nieters e, Heiner Boeing f, Anne Tjřnneland g, Kim Overvad h,i, Carmen Martinez j, Miren Dorronsoro k, Carlos A Gonzalez l, Timothy J Key m, Antonia Trichopoulou n, Androniki Naska n, Paolo Vineis o, Rosario Tumino p, Vittorio Krogh q, H Bas Bueno-de-Mesquita r, Petra HM Peeters s, Göran Berglund t, Göran Hallmans u, Eiliv Lund v, Guri Skeie v, Rudolf Kaaks c and Elio Riboli c *
Abstract
Background Dietary fibre is thought to protect against colorectal cancer but this view has been challenged by recent prospective and intervention studies that showed no protective effect.
Methods
We prospectively examined the association between dietary fibre intake and incidence of colorectal cancer in 519978 individuals aged 25–70 years taking part in the EPIC study, recruited from ten European countries. Participants completed a dietary questionnaire in 1992–98 and were followed up for cancer incidence. Relative risk estimates were obtained from fibre intake, categorised by sex-specific, cohort-wide quintiles, and from linear models relating the hazard ratio to fibre intake expressed as a continuous variable.
Findings
Follow-up consisted of 1939011 person-years, and data for 1065 reported cases of colorectal cancer were included in the analysis. Dietary fibre in foods was inversely related to incidence of large bowel cancer (adjusted relative risk 0·75 [95% CI 0·59–0·95] for the highest versus lowest quintile of intake), the protective effect being greatest for the left side of the colon, and least for the rectum. After calibration with more detailed dietary data, the adjusted relative risk for the highest versus lowest quintile of fibre from food intake was 0·58 (0·41–0·85). No food source of fibre was significantly more protective than others, and non-food supplement sources of fibre were not investigated.
Interpretation
In populations with low average intake of dietary fibre, an approximate doubling of total fibre intake from foods could reduce the risk of colorectal cancer by 40%.
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Affiliations
a MRC Dunn Human Nutrition Unit, Cambridge, UK.
b Strangeways Research Laboratory, University of Cambridge, Cambridge, UK.
c International Agency for Research on Cancer (IARC-WHO), Lyon, France.
d INSERM, U 521, Institut Gustave Roussy, Villejuif, France.
e German Cancer Research Centre, Heidelberg, Germany.
f German Institute of Human Nutrition, Potsdam-Rehbücke, Germany.
g Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark.
h Department of Clinical Epidemiology, Aalborg Hospital and Aarhus University Hospital, Denmark.
i Department of Epidemiology and Social Medicine, University of Aarhus, Denmark.
j Andalusian School of Public Health, Granada, Spain.
k Department of Public Health of Guipuzkoa, San Sebastian, Spain.
l Catalan Institute of Oncology, Barcelona, Spain.
m Cancer Research UK, Radcliffe Infirmary, Oxford, UK.
n University of Athens Medical School, Greece.
o University of Torino and CPO-Piemonte, Torino, Italy.
p Ragusa Cancer Registry, Sicily, Italy.
q Department of Epidemiology, National Cancer Institute, Milan, Italy.
r National Institute of Public Health and the Environment, Bilthoven, Netherlands.
s Julius Centre for Health Sciences and Primary Care, University Medical Center, Netherlands.
t Malmö Diet and Cancer Study, Lund University, Malmö, Sweden.
u Department of Nutritional Research, University of Umeĺ, Sweden.
v Institute of Community Medicine, University of Tromsř, Norway.
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* Correspondence to: Dr Elio Riboli, Unit of Nutrition and Cancer, International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert-Thomas, 69372 Lyon cedex 08, France
Source
Elsevier Science Inc.
© 2003 Elsevier Science Ltd
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Dig Dis Sci. 2002 Aug;47(8):1697-704.
High-fiber diet supplementation in patients with irritable bowel syndrome (IBS): a multicenter, randomized, open trial comparison between wheat bran diet and partially hydrolyzed guar gum (PHGG).
Parisi GC, Zilli M, Miani MP, Carrara M, Bottona E, Verdianelli G, Battaglia G, Desideri S, Faedo A, Marzolino C, Tonon A, Ermani M, Leandro G.
Servizio di Gastroenterologia, Casa di Cura Abano Terme USL 16, Padova, Italy.
High-fiber diet supplementation is commonly used in IBS, although it poses several management problems. Partially hydrolyzed guar gum (PHGG) has shown beneficial effects in animal and human studies, but its potential role in IBS symptom relief has not been evaluated yet. We investigated PHGG in IBS patients and compared it to a wheat bran diet. Abdominal pain, bowel habits, and subjective overall rating were longitudinally evaluated in 188 adult IBS patients (139 women and 49 men) for 12 weeks. Patients were classified as having diarrhea-predominant, constipation-predominant, or changeable bowel habits and were randomly assigned to groups receiving fiber (30 g/day of wheat bran) or PHGG (5 g/day). After four weeks, patients were allowed to switch group, depending on their subjective evaluation of their symptoms. Significantly more patients switched from fiber to PHGG (49.9%) than from PHGG to fiber (10.9%) at four weeks. Per protocol analysis showed that both fiber and PHGG were effective in improving pain and bowel habits, but no difference was found between the two groups. Conversely, intention-to-treat analysis showed a significantly greater success in the PHGG group (60%) than in the fiber group (40%). Moreover, significantly more patients in the PHGG group reported a greater subjective improvement than those in the Fiber group. In conclusion, improvements in core IBS symptoms (abdominal pain and bowel habits) were observed with both bran and PHGG, but the latter was better tolerated and preferred by patients, revealing a higher probability of success than bran and a lower probability of patients abandoning the prescribed regimen, suggesting that it can increase the benefits deriving from fiber intake in IBS, making it a valid option to consider for high-fiber diet supplementation.
Publication Types:
Clinical Trial
Multicenter Study
Randomized Controlled Trial
PMID: 12184518 [PubMed - indexed for MEDLINE]
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Nutrition. 1998 May;14(5):470-1. Related Articles, Links
Bran: may irritate irritable bowel.
Lewis MJ, Whorwell PJ.
The irritable gut is known to be hypersensitive, and it is reasonable to suspect that patients with the disorder might be hyperreactive to agents that stimulate or irritate it. This appears to be a possible explanation for the adverse effects of bran on hospital patients with this disorder, but we do not yet know how this product affects community IBS sufferers. We cannot ignore the fact that fiber and bran have major beneficial effects in other areas, not least in the reduction of colonic carcinoma. In conclusion, it is probably best to recommend that patients with IBS be left to judge for themselves whether bran helps or exacerbates their symptoms, but there is enough evidence to suggest that the current dogma of routinely treating all IBS sufferers with bran should be challenged. Proprietary sources of fiber, such as ispaghula, may be more appropriate for those IBS subjects (for example, constipated) for whom fiber supplementation is believed justified.
PMID: 9614316 [PubMed - indexed for MEDLINE]
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Lancet. 1994 Jul 2;344(8914):39-40.
Bran and irritable bowel syndrome: time for reappraisal.
Francis CY, Whorwell PJ.
Department of Medicine, University Hospital of South Manchester, UK.
Whilst following up large numbers of patients with irritable bowel syndrome we got the impression that wholemeal wheat and bran products made people with the condition worse rather than better. One hundred consecutive new referrals, all of whom had tried bran, were questioned to resolve this issue. 55% of patients were made worse by bran whereas only 10% had found it helpful. With the exception of fruit, other forms of dietary fibre were not as detrimental and proprietary supplements were found to be beneficial. All symptoms of irritable bowel syndrome were exacerbated by bran, with bowel disturbance most often adversely affected, followed by abdominal distension and pain. The results of this study suggest that the use of bran in irritable bowel syndrome should be reconsidered. The study also raises the possibility that excessive consumption of bran in the community may actually be creating patients with irritable bowel syndrome by exacerbating mild, non-complaining cases.
PMID: 7912305 [PubMed - indexed for MEDLINE]
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Gastroenterol Clin North Am. 1991 Jun;20(2):313-24.
Diet and the irritable bowel syndrome.
Friedman G.
Department of Medicine, Mt. Sinai School of Medicine, New York, New York.
Food intake plays a key role in triggering or perpetuating symptoms in patients with IBS. Evaluation of the impact of diet in the individual patient requires a precise dietary history and a 7-day prospective dietary analysis, which should include the quality and quantity of food consumed, chronologic sequence and nature of symptoms, and the frequency and consistency of bowel movements. The caloric density of the meal, total fat intake, the quantity and quality of lactose-containing foods, sorbitol, fructose, and the nature and quantity of soluble and insoluble fiber intake must be noted. Patients with reflux esophageal symptoms should eliminate foods that decrease LES pressure, such as chocolate, peppermint, alcohol, and coffee. Direct esophageal mucosal irritants such as tomatoes, citrus juices, sharp condiments, and alcohol should be limited. Gastric emptying is slowed with the ingestion of fats and soluble fiber. Small bowel motility is slowed by soluble fiber and fatty foods. Gaseous syndromes may be reduced by avoidance of smoking, chewing gum, excessive liquid intake, and carbonated drinks. The reduced intake of large amounts of lactose-containing foods, sorbitol, and fructose may limit postprandial bloating. Flatus production can be lowered by reducing fermentable carbohydrates such as beans, cabbage, lentils, brussel sprouts, and legumes. Soluble and insoluble fiber ingestion will reduce sigmoidal intraluminal pressures and overcome spastic constipation when given in progressive graded doses. Effective dietary manipulations remain a key factor in reducing symptoms in IBS.
Publication Types:
Review
Review, Tutorial
PMID: 2066155 [PubMed - indexed for MEDLINE]
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High-Protein Diets Can Hurt Kidneys - Damage Stems From Proteins Found in Meat
By Sid Kirchheimer
WebMD Medical News
March 17, 2003 -- High-protein diets like that of the popular Atkins diet may accelerate the loss of kidney function in people with early problems. However, these controversial diets do not seem to affect people with normal kidneys, suggests new research.
The problem is, as many as 20 million Americans are at risk for reduced kidney function but don't know it. Therefore, people on high-protein diets may be unknowingly damaging their kidneys.
"There are no symptoms attributable to this early kidney disease, but it's very prevalent," says Eric Knight, MD, MPH, lead researcher of the study and a doctor at Brigham and Women's Hospital in Boston. Those at highest risk are people with high blood pressure, diabetes, or are older than age 65, he says.
Even in his study, about one in four of the 1,624 women studied had mildly reduced kidney function that produced no obvious symptoms.
Knight's findings on high-protein diets are published in the March 18 edition of Annals of Internal Medicine. It's the latest chapter in the ongoing Nurses Health Study, which has already documented that frequent meat consumption may increase risk of colon cancer.
The women studied were questioned about their consumption of meat and other foods, and other health risks were also evaluated. They were tracked for 11 years, and researchers found that those with mild kidney problems who ate a high-protein diet --- especially protein from meat -- had a faster loss in function. No such association was noted among women with these kidney problems who got most of their protein from dairy foods. However, high meat consumption didn't seem to exacerbate problems in those with healthy kidneys.
"We saw a significantly measurable association in those consuming about 1.3 grams of animal protein for each kilo of body weight," Knight tells WebMD. "That level is not as high as the protein you get from animal sources in the Atkins diet. So clearly a person who is undertaking a high-protein diet such as Atkins should have a kidney function test and carefully be monitored while following this diet."
Are high-protein diets safe for those with normal kidney function?
"If the Atkins diet was the only way of losing weight, perhaps the benefits would outweigh the risks," he says. "Obviously, extreme obesity is a risk factor of kidney disease. But there are other health risks associated with high consumption of meat products, such as too much animal fats and saturated fats that increase the risk of heart disease. I think the message of our study is that people with mild reduced kidney function should be careful to moderate their intake of meat overall and very carefully consider the risk and benefits before starting an Atkins-type diet."
When beginning the Atkins plan, dieters typically eat about 2 grams of animal protein for each gram of body weight, says Colette Heimowitz, director of education and research for Atkins Nutritionals. That means a woman weighing 150 pounds would consume about 135 grams of protein each day -- nearly 40% more than what was typically consumed by those in Knight's study. In later stages of the high-protein diet, the amount of protein is reduced to levels consumed by those in Knight's study.
"We tell people they shouldn't do this program without first getting a physical and be monitored by their doctors, and those with mild renal insufficiency need to be under a doctor's supervision because they can't take in as much protein as the program offers in the induction phase," Heimowitz tells WebMD. "And we already say that in our books and on our web site. They can still follow an Atkins-type weight-loss plan by choosing healthy fats and healthy carbohydrates but will lose weight at a slower pace."
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SOURCES: Annals of Internal Medicine, March 18, 2003. Eric Knight, MD, MPH, doctor, Brigham and Women's Hospital; research fellow, Harvard Medical School, Boston. Colette Heimowitz, director of education and research, Atkins Nutritionals, New York.
© 2003 WebMD Inc. All rights reserved.
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European Journal of Nutrition
Publisher: Steinkopff Verlag
ISSN: 1436-6207
DOI: 10.1007/s00394-002-0380-4
Issue: Volume 41, Number 6/December 2002
Pages: 244 - 248
Relationship between lifestyle factors and defecation in a Japanese population
Shigeyuki Nakaji A1, Shoji Tokunaga A2, Juichi Sakamoto A3, Masahiro Todate A3, Tadashi Shimoyama A1, Takashi Umeda A1, Kazuo Sugawara A1
A1 Department of Hygiene, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562 Japan. nakaji@cc.hirosaki-u.ac.jp
A2 Department of Preventive Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
A3 First Department of Internal Medicine, Hirosaki University School of Medicine, Hirosaki, Japan
Abstract:
Summary. Background: There is a paucity of accurate data regarding any association in the general population between defecation and lifestyle factors such as diet, exercise, physique, and childbirth.
Aims of the study: To evaluate the effects of such lifestyle factors on defecation among regional residents of Japan.
Methods: Residents (n = 1,699) of northern Japan, aged over 40 years, were surveyed in 1995 using a questionnaire to assess their lifestyle factors (diet, beverage consumption, exercise, physique, and childbirth), and examining their defecation status. We evaluated the relationship between these lifestyle factors and defecation using logistic regression analysis. The authors used four measures (defecation frequency, subjective defecation state, subjective fecal properties, and fecal consistency) and assigned the subjects to a group defined by their defecatory status: constipation, diarrhea, or normal, depending on the responses of the subjects to all four criteria.
Results: The tendency for constipation correlated positively with age in males (p = 0.130), although this trend was not observed in females (p = 0.641). Of the dietary factors examined, only rice, which accounts for the largest proportion of daily dietary fiber intake in Japan, demonstrated a preventive effect on constipation in both sexes (p = 0.050 in males and 0.003 in females). Walking was a preventive factor for constipation among males (p = 0.049), and alcohol also inhibited constipation among males (p = 0.007).
Conclusions: These results suggest that exercise, such as walking, and a high intake of dietary fiber, such as rice, were useful in the maintenance of defecation.
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Gastroenterol Clin North Am. 1989 Sep;18(3):513-24.
Nutritional therapy of irritable bowel syndrome.
Friedman G.
Mount Sinai School of Medicine, New York, New York.
Nutritional factors relative to IBS include diagnostic and therapeutic considerations. Etiologically, foods do not cause IBS. A small percentage of patients with childhood allergic diatheses, usually in association with atopic dermatitis and asthma, may be intolerant to one or more of wheat, corn, dairy products, coffee, tea, or citrus fruits. Diagnostically, many patients labeled as IBS subjects are in fact intolerant to the ingestion of lactose-containing foods, sorbitol, fructose, or combinations of fructose and sorbitol. A precise dietary history will characterize this group. Taken in its broadest context, IBS involves the entire hollow tract inclusive of esophagus, stomach, small bowel, and colon. The symptomatic presentation relative to the hollow organ involved allows the selection of dietary manipulations that may help to reduce symptoms. Gastroesophageal reflux, a consequence of low LES pressure in some IBS patients, may be treated with the elimination of fatty foods, alcohol, chocolate, and peppermint. Delayed gastric emptying may be helped by the elimination of fatty foods and reduction of soluble fiber. Aberrant small bowel motor function may be ameliorated by reduction of lactose, sorbitol, and fructose and the addition of soluble fiber. Gas syndromes may be improved by reduced intake of beans, cabbage, lentils, legumes, apples, grapes, and raisins. Colonic motor dysfunction may be overcome by the gradual addition of combinations of soluble and insoluble fiber-containing foods and supplements. The selective use of activated charcoal and simethicone may be helpful.
Publication Types:
Review
Review, Tutorial
PMID: 2553606 [PubMed - indexed for MEDLINE]
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Note: Calcium polycarbophil is sold as Equalactin and Fibercon
Aliment Pharmacol Ther. 1993 Feb;7(1):87-92.
Calcium polycarbophil compared with placebo in irritable bowel syndrome.
Toskes PP, Connery KL, Ritchey TW.
Division of Gastroenterology, Hepatology and Nutrition, University of Florida College of Medicine, Gainesville 32610.
Calcium polycarbophil was compared with placebo in 23 patients with irritable bowel syndrome in a six-month, randomized double-blind crossover study. Patients received polycarbophil tablets at a dosage of 6 g/day (twelve 0.5-g tablets) or matching placebo tablets. At study end, among patients expressing a preference, 15 of 21 (71%) chose polycarbophil over placebo for relief of the symptoms of irritable bowel syndrome. Statistically significant differences favouring polycarbophil were found among the following patient subgroups: 15 (79%) of 19 with constipation: all six with alternating diarrhoea and constipation; 13 (87%) of 15 with bloating: and 11 (92%) of 12 with two or more symptoms. Polycarbophil was rated better than placebo in monthly global responses to therapy. Patient diary entries showed statistically significant improvement for ease of passage with polycarbophil. Polycarbophil was rated better than placebo for relief of nausea, pain, and bloating. The data suggest that calcium polycarbophil can benefit irritable bowel syndrome patients with constipation or alternating diarrhoea and constipation and may be particularly useful in patients with bloating as a major complaint.
Publication Types:
Clinical Trial
Randomized Controlled Trial
PMID: 8439642 [PubMed - indexed for MEDLINE]
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Br J Nutr. 2001 Mar;85 Suppl 1:S23-30.
Beneficial health effects of low-digestible carbohydrate consumption.
Scheppach W, Luehrs H, Menzel T.
Department of Medicine, University of Wuerzburg, Germany. w.scheppach@medizin.uni-wuerzburg.de
Low-digestible carbohydrates represent a class of enzyme-resistant saccharides that have specific effects on the human gastrointestinal tract. in the small bowel, they affect nutrient digestion and absorption, glucose and lipid metabolism and protect against known risk factors of cardiovascular disease. In the colon they are mainly degraded by anaerobic bacteria in a process called fermentation. As a consequence, faecal nitrogen excretion is enhanced, which is used clinically to prevent or treat hepatic encephalopathy. Low-digestible carbohydrates are trophic to the epithelia of the ileum and colon, which helps to avoid bacterial translocation. Short-chain fatty acids are important fermentation products and are evaluated as new therapeutics in acute colitis. They are considered in the primary prevention of colorectal cancer. The bifidogenic effect of fructo-oligosaccharides merits further attention, Unfermented carbohydrates increase faecal bulk and play a role in the treatment of chronic functional constipation, symptomatic diverticulosis and, possibly, the irritable bowel syndrome. In conclusion, low-digestible carbohydrates may play a role in the maintenance of human digestive health. However, the strength of evidence differs between disease entities.
Publication Types:
Review
Review, Tutorial
PMID: 11321025 [PubMed - indexed for MEDLINE]
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Scand J Gastroenterol. 2000 Oct;35(10):1048-52.
Fructose- and sorbitol-reduced diet improves mood and gastrointestinal disturbances in fructose malabsorbers.
Ledochowski M, Widner B, Bair H, Probst T, Fuchs D.
Dept. of Clinical Nutrition, Institute of Medical Chemistry and Biochemistry, University of Innsbruck, Austria.
BACKGROUND: Fructose malabsorption is characterized by the inability to absorb fructose efficiently. As a consequence fructose reaches the colon where it is broken down by bacteria to short fatty acids, CO2 and H2. Bloating, cramps, osmotic diarrhea and other symptoms of irritable bowel syndrome are the consequences and can be seen in about 50% of fructose malabsorbers. We have previously shown that fructose malabsorption is associated with early signs of mental depression and low serum tryptophan concentrations. It was therefore of interest whether a fructose-reduced diet could not only improve gastrointestinal complaints but also depressive signs seen in fructose malabsorbers. METHODS: Fifty-three adults (12 males, 41 females), who were identified as fructose malabsorbers according to their breath-H2 concentrations, filled out a Beck's depression inventory-questionnaire, and a questionnaire with arbitrary scales for measurement of meteorism, stool frequency and quality of life for a 4-week period before dietary intervention and 4 weeks after dietary change as for fructose- and sorbitol-reduced diet. RESULTS: Depression scores were reduced by 65.2% after 4 weeks of diet (P < 0.0001), and there was a significant reduction of meteorism (P < 0.0001) and stool frequency (P < 0.01). Improvement of signs of depression and of meteorism was more pronounced in females than in males. CONCLUSION: Fructose- and sorbitol-reduced diet in subjects with fructose malabsorption does not only reduce gastrointestinal symptoms but also improves mood and early signs of depression.
Publication Types:
Clinical Trial
PMID: 11099057 [PubMed - indexed for MEDLINE]
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Am J Gastroenterol. 1989 Apr;84(4):375-8. Related Articles, Links
Intestinal gas production from bacterial fermentation of undigested carbohydrate in irritable bowel syndrome.
Haderstorfer B, Psycholgin D, Whitehead WE, Schuster MM.
Division of Digestive Diseases, Francis Scott Key Medical Center, Baltimore, Maryland.
The relationship between abdominal pain and bowel gas from bacterial fermentation of undigested carbohydrate was investigated in nine patients with irritable bowel syndrome (IBS), six lactose malabsorbers, and 11 asymptomatic controls. All subjects took breath samples and marked analog scales for abdominal pain, bloating, and psychological stress hourly during all waking hours for 7 days. Breath samples were analyzed for hydrogen concentration within 3 days, and the concentration was corrected for storage time. Symptoms of pain and bloating were significantly more common in IBS patients than in lactose malabsorbers or normal controls, and pain was significantly correlated with bloating in IBS patients. Breath hydrogen concentration was similar in all three groups, and breath hydrogen was not correlated with pain ratings in IBS patients. Thus, abdominal pain may be related to bloating from gastrointestinal gas, but bacterial fermentation cannot be the cause of such gas. The most likely source is swallowed air. This study also demonstrates the feasibility of monitoring hydrogen production in the bowel in field studies by having subjects collect hourly breath samples.
PMID: 2929557 [PubMed - indexed for MEDLINE]
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Journal of Paediatrics and Child Health
Volume 39 Issue 5 Page 329 - July 2003
doi:10.1046/j.1440-1754.2003.00152.x
Cows milk consumption in constipation and anal fissure in infants and young children
F Andran 1, S Day 1, E Mete2
Objective: To examine daily cows milk consumption and duration of breastfeeding in infants and young children with anal fissure and constipation.
Methods: Two groups of 30 consecutive children aged between 4 months and 3 years were evaluated retrospectively. Group I comprised children with chronic constipation and anal fissure in whom surgical causes were excluded, and group II comprised normal children. The daily consumption of cows milk, duration of breastfeeding and other clinical features of the children were investigated
Results: The mean daily consumption of cows milk was significantly higher in group I (756 mL, range 2001500 mL) than group II (253 mL, range 01000 mL) (P < 0.001). Group I children were breastfed for a significantly shorter period (5.8 months, range 018 months) than group II (10.1 months, range 224 months) (P < 0.006). The odds ratios for the two factors children consuming more than 200 mL of cows milk per day (25 children in group I, 11 children in group II) and breastfeeding for less than 4 months (16 children in group I, 5 children in group II) were calculated to be 8.6 (95% confidence interval [CI]: 0.230.74, P = 0.0005) and 5.7 (95% CI: 0.370.66, P = 0.007), respectively.
Conclusions: Infants and young children with chronic constipation and anal fissure may consume larger amounts of cows milk than children with a normal bowel habit. Additionally, shorter duration of breastfeeding and early bottle feeding with cows milk may play a role in the development of constipation and anal fissure in infants and young children.
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Water Works
Health Sciences Institute e-Alert
September 16, 2003
You've probably heard that dietary fiber is good for your
heart. But if you've been eating lots of whole wheat bread
and high-fiber cereal in hopes that you're doing your
cardiovascular system a favor, then you may have been barking up the wrong tree.
Two recent studies reinforce previous research that revealed a clear relationship between dietary fiber and heart health.
And the studies show that choosing your fiber sources
carefully can make all the difference. Because there are two types of fiber, and while both are good for you, one has a more positive effect on your heart than the other.
------------------------------------------------------------
Fiber chores
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There's no need to stop the presses for the "news" that
dietary fiber is good for you. Low fiber intake has been
associated with an increased risk of a variety of cancers
(including breast and colon cancers), and I think it would be a very rare HSI member who was not aware that dietary fiber helps maintain a healthy digestive system.
All dietary fibers are classified as either water-soluble or insoluble. And because water-soluble fibers have been shown to support cardiovascular health, a team of researchers at Tulane University studied the dietary and medical records of nearly 10,000 subjects enrolled in the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study (NHEFS) looking for correlations between water-soluble fiber intake and coronary heart disease (CHD).
All subjects were disease-free when the study began. During
an average follow-up period of 19 years, 1843 cases of CHD
were recorded. Examination of the dietary records showed that subjects with the highest intake of insoluble fiber
(approximately 21 grams per day) had about 12 percent lower
risk of developing CHD as those with the lowest intake
(approximately 6 grams per day).
When the same records were compared for water-soluble fiber
intake, subjects with the highest intake of this fiber
(approximately 6 grams per day) had a 15 percent lower risk
of developing CHD, compared to those with the lowest intake
(less than one gram per day).
------------------------------------------------------------Cereal killer
Another recent study among almost 1,000 heart patients in
Milan, Italy, produced conclusions similar to the Tulane
study.
Dietary factors were assessed in interviews that showed that higher fiber intake reduced the risk of heart attack by well over 25 percent. But among those who had the highest intake of fruit and water-soluble fiber, heart attack risk was reduced by an impressive 36 percent.
One surprising fact emerged from the collected data: Those
with the highest intake of cereal fiber actually increased
their heart attack risk by more than 10 percent. This was
attributed to the fact that the sources of this type of fiber appeared to be refined grains. It's no secret to most of us that many food products claim to be "whole grain" or "whole wheat," but actually contain very little of either.
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Go to the source
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Most people don't eat enough unrefined, water-soluble fiber
to produce the positive results shown in the Milan and Tulane studies. But good quality water-soluble fiber is easy to come by when a little care is taken to find unrefined sources of these foods:
* Fruits, including oranges, peaches, apples, and grapes
* Vegetables, including carrots, squash, and corn
* Nuts and seeds (in particular, psyllium seeds)
* Legumes, including peanuts, lentils, peas, and kidney,
black, and pinto beans
* Oats and barley
Some people add fiber supplements to their diets, but William Campbell Douglass, M.D., has warned against using these supplements and eating fiber-enriched food, stating that the total effect they may have on the human body is still unknown and potentially dangerous. Dr. Douglass compares fiber-enriched foods to trying to make a silk purse out of a sow's ear, noting that, "adding fiber to foods with refined carbohydrates and artery clogging animal fats isn't going to make these already unhealthy foods any less bad for you."
Exactly so. Especially when it's so easy to find plenty of
water-soluble fiber foods in your neighborhood grocery store.
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Milk Slows Recovery from Bowel Surgery
Milk slows down recovery from bowel surgery, according to a study presented at the annual meeting of the American Society of Colon and Rectal Surgeons.
The study, led by Dr. L. Peter Fielding of York Hospital, in York, PA, compared patients given a dairy-free diet to others given a "standard" hospital diet. The dairy-free diet cut the incidence of diarrhea from 32 percent to 5 percent, and shortened the recovery from ten days to seven, cutting hospital costs from $10,337 to $6,751.
About 65,000 people undergo bowel surgery each year. The researchers estimated that if all hospitals instituted the diet change, they would save $250 million annually.
Lactose intolerance (an inability to digest the milk sugar lactose) may not be the only reason people benefit from the diet change. Both the fat and the protein in dairy products can affect digestive function.
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Fibre and breast cancer.
Gerber M.
Cancer Research Center, INSERM-CRLC, Montpellier, France.
The strength of the hypothesis that fibre reduces the risk of breast cancer is its biological plausibility, which is supported by experimental and interventional findings and by the coherence of observational studies. However, at least half the available epidemiological studies have failed to show a decreased risk in breast cancer for an increased fibre intake. But intervention studies taking the plasma concentration of oestrogens as an end-point showed significantly lower levels of breast cancer in women with a high-fibre and low-fat diet than in women with usual Western diets. Any reduction in breast cancer risk appears to be significantly dependent on the level of fibre intake. Several explanations can be proposed, including measurement errors in food intake, the insufficiency of food-composition tables, the difficulty of allowing for the diversity of fibre intake and the complexity of the natural history of breast cancer. More research is needed, not only better nutritional surveys for the different types of fibre intake and improvements in food-composition tables, but also epidemiological studies with the power to control for all the eventual confounding risk factors. Although the scientific evidence is not complete, recommendations for a fibre-rich diet should be made, both for cereals and for fruit and vegetables, in part because such diets at least do no harm, but also because fibre is known to be protective against other pathological conditions.
Publication Types:
Review
Review, Tutorial
PMID: 9696944 [PubMed - indexed for MEDLINE]
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Essential Oils as Components of a Diet-Based Approach to Management of Helicobacter Infection
Essential Oils as Components of a Diet-Based Approach to Management of Helicobacter Infection
G. E. Bergonzelli,* D. Donnicola, N. Porta, and I. E. Corthésy-Theulaz
Nestle Research Center, Lausanne, Switzerland
Received 30 December 2002/ Returned for modification 26 April 2003/ Accepted 7 July 2003
An increased density of Helicobacter pylori in the gastric mucosa can be associated with more severe gastritis and an increased incidence of peptic ulcers. Therefore, people with asymptomatic gastritis would certainly benefit from a nutritional approach to help them manage the infection and therefore decrease the risk of development of associated pathologies. We analyzed the activities of 60 essential oils against H. pylori P1 and identified 30 oils that affected growth, with in vitro inhibition zones ranging between 0.7 and 6.3 cm in diameter. We further analyzed the effects of 16 oils with different activities on H. pylori P1 viability. Fifteen showed strong bactericidal activities, with minimal bactericidal concentrations after 24 h ranging from 0.02 to 0.1 g/liter at pH 7.4. Even though slight variations in activities were observed, the essential oils that displayed the strongest bactericidal potentials against H. pylori P1 were also active against other Helicobacter strains tested. Among the pure constituents of different essential oils tested, carvacrol, isoeugenol, nerol, citral, and sabinene exhibited the strongest anti-H. pylori activities. Although oral treatment of H. pylori SS1-infected mice with carrot seed oil did not result in significant decreases in the bacterial loads in the treated animals compared to those in the control animals, in all experiments performed, the infection was cleared in 20 to 30% of carrot seed oil-treated animals. Our results indicate that essential oils are unlikely to be efficient anti-Helicobacter agents in vivo. However, their effects may not be irrelevant if one plans to use them as food additives to complement present therapies.
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* Corresponding author. Mailing address: Nestle Research Center, P.O. Box 4, CH-1000 Lausanne 26, Switzerland.
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Antimicrobial Agents and Chemotherapy, October 2003, p. 3240-3246, Vol. 47, No. 10
0066-4804/03/$08.00+0 DOI: 10.1128/AAC.47.10.3240-3246.2003
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Fructose may play role in irritable bowel syndrome
Globe and Mail Update
A diet high in fructose may contribute to symptoms of irritable bowel syndrome, a study released Monday says.
IBS commonly causes symptoms such as diarrhea, constipation, abdominal discomfort and bloating. Researchers at the University of Iowa Hospitals and Clinics in Iowa City have been investigating the effects of a diet high in fructose (the simple sugar found in honey and many types of fruit) on people suffering from IBS.
The researchers have found that there may be a significant portion of the population who are fructose intolerant, and in previous studies, they found that one-third to one-half of people suffering from IBS symptoms are fructose intolerant.
"Although lactose intolerance is well-known, fructose intolerance is just beginning to be recognized," said one of the study's authors, Dr. Young Choi.
In the study released on Monday, researchers tested 80 patients with suspected IBS and found that 30 were fructose intolerant. Of those 30 patients, half were placed on a diet that eliminated the simple sugar from their diets.
"For those who were compliant, symptoms, such as abdominal pain, bloating and diarrhea, declined significantly,," the study's authors say.
As well, the prevalence of IBS in the study group decreased, the authors said.
Bowel symptoms remained the same among the patients who did not modify their diets, the study says. The authors warn, however, that because of the small sample size, more significant studies are needed to confirm the findings.
However, Dr. Choi said, "a fructose-restricted diet significantly improved symptoms in patients with IBS and fructose intolerance. Fructose intolerance is yet another piece of the IBS puzzle — whose treatment, when adhered to — confers significant benefits."
IBS affects between 10 and 15 per cent of the U.S. population, according to the study's authors.
Approximately 12.1 per cent of the Canadian population, about 2.8 million Canadians, suffer from the condition, according to a study funded by Zelnorm, a prescription drug for IBS sufferers that just became available in Canada this year.
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Fat, Fructose May Contribute to IBS Symptoms
Charlene Laino
Oct. 14, 2003 (Baltimore) — Two new studies exploring the role of diet in irritable bowel syndrome (IBS) suggest that fat and fructose may contribute to symptoms of the gastrointestinal disorder that affects more than 1 in 10 Americans.
One study showed that patients with IBS and fructose intolerance who eliminated fruit and other fructose-rich foods from their diet experienced an improvement in symptoms.
Another study showed that people with functional gastrointestinal disorders, about half of whom had IBS, consumed a diet with a higher proportion of high-fat, low-carbohydrate foods than their healthy counterparts.
Neither study proves cause-and-effect, researchers stressed. But both studies, presented here this week at the 68th annual scientific meeting of the American College of Gastroenterology, point to the need to work with patients to identify possible dietary triggers of gastrointestinal symptoms, they said.
In the first study, Young K. Choi, MD, from the University of Iowa in Iowa City, and colleagues tested 80 patients with suspected IBS; 30 had positive fructose breath tests. The patients were taught to identify foods high in fructose and urged to avoid them.
While not as well known as lactose intolerance, fructose intolerance is common, with previous research by the same investigators showing it affects up to 58% of patients with symptoms of IBS.
After one year, 26 patients were available for a follow-up evaluation that included a structured interview to assess their dietary compliance and symptom patterns. Only 54% of participants reported that they remained on the fructose-restricted diet for a significant amount of time, Dr. Choi reported.
But those who remain on the fructose-restricted program reported significantly less abdominal pain, bloating, and diarrhea than before changing their diets (P < .05), he said. Noncompliant patients showed no improvement in symptoms.
On the ROME I scale, only 43% of patients who complied with the fructose-restricted diet continued to have symptoms of IBS compared with 75% of those who continued to eat fructose-rich foods.
Eleven (79%) of 14 patients who avoided fructose reported a strong correlation between occasional noncompliance and symptoms, the study showed, compared with 1 (8%) of 12 noncompliant patients.
Richard G. Locke, III, MD, associate professor of medicine at the Mayo Clinic in Rochester, Minnesota, questioned whether patients in the study really had IBS. "We used to think people who were intolerant to milk had IBS but now we know they have lactose intolerance," Dr. Locke said. "The same thing could be happening here. It's a matter of labeling."
The important message is to "educate patients that fructose can cause these symptoms," said Yuri A. Saito, MD, MPH, also of the Mayo Clinic. "The general public is not aware of this."
The second study, performed by Dr. Saito and colleagues, from the Division of Gastroenterology and Hepatology at Mayo, enrolled 221 patients, aged 20 to 50 years, about half of whom reported symptoms of functional gastrointestinal disorders on a well-validated self-report bowel disease questionnaire. All of the participants completed the Harvard Food Frequency Questionnaire, and a subset of 53 cases and 58 controls also kept diet diaries for one week.
Of the cases, 46% had IBS, 27% had functional dyspepsia, 20% had both, and the rest had other functional gastrointestinal disorders, Dr. Saito reported.
The Wilcoxon rank sum test showed that patients with functional gastrointestinal disorders reported consuming more fat in their diets: 33.0% of total calories vs. 30.7% for control patients (P < .05). The findings held true for both saturated fat and monounsaturated fat, she said.
Also, carbohydrates accounted for 49.1% of total calories in cases patients compared with 51.9% in control patients (P < .05), the study showed.
No significant differences between the two groups were found for protein, fiber, iron, calcium, niacin, or vitamins B, C, D, or E intake.
Subjects with functional gastrointestinal disease were also significantly more likely to suffer from food allergies than healthy subjects, Dr. Saito reported.
Further studies are needed to determine whether a high-fat, low-carbohydrate diet causes gastrointestinal symptoms or reflects changes that are adaptive, she said.
In the meantime, Dr. Saito said she does not recommend any blanket change in dietary recommendations. Instead, she works with her patients to uncover any foods that make their symptoms worse so they can be eliminated from the diet. "It is important to review my patients' food histories and look for obvious triggers such as excess fructose or sorbitol," she said.
Kevin W. Olden, MD, associate professor of medicine in the Division of Gastroenterology at the Mayo Clinic in Scottsdale, Arizona, agreed. "I advise my patients to eat what they enjoy. If they identify a food that makes them feel sicker, they should not eat that food. But you can't tell everyone not to eat cornflakes." Dr. Olden was not involved with the study.
ACG 68th Annual Scientific Meeting: Abstract 21, presented Oct. 13, 2003; Abstract 547, presented Oct. 14, 2003.
Reviewed by Gary D. Vogin, MD
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Vol. 164 No. 2, January 26, 2004
Effects of an Ad Libitum Low-Fat, High-Carbohydrate Diet on Body Weight, Body Composition, and Fat Distribution in Older Men and Women
A Randomized Controlled Trial
Nicholas P. Hays, PhD; Raymond D. Starling, PhD; Xiaolan Liu, MD; Dennis H. Sullivan, MD; Todd A. Trappe, PhD; James D. Fluckey, PhD; William J. Evans, PhD
Arch Intern Med. 2004;164:210-217.
Background The efficacy of ad libitum low-fat diets in reducing body weight and fat in overweight and obese adults remains controversial.
Methods We examined the effect of a 12-week low-fat, high–complex carbohydrate diet alone (HI-CHO) and in combination with aerobic exercise training (HI-CHO + EX) on body weight and composition in 34 individuals with impaired glucose tolerance (20 women and 14 men; mean ± SEM age, 66 ± 1 years). Participants were randomly assigned to a control diet (41% fat, 14% protein, 45% carbohydrates, and 7 g of fiber per 1000 kcal), a HI-CHO diet (18% fat, 19% protein, 63% carbohydrates, and 26 g of fiber per 1000 kcal), or a HI-CHO diet plus endurance exercise 4 d/wk, 45 min/d, at 80% peak oxygen consumption (HI-CHO + EX). Participants were provided 150% of estimated energy needs and were instructed to consume food ad libitum. Total food intake, body composition, resting metabolic rate, and substrate oxidation were measured.
Results There was no significant difference in total food intake among the 3 groups and no change in energy intake over time. The HI-CHO + EX and HI-CHO groups lost more body weight (–4.8 ± 0.9 kg [P = .003] and –3.2 ± 1.2 kg [P = .02]) and a higher percentage of body fat (–3.5% ± 0.7% [P = .01] and –2.2% ± 1.2% [P = .049]) than controls (–0.1 ± 0.6 kg and 0.2% ± 0.6%). In addition, thigh fat area decreased in the HI-CHO (P = .003) and HI-CHO + EX (P<.001) groups compared with controls. High carbohydrate intake and weight loss did not result in a decreased resting metabolic rate or reduced fat oxidation.
Conclusion A high-carbohydrate diet consumed ad libitum, with no attempt at energy restriction or change in energy intake, results in losses of body weight and body fat in older men and women.
From the Nutrition, Metabolism, and Exercise Laboratory, Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, Little Rock. Dr Starling is now with Pfizer Global Research and Development, Groton, Conn. The authors have no relevant financial interest in this article.
http://archinte.ama-assn.org/cgi/content/abstract/164/2/210
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Low Carb or Low Fiber Diets are a Prescription
for Prebiotics: Gums are Prebiotics
Dennis T. Gordon, Ph.D.
The Atkins Diet and similar low carbohydrate diets are causing a major change in dietary habits. The Atkins Diet is rapidly winning converts for weight management. Excessive weight gain is a serious public health epidemic; however, strict adherence to the low carbohydrate, high protein diets for more than a few months can cause some serious health complications.
The Atkins Diet curtails the consumption of a variety of foods that provide thousands of health promoting compounds (nutraceuticals) that help prevent many diseases. Also, these diets can provide too much protein, which taxes the kidneys, and too much fat, which leads to higher blood lipid levels and cardiovascular disease. Finally, the Atkins Diet significantly reduces the recommended amount of dietary fiber participants consume.
The U.S. National Academy of Sciences (NAS) recently established the first set of guidelines for dietary fiber intake which suggests that women and men should eat a wide variety of foods to provide 25g and 38g of fiber, respectively per day. At the time of these first guidelines, average consumption was approximately one-half
these recommended amounts. Adherence to a low carbohydrate diet which significantly reduces the variety of foods consumed co uld lower dietary fiber intake to less than 25% of recommended amounts, and this can lead to serious
health complications such as constipation, diverticulosis, and intestinal cancers.
Dietary fiber is simply the carbohydrate portion of the diet that is nondigestible and is commonly described as consisting of insoluble and soluble fractions. As insoluble dietary fiber passes through the intestine, it provides bulk and holds water that aids regular bowel movements, thus preventing constipation. Examples of insoluble dietary fiber are cellulose, hemicellulose, and wheat bran. When insoluble dietary fiber reaches the large intestine, it undergoes partial fermentation.
However, soluble dietary fiber such as guar gum, Acacia (gum arabic), pectin, and alginates undergo almost complete fermentation. Due to the extent of the fermentation, gums contribute 0 net carbohydrates to the diet because the carbohydrate portion is soluble dietary fiber. Once fermented, soluble fiber becomes "the" important source of energy for intestinal bacterial growth.
The relatively new term (1995) used to describe soluble dietary fiber or gums is "prebiotic." A more scientific definition of a prebiotic is "a nondigestible food ingredient that beneficially affects the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria in the colon, and thus improves host health".1
As prebiotics are fermented in the large intestine, more short chain fatty acids (SCFA) (i.e., acetic, propionic, and butyric) are produced. The SCFA decrease the pH
of the large intestine favoring the growth of more non-pathogenic organisms (Lactobacillus and Bifidobacteria sp) compared to pathogenic organisms (i.e., Proteus and Staphylococci sp). These changes in the large intestine, brought about by increased fermentation of prebiotics, leads to increased disease prevention. It's important for food manufacturers to recognize that current fad diets limit food choices and are too low in dietary fiber, and prebiotics explore other avenues for including fiber in the diet. Creatively designed foods that provide complete nutrition are one way to help ease the obesity epidemic.
1 Gibson G., R and Roberfroid M. B.
Dietary modulation of the human colonic
microbiota —introducing the concept
of prebiotic. 1995. J. Nutr., 125:1401–1412.
http://www.northstar-m.com/GoNorth/HTML_Emails/TICGums/TICGums12/PDFs/NLWinter04Page04.pdf
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McDonald's has documentary beef
Execs blast unseen movie 'Super Size Me,' emphasize choices
By Delroy Alexander
Tribune staff reporter
Published February 22, 2004
The red-haired clown with a larger-than-life smile has welcomed generations of children to McDonald's. But the bloated mug of a filmmaker soon could scare away health-conscious adults.
In the new documentary "Super Size Me," filmmaker Morgan Spurlock eats only McDonald's food for 30 days and documents his rapidly deteriorating health.
Interspersed with segments about obesity and processed food in the United States, viewers watch Spurlock pack on 25 pounds, ride out wild mood swings and get warnings from doctors about his rising cholesterol levels and liver toxicity. The movie will be released to theaters by the end of May.
The 90-minute movie could cause more people to bring obesity lawsuits against McDonald's Corp., predicts John Banzhaf, a professor at George Washington Law School. A consultant in lawsuits against McDonald's, Banzhaf appears in the documentary and was instrumental in building a case against the tobacco industry.
"What this movie did is show that if you eat there frequently, yes there can be problems," Banzhaf said.
"I would bet a lot of people are working overtime to figure out how to deal with this film," said Larry Kramer, a crisis management expert with Manning Selvage & Lee, who advised Nike boss Phil Knight in 1998 after a documentary showed children making its shoes in Indonesia.
Filmmaker Michael Moore's "The Big One" quickly led to major changes in Nike's operations, including the introduction of a minimum working age of 18 in its Indonesian factories.
Kramer said he likens McDonald's current predicament to a situation he faced in 1993, when he helped burger chain Jack in the Box rebound from a food poisoning outbreak blamed for the deaths of four children.
"We had to provide some perspective on food safety and tell our customers some hard truths," he said. "We told them that most food safety problems actually occurred in the home. I think the challenge that McDonald's faces is to communicate that eating three squares a day at its restaurants is not a healthy pursuit. People have to make smart choices."
In McDonald's case, executives are already in crisis management mode, openly questioning the film's content even though they haven't seen the picture yet.
"Absolutely, I'm a bit carried away," said an irate Ken Barun, Ronald McDonald House Charities president and the man in charge of the company's healthy/active lifestyle initiative.
"The movie is a distortion of reality. I'm sure we'll have more to say after we've seen the film," Barun said.
McDonald's is adamant that the nation's obesity problems are complex and the issues rely heavily on what consumers choose to eat.
"This is really not about McDonald's. It's more about personal responsibility," said Cathy Kapica, McDonald's director of worldwide nutrition who described the film she has yet to see as an exercise in binge eating. "I'm not sure that comes across in the movie."
The company's broader strategy is already clear.
Its executives are stressing personal choice, telling customers to make sensible choices and to limit fatty or sugary foods. McDonald's also is trying to educate consumers about the broader range of offerings it has on its menu. And the company is asking the media to closely examine Spurlock's motives.
"I don't think what we are seeing here has any balance at all," said Barun, who like others at the company has only seen clips and Spurlock interviews.
"We are talking about someone who has obviously gone to excess and exploited a brand that people will relate to in order to make his movie and capitalize on something that is unrealistic. It should be put in the category of the rest of the shock TV that you see. It's a distortion of reality."
Barun's reference to shock TV is a subtle dig at the filmmaker's past. Spurlock was the brains behind a Web-cast and short-lived MTV show in 2000 called "I Bet You Will," which centered on people doing almost anything for money. Often, shows involved bizarre eating stunts.
Filmmaker got no comment
Oak Brook-based McDonald's already may have missed a golden opportunity to get its point across when it opted not to speak with Spurlock. He captures himself in his film persistently trying to get an interview with company executives, following in the footsteps of filmmaker Moore in his "Roger & Me" documentary about General Motors Corp.
Kramer, the crisis management expert, said McDonald's must take authority on the issue of food and nutrition to counter any impact from "Super Size Me."
"They have to be the ones that say, `No, you shouldn't be eating six cheeseburgers a day.' It's a very credible answer and doesn't alienate their core customer that does eat a lot of cheeseburgers."
The company is doing exactly that.
For instance, customers soon will be able to buy an adult Happy Meal, which includes a salad, bottle of water, a pedometer and a diet and activity log designed by nutrition expert Bob Greene.
"We've been putting nutritional information in stores for 20-plus years," Barun said. "The Go Active [Adult Happy Meal] is going to be introduced nationally, and a big campaign is coming to get people to walk and eat more vegetables and fruits."
Barun and Kapica also point to healthier offerings such as grilled chicken, recently introduced salads and the move late last year to an all-white-meat chicken McNugget, a key part of the children's Happy Meal.
The old McNugget drew criticism in an ill-fated obesity lawsuit against McDonald's last year from a judge who described the product as a "McFrankenstein creation of various elements not utilized by the home cook."
No impact on bottom line yet
After the company won the legal battle, in which two overweight teenagers claimed their health problems were related to eating at the chain, criticism of McDonald's and other fast-food chains died down.
Even with the talk of obesity and potential lawsuits, McDonald's bottom line has yet to feel the pinch.
"We are concerned with the increasing debate and what kind of impact it might have, but the sales trends don't show any impact," said Mark Sheridan, a restaurant analyst with Johnson Rice & Co. "People talk healthy but eat what tastes good."
And so far, McDonald's remains reluctant to recommend just how many times a week a burger lover should visit its restaurants.
"It's an individual thing; there's no specific numbers," said Kapica. "It's not where you eat, it's what you eat and, especially, how much you eat."
Copyright © 2004, Chicago Tribune
http://www.chicagotribune.com/business/chi-0402220312feb22,1,268700.story
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Stress May Lead To Food Allergies
Feeling stressed? Watch out -- you could be giving yourself food allergies.
Researchers from the University of Amsterdam have found a link between stress and food allergies, as well as other intestinal disorders.
Annette van Kalkeren, a biologist from the university, found that mice that have been subjected to stress have intestines that overreact to certain foods.
Kalkeren investigated the reaction of pieces of mouse intestine to egg albumin, a substance found in eggs. Just like humans, mice can become allergic to the substance. She found that the intestines of mice subjected to prolonged stress had more symptoms of food allergies.
The intestinal wall becomes more permeable under stressful conditions. Harmful substances penetrate the intestinal wall, which causes a panic response by the immune system. That could be the start of an allergy.
During chronic stress, the body's natural defense is weakened and allergens can penetrate deep into the body. Food allergies and various intestinal diseases, such as Crohn's disease, ulcerative colitus and irritable bowel syndrome can in part be caused or enhanced by chronic stress.
But how did the mice get stressed in the first place? Kalkeren exposed them to several "stressful environments -- including cold, extended time in a narrow tube, social isolation, and swimming.
http://www.nbc11.com/health/1406559/detail.html
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While health foods may seem expensive, healthy diets save money in the long run
By Ann Betkowski
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Everyone is looking for the lose-weight quick solution. Adding to this is the fact that nutritionists are frequently changing their minds on what is good and what is bad for us. If even the experts cannot agree, how are we to make the right choices?
According to Dr. David Katz, author of "The Way to Eat," the nutrition community is nearly universal in its support in a diet rich in grains, fruits and vegetables and restricted in saturated fat and processed foods. Therefore make your commitment strong and stay with it.
"It is easy to say why not just eat whatever I want since the experts cannot agree," Katz said, "but everyone generally agrees that including five fruits and vegetables a day in your diet is best."
Katz reminds us that "in general, if something you hear seems too good to be true, it likely is."
Here are some answers to some common questions regarding healthy eating.
Why are healthy foods more expensive?
Most people believe that healthy food is more expensive than unhealthy food. However, when the costs of the entire diet are considered, eating well costs less than eating poorly.
According to Katz, many healthy foods can be expensive. Many specialty products are made in smaller quantities and so they can be more expensive. Organically grown produce can also be more expensive, but you get what you pay for. These fruits and vegetables tend to be more flavorful and do not include chemicals and pesticides.
However, compared to meat and animal products, plant-based foods are generally less expensive.
"Each time you substitute beans, lentils or tofu for meat, the fiber and nutrient content of the diet goes up, while the fat content and cost go down," Katz said.
"Whole grains are generally inexpensive as well," said Katz. "By increasing the amount of whole grain oats, rice, wheat, couscous and/or barley, you also improve your diet as well as your wallet. The same is true for butter, cream and soda."
Revising your diet to a healthier one can actually be cost-effective.
What is the real word on breakfast?
Breakfast is important but different people are hungry at different times of the day therefore the time to eat breakfast can be different for everyone. According to Katz, let hunger be your guide. If you wake up at 6 or 7 a.m. and are not hungry until 9 or 10 a.m., wait and have your breakfast then instead of having two meals in the morning.
"If you are not hungry first thing in the morning, and have breakfast later when you are, there can be several benefits," Katz said. If you eat breakfast later it could reduce your appetite for lunch. You may then eat less for lunch and have a healthy mid-afternoon snack. That snack may give you the energy you need to exercise and then enjoy a smaller dinner. In other words, having breakfast when you are ready for it can be the most beneficial.
Of course, Katz said, if you are hungry first thing in the morning, then that is when you should eat. However, try to include foods high in fiber, such as whole grain cereals. These tend to maintain energy levels longer than processed foods.
So what does "healthy food" really mean?
Food, in general, tends to be categorized into healthy and unhealthy groups. However, there can be big differences in sugar, fat and calories depending on their particular content. For example, a salad made up of mostly bacon bits, croutons, cold cuts and cheese includes a lot of fat and calories.
He suggests you do not think of food in categories but as the actual foods that you eat. "If you take in too many calories, your weight will go up. If you eat too much saturated fat, your cholesterol will rise," he said.
Therefore, Katz suggests that it is very important to read the labels on all the foods you are eating.
http://www.dailytimesonline.com/news/stories/20040301/localnews/48311.html
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How sweet it isn't
BY KIM SEVERSON
San Francisco Chronicle
An overweight America may be fixated on fat and obsessed with carbs, but nutritionists say the real problem is much sweeter -- we're awash in sugar.
Not just any sugar, but high fructose corn syrup.
The nation eats more sweetener made from corn than from sugar cane or beets, gulping it down in drinks as well as in frozen food and baked goods. Even ketchup is laced with it.
Almost all nutritionists finger high fructose corn syrup as a major culprit in the nation's obesity crisis. The inexpensive sweetener flooded the American food supply in the early 1980s, just about the time the nation's obesity rate started its unprecedented climb.
The question is why did it make us so fat. Is it simply the Big Gulp syndrome -- that we're eating too many empty calories in ever-increasing portion sizes? Or does the fructose in all that corn syrup do something more insidious -- literally short-wire our metabolism and force us to gain weight?
Loading high fructose corn syrup into increasingly larger portions of soda and processed food has packed more calories into us and more money into food processing companies, say nutritionists and food activists. But some health experts argue that the issue is bigger than mere calories. The theory goes like this: The body processes the fructose in high fructose corn syrup differently than it does old-fashioned cane or beet sugar, which in turn alters the way metabolic-regulating hormones function. It also forces the liver to kick more fat out into the bloodstream.
The end result is that our bodies are essentially tricked into wanting to eat more and at the same time, we are storing more fat.
IT'S EVERYWHERE
''One of the issues is the ease with which you can consume this stuff,'' says Carol Porter, director of nutrition and food services at the University of California at San Francisco. ``It's not that fructose itself is so bad, but they put it in so much food that you consume so much of it without knowing it.''
A single 12-ounce can of soda has as much as 13 teaspoons of sugar in the form of high fructose corn syrup. And because the amount of soda we drink has more than doubled since 1970 to about 56 gallons per person a year, so has the amount of high fructose corn syrup we take in. In 2001, we consumed almost 63 pounds of it, up from 1 ˝ pounds in the mid-'70s -- a more than 4,000 percent spike, according to the U.S. Department of Agriculture.
The USDA suggests most of us limit our intake of added sugar -- that's everything from the high fructose corn syrup hidden in your breakfast cereal to the sugar cube you drop into your after-dinner espresso -- to about 10 to 12 teaspoons a day. But we're not doing so well. In 2000, we ate an average of 31 teaspoons a day, which was more than 15 percent of our caloric intake. And much of that was in sweetened drinks.
So, the answer is to just avoid soda, right? Unfortunately, it's not that simple, because the inexpensive, versatile sweetener has crept into plenty of other places. A low-fat, fruit-flavored yogurt, for example, can have 10 teaspoons of fructose-based sweetener in one serving.
IN FROZEN FOODS
Because high fructose corn syrup mixes easily, extends shelf-life and is as much as 20 percent cheaper than other sources of sugar, large-scale food manufacturers love it. It can help prevent freezer burn, so you'll find it on the labels of many frozen foods. It helps breads brown and keeps them soft, which is why hot dog buns and even English muffins hold unexpected amounts.
The question remains just how much more dangerous high fructose corn syrup is than other sugars.
Fructose, as the name implies, is the sugar found naturally in fruit. It can be extracted, turned into granules and used like sugar in the kitchen. It used to be considered a healthier alternative to sucrose -- plain old table sugar. It's sweeter, so less is needed to achieve the same taste.
Diabetics use it because fructose doesn't stimulate insulin production, so blood sugar levels remain stable.
The process of pulling sugar from cornstarch wasn't perfected until the early 1970s, when Japanese researchers developed a reliable way to turn cornstarch into syrup sweet enough to compete with liquid sugar. After some tinkering, they landed on a formula that was 55 percent fructose and 45 percent glucose -- sweet enough and cheap enough to make most soda companies jump from liquid sugar to high fructose corn syrup by the 1980s.
`FATTEST PEOPLE IN THE WORLD'
Journalist Greg Crister lays out a compelling case against high fructose corn syrup in his 2003 book, Fat Land: How Americans Became the Fattest People in the World. He argues that federal policies that aimed to stabilize food prices and support corn production in the 1970s led to a glut of corn and then to high fructose corn syrup. With a cheaper way to sweeten food, producers pumped up the size and amount of sweet snacks and drinks on the market and increased profits.
Crister writes that despite the food industry's arguments that sugar is sugar, whether fructose or sucrose, no group ``has yet refuted the growing scientific concern that, when all is said and done, fructose . . . is about the furthest thing from natural that one can imagine, let alone eat.''
The latest case against high fructose corn syrup began in earnest a few years ago. Dr. George Bray, principal investigator of the Diabetes Prevention Program at Louisiana State University Medical Center, told the International Congress on Obesity that in 1980, just after high fructose corn syrup was introduced in mass quantities, relatively stable obesity rates began to climb. By 2000, they had doubled.
Further, the American Journal of Clinical Nutrition in 2002 published research that showed that teenagers' milk consumption between 1965 and 1996 decreased by 36 percent, while soda consumption increased by more than 200 percent. Bray argues that without calcium, which nutritionists agree can help the body regulate weight, kids got fatter. He says that he could find no other single combination of environmental or food changes that were as significant to the rise in obesity.
Other studies at UC Davis and the University of Michigan have shown that consuming fructose, which is more readily converted to fat by the liver, increases the fat in the bloodstream in the form of triglycerides.
And unlike other types of carbohydrate made up of glucose, fructose does not stimulate the pancreas to produce insulin. Peter Havel, a nutrition researcher at UC Davis who studies the metabolic effects of fructose, has also shown that fructose fails to increase the production of leptin, a hormone produced by the body's fat cells.
Both insulin and leptin act as signals to the brain to turn down the appetite and control body weight. And in another metabolic twist, Havel's research shows that fructose does not appear to suppress the production of ghrelin, a hormone that increases hunger and appetite.
Other researchers, too, are finding problems with high fructose corn syrup. A study in last month's Journal of the National Cancer Institute suggests that women whose diet was high in total carbohydrate and fructose intake had an increased risk of colorectal cancer. And Dr. Mel Heyman, chief of pediatric gastroenterology and nutrition at UCSF, is seeing sick children whose bodies have been overloaded with fructose from naturally occurring fructose in fruit juice combined with soda and processed food.
''The way the body handles glucose is different from fructose,'' he says. 'It can overload the intestines' ability to absorb carbohydrates by giving it too much fructose. That can cause cramps, bloating and loose stools.''
DISSENTING VIEW
Like others in the field, he says there is much to discover in how sugar works, but he disagrees that high fructose corn syrup is somehow reprogramming our bodies toward obesity. Rather, he says, we're just eating too much of it.
Nutrition theory holds that the basic make-up of fructose-laced corn syrup is not much different from table sugar. They react about the same in the body, says Dr. Walter Willett, a professor of epidemiology and nutrition at Harvard School of Public Health. ``There are some modest differences in metabolism, but I don't think fructose per se is the culprit.''
Neither do the food companies that use it in copious amounts.
Says Stephanie Childs, a spokesperson for the Grocery Manufacturers Association: ``At the end of the day, how any sweetener affects your weight depends on how many calories you are taking in overall. Overemphasizing one nutrient at the detriment of others is not going to solve the problem.''
Even some leading nutrition reformers aren't convinced that high fructose corn syrup is of itself the issue. The bigger battle, says Michael Jacobson, executive director of the Center for Science in the Public Interest, a consumer advocacy group, is to get added sugars listed on food labels with a percentage of daily value. That means a consumer could look at a package and see that, for example, one soda provides almost all the sugar a person should eat in a day.
''It simply comes down to this,'' he says. ``We're eating too much refined sugars, be it sucrose or high fructose corn syrup or any other refined sugar.''
http://www.miami.com/mld/miamiherald/living/health/8075662.htm
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Systematic Review: The Role of Different Types of Fibre in IBS
This systematic review shows that there is limited and conflicting evidence for the effectiveness of fibre in the treatment of irritable bowel syndrome symptoms. For the measure of efficacy, i.e. the proportion of patients with global irritable bowel syndrome symptom improvement, fibre was significantly better than control. Fibre therapy also showed favourable results in irritable bowel syndrome-related constipation. However, it may increase abdominal pain in some irritable bowel syndrome patients. The effect of psyllium on constipation was based on only two studies: Jalihal and Kurian[25] with a dose of 30 g and Prior and Whorwell[28] with a dose of approximately 5 g. Pooling with other studies with a lower dosage might underestimate the effects of a reasonable dose of psyllium.
The two types of fibre, soluble and insoluble, affected irritable bowel syndrome symptoms differently. Soluble fibre was beneficial to global symptom improvement, whereas insoluble fibre was not more effective than placebo and may, in some irritable bowel syndrome patients, worsen symptoms when compared with a normal diet. In two studies, a considerable effect was found. In one of these, a reasonable dose of psyllium was used.[25] Toskes et al. used calcium polycarbophil, which is a synthetic fibre resistant to bacterial degradation.[29] Pooling of these studies with other psyllium studies that use sub-optimal doses underestimates the treatment effect.
Evidence for the effectiveness of soluble fibre was obtained from the pooled results. Irritable bowel syndrome patients treated with this type of fibre reported 1.3 times more global improvement than controls. The effect of soluble fibre on irritable bowel syndrome-related abdominal pain, however, was controversial. Indeed, the studies that reported on the outcome measure of relief of abdominal pain varied considerably and showed conflicting results.[24,25,28]
The efficacy of insoluble fibre in the treatment of irritable bowel syndrome patients was also controversial. The studies showed that diets with a large amount of insoluble fibre might actually be worse than a normal diet. The clinical improvement of irritable bowel syndrome patients treated with insoluble fibre was no better than that obtained with placebo.[33,34,37,38]
The outcomes used in each of the randomized trials varied considerably. Consequently, several important outcomes were reported in only some of the trials. Moreover, they were measured in different ways. Generic outcomes, such as the quality of life, were not used in any of the trials. In terms of both global irritable bowel syndrome symptom improvement and individual symptom improvement, the studies showed heterogeneous results. The main reason for this may be the small sample sizes studied, which could have produced type II errors. Two studies in our analysis used either a single-blind or an open allocation of intervention,[36,39] whereas it is recommended that double-blind assessment should be used in irritable bowel syndrome trials.[40] However, many difficulties are encountered in the design and execution of trials with dietary intervention. As blinding is difficult in trials evaluating high-fibre dietary advice, we accepted these studies.
Three studies were excluded from our analysis as no data could be extracted to calculate a relative risk. None of these showed a positive response to treatment. This might have given rise to an over-estimation of the effectiveness of fibre.
The majority of patients with irritable bowel syndrome are managed in primary care.[4] Unfortunately, none of the selected studies included patients treated in a primary care setting. This limits the external validity of our results. Irritable bowel syndrome patients in primary care may, in fact, respond differently to dietary therapy than referred patients.[41] Furthermore, primary care patients who respond to treatment with bulking agents are less likely to be referred to a hospital clinic. Moreover, more than half of the symptomatic 'patients' from the general population do not even present to their general practitioner. The efficacy of fibre in this population is unknown.
The role of fibre in the pathophysiology of irritable bowel syndrome remains poorly understood.[42] An increase in the amount of dietary fibre is an almost universal recommendation in the primary care management of irritable bowel syndrome,[3,5] and guidelines on irritable bowel syndrome management for out-clinic patients advise an increase in fibre intake in the event of constipation.[5,43] However, our review showed only limited support for this recommendation.
In summary, our systematic review demonstrates the effectiveness of fibre therapy in irritable bowel syndrome patients, but only in terms of either global symptom improvement or constipation. The effectiveness on individual symptoms is variable. There is no effect of fibre in irritable bowel syndrome-related abdominal pain. Soluble and insoluble fibre have different effects on global irritable bowel syndrome symptoms. Insoluble fibre is probably no better than placebo and may, in some patients, even worsen the clinical outcome. For the development of evidence-based management guidelines, valid clinical studies in primary care patients, focusing on the effectiveness and tolerability of soluble and insoluble fibre, are needed.
Dr J.W.M. Muris, Maastricht University, Department of General Practice, PO Box 616, NL-6200 MD Maastricht, The Netherlands. E-mail: jean.muris@hag.unimaas.nl
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Aliment Pharmacol Ther 19(3):245-251, 2004. © 2004 Blackwell Publishing
http://www.medscape.com/viewarticle/469549_4
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Low-carb diets increase demand for laxatives
Sales of fiber supplements soar as irregularity spreads
The Associated Press
Updated: 5:48 p.m. ET March 30, 2004 PITTSBURGH - The mass of dieters doing away with carbohydrates may be changing the demographics for companies that traditionally have marketed fiber laxatives to the silver-haired crowd.
In an advertising campaign appearing at newsstands, GlaxoSmithKline is offering a "zero-carb solution to a low-carb problem," referring to the irregularity suffered by some people on the Atkins and South Beach diets.
It was the first shot in a marketing blitz that has pharmaceutical companies seeking out consumers who might traditionally be more familiar with hair gel products than fiber laxatives.
GlaxoSmithKline said it is responding to a bump in sales and a surge in calls over the past year to consumer lines regarding Citrucel, its fiber laxative.
Just days after the GlaxoSmithKline ads appeared, Proctor & Gamble fired back, promising in advertisements that their brand, Metamucil, allows users to "Stay regular. The 0 net carb way."
Labels on Citrucel caplets now let the low-carb crowd know the fiber laxative won't set them back. The caplet form has no carbohydrates and can "help you get back on track," according to magazine ads appearing in March editions.
Patrick Seiffert, brand manager for Citrucel, said GlaxoSmithKline is targeting consumers who follow a particular lifestyle and not an age group, but acknowledges that the target audience for the product may be changing, largely because of low-carb dieters.
"About 20 percent of the population is now on a low-carb diet and about a third experience changes in regularity," Seiffert said. "That's about 13 million people. That's significant for us."
The estimated number of people on low-carbohydrate diets varies widely, as does the number of people who suffer adverse effects from eating more meats and cheeses, hallmarks of the diet.
Yet Internet forums dedicated to Atkins and South Beach are clogged with the woes of people who have not replaced the fiber that was once part of their diet.
http://msnbc.msn.com/id/4633283/
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Nutrition experts push trans fats ban - Say trans-fats are disastrous for your health.
20/05/2004 A campaign is being launched to purge these molecules called trans-fatty acids, or "trans-fats" from the United States` cakes, snacks and fast foods.
Small quantities of trans-fats occur naturally in meats and dairy products, but most arrive in our stomachs through processed foods. They are manufactured by pumping hydrogen into vegetable oils to create partially hydrogenated oils and solid margarines.
Such fats are preferred by industry because they are versatile and last longer. But nutrition experts say trans-fats are disastrous for your health. Whereas saturated fats raise both `bad` low density lipoprotein cholesterol (LDL) and `good` high density lipoproteins (HDL), trans-fats boost LDL without affecting HDL, increasing the risk of heart disease.
Nutritional guidelines have long advocated cutting back on the saturated fatty acids found in meat and dairy products, and boosting unsaturated fats abundant in nuts, seeds and vegetable oils.
But trans-fats have taken longer to attract attention because their effects on health were less clear.
Evidence for the harmful effects of trans-fats has mounted, however. In 2002, a US expert committee charged with making nutritional recommendations concluded that there was no level of trans-fats in the diet that could be deemed safe.
A US nutritional group called the Center for Science in the Public Interest, based in Washington DC, now hopes that its TransFreeAmerica campaign will raise awareness of the health concerns. It is urging food manufacturers to eliminate trans-fats and advising consumers to boycott foods containing them. It is also calling on the US Food and Drug Administration to outlaw partially hydrogenated vegetable oils.
The plan is likely to meet resistance from some food industry members reluctant to change existing supply and production processes, predicts Turner. "It`s difficult to think we would ever get completely trans-fat free," she says.
Some countries and companies have already made moves to cut trans-fats. In 2003, the Danish government issued regulations slashing the amount allowed in foods.
In the United States, some food manufacturers such as Kraft Foods and McCain are scaling back the amount of trans-fats in their products. And from 2006, food companies will be required to list the amount of trans-fat on nutrition labels, so that consumers can choose what to buy.
The new campaign, "may accelerate the rate at which the industry moves," says nutrition expert Alice Lichtenstein of Tufts University in Boston. But it is important that trans-fats are replaced with healthy alternatives, she points out, such as plant oils rather than butter.
http://www.foodingredientsfirst.com/newsmaker_article.asp?idNewsMaker=5737&fSite=AO545
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Too Much Drinking Could Serve Up Colon Cancer
MONDAY, April 19 (HealthDayNews) -- People who drink more than three glasses of wine, beer or liquor a day may increase their risk of colorectal cancer by 40 percent.
That's the claim of a Brigham and Women's Hospital study in the April 20 issue of the Annals of Internal Medicine.
Consuming two average-size alcoholic drinks a day was associated with a small increased risk for colorectal cancer.
In this study, researchers analyzed data from eight studies that tracked nearly half a million people for up to 16 years. This new study is one of the largest to show that any kind of alcohol can influence a person's risk of colorectal cancer.
"The alcohol debate can certainly be a confusing one for patients, especially given alcohol's apparent protective effect on heart disease," study author Eunyoung Cho said in a prepared statement.
"Examining how alcohol is associated with other diseases like colorectal cancer is helpful for patients trying to balance the healthful effects of alcohol against the potential risks," Cho said.
http://www.principalhealthnews.com/article/hscoutn/103695010;jsessionid=H240CK4NISUDWCTYAEPENAQ
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PCRM Launches National Campaign Calling for End to American Cancer Society "Cattle Barons' Ball" Events
Cancer Society Promotes Disease with Beef Fundraisers, Say Doctors
WASHINGTON – The Physicians Committee for Responsible Medicine (PCRM) is calling on the American Cancer Society to put an end to its "Cattle Barons' Ball" events – beef-themed fundraisers promoting the very disease the cancer research and prevention giant is committed to curing.
The fundraisers feature Western and cowboy themes, including "chuck wagons" loaded with beef and other meats. More than 30 are held each year, mostly in the South and Southwest, almost two-thirds of them in Texas and Florida.
PCRM Nutrition Director Amy Joy Lanou, Ph.D., has written to the local organizers of the ACS-sponsored Cattle Barons events across the country urging them to either cancel or find new themes. As part of its campaign – "Cancer: It's What's for Dinner at the Cattle Barons' Ball" – PCRM has launched a nationwide e-mail write-in effort calling on American Cancer Society CEO John Seffrin, Ph.D. and ACS chapters to call off or re-theme these events. An e-mail "postcard" can be sent to Dr. Seffrin by going to PCRM's Web site www.AmericanCancerSocietyPromotesDisease.org/letter.html. Dates and full contact information on all upcoming Cattle Barons' Ball events are here as well.
"It is irresponsible of the American Cancer Society to sponsor events that promote beef consumption," said Lanou. "For more than 20 years, major scientific studies have linked beef and other meats with increased risk of cancer, particularly colorectal cancers."
A 1990 Harvard University study published in the New England Journal of Medicine linked regular meat consumption with a three-fold increase in colon cancer risk and a higher risk of cancer overall. Colorectal cancer is the second leading cause of cancer-related deaths in the United States for both men and women.
Lanou notes that the American Cancer Society is well aware of the association between meat and cancer.
"Recommendations to limit the consumption of red meat appear frequently in ACS educational materials, news reports, and on the ACS Web site. Given this, it is wholly inappropriate for the American Cancer Society to sponsor fund-raisers that promote the eating of beef," she said. "The ACS is condemning millions of Americans to a battle with a deadly, often incurable disease."
http://pcrm.org/news/issues040329.html
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May 18 , 2004
CONTACT: Jeanne Stuart McVey, 202-686-2210, ext. 316, jeannem@pcrm.org
New Studies Reveal Cholesterol and Weight Concerns for Low-Carb Dieters
* One-third of Low-Carb Dieters Show Marked Rise in "Bad" Cholesterol
* Diet's Weight-Loss Benefits Fade after Six Months
* Doctors Call on DHHS Secretary Tommy Thompson to Evaluate Risks
Washington, D.C.—Two new studies published in the May 18, 2004, Annals of Internal Medicine provide bad news for low-carb dieters, say doctors for the Physicians Committee for Responsible Medicine. The first, conducted at Duke University, showed that "bad" (LDL) cholesterol levels rose significantly in 30 percent of low-carbohydrate dieters. The second, conducted at the Philadelphia Veterans Affairs Medical Center, showed that weight lost during low-carb dieting started to return after six months.
Normally, weight loss causes cholesterol levels to fall. However, some low-carb dieters have experienced the opposite effect—significant increases of cholesterol levels. In the Duke University study, two study participants dropped out because of high levels of LDL ("bad") cholesterol: One had an increase in LDL cholesterol from 182 mg/dl to 219 mg/dl in four weeks; the second had an increase from 184 mg/dl to 283 mg/dl in three months. Normal levels are < 100 mg/dl. A third participant developed chest pain and was subsequently diagnosed with coronary heart disease. In all, 45 people followed the low-carb diet for 6 months. But 30 percent of them had an LDL cholesterol increase of more than 10 percent.
In the Philadelphia study, low-carb dieters lost substantial amounts of weight over the first six months. But after that point, the average weight began to climb so that weight loss after one year (11.2 pounds) was not significantly better than that seen with other diets. Two study participants on the low-carb diet died, one from hyperosmolar coma five months into the study, and the second from severe ischemic cardiomyopathy ten months into the study.
"This new evidence confirms that levels of "bad" cholesterol worsen in a substantial number of low-carbohydrate dieters," said PCRM resident Neal D. Barnard, M.D. "And the supposedly dramatic benefits of the diet do not hold up over the long term." A 2003 study conducted at the University of Pennsylvania showed that low-carb dieters began to regain lost weight after six months. The new results confirm these findings.
PCRM is urging the Secretary of the Department of Health and Human Services, Tommy Thompson, to convene a panel to investigate the potential adverse effects of low-carbohydrate diets on cholesterol levels, as well as on calcium losses, another problem observed in recent low-carbohydrate diet studies.
For an interview with Dr. Barnard or another PCRM nutrition expert, please call Jeanne Stuart McVey at 202-686-2210, ext. 316 or 415-509-1833 or jeannem@pcrm.org .
Founded in 1985, the Physicians Committee for Responsible Medicine is a nonprofit health organization that promotes preventive medicine, especially good nutrition. PCRM also conducts clinical research studies, opposes unethical human experimentation, and promotes alternatives to animal research.
http://pcrm.org/news/issues040517.html
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CONTACT: Monday, May 17, 1:00 pm CDT Kellie Hanzak, 202-955-6222 khanzak@spectrumscience.com Jessica Willocks, 301-941-2625 jwillocks@gastro.org
In New Orleans: Morial Convention Center 504-670-6420
GI HEALTH AFFECTED BY CONSUMPTION OF COFFEE AND CARBONATED DRINKS
Though Some Gain Liver Benefits from Coffee, Soda Drinkers at Increased Risk for Cancer
New Orleans, LA – According to new research presented today at Digestive Disease Week, drinking caffeinated beverages may benefit some people who are at high-risk for liver disease. Conversely, a study by researchers from India found that soda drinkers, who represent a huge percentage of the American population, may actually have an increased risk of developing esophageal cancer. DDW is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. "This research supports the widespread medical recommendations for healthy eating," said Lee Kaplan, M.D., Ph.D., of Massachusetts General Hospital. "The relationships between diet and disease that these investigators have seen are intriguing and should stimulate further exploration in this important area. It is even more apparent that lifestyle and dietary choices made during youth can have a significant impact on health later in life."
Coffee and Caffeine Consumption Protect Against Liver Injury in the United States Population (Abstract 100766*)
Researchers from the National Institute of Diabetes and Digestive and Kidney Disease of the National Institutes of Health are reporting that among people who are at high risk for liver problems, coffee drinking and consumption of other caffeinated beverages may reduce risk of liver disease. The national, population-based study was conducted among 5,944 adult participants of the third U.S. National Health and Nutrition Examination Survey (NHANES III) who were at high risk for liver injury (due to excessive alcohol consumption, hepatitis B or C, iron overload, obesity, or impaired
2 – 2 – 2 Coffee and Carbonated Drinks glucose metabolism). Participants were asked about consumption of caffeine-containing coffee, tea and soft drinks. The study found an inverse correlation between coffee and caffeine consumption and liver injury, which was classified by abnormal serum alanine aminotransferase (ALT) activity and was seen in approximately 8.7 percent of this high-risk population. In analyses both unadjusted and adjusted for age, sex, ethnicity and cigarette smoking, the prevalence of liver injury declined with increasing coffee drinking and caffeine consumption, though the protective effect was greater for caffeine intake. The correlation was consistent across subgroups when defined by individual risk factors for liver injury, as well as when applied to persons without impaired liver function.
"There is surprisingly little evidence-based information on the influence of diet and nutrition on the course and severity of chronic liver disease," said James Everhart, M.D., M.P.H., co- author of the study. "These results warrant further study."
Rise of Esophageal Adenocarcinoma in USA is Temporally Associated with the Rise in Carbonated Soft Drink Consumption (Abstract 105860*)
Researchers at Tata Memorial Hospital in India have found a strong correlation between the rise in per capita consumption of carbonated soft drinks (CSD) in the past 20 years and the increasing rates of esophageal cancer (ACE) in the United States. Based on available data on diet changes in America from the U.S. Department of Agriculture, per capita consumption of CSD rose by more than 450 percent during the past half-century, from 10.8 gallons in 1946 to 49.2 gallons in 2000. At the same time, in the last 25 years, incidence rates of ACE have risen by more than 570 percent in American white males and continue to increase.
The rise in CSD consumption preceded the rise in cases of ACE by 20 years. A 40 percent increase for each five-year increase in date of birth – a birth cohort effect – was previously reported. Using linear regression to compare trends between CSD and ACE rates, the researchers found a highly significant correlation between the two (r=0.99, 95% CI 0.96-1.0).
3 – 3 – 3 Coffee and Carbonated Drinks Researchers found published data for a strong biological basis to explain the increased dose and duration of esophageal exposure to acid: CSD drinking causes gastric distension that triggers reflux. Consumption of 350 milliliters of CSD per day (approximately one can of soda) corresponds to 53.5 minutes of pH less than four and 53 gallons per year translates to 32,100 more minutes of acid exposure per year. Excess CSD consumption started in childhood and American teenagers drank two cans of CSD per day on average, which can explain the birth cohort effect. White children drank significantly more CSD than black children. In general, identical time trends were seen worldwide, as countries with per capita CSD below 10 gallons (including Eastern Europe, Japan, China, Taiwan, Korea and India, among others) had little increase in the incidence of ACE.
Countries with per capita CSD of more than 20 gallons have seen a rising trend of ACE cases. "The surprisingly strong correlation demonstrates the impact of diet patterns on health trends," said Mohandas Mallath, M.D., lead author on the study. "This study re-emphasizes a general life style dictum that 'if little is good, a lot isn't better.' As the rates may continue to rise for another 20 years, we believe that more epidemiological studies are urgently required to establish the true association."
### Digestive Disease Week (DDW) is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. Jointly sponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA), the American Society for Gastrointestinal Endoscopy (ASGE) and the Society for Surgery of the Alimentary Tract (SSAT), DDW takes place May 15-20, 2004 in New Orleans, Louisiana. The meeting showcases approximately 5,000 abstracts and hundreds of lectures on the latest advances in GI research, medicine and technology. *Abstract numbers listed above correlate to abstract ID numbers listed on the DDW Web site, www.ddw.org. They do not coincide with program numbers as found in the printed DDW Program Guide.
AbstractID – 100766 First Author – Ruhl Institution –
Social & Scientific Systems Coffee and Caffeine Consumption Protect Against Liver Injury in the United States
Population Constance E. Ruhl, James E. Everhart Background & Aims:
The concept that patient behavior may influence the course and severity of chronic liver disease is appealing, but not well investigated. Based on the results of experimental data and epidemiological surveys, we investigated whether coffee drinking and caffeine consumption reduced the risk of liver injury in persons at high risk for liver injury in a national, population-based study. Methods: 5,944 adult participants in the third U.S. National Health and Nutrition Examination Survey (NHANES III), 1988-1994, who were at high risk for liver injury (due to excessive alcohol consumption, hepatitis B or C, iron overload, obesity, or impaired glucose metabolism) were asked about consumption of caffeine-containing coffee, tea, and soft drinks. Total caffeine from these beverages was calculated and divided into quintiles. Liver injury was indicated by abnormal serum alanine aminotransferase (ALT) activity (> 43 U/L). All analyses incorporated sample weights and the design effects of the survey.
Results: Elevated ALT activity was found in 8.7% of this high risk population. In unadjusted analysis, the prevalence of liver injury declined with both increasing coffee drinking and caffeine consumption. (p<0.05). Multivariate logistic regression analyses adjusting for age, sex, ethnicity, and cigarette smoking, also demonstrated that the risk of liver injury declined with increasing coffee drinking and caffeine consumption, with the protective effect being stronger for caffeine consumption (table). These relationships were consistent across subgroups defined by individual risk factors for liver injury and relatively unchanged when analyses included all NHANES III participants or when limited to persons without impaired liver function and without right upper quadrant pain.
Conclusion: In this large, national, population-based study, among persons at high risk for liver injury, coffee drinking and caffeine consumption from beverages were associated with lower risk of injury. These possible beneficial effects deserve further investigation. Multivariate-adjusted Logistic Regression Odds Ratios and 95% Confidence Intervals for Elevated ALT OR 95% CI p-value for trend Coffee (cups / day) 0.034 0 1.0 < 1 1.4 0.84 - 2.4 1 - 2 0.83 0.49 - 1.4 > 2 0.56 0.31 - 1.0 Caffeine quintiles (mg / day) < 0.001 < 49 1.0 49 - < 142 0.78 0.49 - 1.3 142 - < 200 0.72 0.41 - 1.2 200 - < 373 0.62 0.35 - 1.1 >=373 0.31 0.16 - 0.61
AbstractID – 105860 First Author – Mallath Institution – Tata Memorial HospitalRise of Esophageal Adenocarcinoma in USA is Temporally Associated With the Rise in Carbonated Soft Drink Consumption. Mohandas K. Mallath
Background and Aims: Incidence rates for adenocarcinoma of the esophagus (ACE) in rose by 570% in American white males in last 25 years and is still continuing to rise. There has been a 40% increase for each 5-year increase in date of birth- a birth cohort effect (El-Serag HB et al. Gut 2002;50:368-372) The reason for this rise remains unexplained. Time-trends in rates of ACE have wide variations world wide. We aimed to identify potential new risk factors that could explain these observations.
Methods: US Department of Agriculture (USDA) data was searched for major changes in the diets of Americans in 5 decades. Per capita carbonated soft drinks (CSD) consumption rose by 450% in USA from 10.8 gallons in 1946 to 53 gallons in 2000. Rise in CSD consumption preceded the rise of ACE by 20 years. Temporal trends between 3-year average of per capita consumption of CSD and incidence of ACE were analyzed by linear regression.
Results: Highly significant correlation was obtained between 3-yearly incidence of ACE (1974-2000) and the 3-yearly per capita consumption of CSD 20 years before (1964-1980); r=0.99, 95%CI 0.92-1.0; p<0.001 r2=0.98. We found strong biological basis to explain increased dose and duration of exposure to acid: 1. Consumption of 350 ml CSD per day corresponds to 53.5 minutes of pH <4 (Shoenut et al. Dig Dis Sci 1998;43:834-39), and 53 gallons per year would mean 32100 more minutes of acid exposure per year. 2. Excess CSD drinking started in childhood and American teenagers drank 2 cans of CSD per day (USDA) explaining the Birth Cohort Effect. 3. Prevalence of H pylori infection in the population fell during the same period to increase endogenous acid secretion. In general identical time trends were seen worldwide. Countries with per capita CSD below 10 gallons (e.g. East Europe, Japan, China, Taiwan, Korea, India, etc) had little increase in the incidence of ACE. Countries with per capita CSD more than 20 gallons are reporting a rising trend of ACE. Scotland with high rates of ACE over England had a 1.8 times higher consumption of CSD.
Conclusion: The linear association between per capita consumption of CSD 20 years before and the incidence of ACE is very strong. A biological explanation exists for this association, which is seen worldwide. The rising rates may continue for another 20 years. These findings are strong enough to initiate good epidemiological studies to establish the true association between CSD consumption and rates of ACE.
James Edgar Everhart, M.D., M.P.H. James Everhart, M.D., M.P.H., currently serves as chief medical officer of the Epidemiology and Clinical Trials Division of Digestive Diseases and Nutrition at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). His major research interests include digestive diseases, nutrition and epidemiology. Dr. Everhart maintains professional memberships in the Society for Epidemiological Research, the American Gastroenterological Association and the American Association for the Study of Liver Disease. He received the National Institute of Health's Director's Award in 1995 and has co-authored more than 100 articles appearing in publications such as the American Journal of Public Health, Journal of the American Medical Association and Hepatology. Additionally, Dr. Everhart has been invited to more than 30 presentations for organizations including the National Cancer Institute and the National Institute of Health. Dr. Everhart earned his bachelors in chemistry from Duke University and his doctor of medicine from the University of Virginia School of Medicine. He earned his masters in public health from Johns Hopkins School of Hygiene and Public Health. Dr. Everhart completed his residency in internal medicine at Allentown Affiliated Hospitals.
Mohandas K. Mallath, M.D. Mohandas K. Mallath, M.D., is professor and head of the Department of Digestive Diseases and Clinical Nutrition and officer-in-charge of the Postgraduate Studies Section at Tata Memorial Hospital. His research interests include cancer chemotherapy, familial cancer, medical screening, pre-neoplastic lesions, clinical nutrition, epidemiology, clinical trials and medical ethics. Dr. Mallath maintains membership to the Tata Memorial Hospital Scientific Review Committee, the Ethics Committee and the Infection Control Committee. He is also member of international organizations such as the American College of Gastroenterology and the European Society for Enteral and Parenteral Nutrition. Dr. Mallath is president-elect of the Society for Gastrointestinal Endoscopy of India. He has had more than 80 peer reviewed articles, authored 20 book chapters and developed more than 90 conference abstracts. Dr. Mallath earned his bachelors degree from Goa Medical College and his medical degree from the University of Bombay. He completed his residency at Goa Medical College and his fellowship in gastroenterology and ICU at Tata Memorial Hospital.
http://www.ddw.org/media/newsReleases/Caffeine.pdf
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CONTACT: Monday, May 17, 1:00 pm CDT
Kellie Hanzak, 202-955-6222 khanzak@spectrumscience.com">khanzak@spectrumscience.com</a> Jessica Willocks, 301-941-2625 <a href="mailto:jwillocks@gastro.org
In New Orleans: Morial Convention Center 504-670-6420
STUDIES INDICATE HEALTHY EATING MAY AFFECT CANCER DEVELOPMENT, IMPROVE DIGESTIVE SYSTEM
Research of Eating Behavior, Herbal Extracts, Shows Significant GI Benefits
New Orleans, LA – Making simple dietetic changes, such as incorporating green tea and fruits, may have a large impact on gastrointestinal health, according to new research presented today at Digestive Disease Week in New Orleans. Digestive Disease Week (DDW) is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery.
"Particularly for children, healthy eating patterns are important for proper GI function and development," said Lee Kaplan, M.D., Ph.D., of Massachusetts General Hospital. "Incorporating a healthy diet into a sound lifestyle can help prevent some of the most common GI-related conditions today."
Mechanism of Cell Growth Inhibition by Green Tea Extract in Barrett's Associated Esophageal Adenocarcinoma (Abstract 103982*)
Previous studies have found that the major polyphenol in green tea extracts, epigallocatechin gallate (EGCG), has chemopreventive effects on cancers affecting a number of organs in the digestive tract. In this study, researchers at the Harvard Medical School and VA Boston Healthcare System investigated the effects of EGCG on human esophageal cancer cells associated with Barrett's esophagus.
2 – 2 – 2 Healthy Eating
The team found that EGCG inhibits the growth and reproduction of Barrett's esophagus-associated human esophageal adenocarcinoma (cancer) cells (SEG-1 and BIC-1). They concluded that exposure to EGCG induces apoptosis (programmed cell death) and results in increased levels of the proteins caspase-3 and cleaved poly-ADP-ribose polymerase (PARP). In the study, the adenocarcinoma cells were treated with different concentrations of EGCG and monitored for cell growth, method of cell death and changes in apoptotic protein levels. Treatment of cells with EGCG inhibited cell growth and caused signs of early apoptosis at 24 hours. Further studies found that EGCG significantly increased levels of active caspase-3 and cleaved PARP proteins.
"Research suggests that drinking green tea may be both a valuable chemopreventive therapy as well as a treatment for esophageal adenocarcinoma," said Howard Chang, M.D., an investigator of the study. "Our results suggest that extracts in green tea may help to lower the prevalence of esophageal adenocarcinoma, one of the fastest growing cancers in western countries."
Effect of Eating and Nutrients on Recurrent Abdominal Pain in Children: A Population-Based Study (Abstract 103866*)
Recurrent abdominal pain (RAP) is a common condition in children and adolescents that is poorly characterized and often misdiagnosed. Researchers from the Baylor College of Medicine examined RAP in children to identify its clinical appearance and found that while it is common among school children, healthy eating habits appear to play a protective role against the condition.
A total of 700 school children completed a questionnaire that ranked RAP into three scales: pain intensity, non-pain symptoms and satisfaction. The overall prevalence of RAP was about one-quarter, with no differences with regard to ethnicity. Based on a pain intensity scale, 60 percent of children reported moderate to severe pain and 45 percent had pain for more than 30 minutes.
Children who ate daily in fast-food restaurants had more frequent episodes of pain than those who ate fast food only once per week. Eating fresh fruits played a protective role against RAP, even for those children who ate two or fewer servings of fruits per week.
3 – 3 – 3 Healthy Eating
"Our study found that abdominal pain is common among school children and can cause interruptions in school activities and lifestyles," said Hoda Malaty, M.D., lead investigator of the study. "But consistent with physician recommendations, we found that healthy eating habits appear to protect the GI tract from these symptoms." With their parents, school children completed a standardized questionnaire concerning socioeconomic parameters and abdominal pain intensity, frequency, duration, nature of RAP and possible relationships with school activities, eating patterns and other upper gastrointestinal symptoms.
Children were identified as having RAP if they met the widely-accepted Apley's Criteria: (1) at least three attacks of pain; (2) pain severe enough to affect activities; (3) attacks occurring over a period of 3 months; and (4) no known organic cause.
### Digestive Disease Week (DDW) is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. Jointly sponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA), the American Society for Gastrointestinal Endoscopy (ASGE) and the Society for Surgery of the Alimentary Tract (SSAT), DDW takes place May 15-20, 2004 in New Orleans, Louisiana. The meeting showcases approximately 5,000 abstracts and hundreds of lectures on the latest advances in GI research, medicine and technology. *Abstract numbers listed above correlate to abstract ID numbers listed on the DDW Web site, www.ddw.org. They do not coincide with program numbers as found in the printed DDW Program Guide.
http://www.ddw.org/media/newsReleases/FoodHerbals.pdf
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High Protein Diet May Affect Female Fertility
Reuters Health
Monday, June 28, 2004
BERLIN (Reuters) - Eating a high protein diet may make it more difficult for women to conceive, American researchers said on Monday.
Dr David Gardner, of the Colorado Center for Reproductive Medicine in Englewood, said diets containing 25 percent protein disrupt the development of early mice embryos and may have a similar impact in humans.
"Although our investigations were conducted in mice, our data may have implications for diet and reproduction in humans," Gardner told a fertility meeting.
In mice the high protein diet seems to interfere with a genetic process known as imprinting, which controls the activity of genes inherited from the father and mother.
The researchers fed mice a diet of either 25 percent or 14 percent protein for four weeks before mating them. Afterwards they examined 42 of the resulting early embryos, which are known as blastocysts, to see if imprinting for an important growth gene was altered.
They also transferred 174 early embryos into the wombs of mice that were eating a normal diet to study the impact of maternal diet before implantation on fetal development.
"We found only 36 percent of blastocysts developed in mothers on the 25 percent diet showed a normal imprinting pattern, compared to 70 percent in the control group," Gardner explained.
Fewer embryos in the high protein group developed into fetuses - 65 percent compared to 81 percent in the lower protein group.
"These findings, together with similar work carried out in cows means that it would be prudent to advise couples who are trying to conceive...to ensure that the woman's protein intake is less than 20 percent of their total energy consumption," Gardner told the European Society of Human Reproduction and Embryology.
"The available data certainly indicate that a high protein diet is not advisable while trying to conceive," he added.
But Dr Stuart Trager, the medical director of Atkins Nutritionals Inc, which developed the low-carbohydrate Atkins Diet, said some studies have shown a positive correlation between controlling carbohydrates and female fertility.
"The differences between mice and human embryos have recently been demonstrated by the ability to produce mice embryos from a single parent, a process that cannot be replicated in humans," Trager said in a statement.
"This casts a large discrepancy on the ability to derive conclusions about the clinical implications of this study with regard to humans," he added.
http://www.nlm.nih.gov/medlineplus/news/fullstory_18623.html
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Scand J Gastroenterol. 1994 Oct;29(10):916-22.
Effect of fiber source on short-chain fatty acid production and on the growth and toxin production by Clostridium difficile.
May T, Mackie RI, Fahey GC Jr, Cremin JC, Garleb KA.
Dept. of Animal Sciences, University of Illinois, Urbana.
BACKGROUND: Fermentable fiber promotes the growth of resident gut microbes, which modify the environment of the gastrointestinal tract and thus prevent colonization by Clostridium difficile. METHODS: An in vitro system with pigs as fecal inoculum donors was used to estimate fiber fermentability and changes in intestinal microbiota. RESULTS: Acetate and propionate production (mumol/mg substrate fermented/day) was greatest for gum arabic (1013.4 and 704.1, respectively); butyrate production was greatest for xylo-oligosaccharide (345.6). Growth of total anaerobes and clostridia was greatest for gum arabic (21.2 and 16.2 x 10(8) counts/ml, respectively) and xylo-oligosaccharides (21.0 and 19.6 x 10(8) respectively); growth of acidogenic bacteria was greatest with fructo-oligosaccharide (6.7 x 10(8) counts/ml). No culturable counts of C. difficile were obtained, nor was toxin A detected. CONCLUSIONS: Fermentable fibers support the growth of indigenous intestinal bacteria, particularly acidogenic bacteria, and yield large amounts of short-chain fatty acids with decreased gut pH. These factors contribute to the prevention of growth and toxin elaboration by C. difficile.
PMID: 7839098 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=7839098
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Berries, Beans Top 'Best Antioxidants List'
By E.J. Mundell
HealthDay Reporter
From HealthDayNews
June 28 2004 — A variety of veggies, fruits and nuts battled it out this month for the top spot on a new list of the 20 most antioxidant-rich foods, ranked by nutrition scientists at the U.S. Department of Agriculture.
In the end, small red beans won the day, narrowly beating out wild blueberries as the food with the highest concentration of disease-fighting compounds per serving.
Antioxidants fight damage to cells from rogue molecules called "free radicals." Experts believe this assault on cells may fuel killer diseases such as heart disease and cancer, and even aging itself.
The new Top 20 list, published in the June issue of the Journal of Agricultural and Food Chemistry, "is a relative ranking of the capacity of foods to interfere with or prevent oxidative processes and to scavenge free radicals," explained list co-creator Ronald L. Prior, a USDA nutritionist and research chemist based in Little Rock, Ark.
Prior and his colleagues used the most advanced technologies available to tabulate antioxidant levels in more than 100 different types of fruits, vegetables, berries, nuts and spices.
Their Top 20:
1) Small red beans (dried).
2) Wild blueberries.
3) Red Kidney beans.
4) Pinto beans.
5) Blueberries (cultivated).
6) Cranberries.
7) Artichokes (cooked).
8) Blackberries.
9) Prunes.
10) Raspberries.
11) Strawberries.
12) Red Delicious apples.
13) Granny Smith apples.
14) Pecans.
15) Sweet cherries.
16) Black plums.
17) Russet potatoes (cooked).
18) Black beans (dried).
19) Plums.
20) Gala apples.
There's "still a lot we haven't learned" about why some foods are richer in antioxidants than others, Prior said. Even though the small red bean came out on top, "we don't have a lot of information on beans," he added.
Berries are better understood. "The components that contribute a lot of the antioxidant activity are what are called anthocyanins, the compounds that give many berries their dark blue color," he said.
Food Color Makes a Difference
In fact, color may be key to spotting foods that fight free radicals, said Roberta Anding, an American Dietetic Association spokeswoman and a nutritionist at Texas Children's Hospital in Houston.
"If you're looking for the best places to get antioxidants, I will usually tell folks to look at the colors of the rainbow," she added.
For example, "you'll find lutein with some of the yellow pigments found in corn; orange can be the pigments from the carotenoid family that are found in cantaloupe, butternut squash and mango; red could come from things like lycopene, found in tomatoes and watermelon. And then the darker colors — the purples, blues, in berries," she said.
But Prior cautioned that just because a food has proven to be antioxidant-rich in the USDA's lab, that doesn't mean all those nutrients will be successfully absorbed by the human digestive tract.
"As we learn more and more, we're finding that, depending on the chemical makeup of antioxidants in different foods, some of them aren't apparently absorbed as well, or else they are metabolized in a form where they are no longer antioxidants," he said.
Whether a food is eaten fresh, frozen, processed or cooked can also affect its antioxidant potency — for good or ill, he said. Blueberries are best when eaten fresh rather than cooked in a pie, for example. On the other hand, research has shown that gentle cooking raises the antioxidant power of tomatoes, he noted.
Although experts are working hard on the project, ongoing efforts to come up with daily dietary guidelines for antioxidant consumption will be "a long process," Prior said.
"How antioxidants behave, how they act within the body, the dose-response — we just don't know enough about it," he said.
For her part, Anding said people shouldn't get too hung up on gorging on one particular food, but "cast your net widely," eating generous daily servings of a variety of fruits, vegetables and other wholesome foods.
Looking over the USDA's list, Anding suggested creating what she called an antioxidant "power salad."
First, she said, "put together a salad with a variety of mixed greens. Then I'd throw in some dried cranberries or blueberries from the health food store, toss in a few nuts, with a low-fat salad. Again — choosing from the colors of the rainbow."
http://abcnews.go.com/sections/living/Healthology/Antioxidants_list_healthday.html
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Walnuts are one of the most nutritious whole food
sources of alpha-linolenic acid (ALA), an essential omega-3 fatty
acid. Walnut consumption has been proven to significantly lower total
cholesterol levels as well as LDL or "bad" cholesterol levels.
Recently-published research also shows including walnuts in the diet
can improve vascular function, which can aid in the prevention of
heart disease and stroke.
Additional promising research from Penn State showing an ALA diet to
improve vascular function was reported May 6 at the American Heart
Association's 5th Annual Conference on Arteriosclerosis, Thrombosis,
and Vascular Biology in San Francisco. Lead author Sheila G. West,
Ph.D. says, "Our findings suggest that the special kind of fatty
acids that are present in walnuts can improve the function of arteries
and allow them to dilate better."
Many researchers cite the special combination of nutrients in walnuts
as accounting for these beneficial effects. In addition to providing a
significant concentration of ALA, walnuts contain many vitamins,
minerals, protein, fiber, melatonin, L-arginine and several other
important nutrients.
ALA is essential for optimal function of every cell in our bodies but
since our bodies can't create this "good" fat, we have to get it
from the foods we eat. The National Academy of Sciences recommends a
daily intake of 1.6 and 1.1 grams of ALA for men and women
respectively. With 2.5 grams of ALA, one ounce of walnuts more than
fulfills this requirement.
Based on a decade of evidence supporting the health benefits of
walnuts, the FDA affirmed a qualified health claim for walnuts (the
first for a whole food) in March 2004.
http://www.walnuts.org
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SOYFOODS APPEAR TO CUT RISK OF ENDOMETRIAL CANCER
Regular intake of soyfoods is associated with a reduced risk of endometrial cancer, finds a large study of Chinese women published in tomorrow's British Medical Journal (vol 328, p1285). Thought to be one of the largest studies into the association between soy and endometrial cancer, the researchers from the Shanghai Cancer Institute and Vanderbilt University in the US report an inverse dose-response relation between intake of soya food and risk of the disease, which affects the lining of the womb.
They also found that the association was more pronounced among women with a higher body mass index or a higher waist:hip ratio. Endometrial cancer is the fifth most common cancer among women worldwide - around 7,090 American women will die of the disease in 2004 - but incidence
of the cancer varies more than 10-fold worldwide.
Given that Asian women have a lower incidence of endometrial cancer and eat more soya food than their Western counterparts, the authors hypothesized that dietary factors may play an important role in this international variation.
Soy isoflavones are thought to play a role in the development of hormone related cancers, including breast and endometrial cancer. These and other plant estrogens have been shown to alter circulating concentrations of ovarian steroid hormones, prolong the menstrual cycle and alleviate symptoms of menopause, although evidence is not
entirely consistent.
Researchers interviewed 832 women in Shanghai who were diagnosed with endometrial cancer between 1997 and 2001 and were between the ages of 30 and 69 years. A further 846 healthy women of the same age were randomly selected as a control group. Soya food intake over five years was measured and current body measurements were taken.
Women with the highest intake of soy protein were a third less likely to develop endometrial cancer than those with the lowest intake. Those with the highest isoflavone consumption had a 23 percent lower risk than the lowest intake group.
The researchers added: "The indication that women with a high body mass index or waist:hip ratio may benefit more from increased soya food intake needs to be verified in future studies," said the authors.
http://www.nowfoods.com?cat_id=2626
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Soybean protein reduces body fat in women
25/06/2004 - A Japanese study finds that soybean beta-conglycinin may help to maintain a healthy body fat ratio and serum lipid levels in healthy women.
Beta-conglycinin, a major soy storage protein, has previously been found to reduce triglyceride levels in obese mice and inhibit atherosclerosis in mice.
In the new study, researchers measured changes in body fat ratio and serum lipids after the ingestion of beta-conglycinin by 41 healthy women. The trend of change in body fat ratio following ingestion of the beta-conglycinin differed between students with a baseline body fat ratio over 25 per cent and those less than this amount.
In the former group the beta-conglycinin suppressed the increase in body fat ratio and in the six subjects who had a high total cholesterol level (e 5.72 mmol/L) there was a tendency towards reduced levels of serum triglyceride, free fatty acid, total cholesterol and lipoprotein although those levels did not change significantly.
The researchers concluded that if soybean beta-conglycinin is ingested continuously (5g daily), it will be effective in keeping body fat ratio and serum lipid levels normal and eliminating excessive lipids from the body.
This study was reported in the Journal of Nutritional Science and Vitaminology 2004;50(1):26-31).
http://www.nutraingredients.com/news/news.asp?id=9521
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Oregano tops list of healthy herbs
Researchers from the US Department of Agriculture have found that herbs are an abundant source of antioxidants and could provide potential anticancer benefits when supplementing a balanced diet.
The research, published in the Journal of Agricultural and Food Chemistry, a peer-reviewed journal of the American Chemical Society, showed that herbs have higher antioxidant activity than fruits, vegetables and some spices, including garlic.
"Some herbs should be considered as regular vegetables," said Shiow Y. Wang, Ph.D., the study's lead researcher and a biochemist with the USDA's Beltsville Agricultural Research Center in Beltsville, Md. "People should use more herbs for flavouring instead of salt and artificial chemicals."
Using various chemical tests, Wang studied and compared the antioxidant activity of 39 commonly used herbs grown in the same location and conditions. The study, which did not involve animal or human subjects, included 27 culinary and 12 medicinal herbs.
The herbs with the highest antioxidant activity belonged to the oregano family, the research showed. In general, oregano had three to 20 times higher antioxidant activity than the other herbs studied.
On a per gram fresh weight basis, oregano and other herbs ranked even higher in antioxidant activity than fruits and vegetables, which are known to be high in antioxidants. Oregano has 42 times more antioxidant activity than apples, 30 times more than potatoes, 12 times more than oranges and four times more than blueberries, Wang said.
Other herbs were also found to be high in antioxidants, including dill, garden thyme, rosemary and peppermint.
The most active phenol component in some of the herbs with the highest antioxidant activity, particularly oregano, was rosmarinic acid, a strong antioxidant.
Antioxidants are a class of compounds thought to prevent certain types of chemical damage caused by an excess of free radicals, charged molecules that are generated by a variety of sources including pesticides, smoking and exhaust fumes. Destroying free radicals may help fight cancer, heart disease and stroke, researchers believe.
Fruits and vegetables have long been viewed as a rich source of antioxidant compounds. Health officials have been urging consumers for years to eat more fruits and vegetables in order to gain the health benefits of antioxidants, but progress has been slow, according to researchers. Westerners still tend to favour diets that are rich in fats and carbohydrates, they say.
More recently, researchers have begun to formally study the health benefits of herbs and spices. The two differ mainly by source. Herbs typically come from the leaves of plants. Spices come from the bark, stem and seeds of plants. Both have been used for thousands of years to flavour foods and treat illness.
In general, fresh herbs and spices are healthier and contain higher antioxidant levels compared to their processed counterparts, according to Wang. For example, the antioxidant activity of fresh garlic is 1.5 times higher than dry garlic powder.
Just as consuming too much of any food product can carry health risks, herbs should be used with moderation, Wang cautioned. Herbs are no substitute for a balanced diet, she added, and pregnant women in particular should consult their physicians before taking herbal supplements.
http://www.nutraingredients.com/news/news.asp?id=3319
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June 15, 2004 -- Calcium supplements could cut colon polyp risk -- especially advanced polyps that lead to colon cancer, new research suggests.
The report appears in the latest issue of the Journal of the National Cancer Institute.
"Our results suggest that calcium supplementation may have a more pronounced ... effect on advanced [colon polyps] than on other types of polyps," writes lead researcher Kristin Wallace, MS, with Dartmouth Medical School in Lebanon, N.H.
While some research has looked at this link, few have addressed it in any detail -- to look for the effects of calcium on different types of colon polyps, Wallace explains. These studies make no distinction on the effects of calcium supplements on polyp size or other characteristics.
Also, what are the effects of calcium in the diet and from pills? One study has suggested that a 700 mg supplement daily may prevent polyps. However, it's not been clear whether a high-calcium diet boosts or hinders that effect, she writes.
The researchers analyzed data from patients involved in the large Calcium Polyp Prevention Study. The analysis involved 913 patients whose average age was 61 and who were followed for at least four years.
They had been randomly assigned to take either 1,200 mg calcium supplements or a placebo. Each volunteer was asked about the calcium, fat, and fiber they typically got in their diet. Each participant had a history of having a polyp removed at least three years prior to the start of the study. They also had a colonoscopy at the beginning of the study to document no remaining polyps in the colon.
After four years:
The calcium group had 18% fewer noncancerous polyps and 35% fewer advanced polyps -- those with features that have a higher potential to become colorectal cancer -- compared with the placebo group.
There was another interesting pattern: Those with fewest polyps ate a high-calcium, high-fiber, low-fat diet. However, the numbers did not tally up as a definitive finding, notes Wallace.
In all, her study suggests that total calcium intake over 1,200 mg daily is necessary for colon protection -- and that a high-fiber diet with modest levels of fat will boost the protective effects, she writes.
Wallace's findings are in line with similar studies but fall short of proving a preventive link between calcium, colon polyps, and colon cancer, writes Arthur Schatzkin, PhD, with the National Cancer Institute, in an editorial.
However, studies are in place that could prove that this one nutritional factor -- calcium -- could offer protection against colon cancer. "That would be a tremendous advance," writes Schatzkin.
It's not clear how calcium acts to reduce colon polyps, writes Wallace. It may be that calcium binds "irritants" like bile acids and other fats in the bowel that are carcinogenic -- acting as a sort of "soap," possibly preventing colon cancer.
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SOURCES: Wallace, K. Journal of the National Cancer Institute, June 16, 2004; vol 96: pp 921-925. Schatzkin, A. Journal of the National Cancer Institute, June 16, 2004; vol 96: pp 893-894.
http://my.webmd.com/content/article/88/100106.htm
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Using cranberry juice for urinary tract infections has been known for a while, with recent studies showing a 20% decreased risk in urinary tract infections in women(1). The role for cranberry juice in helping promote health and prevent disease has now been broadened to include peptic ulcers. A new study in Food Nutrition and Science (2) found that a high-molecular-weight constituent in cranberry juice is able to prevent the bacteria Helicobacter Pylori from binding to the lining of the stomach.
H. pylori weakens the protective mucous coating of the stomach and duodenum, which allows acid to get through to the sensitive lining beneath. H. pylori is able to survive in stomach acid because it secretes enzymes that neutralize the acid. This mechanism allows H. pylori to make its way to the "safe" area of the protective mucous lining. The bacterium's spiral shape then allows it to burrow through the lining, causing a sore, or ulcer (3).
Peptic ulcers affect 25 million Americans at some point in their lives and are responsible for 1 million ulcer-related hospitalizations each year. H. Pylori has also been linked to stomach cancer, acid reflux disease, and gastritis (stomach inflammation).
References:
1. Kontiokari T. Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women. British Medical Journal 2001;322: 1571-1573
2. Burger O. Inhibition of Helicobacter pylori adhesion to human gastric mucus by a high-molecular-weight constituent of cranberry juice. Critical Reviews in Food Science and Nutrition 2002; 42 (supplement): 279-284
3. MedLine Plus "H. Pylori and Peptic Ulcer"
Abstracted from "Is Cranberry Juice of Help to Peptic Ulcer Sufferers?" in Total Health Magazine, Volume 25 Number 3.
http://www.nowfoods.com/?action=itemdetail&item_id=19240
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American Journal of Clinical Nutrition, Vol. 80, No. 2, 245-256, August 2004
© 2004 American Society for Clinical Nutrition
Yogurt and gut function
Oskar Adolfsson, Simin Nikbin Meydani and Robert M Russell
1 From the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston
In recent years, numerous studies have been published on the health effects of yogurt and the bacterial cultures used in the production of yogurt. In the United States, these lactic acid-producing bacteria (LAB) include Lactobacillus and Streptococcus species. The benefits of yogurt and LAB on gastrointestinal health have been investigated in animal models and, occasionally, in human subjects. Some studies using yogurt, individual LAB species, or both showed promising health benefits for certain gastrointestinal conditions, including lactose intolerance, constipation, diarrheal diseases, colon cancer, inflammatory bowel disease, Helicobacter pylori infection, and allergies. Patients with any of these conditions could possibly benefit from the consumption of yogurt. The benefits of yogurt consumption to gastrointestinal function are most likely due to effects mediated through the gut microflora, bowel transit, and enhancement of gastrointestinal innate and adaptive immune responses. Although substantial evidence currently exists to support a beneficial effect of yogurt consumption on gastrointestinal health, there is inconsistency in reported results, which may be due to differences in the strains of LAB used, in routes of administration, or in investigational procedures or to the lack of objective definition of "gut health." Further well-designed, controlled human studies of adequate duration are needed to confirm or extend these findings.
http://www.ajcn.org/cgi/content/abstract/80/2/245
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By Martha King, July 30, 2004, Abstracted from Am J Clin Nutr. 2004 Jul;80(1):76-81.
Nuts, which are high in fat, may be a food avoided by some, but a recent study published in the American Journal of Clinical Nutrition suggests an important health benefit from eating just 5 oz. of nuts per week.
Researchers followed the diets and health of more than 80,000 women over the period 1980 – 2000 by means of questionnaires mailed to them every 2 years. The authors of the study, from Harvard and Brigham and Women's Hospital in Boston, were investigating whether including nuts in the diet is associated with reduced risk for gallbladder removal, a common surgical procedure.
The participants were women in the Nurses' Health Study, between ages 30 – 55 and had no previous history of gallbladder disease. They reported on their dietary intake of nuts (including peanuts, peanut butter and other nuts) and whether they had undergone surgery for gallbladder removal.
Dietary intake of nuts was measured by the number of servings eaten, with an ounce of nuts or one tablespoon of peanut butter counting as a serving. Dietary intake varied from less than a serving per month, to eating 5 or more servings per week amongst the women studied. Over the course of the study, there were 7831 cases of gallbladder removal surgery, also known as cholecystectomy.
After controlling for other risks of gallbladder disease, it was found that women who ate nuts 5 or more times per week had a 25 percent lower risk of cholecystectomy compared with women who ate nuts rarely or never. In addition, the study noted that women who consumed the most nuts, tended to weigh less, indicating that the energy contained in nuts tends to be balanced by reduced intakes of other calorie sources or by increased activity.
Nuts are rich in several compounds that may protect against gallstone disease. A good source of dietary fiber, (one ounce of peanuts or mixed nuts provides about 2.5 grams of fiber) nuts may protect against gallstone formation. Nuts are also a source of phytosterols, which may lower blood cholesterol. (An estimated 80% of gallstones are cholesterol stones). Nuts contain mono- and polyunsaturated fats as well, that have good effects on blood fat levels. In addition, nuts are a rich source of magnesium, which may also decrease the occurrence of gallstones.
http://www.icebase.com/reader.ice?CICB3142281457&will&883
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The Lowdown on Low Carbs
In America recently, the new road to weight loss has been paved with high-protein, low-carb diets. In the past few years, an estimated 32 million carb-conscious Americans began taking cues from the well-known Atkins and South Beach diets, which forbid or severely limit eating bread, pasta, potatoes and other starches. These diets also blacklist refined flours, so out go the sugary sweets—cookies, donuts, cakes or candies. One effect of this anti-carb quest is that Americans now spend some $2.5 billion a year on low-carb products in hopes of shrinking their waistlines but keeping their food choices ample. As the food industry stocks hundreds of new, low "net" carb items onto supermarket shelves, some of the beleaguered heavy-carb industries—for instance orange and potato growers—have attempted to re-position their products as healthy "smart carbs."
But are low-carb diets really good for us?
Studies needed
Ironically, the study often credited with helping kick start the low-carb craze—published by Duke University in 20021—enrolled just 51 patients for a diet that lasted six-months. That's not a very long time for something that could potentially affect the rest of your life.
"Nobody knows the long-term effects, since it hasn't been carefully studied," says Eric J. Topol, M.D, chairman, Cleveland Clinic department of cardiovascular medicine. "It's all about total calories and good versus bad carbohydrates. So you're taking a risk if you, and your diet, don't take these points into account."
New studies, however, are being launched that will examine the low-carb diet's long-term effect on weight, arteries, cholesterol, body composition, bones and kidneys. But for now, the verdict is still out. There are, however, some things we do know.
"Long-term scientific evidence has proved that foods like fatty cuts of meat, cheese, cream, and butter—allowable foods on the Atkins diet—are all high in saturated fat and cholesterol," says Melissa Stevens Ohlson, M.S., R.D., L.D., nutrition program coordinator in preventive cardiology and rehabilitation. "These are the same foods associated with increases in blood cholesterol and risk for heart disease."
In addition, foods high in saturated fat have a direct impact on the flow of blood in arteries. Studies conducted on high-fat versus low-fat meals have shown that the arterial wall is narrowed after a high-fat meal, restricting the flow of blood. If you already have some narrowing of the arteries, this means further constriction of the arteries that could increase the risk of having a heart attack or stroke.
"Conversely, the foods that low-carbohydrate diets discourage are precisely the foods that have been shown to protect the body from heart disease—a variety of fruits, vegetables, legumes [dried beans, lentils, split peas] and unrefined whole grains," says Ohlson. These foods provide the body with vitamins, minerals and phytonutrients that are essential to good health.
Ketones may be key
In high-protein diets, the body's normal fuel for energy—carbohydrates—are in severe short supply, so it compensates by burning fat. But this inefficient means of providing the body with an alternative source of energy also produces toxic byproducts known as ketones, in a process called ketosis. Some ketones leave the body via the lungs, while others must be excreted by the kidneys, a process that not only can overwork the organs, but also one that requires lots of water.
"Most of the weight loss in the first two weeks of a low-carb diet is from fluid loss," says Sethu Reddy, M.D., chairman, Cleveland Clinic department of endocrinology, diabetes and metabolism. "This can cause problems like dehydration."
But along with the ketones, the kidney may also excrete beneficial electrolytes, such as calcium, magnesium and potassium. "During ketosis," says Dr. Reddy, "the kidneys excrete potassium, and the potassium level in the blood can drop to a dangerous level. This has the potential to lead to muscle fatigue and heart arrhythmias."
Other experts question whether the excess protein in low-carb diets might leach calcium from bones, weakening them. The salt and water depletion that occurs during ketosis may cause hypotension (low blood pressure), fatigue, fainting, constipation and kidney stones. Some experts fear ketosis may impair metabolism of insulin and liver function. And most important, the impact that ketosis may have on people who have diabetes, high cholesterol or high blood pressure has yet to be determined.
Finally, consider this: most dieters go off a diet at some point—that's human nature. And when the weight returns, they jump back on the dieting bandwagon, returning again and again to the "induction" or the extreme, limited-eating phase of the diet. "Repeated return to the induction phase makes for yo-yo dieting," says Dr. Reddy. "The body's metabolism shifts to become more efficient and conservative— leading to fat gain."
1. Westman EC, Yancy WS, Edman JS, Tomlin KF, Perkins CE. Effect of 6-month adherence to a very low carbohydrate diet program. Am J Med 2002;113(1):30-6.
Source: Cleveland Clinic Magazine 2004
http://www.clevelandclinic.org/ (site is in frames, so you have to do a site search for this specific article)
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Food Elimination Based on IgG Antibodies Helpful in Irritable Bowel Syndrome
News Author: Laurie Barclay, MD
CME Author: Désirée Lie, MD, MSEd
Sept. 16, 2004 — In irritable bowel syndrome (IBS), food elimination based on IgG antibodies reduced the symptom score by 26% in fully compliant patients, according to the results of a randomized, controlled trial study published in the October issue of Gut.
"Patients with irritable bowel syndrome (IBS) often feel they have some form of dietary intolerance and frequently try exclusion diets," write W. Atkinson, MD, from the University Hospital of South Manchester in the U.K., and colleagues. "Tests attempting to predict food sensitivity in IBS have been disappointing but none has utilised IgG antibodies."
The authors suggest that adverse reactions to food in patients with IBS might be caused by some form of immunologic mechanism other than dietary allergy, particularly one mediated by IgG antibodies.
In this study, 150 outpatients with IBS were randomized to receive, for three months, either a diet (the "true diet") excluding all foods to which they had IgG antibodies based on enzyme-linked immunosorbent assay (ELISA) test or a "sham diet" excluding the same number of foods but not those to which they had antibodies. Primary outcome measures were change in IBS symptom severity and global rating scores, whereas secondary outcomes were noncolonic symptomatology, quality of life (QOL), and anxiety-depression. Analysis was based on intent-to-treat using a generalized linear model.
After 12 weeks, there was a 10% greater reduction in symptom score in the true diet group than in the sham diet group (mean difference, 39; 95% confidence interval [CI], 5 to 72); P = .02). In fully compliant patients, reduction in symptom score was 26% (mean difference, 98; 95% CI, 52 to 144; P < .001).
As a whole, the true diet group also had significant improvements in global rating (P = .048; number needed-to-treat [NNT], 9). These improvements were even more pronounced in compliant patients (P = .006; NNT, 2.5). The NNT for each group is considerably better than the NNT of 17 achieved after three months of treatment with tegaserod, a drug that has been recently licensed for use in IBS.
The true diet group also fared better than did the sham diet group in all other outcomes. In the true diet group, relaxing the diet led to a 24% greater deterioration in symptoms (difference, 52; 95% CI, 18 to 88; P = .003).
"Food elimination based on IgG antibodies may be effective in reducing IBS symptoms and is worthy of further biomedical research," the authors write. "Many patients with IBS would prefer a dietary solution to their problem rather than having to take medication, and the economic benefits of this approach to health services are obvious. It is well known that patients expend large sums of money on a variety of unsubstantiated tests in a vain attempt to identify dietary intolerances."
Gut. 2004;53:1459-1464
Medscape Medical News 2004. © 2004 Medscape
http://www.medscape.com/viewarticle/489349
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Health to drive honey choice for food formulations?
22/10/2004 - Health-promoting compounds found in honey could make this ingredient a more attractive option for food makers currently using bulk sweeteners such as high-fructose corn syrup and looking to jump on board the growing health foods trend, say scientists in the US.
Researchers at the University of Illinois at Urbana-Champaign say that honey may be a healthier alternative to corn syrup due to its higher level of antioxidants, compounds which are believed to fight cancer, heart disease and other diseases.
Honey, which contains a number of antioxidant components that act as preservatives, also shows promise as a replacement for some synthetic antioxidants widely used as preservatives in salad dressings and other foods, according to Nicki Engeseth, associate professor of food chemistry at the university.
High fructose syrups, known as isoglucose in Europe, kicked off in the US in the 1970s when the country developed new technologies to process this bulk calorific sweetener. The ingredient, an alternative to sucrose, rapidly gained in popularity and is now used extensively by soft drinks makers such as Coca-Cola and PepsiCo.
Honey, a natural syrup produced by bees is similar to invert sugar, with a small but variable excess of levulose (fructose). The composition and flavour of honey varies with the plant source of the nectar, processing and storage but a typical composition is 41 per cent fructose, 34 per cent glucose, 18 per cent water, and 2 per cent sucrose with a pH of 3.8 to 4.2.
According to the US researchers, dark-coloured honey, such as buckwheat honey, is generally thought to contain higher levels of antioxidants than the light-coloured varieties. Previous studies by the researchers, who presented their findings this week at the American Chemical Society meeting in Illinois, suggest that honey may have the same level of disease-fighting antioxidants as that of some common fruits.
Competition for European suppliers of honey ramped up recently when Brussels cleared the way to end a two-year ban on food imports from China, paving the way for cheaper raw materials for honey formulations.
Meeting at the Standing Committee on the Food Chain and Animal Health in July member states cleared a Commission proposal to allow Chinese imports of honey, lifting a ban imposed on the product in 2002 after the antibiotic – chloramphenicol –was found to be present.
In international terms China is currently by far the largest honey producing nation in the world, with around a 40 per cent slice of the market. The next biggest producers are the US, Argentina and Ukraine.
According to the American Honey Producers Association, China and Argentina have been adversely affecting America's domestic honey industry with cheap imports, although there is a counter argument that both China and Argentina have been helping to counterbalance falling production in the US. Also starting to emerge onto the world honey production arena are Thailand and Vietnam.
http://www.nutraingredients.com/news/news-NG.asp?n=55557-health-to-drive
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Soy unlikely to impact fertility
20/10/2004 - Soy is unlikely to damage fertility in women, report researchers, who investigated the theory that its positive impact on breast cancer risk may have other, unwanted effects.
Their study, carried out on monkeys, also offers insight into how the plant food impacts breast cancer risk.
Women in Asian countries where a lot of soy is consumed have dramatically lower rates of breast cancer than women in the United States and Europe. Isoflavones, a kind of plant oestrogen found in soy, are thought to be play a role in this lower incidence, either by increasing menstrual cycle length or reducing ovarian hormones – both of which would reduce lifetime exposure to oestrogen. However, these changes in the menstrual cycle could also impair fertility.
But a new study, presented at the annual meeting of the American Society for Reproductive Medicine in Philadelphia, fails to confirm these concerns. The team from the Wake Forest University Baptist Medical Center and Emory University School of Medicine tested the hypothesis on monkeys, which have menstrual cycles similar to those of women.
For one year, half of the monkeys were fed a high-soy diet and half got their protein from animal sources. All monkeys were evaluated during this period for changes in ovarian hormones and menstrual cycles.
"Our study was designed to determine whether a soy supplement containing twice the level of plant oestrogen consumed by Asian women would alter any aspect of the menstrual cycle or ovarian function in monkeys," said lead researcher Jay Kaplan.
"Soy treatment did not change any characteristics of the menstrual cycle, including length, amount of bleeding or hormone levels," he explained. "This suggests that any protection that soy may provide against breast cancer does not come from changes in the menstrual cycle."
He said consumption of a high-soy diet probably would not compromise fertility, although further research is warranted to evaluate effects of soy on placenta function and on the foetus.
The findings are positive for the booming soy products industry, which has seen increasing interest in the use of isoflavones in supplements to alleviate menopausal symptoms, maintain bone health and improve heart health.
http://www.nutraingredients.com/news/news-ng.asp?id=55524-soy-unlikely-to
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Study: Vegetarian Diet Lowers Cholesterol
source: Associated Press Health News
A new vegetarian diet emphasizing soy and soluble fiber can lower cholesterol by a surprising one-third. But finicky eaters may balk at its daily helpings of okra, eggplant and Metamucil, among other things.
The Portfolio diet, as it's called, involves several trendy nutrients that have been shown separately to be good for the heart. Canadian researchers set out to see what would happen if they were combined into a single regimen.
In Miami Beach on Thursday at a meeting of the American Heart Association, they presented data showing that the combination seems to work. Ordinarly, people do well to lower their cholesterol by 10 percent by changing their diet, so doctors often have to prescribe powerful statin drugs to get their cholesterol down far enough.
"The reductions are surprising," said Cyril Kendall of the University of Toronto, who directed the study. "Most dietitians would not expect that sort of reduction through dietary means."
He said the Portfolio diet appears to do about as well as the older statin drugs that are still frontline therapy for high cholesterol.
His research was sponsored by the Canadian government, the Almond Board of California and the food companies Unilever Canada and Loblaw Brands.
"This was a pretty impressive result," said Dr. Stephen Daniels of Children's Hospital Medical Center in Cincinnati. "However, the results need to be replicated. Can this be done in the real world or only in an experiment?"
The diet is based on a low-fat vegetarian regimen that emphasizes foods shown individually to be beneficial - soy, soluble fiber, plant sterols and almonds. Sources of soluble fiber include oats, barley, legumes, eggplant, okra and Metamucil. Some brands of margarine are high in plant sterols.
In the experiment, 25 volunteers ate either a standard low-fat diet or the Portfolio diet, while researchers watched the effects on their LDL cholesterol, which increases the risk of heart disease, and HDL, which lowers it. After a month, LDL levels fell 12 percent in those on the standard diet and 35 percent in those on the Portfolio diet. However, HDL levels were unchanged in people on the Portfolio diet.
Kendall said volunteers found the diet extremely filling, and several stayed on it after the experiment ended.
"It appears that a Portfolio diet is effective at reducing cholesterol and coronary heart disease risk," he said.
Whether it truly is as good as a statin, though, remains to be seen. Those drugs have been proven to reduce the risk of heart attacks and death, while the diet has not been put to that test. And statins may also protect the heart in ways that go beyond their effect on cholesterol.
In the experiment, dieters got foods supplied by the researchers that are all available from supermarkets or health food stores. Every meal contained soy in some form, such as soy yogurt or soy milk.
A typical breakfast included oat bran, fruit and soy milk. Lunch might feature vegetarian chili, oat bran bread and tomato. A dinner could consist of vegetable curry, a soy burger, northern beans, barley, okra, eggplant, cauliflower, onions and red peppers. Volunteers also got Metamucil three times a day to provide soluble fiber from psyllium.
On a 2,000-calorie daily diet, volunteers got two grams of plant sterols from enriched margarine, 16 grams of soluble fiber from oats, barley and psyllium, and 45 grams of soy protein. They also got 200 grams of eggplant and 100 grams of okra daily and 30 grams of raw almonds. Additional vegetable protein was provides by beans, chick peas and lentils.
In another report at the conference, researchers from Children's Hospital in Boston found that people who eat breakfast every morning are less likely to be overweight or show early signs of diabetes. Among the 2,831 volunteers, white men and women who ate breakfast daily were only half as likely to be obese as were those who ate it seldom or never. Black men were 35 percent less likely, but for reasons the researchers could not explain, breakfast was not linked with lower weight in black women.
Mark Pereira, who presented the data, said people who eat breakfast may be less likely to snack during the day, so they end up eating less.
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EDITOR'S NOTE: Medical Editor Daniel Q. Haney is a special correspondent for The Associated Press.
http://www.rednova.com/news/stories/2/2003/03/08/story007.html
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Soy could stop spread of breast cancer
24/09/2004
An in-vitro study carried out at the University of Ulster, has concludede that eating more soy-rich foods could reduce the spread of breast cancer.
Previous studies have tested the effect of soy and breast cancer on animals, but this is the first time the study has been carried out in-vitro.
"In our study we used cell cultures to examine the effects of isoflavones on the invasion of breast cancer cells," said Dr Pamela Magee from the university's School of Biomedical Sciences. "The isoflavones exerted potent inhibitory effects on breast cancer cell invasion, even at concentrations similar to those found in South East-Asian populations."
South-East Asian populations traditionally consume high amounts of soy and have a low incidence of breast cancer. Soy contains naturally occurring hormone-like compounds called isoflavones that scientists believe can inhibit breast cancer development.
"Our findings seem to indicate that eating a soy rich products such as soy milk, soy drinks and desserts, could have an important role in preventing the spread of cancer cells in the body," said Magee. "Further studies in human volunteers are now needed to confirm whether soy isoflavones will protect against breast cancer spread in patients."
Breast cancer is the most common form of cancer affecting women in the western world, with 950 women in Northern Ireland alone suffering from the disease per year.
There have been recent advances in tumour detection and treatment, but the spread of cancer remains a significant cause of mortality.
"The invasion of cancerous cells from their site of origin into the neighbouring environment enables cancerous cells to travel and grow at new sites within the body," said Maggee. "Any agent, therefore, which can prevent the invasive process could become a powerful tool in the prevention of cancer spread."
This study was funded by the EU's "Quality of Life and Management of Living Resources" project. Ulster is working with 12 European partners on this project and is now investigating the genes of invasion in breast cancer.
Last year, researchers from the Harvard Medical School assessed the combined impact of soy products and different types of tea on a breast cancer model in mice and found that a mixture of soy phytochemicals and green tea could help slow the progression of breast cancer.
The mice were treated with genistein-rich soy isoflavones, soy phytochemical concentrate, black tea and green tea individually, and then with a soy phytochemical-black tea mixture and a soy-green tea combination.
Researchers assessed the growth of tumours and increase in cells as well as expressions of tumour oestrogen receptors.
Both the soy isoflavones and the soy phytochemical concentrate led to dose-dependent inhibition of tumour growth by slowing cancer cell proliferation, they reported in the 1 January issue of the International Journal of Cancer (vol 108, issue 1, pp 8-14).
http://www.nutraingredients.com/news/news-NG.asp?n=54930-soy-could-stop
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Gut 2004;53:1577-1582
© 2004 by BMJ Publishing Group Ltd & British Society of Gastroenterology
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GUT MOTILITY
Inhibitory actions of a high psyllium diet on intestinal gas transit in healthy volunteers
S Gonlachanvit, R Coleski, C Owyang and WL Hasler
Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, MI, USA
ABSTRACT
Background: Psyllium fibre treatment often produces gaseous symptoms which have been attributed to fermentation by colonic bacteria with increased gas production. Effects of psyllium fibre ingestion on intestinal gas flow are unexplored.
Aims: We aimed to test the hypothesis that consumption of a high psyllium fibre diet retards gas transit.
Subjects: Ten healthy volunteers participated.
Methods: To investigate the effects of psyllium fibre on gas dynamics, physiological gas mixtures were jejunally perfused at 12 ml/minx2 hours after a standard diet for seven days with and without psyllium 30 g/day in a crossover fashion. Gas was collected from an intrarectal catheter to bypass the anus and evacuation was quantified in real time using a barostat.
Results: On initiating gas perfusion under control conditions, an initial lag phase with no gas expulsion was observed (1129 (274) seconds). Thereafter, gas evacuation from the rectum proceeded with cumulative volumes of 1429 (108) ml by the end of the second hour. Evacuation was pulsatile with passage of 20.9 (2.5) boluses, with mean volumes of 68.2 (5.0) ml. Psyllium fibre prolonged the lag time (2265 (304) seconds; p<0.05) and reduced cumulative gas evacuation volumes (1022 (80) ml; p<0.05). Decreased gas evacuation resulted from reductions in the numbers of bolus passages (14.2 (1.1); p<0.05) but not bolus volumes (70.7 (3.4) ml; p = 0.66).
Conclusions: Consumption of a high psyllium fibre diet retards intestinal gas transit by decreasing bolus propulsion to the rectum. Thus, in addition to increasing gas production by colonic flora, psyllium fibre ingestion may elicit gaseous symptoms by promoting gas retention.
http://gut.bmjjournals.com/cgi/content/abstract/53/11/1577
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Higher Fiber Shown To Reduce Estrogen Levels
October 19, 2004
An international team has demonstrated that women with a higher intake of dietary fiber have lower circulating estrogen levels, a factor associated with lower risk of breast cancer. They say their findings, which offer direct evidence of the association between fiber and the hormone, could lead to a dietary strategy for lowering a woman's risk of breast cancer.
Breast cancer rates have risen in recent decades to become the most common cancer among women in the European Union and US. Britain has one of the highest breast cancer death rates in the world, according to Breast Cancer Research, with one woman in nine developing the disease during her lifetime.
There have already been several studies investigating the relationship between dietary fiber and breast cancer but researchers have not been able to show a true and unequivocal cause-and-effect relationship between fiber and breast cancer risk.
In a new study, researchers from the Keck School of Medicine of the University of Southern California in Los Angeles, the University of Hawaii in Honolulu, and the University of Helsinki in Finland examined blood estrogen levels in around 250 Mexican-American women, an ethnic group in which dietary fiber intake is higher on average than in most other populations.
"Latinas enrolled in the Multiethnic Cohort Study have lower breast cancer rates than any major racial/ethnic group in the US. Even after adjusting for known risk factors, their incidence rate is still 20 percent less than white women, who have been the focus of the majority of earlier research and whose dietary fiber intake is generally not that high," explained the study first author Kristine Monroe, a postdoctoral fellow in the Keck School's department of Preventive Medicine.
Dietary fiber intake was quantified by a food frequency questionnaire administered at the time of the blood draw and by using biomarkers of dietary fiber intake found in the blood samples.
Speaking yesterday at the American Association for Cancer Research (AACR) conference, 'Frontiers in Cancer Prevention Research', the researchers said they found the two female hormones estrone and estradiol dropped sharply as dietary fiber intake increased.
In addition, as dietary fat intake increased in the women studied, so did the hormone levels. "However, when dietary fiber and fat are both included in the statistical model, only dietary fiber remains a significant predictor of hormone levels," said Monroe.
The next step is to see if a higher intake of dietary fiber in these women leads to a lower incidence of breast cancer, she added. "This study provides clear evidence of an association between dietary fiber intake and circulating hormone levels in postmenopausal Latina women and potentially provides a dietary means for lowering a woman's risk of breast cancer," concluded the researchers.
Earlier this year a Swedish team reported that postmenopausal women in the highest quintile of fiber intake had a 40 percent lower risk of breast cancer than those with the lowest. Combining high fiber with a low fat diet reduced the risk even further.
http://www.nowfoods.com/?action=itemdetail&item_id=42322&TPL_NAME=printview.tpl&CSPID=b1bea10afacfa3231fb97d01d0ebe123
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Gut. 2005 Jan;54(1):11-7.
Dietary intake and the risk of gastro-oesophageal reflux disease: a cross sectional study in volunteers.
El-Serag HB, Satia JA, Rabeneck L.
Section of Gastroenterology and Health Services Research, The Houston Veterans Affairs Medical Center (152), 2002 Holcombe Blvd, Houston, TX 77030, USA. hasheme@bcm.tmc.edu
BACKGROUND: Although diet has been associated with gastro-oesophageal reflux disease (GORD), the role of dietary components (total energy, macro and micronutrients) is unknown. We examined associations of GORD symptoms with intakes of specific dietary components.
METHODS: We conducted a cross sectional study in a sample of employees (non-patients) at the Houston VAMC. The Gastro Esophageal Reflux Questionnaire was used to identify the onset, frequency, and severity of GORD symptoms. Dietary intake (usual frequency of consumption of various foods and portion sizes) over the preceding year was assessed using the Block 98 food frequency questionnaire. Upper endoscopy was offered to all participants and oesophageal erosions recorded according to the LA classification. We compared the dietary intake (macronutrients, micronutrients, food groups) of participants with or without GORD symptoms, or erosive oesophagitis. Stepwise multiple logistic regression analyses were used to examine associations between nutrients and GORD symptoms or oesophageal erosions, adjusting for demographic characteristics, body mass index (BMI), and total energy intake.
RESULTS: A total of 371 of 915 respondents (41%) had complete and interpretable answers to both heartburn and regurgitation questions and met validity criteria for the Block 98 FFQ. Mean age was 43 years, 260 (70%) were women, and 103 (28%) reported at least weekly occurrences of heartburn or regurgitation. Of the 164 respondents on whom endoscopies were performed, erosive oesophagitis was detected in 40 (24%). Compared to participants without GORD symptoms, daily intakes of total fat, saturated fat, cholesterol, percentage of energy from dietary fat, and average fat servings were significantly higher in participants with GORD symptoms. In addition, there was a dose-response relationship between GORD and saturated fat and cholesterol. The effect of dietary fat became non-significant when adjusted for BMI. However, high saturated fat, cholesterol, or fat servings were associated with GORD symptoms only in participants with a BMI >25 kg/m2 (effect modification). Fibre intake remained inversely associated with the risk of GORD symptoms in adjusted full models. Participants with erosive oesophagitis had significantly higher daily intakes of total fat and protein than those without it (p<0.05).
CONCLUSIONS: In this cross sectional study, high dietary fat intake was associated with an increased risk of GORD symptoms and erosive oesophagitis while high fibre intake correlated with a reduced risk of GORD symptoms. It is unclear if the effects of dietary fat are independent of obesity.
PMID: 15591498 [PubMed - in process]
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http://www.docguide.com/news/content.nsf/PaperFrameSet?OpenForm&newsid=8525697700573E1885256F6B003CD917&topabstract=1&u=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15591498
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Red Meat Consumption Linked to Colorectal Cancer
NEW YORK (Reuters Health) Jan 11 - Long-term high consumption of red and processed meat may increase the risk of cancer in the distal colon and rectum, according to a report in the Journal of the American Medical Association for January 12th. However, the results of a second report in the same issue found that increased vegetable and fruit intake did not reduce the risk of breast cancer.
Dr. Michael J. Thun, with the American Cancer Society in Atlanta, and colleagues followed a cohort of 148,610 adults, median age 63 years, who completed questionnaires in 1982 and again between 1992 and 1993 regarding their diet, exercise, medical history and other lifestyle habits. There was a 10-fold difference between lowest and highest quintiles of red meat in men, and a 17-fold difference in women.
By 2001, there were 1667 incident cases of colorectal cancer.
Only when long-term consumption at both time points was considered was there a significantly increased multivariate-adjusted risk associated with the highest tertiles of consumption of processed meats (rate ratio 1.50) and ratio of red meat to poultry and fish (rate ratio 1.53) compared with the lowest tertiles.
Prolonged high consumption of poultry and fish was marginally associated with lower risk of colon cancer (rate ratio 0.70-0.77), but not rectal cancer.
In the second study by Dr. Petra H. M. Peeters, at University Medical Center in Utrecht, the Netherlands and colleagues, approximately 285,000 women ages 25 to 70 from eight European countries were followed for a median of 5.4 years. The subjects, participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) study, had completed dietary questionnaires.
During follow-up in 2002, there were 3659 incident cases of invasive breast cancer.
Even though the mean intake of total fruits and vegetables in the upper quintiles was 2- to 3-times higher than that in the lowest quintile, the authors observed no significant associations between intake and breast cancer risk.
Dr. Peeters' group found no evidence for inverse associations between intake of vegetable subtypes and breast cancer risk.
In an accompanying editorial, Dr. Walter C. Willett, at Harvard School of Public Health in Boston, comments that, despite the negative results for breast cancer risk, "reductions in blood pressure and epidemiological evidence for lower risks of cardiovascular disease provide sufficient reason to consume" fruits and vegetables in abundance.
Regarding the association between meat consumption and colorectal cancer, he adds, "prudence would suggest that red meat, and processed meats in particular, should be eaten sparingly to minimize risk."
JAMA 2005;293:172-193,233-234.
Reuters Health Information 2005. © 2005 Reuters Ltd.
http://www.medscape.com/viewarticle/497314?src=mp
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Grapefruit Juice Can Interact With Medicines
Grapefruit juice has been touted as containing many compounds that can reduce hardening of the arteries (atherosclerosis) and even the risk of cancer. A nutraceutical is a food or part of a food that allegedly provides medicinal or health benefits, including the prevention and treatment of disease. Grapefruit juice can, therefore, be justifiably referred to as a classic nutraceutical. However, for many persons taking certain medications, grapefruit juice might actually better be termed a "nutrapollutical!"
It turns out that grapefruit juice can directly or indirectly interact in important ways with a number of medications. This is especially significant since grapefruit juice is consumed by approximately one fifth of Americans for breakfast - a time when medications are also commonly taken.
Grapefruit juice inhibits a special enzyme in the intestines that is responsible for the natural breakdown and absorption of many medications. When the action of this enzyme is blocked, the blood levels of these medications increase, which can lead to toxic side effects from the medications.
Amazingly, this remarkable food-drug interaction was discovered completely by accident! Researchers were investigating the relationship of certain drugs to alcohol and used a solution of alcohol with grapefruit juice to mask the taste of alcohol for the study. Subsequently, it was found that the grapefruit juice itself was actually increasing the amount of the study drug in the body.
Grapefruit juice research has suggested that flavonoids and/or furanocoumarin compounds are the substances that act to block the enzyme in the intestines that normally metabolizes many drugs.
The grapefruit juice-drug interaction can lead to unpredictable and hazardous levels of certain important drugs.
These are medications with which grapefruit juice should NOT be consumed unless advised by a doctor:
Statins (Cholesterol Drugs): Mevacor (Lovastatin), Lipitor (Atorvastatin), Zocor (Simvastatin)
Antihistamines: Ebastine, Seldane (Terfenadine, taken off the U.S. market)
Calcium Channel Blockers (Blood Pressure Drugs): Nimotop (Nimodipine), Nitrendipine, Plendil (Felodipine), Pranidipine, Sular (Nisoldipine)
Psychiatric Medications: Buspar (Buspirone), Halcion (Triazolam), Tegretol (Carbamazepine), Valium (Diazepam), Versed (Midazolam)
Intestinal Medications: Propulsid (Cisapride, taken off the U.S. market)
Immune Suppressants: Neoral (Cyclosporine), Prograf (Tacrolimus)
Pain Medications: Methadone
Impotence Drug: Viagra (Sildenafil)
Toxic blood levels of these medications can occur when patients taking them consume grapefruit juice. The high blood levels of the medications can cause damage to organs or impair their normal function, which can be dangerous. If you or a family member are taking any of these medications, beware of the "nutrapollutical" - grapefruit juice.
Source: Mayo Clin Proc. 2000;75:933-942.
http://www.medicinenet.com/script/main/art.asp?articlekey=14760
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The American Journal of Gastroenterology
Volume 100 Issue 2 Page 383 - February 2005
doi:10.1111/j.1572-0241.2005.40100.x
Visceral Sensitivity and Symptoms in Patients with Constipation- or Diarrhea-predominant Irritable Bowel Syndrome (IBS): Effect of a Low-Fat Intraduodenal Infusion
Maria Pia Caldarella, M.D.1, Angelo Milano, M.D.1, Francesco Laterza, M.D.1, Flora Sacco, M.D.1, Crysanthi Balatsinou, M.D.1, Domenico Lapenna, M.D.1, Sante Donato Pierdomenico, M.D.1, Franco Cuccurullo, M.D.1, and Matteo Neri, M.D.1
BACKGROUND: Visceral hypersensitivity is common in Irritable Bowel Syndrome (IBS) patients, and symptoms exacerbate postprandially (after eating). Yet the effects of nutrients on visceral sensitivity and symptoms in these patients have not been fully explored.
AIMS: To evaluate the differences of visceral sensitivity and symptoms in healthy subjects and IBS patients during fasting and intraduodenal lipids (fats) infusion.
METHODS: Graded rectal distensions at fixed tension levels were performed in 16 IBS patients (8 IBS-C and 8 IBS-D) and 6 healthy subjects before and during intraduodenal lipids infusion at 0.5 kcal/min. Tension levels were increased in 4 gr increments up to 64 gr or discomfort during both conditions. At each step, perception and symptoms were measured by means of a validated questionnaire.
RESULTS: In basal conditions, perception thresholds in IBS patients and health were, respectively, 8 ± 2 gr versus 32 ± 9 gr (p< 0.001) with no changes during lipids. Intraduodenal lipids infusion significantly lowered threshold of discomfort in IBS patients in comparison to fasting (24 ± 6 gr vs 34 ± 4 gr; p< 0.05), while health tolerated all distension without discomfort. No differences of compliance, perception, or discomfort were observed between the two subgroups of patients at each tension step. The predominant symptom elicited in patients with IBS-C was abdominal pain (54%), while patients with IBS-D exhibited urgency (63%, p< 0.005); this pattern was maintained during lipids.
CONCLUSIONS: Intraduodenal lipids increase visceral sensitivity in both IBS-C and IBS-D; symptoms specificity in response to rectal distension is maintained in the postprandial period. Lipids may be responsible for the postprandial symptoms exacerbation in IBS.
http://www.blackwell-synergy.com/links/doi/10.1111/j.1572-0241.2005.40100.x/abs/
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Food makers could one day face demand for fructose-free products as two new studies link the sugar found in fruits to a role in gastrointestinal disorders.
Research to be presented today at the annual meeting of the American College of Gastroenterology looks at the role that diet plays in gastrointestinal disorders such as irritable bowel syndrome (IBS) and dyspepsia.
The preliminary findings suggest that both fructose, the simple sugar found in honey and many fruits, and fat contribute to symptoms of IBS. IBS is characterized by abdominal discomfort, bloating, and change in bowel habits (constipation and/or diarrhoea).
Although lactose intolerance is well-known, fructose intolerance is just beginning to be recognised. Dr Young K. Choi and colleagues from the University of Iowa Hospitals and Clinics found previously that one-third to one-half of patients with IBS symptoms are fructose intolerant.
"A fructose-restricted diet significantly improved symptoms in patients with IBS and fructose intolerance," said Dr Choi. "Fructose intolerance is yet another piece of the IBS puzzle, whose treatment -- when adhered to -- confers significant benefits."
The University of Iowa researchers tested 80 patients with suspected IBS and found that 30 were fructose intolerant. Patients were taught about eliminating fructose from their diet, and after one year, 26 were interviewed to assess their symptoms. Only one-half of the patients complied with the fructose-restricted diet.
For those who were compliant, symptoms (such as abdominal pain, bloating, and diarrhoea) declined significantly from their reported symptoms before the diet modification. Also, the prevalence of IBS in this group declined, said the researchers. For the group that did not comply with the diet modification, bowel symptoms stayed the same over the study period.
In the second study, Dr Yuri A. Saito and colleagues of the dof Gastroenterology and Hepatology at Mayo Clinic and Foundation carried out a population-based study on 221 participants aged 20 to 50 years old. 53 cases and 58 controls were asked to record their diet for one week.
Dr Saito and colleagues found that those with IBS or dyspepsia reported consuming a significantly higher proportion of fat in their diet (33.0 per cent for those with GI disorders, 30.7 per cent for controls). No significant differences were found for protein, fibre, iron, calcium, niacin, or vitamins B1, B2, B6, B12, C, D, or E.
"Future studies are needed to determine whether fat intake causes gastrointestinal symptoms," said Dr Saito. Further studies are also needed to confirm the results of the first, smaller study.
http://www.nutraingredients.com/news/ng.asp?id=38799
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UK investigates dietary management of constipation
4/02/2005 - UK researchers are to investigate how dietary changes could help people better manage constipation in the biggest study on the condition ever undertaken.
Constipation affects one in five older people and the burden on healthcare resources is expected to increase as the proportion of older people in the population rises.
In Britain, it leads to nearly half a million doctor's consultations each year and doctors prescribe more drugs for the condition than they do for patients with diabetes or high blood pressure, costing UK health services Ł50 million each year.
Yet it has largely been overlooked for major health studies.
The new research, to be carried out at the University of Newcastle upon Tyne on nearly 2,000 patients aged over 55, is backed by Ł650,000 in government funding.
It will examine how effectively patients can manage their constipation by making changes to their diet and lifestyle. The usual method of treating constipation is to prescribe laxatives.
Results to determine the most cost-effective way of managing constipation will be used by the government to inform the treatment of constipation by health professionals nationwide.
http://www.nutraingredients.com/news/ng.asp?id=58319
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Fruit, vegetable juices may stall Alzheimer's disease
Certain polyphenols abundant in fruit and vegetable juices may play an important role in delaying the onset of Alzheimer's disease, reports Dominique Patton.
Amy Borenstein from the University of South Florida said yesterday that her team had found a 75 per cent reduced risk of the disease among elderly people who drank fruit or vegetable juices at least three times per week compared with those who drank these juices less than once a week.
There was no apparent dementia-related benefit from dietary or supplemental vitamin E, C or beta-carotene intake, she added.
The research was presented at the US-based Alzheimer's Association's first conference on prevention of dementia, running in Washington this week (abstract 05-A-103-ALZ-PC).
There are nearly 18 million people with dementia in the world and the most common cause of this dementia is Alzheimer's disease. By 2025 this figure will rise to 34 million, with 71 per cent of these likely to live in developing countries, making the need for prevention of the uncurable disease crucial.
Ageing populations and increasing overweight are driving incidence of the disease upwards.
The Florida researchers studied more than 1,800 older Japanese American men and women from the Kame Project in Seattle, in which participants were dementia-free at the onset of the study and were followed for up to nine years.
Dietary consumption was determined using a food frequency questionnaire given at the beginning of the study that provided information on intake of fruits, vegetables, tea, wine, and fruit and vegetable juices.
The accumulation of reactive oxygen species in the brain are thought to exhaust antioxidant capacity and lead to the onset or progression of Alzheimer's.
Antioxidant vitamins, particularly vitamin E from dietary fruits and vegetables, has been associated with delayed onset of the disease, although there is little evidence to date that supplements can offer the same benefit.
But animal studies have found that a number of polyphenols from juices have stronger protection for neuronal cells against oxidation than vitamins E and C.
"These findings suggest that something as simple as incorporating more fruit and vegetable juices into our diet may have a significant impact on our brain health," Borenstein said.
The results could lead to a new avenue of inquiry in the prevention of Alzheimer's, the researchers added.
Another poster presentation at the conference found that moderate alcohol consumption could also influence onset of the disease, confirming previous studies showing a benefit from wine in particular.
Author Mark Sager from the University of Wisconsin-Madison medical school said: "These findings contribute to the growing body of evidence that health and lifestyle variables in middle age may be associated with the subsequent risk of developing Alzheimer's in later life."
http://www.nutraingredients.com/news/news-ng.asp?n=60755-fruit-vegetable-juices
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IBS Sufferers Hypersensitive to Common Foods
LONDON--Research indicates sufferers of irritable bowel syndrome (IBS) may be hypersensitive to antigens contained in wheat, beef, pork and lamb, according to a study in the July issue of the American Journal of Gastroenterology [epub ahead of print].
British researchers studied the effects of 16 common foods in 108 IBS patients (52 diarrhea-predominant; 32 constipation-predominant; 24 alternating) and 43 controls using IgG4 and IgE titers and skin prick testing (SPT). Data results and patients' IBS symptoms were correlated.
Researchers found IBS patients had significantly higher IgG4 titers to wheat, beef, pork and lamb compared to controls. These differences were maintained across all three subgroups. Antibody titers to potatoes, rice, fish, chicken, yeast, tomato and shrimps were not significantly different and no significant difference in IgE titers was observed between IBS and controls. No correlation was seen between the pattern of elevated IgG4 antibody titers and patients' symptoms, such as pain bloating and stool frequency.
Researchers concluded serum elevated IgG4 antibodies to wheat, beef, pork and lamb may be the result of physiological damage caused by IBS.
"The response to exclusion diet based on elevated food-specific IgG4 in future studies may be useful in establishing the significance of these findings," wrote the study authors.
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1572-0241.2005.41348.x
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A carefully controlled study designed to evaluate the influence of glycemic index/glycemic load (GI/GL) on glycemic response, appetite and food intake was published in the September 2005 issue of Diabetes Care. The researchers set out to either prove or disprove the believe held by some that diets with high GI/GL enhance appetite and promote weight gain. This is one of the first studies to control for other meal characteristics that are known to affect glycemic response (GR). These include the duration, nutrient composition, energy density, volume or weight, consistency and palatability of the meal. This study evaluated the effects of consuming high- and low-GI/GL meals on blood glucose and insulin, appetite and food intake.
The results indicated that there were no significant differences in plasma glucose or insulin responses, appetite ratings or food intake between treatments. This show that the glycemic response of foods tested in isolation does not hold true when meals are consumed ad lib over time. In other words the GI/GL of food is inconsequential in normal eating conditions.
Because appetite and intake are governed by a large array of food properties, attributing the treatment effects to the GI value of foods is very difficult. Many of the studies that have linked the two have not incorporated control subjects. As a result there is no way of knowing if the appetite and intake were affected by other factors. The above study sought to address many of these potentially confounding factors. These findings raise questions about the predictive power of the GI of a specific food or diet for either appetite or dietary responses
Source: Diabetes Care, volume 28, number 9, September 2005
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Journal of the National Cancer Institute, Vol. 98, No. 1, 72-75, January 4, 2006
Articles by Mayne, S. T.
Articles by Fraumeni, J. F.
© The Author 2006. Published by Oxford University Press.
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Carbonated Soft Drink Consumption and Risk of Esophageal Adenocarcinoma
Susan T. Mayne, Harvey A. Risch, Robert Dubrow, Wong-Ho Chow, Marilie D. Gammon, Thomas L. Vaughan, Lauren Borchardt, Janet B. Schoenberg, Janet L. Stanford, A. Brian West, Heidi Rotterdam, William J. Blot, Joseph F. Fraumeni, Jr.
Affiliations of authors: Yale University School of Medicine and Yale Cancer Center, Department of Epidemiology and Public Health, New Haven, CT (STM, HAR, RD, LB); National Cancer Institute, Division of Cancer Epidemiology and Genetics, NIH, DHHS, Bethesda, MD (W-HC, JFF); University of North Carolina, School of Public Health, Department of Epidemiology, Chapel Hill, NC (MDG); Fred Hutchinson Cancer Research Center, Program in Epidemiology, and University of Washington, School of Public Health and Community Medicine, Department of Epidemiology, Seattle, WA (TLV, JLS); New Jersey Department of Health and Senior Services, Center for Cancer Initiatives, Trenton, NJ (JBS); Columbia University, Department of Pathology, New York, NY (HR); New York University Medical Center, Department of Pathology, New York, NY (ABW); International Epidemiology Institute, Rockville, MD (WJB)
Carbonated soft drinks (CSDs) have been associated with gastroesophageal reflux, an established risk factor for esophageal adenocarcinoma. As both CSD consumption and esophageal adenocarcinoma incidence have sharply increased in recent decades, we examined CSD as a risk factor for esophageal and gastric cancers in a U.S. multicenter, population-based case-control study. Associations between CSD intake and risk were estimated by adjusted odds ratios (ORs), comparing the highest versus lowest quartiles of intake.
All statistical tests were two-sided. Contrary to the proposed hypothesis, CSD consumption was inversely associated with esophageal adenocarcinoma risk (highest versus lowest quartiles, OR = 0.47, 95% confidence interval = 0.29 to 0.76; Ptrend = .005), due primarily to intake of diet CSD.
High CSD consumption did not increase risk of any esophageal or gastric cancer subtype in men or women or when analyses were restricted to nonproxy interviews. These findings indicate that CSD consumption (especially diet CSD) is inversely associated with risk of esophageal adenocarcinoma, and thus it is not likely to have contributed to the rising incidence rates.
http://jncicancerspectrum.oxfordjournals.org/cgi/content/abstract/jnci%3b98/1/72
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Organic Diets Significantly Lower Children's
Dietary Exposure to Organophosphorus Pesticides
Chensheng Lu, Kathryn Toepel, Rene Irish,
Richard A. Fenske, Dana B. Barr, and Roberto Bravo
doi:10.1289/ehp.8418 (available at http://dx.doi.org/)
Online 1 September 2005
The National Institute of Environmental Health Sciences
National Institutes of Health
U.S. Department of Health and Human Services
ehponline.org
Abstract
We utilized a novel study design to measure dietary organophosphorus pesticide exposure in a group of 23 elementary school-age children through urinary biomonitoring.
We substituted most of children's conventional diets with organic food items for 5 consecutive days, and collected two, first morning and before the bedtime voids, daily
spot urine samples throughout the 15-day study period. We found that the median urinary concentrations of the specific metabolites for malathion and chlorpyrifos
decreased to the non-detect levels immediately after the introduction of organic diets and remained non-detectable until the conventional diets were re-introduced. The median
concentrations for other organophosphorus pesticide metabolites were also lower in the organic diet consumption days, however, the detection of those metabolites were not
frequent enough to show any statistical significance. In conclusion, we were able to demonstrate that an organic diet provides a dramatic and immediate protective effect
against exposures to organophosphorus pesticides that are commonly used in agricultural production. We also concluded that these children were most likely exposed to these
organophosphorus pesticides exclusively through their diet. To our knowledge this is the first study to employ a longitudinal design with a dietary intervention to assess children's exposure to pesticides. It provides new and persuasive evidence of the effectiveness of this intervention.
http://ehp.niehs.nih.gov/docs/2005/8418/abstract.html
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NO EVIDENCE THAT SOY ESTROGENS INCREASE CANCER RISK
Unlike traditional estrogen therapy, studies suggest that a diet high in the natural plant estrogens found in soy does not increase the risk of uterine cancer in postmenopausal women according to Mark Cline, associate professor of comparative medicine at Wake Forest University Baptist Medical Center.
Soy plants contain estrogen-like compounds called isoflavones or phytoestrogens. These plant estrogens are thousands of times weaker than the estrogen produced by the body but may be present in much higher concentrations in the blood. Evidence about the safety of soy isoflavones has been mixed. It is known that populations typically consuming high soy diets have much lower rates of uterine cancer.
Dr. Cline reported that preliminary results from a two-year study of 375 women half of whom consumed 58mg of soy isoflavones per day and the other half a placebo. No relationship between the soy and endometrial proliferation was shown. Investigators at other institutions have made similar findings.
Source: Today's Dietitian 12-05
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Gut. 2006 Jan 24; [Epub ahead of print] Related Articles, Links
Meal-induced recto-sigmoid tone modification: a low-caloric meal accurately separates functional and organic gastrointestinal disease patients.
Di Stefano M, Miceli E, Missanelli A, Mazzocchi S, Corazza G.
I Department of Medicine, University of Pavia, IRCCS S.Matteo Hospital, Italy.
BACKGROUND AND AIMS: Diagnosis of irritable bowel syndrome is based on arbitrary criteria due to the lack of an accurate diagnostic test. The aim of this study was to evaluate whether recto-sigmoid tone modification after a meal represents an accurate diagnostic approach. METHODS: In a secondary care setting, 32 constipation-predominant and 24 diarrhoea-predominant IBS patients, 10 functional diarrhoea and 10 functional constipation patients, 29 organic gastrointestinal disease patients and 10 healthy volunteers underwent a rectal barostat test in order to measure fasting and post- prandial recto-sigmoid tone. Recto-sigmoid response was assessed following three meals containing different amounts of calories, 200 Kcal, 400 Kcal and 1000 Kcal. RESULTS: After 200 Kcal, healthy volunteers and patients with organic diseases showed a reduction of recto-sigmoid volume of at least 28% of fasting volume, indicating a meal-induced increase of muscle tone. On the contrary, patients with diarrhoea-predominant IBS showed a dilation of the recto-sigmoid colon, indicative of reduced tone and patients with constipation-predominant IBS showed a mild volume reduction or no modification. Functional diarrhoea and constipation patients showed recto-sigmoid tone modification resembling that of the corresponding IBS subtype. A 400 Kcal meal normalized recto-sigmoid tone in more than half the constipation- predominant IBS patients but none of the diarrhoea- predominant IBS patients. On the contrary, a 1000 Kcal meal normalized tone response in all IBS patients. Sensitivity of the test was 100%, specificity 93%, positive predictive value 96% and negative predictive value 100%. CONCLUSION: A post-prandial reduction of recto- sigmoid tone of at least 28% of fasting value after a low- caloric meal accurately separates organic and functional gastrointestinal disease patients. This parameter may, therefore, be used in the positive diagnosis of IBS.
PMID: 16434428
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Influence of alcohol consumption on IBS and dyspepsia
Authors: halder, s. l. s.1; locke, g. r2; schleck, c. d.3; zinsmeister, a. r.3; talley, n. j.2
Source: Neurogastroenterology and Motility, Volume 18, Number 11, November 2006, pp. 1001-1008(8)
Publisher: Blackwell Publishing
The role of alcohol use in irritable bowel syndrome (IBS) and dyspepsia is not well understood. We hypothesised that people with psychological distress who drink no alcohol, or excess alcohol, are at increased risk of having IBS or dyspepsia.
Valid gastrointestinal (GI) symptom surveys were mailed to randomly selected cohorts of community residents. Associations between IBS, dyspepsia and abdominal pain and alcohol use were assessed using logistic regression adjusted for a Somatic Symptom Checklist score (SSC).
A total of 4390 (80%) responded; of these, 10.5% reported IBS, 2% dyspepsia and 22% abdominal pain. Alcohol consumption of greater than 7 drinks per week was associated with a greater odds for dyspepsia and frequent abdominal pain but not IBS. However, significant interactions among gender, alcohol use and SSC scores were detected.
In females with a low SSC score, consuming alcohol greater than 7 drinks per week increased the odds of IBS compared to drinking alcohol moderately. Alcohol consumption was associated with dyspepsia and abdominal pain. A relationship with IBS was identified when interactions with somatization and gender were appropriately considered.
Whether these associations are due to the effects of alcohol on the gut, or a common central mechanism remains to be determined.
http://www.ingentaconnect.com/content/bsc/ngem/2006/00000018/00000011/art00007;jsessionid=4581hohm0t37d.victoria
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Abnormalities of GI transit in bloated irritable bowel syndrome: effect of bran on transit and symptoms.
Hebden JM, Blackshaw E, D'Amato M, Perkins AC, Spiller RC.
Department of Gastroenterology, University Hospital Nottingham, United Kingdom.
OBJECTIVES: Bloating is an important but poorly understood symptom in irritable bowel syndrome (IBS) that is often aggravated by bran. The aim of our study was to determine whether IBS patients with bloating responded to bran differently from healthy controls.
METHODS: A total of 12 patients with IBS (according to Rome I criteria), all with moderate to severe bloating, and 12 healthy controls participated in a two way, double blind, randomized, cross-over trial of bran versus placebo (crushed biscuits) 15 g b.i.d. An average daily pain index and bloating score were derived from daily symptom diaries. On day 14, gastric emptying, small bowel transit, percent remaining in ascending colon, and geometric center of a meal marker at 24 h were calculated from scintigraphic images obtained after ingesting a Tc99m-labeled rice pudding meal with 15 g of either placebo or coarse bran. RESULTS: Results are given as median (range). Bran significantly increased the pain index and bloating (p < 0.02) in IBS patients but not controls. The most striking finding was that the small bowel transit time of the meal without bran was markedly faster in IBS patients than in controls, being 203 min (range 109-313) versus 367 min (219-543), p < 0.001. Although in controls bran accelerated small bowel transit time to 262 min (180-380), p = 0.03, and significantly reduced % remaining in the ascending colon from 22% (0-46) to 3% (0-25), p = 0.03, this was not seen in the IBS patients. Bran accelerated whole gut transit as assessed by geometric center at 24 h in both IBS patients and controls.
CONCLUSIONS: Bran accelerates small bowel transit and ascending colon clearance without causing symptoms in controls. Small bowel transit is rapid in IBS patients with bloating and, unlike in healthy control subjects, cannot be further accelerated by bran, which nevertheless aggravates symptoms of pain and bloating. We speculate that bran-induced bloating may originate in the colon rather than the small bowel.
PMID: 12358250 [PubMed - indexed for MEDLINE]
Am J Gastroenterol. 2002 Sep;97(9):2315-20.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=12358250
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More GI Symptoms, Less Anxiety With Tryptophan Supplementation in IBS
NEW YORK (Reuters Health) Dec 21 - Patients with irritable bowel syndrome (IBS) have an increase in gastrointestinal symptoms after ingestion of a large dose of tryptophan, according to a new study. At the same time, they report having fewer symptoms of anxiety and depression.
British researchers, led by Dr. Jonathan Shufflebotham of the University of Bristol, studied 18 patients with ROME II-defined IBS and 11 age-matched controls. The subjects were evaluated during a phase of acute tryptophan depletion and a phase of acute tryptophan increase.
Participants ate a low-protein diet on the day before each phase of the study and fasted from midnight to 9:00 am on the day of intervention. Baseline levels of tryptophan were measured on that day and patients completed a questionnaire, answering questions about IBS symptoms and symptoms of anxiety and depression.
During acute tryptophan increase, subjects drank a concoction containing 2.3 g tryptophan, 150 ml water, 100 ml flavoring of their choice and 2 spoons of sugar. During acute tryptophan depletion, subjects drank the same drink without the addition of tryptophan.
Total and free plasma concentrations of tryptophan decreased 73% in both patients and controls during tryptophan depletion and increased approximately 60% on the day of supplementation.
IBS patients reported more gastrointestinal symptoms but less anxiety with acute tryptophan increase compared with acute tryptophan depletion. Controls did not have a difference in symptomatology on either day. IBS patients had lower mood scores overall than controls during all phases of the study.
In the study published in the November issue of the American Journal of Gastroenterology, Dr. Shufflebotham and colleagues write that the findings "suggest a difference in serotonergic functioning between these two groups and provides evidence to support the hypothesis that 5-HT dysfunction is involved in IBS."
IBS symptoms respond to treatment with 5-HT4 agonists and 5-HT3 antagonists in some IBS patients, the researchers note. And, "the differing direction of GI and anxiety symptom responses to 5-HT manipulation is counterintuitive but intriguing."
"Further researcher is now needed to clarify which parts of the 5-HT system are dysfunctional in IBS and how this relates to the symptoms experienced by patients with this condition," the team concludes.
Am J Gastroenterol 2006;101:2582-2587.
http://www.medscape.com/viewarticle/549778
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Clin Nurse Spec. 2006 Sep-Oct;20(5):241-7.
Is there any food I can eat? Living with inflammatory bowel disease and/or irritable bowel syndrome.
Fletcher PC, Schneider MA.
Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada N2L 3C5.
INTRODUCTION: Inflammatory bowel disease (Crohn's disease and ulcerative colitis) and irritable bowel syndrome are chronic, debilitating gastrointestinal (GI) disorders. There are no known causes of inflammatory bowel disease and/or irritable bowel syndrome. Both of these GI conditions significantly impair quality of life and the ability to complete activities of daily living. Unfortunately, there has been little education and research surrounding the evaluation of effective coping strategies with respect to GI disorders, particularly from the perspective of those diagnosed. As such, exploring the strategies of individuals with GI disorders would provide information concerning coping strategies from the perspective of those afflicted.
PURPOSE: The overall objective of this research was to explore the lived experience of women who had been diagnosed with inflammatory bowel disease and/or irritable bowel syndrome. This article specifically explores the relationship between food and irritable bowel syndrome and/or inflammatory bowel disease.
METHODS: Eight females, diagnosed with inflammatory bowel disease and/or irritable bowel syndrome, were recruited via on-campus posters from a university in southern Ontario, Canada. Qualitative information was collected in the form of background questionnaires, e-mail interviews, and face-to-face interviews, which were subsequently analyzed for trends.
RESULTS: Every woman reported that one of the most significant means by which to cope with their condition centered around food consumption or controlling their food consumption. Subjects identified the importance of determining their "trigger foods," selecting healthy food choices, the impact of stress, and problems associated with food and travel.
CONCLUSIONS: This research, predicated on the narratives of women diagnosed with GI disorders, substantiates the profound effect that food has on conditions of the GI tract. All of the women identified their relationship with food as a dynamic learning process, one that they thought would be a lifelong struggle. The implications for community health nurses in assisting individuals with GI disorders are discussed.
PMID: 16980794 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=16980794&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus
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Zhonghua Nei Ke Za Zhi. 2007 Aug;46(8):641-3.
[The therapeutic effects of eliminating allergic foods according to food-specific IgG antibodies in irritable bowel syndrome]
Yang CM, Li YQ.
Department of Digestive Disease, Shandong Provincial Hospital, Jinan 250021, China.
OBJECTIVE: To explore the therapeutic effects on irritable bowel syndrome (IBS) by eliminating the allergic foods according to food-specific IgG antibodies and to clarify the etiopathological role and mechanism of food allergy.
METHODS: The food-specific IgG antibodies to a panel of 14 different food antigens in serum were detected with ELISA in fifty five cases with diarrhea-dominant IBS, thirty two with constipation-dominant IBS and eighteen normal controls. The frequency and severity index of symptoms and scores of Irritable Bowel Syndrome Quality of Life (IBS-QOL) in thirty five cases with positive food-specific IgG were observed before and after elimination of allergic foods for two months.
RESULTS: The positive rate of serum food-specific IgG antibodies was 63.6 percent in patients with diarrhea-dominant IBS and 43.8 percent in constipation-dominant IBS. Both were higher than that in normal controls. After eliminating allergic foods for four weeks according to the levels of serum food-specific IgG antibodies, the frequency of symptoms decreased from (3.79 +/- 1.58) to (1.67 +/- 0.70) per week and the severity from 3.18 +/- 1.46 to 1.52 +/- 0.67 with significant differences. After eight weeks, the frequency of symptoms decreased from (3.79 +/- 1.58) to (1.53 +/- 0.69) per week and the severity from 3.18 +/- 1.46 to 1.45 +/- 0.66, also with significant differences. After eliminating allergic foods, the overall health score and the eight dimensionality integrals of QOL except avoiding food in patients with IBS increased significantly than those before treatment. At the end of eight weeks, the symptoms relieved completely in 31.4 percent of the cases and remarkably in 34.3 percent.
CONCLUSIONS: Abnormal immune reactions mediated by IgG antibodies coexisted in patients with IBS. It is of great significance in treating IBS by eliminating the allergic foods according to the serum level of food-specific IgG antibodies.
PMID: 17967233 [PubMed - in process]
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17967233&ordinalpos=10&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
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Volume 6, Issue 7, Pages 765-771 (July 2008)
Dietary Triggers of Abdominal Symptoms in Patients With Irritable Bowel Syndrome: Randomized Placebo-Controlled Evidence
Findings in this article have been presented at the Australian Gastroenterology Week, October 2006 and an abstract published as follows: Shepherd S, Gibson PR. Role of dietary fructose and fructans in initiating symptoms of IBS in fructose malabsorbers. J Gastroenterol Hepatol 2006;18(Suppl):B102.
Susan J. Shepherd, Francis C. Parker, Jane G. Muir, Peter R. Gibson
published online 06 May 2008.
Background & Aims: Observational studies suggest dietary fructose restriction might lead to sustained symptomatic response in patients with irritable bowel syndrome (IBS) and fructose malabsorption. The aims of this study were first to determine whether the efficacy of this dietary change is due to dietary fructose restriction and second to define whether symptom relief was specific to free fructose or to poorly absorbed short-chain carbohydrates in general. Methods: The double-blinded, randomized, quadruple arm, placebo-controlled rechallenge trial took place in the general community. The 25 patients who had responded to dietary change were provided all food, low in free fructose and fructans, for the duration of the study. Patients were randomly challenged by graded dose introduction of fructose, fructans, alone or in combination, or glucose taken as drinks with meals for maximum test period of 2 weeks, with at least 10-day washout period between. For the main outcome measures, symptoms were monitored by daily diary entries and responses to a global symptom question. Results: Seventy percent of patients receiving fructose, 77% receiving fructans, and 79% receiving a mixture reported symptoms were not adequately controlled, compared with 14% receiving glucose (P ≤ 0.002, McNemar test). Similarly, the severity of overall and individual symptoms was significantly and markedly less for glucose than other substances. Symptoms were induced in a dose-dependent manner and mimicked previous IBS symptoms. Conclusions: In patients with IBS and fructose malabsorption, dietary restriction of fructose and/or fructans is likely to be responsible for symptomatic improvement, suggesting efficacy is due to restriction of poorly absorbed short-chain carbohydrates in general.
Abbreviations used in this paper: FM, fructose malabsorption, FODMAPs, Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols, IBS, irritable bowel syndrome, ITT, intention to treat, PP, per protocol, VAS, visual analogue scale
Department of Gastroenterology and Monash University Department of Medicine, Box Hill Hospital, Victoria, Australia
Address requests for reprints to: Ms Sue Shepherd, Department of Medicine, Box Hill Hospital, Box Hill, Victoria 3128, Australia. fax: +61-3-9895-0352.
Susan J. Shepherd was supported by a National Health & Medical Research Council postgraduate biomedical scholarship. Foods were donated by the following organizations: ACI packaging, Advanced Brockerage Australia (Liddell's), Bundaberg Sugar, Cerebos Foods, Coles supermarket, Confoil Pty Ltd, Country Life, Duncan Davis Smallgoods, Findus, Freedom Foods (Aust) Pty Ltd, Goodman Fielder Pty Ltd, Greens General Foods Pty Ltd, Heinz, Ingham chicken, Lactos Pty Ltd, Massel Australia Pty Ltd, McCormick Foods Australia Pty Ltd, National Foods, Orgran (Roma Foods), Pace Farm Pty Ltd, Pakval, Purewater, Riviana Foods, Silly Yaks, Simplot Australia Pty Ltd, Sunrice, The Smiths Snackfood Company Ltd, Trialia Foods, Uncle Rick's, Virgona Fruit and Vegetables.
Susan J. Shepherd has published three cookbooks directed toward issues of fructose malabsorption and celiac disease. The term FODMAPs has been registered by Susan Shepherd and Peter Gibson.
We thank Lance Schiapulus for developing and formulating the test drinks, Nia Rosella and Rosemary Rose for technical support, and Paul Rose, Kathryn Stephens, and Martin Shepherd for logistical support.
PII: S1542-3565(08)00151-1
doi:10.1016/j.cgh.2008.02.058
© 2008 AGA Institute. Published by Elsevier Inc. All rights reserved.
http://journals.elsevierhealth.com/periodicals/yjcgh/article/S1542-3565(08)00151-1/abstract
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BMC Complement Altern Med. 2008 Dec 19;8:65.
Treatments for irritable bowel syndrome: patients' attitudes and acceptability.
Harris LR, Roberts L.
Primary Care Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
BACKGROUND: Irritable Bowel Syndrome, a highly prevalent chronic disorder, places significant burden on the health service and the individual. Symptomatic distress and reduced quality of life are compounded by few efficacious treatments available. As researchers continue to demonstrate the clinical efficacy of alternative therapies, it would be useful to gain a patient-perspective of treatment acceptability and identify patient's attitudes towards those modalities considered not acceptable.
METHODS: Six hundred and forty-five participants identified from an earlier IBS-prevalence study received a postal questionnaire to evaluate preferences and acceptability of nine forms of treatment. Proportions accepting each form of treatment were calculated and thematic analysis of qualitative data undertaken.
RESULTS: A total of 256 (39.7%) of 645 potential respondents completed the questionnaire (mean age 55.9 years, 73% female). Tablets were most acceptable (84%), followed by lifestyle changes (diet (82%), yoga (77%)). Acupuncture (59%) and suppositories (57%) were less acceptable. When explaining lack of acceptability, patient views fell into four broad categories: dislike treatment modality, do not perceive benefit, general barriers and insufficient knowledge. Scepticism, lack of scientific rationale and fear of CAM were mentioned, although others expressed a dislike of conventional medical treatments. Past experiences, age and health concerns, and need for proof of efficacy were reported.
CONCLUSION: Most patients were willing to accept various forms of treatment. However, the reservations expressed by this patient-population must be recognised with particular focus directed towards allaying fears and misconceptions, seeking further evidence base for certain therapies and incorporating physician support and advice.
PMID: 19099570 [PubMed - indexed for MEDLINE]
PMCID: PMC2633319
http://www.ncbi.nlm.nih.gov/pubmed/19099570?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
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Arch Intern Med. 2009 Mar 23;169(6):562-71.
Meat intake and mortality: a prospective study of over half a million people.
Sinha R, Cross AJ, Graubard BI, Leitzmann MF, Schatzkin A.
Division of Cancer Epidemiology and Genetics, National Cancer Institute-Nutritional Epidemiology Branch, Rockville, MD 20852, USA.
BACKGROUND: High intakes of red or processed meat may increase the risk of mortality. Our objective was to determine the relations of red, white, and processed meat intakes to risk for total and cause-specific mortality.
METHODS: The study population included the National Institutes of Health-AARP (formerly known as the American Association of Retired Persons) Diet and Health Study cohort of half a million people aged 50 to 71 years at baseline. Meat intake was estimated from a food frequency questionnaire administered at baseline. Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) within quintiles of meat intake. The covariates included in the models were age, education, marital status, family history of cancer (yes/no) (cancer mortality only), race, body mass index, 31-level smoking history, physical activity, energy intake, alcohol intake, vitamin supplement use, fruit consumption, vegetable consumption, and menopausal hormone therapy among women. Main outcome measures included total mortality and deaths due to cancer, cardiovascular disease, injuries and sudden deaths, and all other causes.
RESULTS: There were 47 976 male deaths and 23 276 female deaths during 10 years of follow-up. Men and women in the highest vs lowest quintile of red (HR, 1.31 [95% CI, 1.27-1.35], and HR, 1.36 [95% CI, 1.30-1.43], respectively) and processed meat (HR, 1.16 [95% CI, 1.12-1.20], and HR, 1.25 [95% CI, 1.20-1.31], respectively) intakes had elevated risks for overall mortality. Regarding cause-specific mortality, men and women had elevated risks for cancer mortality for red (HR, 1.22 [95% CI, 1.16-1.29], and HR, 1.20 [95% CI, 1.12-1.30], respectively) and processed meat (HR, 1.12 [95% CI, 1.06-1.19], and HR, 1.11 [95% CI 1.04-1.19], respectively) intakes. Furthermore, cardiovascular disease risk was elevated for men and women in the highest quintile of red (HR, 1.27 [95% CI, 1.20-1.35], and HR, 1.50 [95% CI, 1.37-1.65], respectively) and processed meat (HR, 1.09 [95% CI, 1.03-1.15], and HR, 1.38 [95% CI, 1.26-1.51], respectively) intakes. When comparing the highest with the lowest quintile of white meat intake, there was an inverse association for total mortality and cancer mortality, as well as all other deaths for both men and women.
CONCLUSION: Red and processed meat intakes were associated with modest increases in total mortality, cancer mortality, and cardiovascular disease mortality.
PMID: 19307518 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/19307518?ordinalpos=6&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
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IBS Diet Cheat Sheet Celebrates 1 Million Downloads by Irritable Bowel Syndrome Patients
Irritable Bowel Syndrome patient-support site HelpForIBS.com features an IBS Diet Cheat Sheet that's seen 5 years of success and over one million downloads.
Seattle, WA (PRWEB) June 9, 2009 -- If you're new to the dietary management of Irritable Bowel Syndrome, learning what you can and can't eat without triggering painful symptoms can be an even more painful process.
To help IBS patients avoid this unnecessary struggle, best-selling author and HelpForIBS.com founder Heather Van Vorous (Eating for IBS, The First Year IBS) designed the IBS Diet Cheat Sheet - a free patient/doctor handout that provides the perfect way to keep critical IBS dietary information at hand.
"The IBS Diet Cheat Sheet uses an easy visual reference of red light, yellow light, and green light foods for IBS," says Van Vorous. "Red light foods are triggers to be avoided, yellow light foods should be eaten but only with caution, and green light foods are safe to eat. The lists are concise and easy to read at a glance, but also quite comprehensive."
The IBS Diet Cheat Sheet also includes the 10 Commandments of Eating for IBS, which explain how to eat, not just what to eat. Commandments such as "Practice creative substitution, not deprivation," "Always eat soluble fiber first," and "Minimize your fat intake to 25% of your diet, max" are among the quick tips that help ward off IBS attacks.
Irritable Bowel Syndrome affects up to 20% of the population and symptoms such as diarrhea, constipation, abdominal pain, bloating and gas are can either be triggered or prevented through diet. The IBS Diet Cheat Sheet gives patients the dietary information they need to avoid problems and gain control.
The free cheat sheet is downloadable here http://www.helpforibs.com/diet/heathersibscheatsheet.pdf and is meant to be carried, taped to the fridge, or kept in the car for traveling. Just five years after its creation the IBS Diet Cheat Sheet has reached over one million people and counting.
About HelpForIBS.com
HelpForIBS.com is the largest IBS community on the internet, with over 5 million visits per year and a membership of over 90,000 subscribers. HelpForIBS.com is dedicated to serving people with IBS, by offering education, support, and products that allow people with Irritable Bowel Syndrome to successfully manage their symptoms through simple and safe lifestyle modifications. HelpForIBS.com was founded by Heather Van Vorous, an IBS author and a sufferer since age 9. Heather's groundbreaking work in the IBS dietary field has led to her inclusion in Marquis Who's Who in Medicine and Healthcare, has been licensed by Novartis pharmaceuticals, and has been publicized worldwide by physicians, IBS organizations, and patients.
http://www.prweb.com/releases/2009/06/prweb2452654.htm
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Published 27 August 2009, doi:10.1136/bmj.b3154
Cite this as: BMJ 2009;339:b3154
Research
Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial
C J Bijkerk, general practitioner1, N J de Wit, associate professor of general practice1, J W M Muris, associate professor of general practice2, P J Whorwell, professor of medicine and gastroenterology3, J A Knottnerus, professor of general practice2, A W Hoes, professor of clinical epidemiology and general practice1
1 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, Netherlands, 2 Department of General Practice, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6200 MD Maastricht, Netherlands, 3 Department of Medicine and Gastroenterology, University of Manchester, Manchester, M23 9LT
Objective To determine the effectiveness of increasing the dietary content of soluble fibre (psyllium) or insoluble fibre (bran) in patients with irritable bowel syndrome.
Design Randomised controlled trial.
Setting General practice.
Participants 275 patients aged 18-65 years with irritable bowel syndrome.
Interventions 12 weeks of treatment with 10 g psyllium (n=85), 10 g bran (n=97), or 10 g placebo (rice flour) (n=93).
Main outcome measures The primary end point was adequate symptom relief during at least two weeks in the previous month, analysed after one, two, and three months of treatment to assess both short term and sustained effectiveness. Secondary end points included irritable bowel syndrome symptom severity score, severity of abdominal pain, and irritable bowel syndrome quality of life scale.
Results The proportion of responders was significantly greater in the psyllium group than in the placebo group during the first month (57% v 35%; relative risk 1.60, 95% confidence interval 1.13 to 2.26) and the second month of treatment (59% v 41%; 1.44, 1.02 to 2.06). Bran was more effective than placebo during the third month of treatment only (57% v 32%; 1.70, 1.12 to 2.57), but this was not statistically significant in the worst case analysis (1.45, 0.97 to 2.16). After three months of treatment, symptom severity in the psyllium group was reduced by 90 points, compared with 49 points in the placebo group (P=0.03) and 58 points in the bran group (P=0.61 versus placebo). No differences were found with respect to quality of life. Fifty four (64%) of the patients allocated to psyllium, 54 (56%) in the bran group, and 56 (60%) in the placebo group completed the three month treatment period. Early dropout was most common in the bran group; the main reason was that the symptoms of irritable bowel syndrome worsened.
Conclusions Psyllium offers benefits in patients with irritable bowel syndrome in primary care.
Trial registration Clinical trials NCT00189033 [ClinicalTrials.gov] .
http://www.bmj.com/cgi/content/abstract/339/aug27_2/b3154
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January 6, 2010 — Dietary fiber may help prevent gain in body weight and waist circumference, according to the results of a prospective cohort study reported online in the December 16, 2009, issue of the American Journal of Clinical Nutrition.
"Dietary fiber may play a role in obesity prevention," write Huaidong Du, from the National Institute for Public Health and the Environment in Bilthoven, the Netherlands, and colleagues. "Until now, the role that fiber from different sources plays in weight change had rarely been studied."
The goal of this study was to evaluate the relationship of total dietary fiber, cereal fiber, and fruit and vegetable fiber with changes in weight and waist circumference. The study cohort consisted of 89,432 European participants, aged 20 to 78 years, without cancer, cardiovascular disease, and diabetes at baseline. Validated, country-specific, food-frequency questionnaires were used to obtain dietary information. Average duration of follow-up was 6.5 years. In each center studied, multiple linear regression analysis was performed, and estimates were combined with random-effect meta-analyses, after adjustment for follow-up duration; other dietary variables; and baseline anthropometric, demographic, and lifestyle factors.
There was an inverse association of total fiber intake with subsequent change in weight and in waist circumference. For each 10-g/day increase in total fiber intake, the pooled estimate was –39 g/year (95% confidence interval [CI], –71 to –7 g/year) for weight change and –0.08 cm/year (95% CI, –0.11 to –0.05 cm/year) for waist circumference change.
For each 10-g/day increase in fiber intake from cereals, there was a weight change of –77 g/year (95% CI, –127 to –26 g/year) and change in waist circumference of –0.10 cm/year (95% CI, –0.18 to –0.02 cm/year). Fruit and vegetable fiber was not associated with weight change. However, the association of fruit and vegetable fiber intake with change in waist circumference was similar to that seen for intake of total dietary fiber and cereal fiber.
Limitations of this study include difference in methodologies used to collect anthropometric data at follow-up because weight and waist circumference measurements at follow-up were self-reported instead of measured at 4 of 6 study centers. In addition, dietary information was collected only once at baseline, which precluded investigating the concurrent association between changes in fiber intake and changes in weight and waist circumference.
"Our finding may support a beneficial role of higher intake of dietary fiber, especially cereal fiber, in prevention of body-weight and waist circumference gain," the study authors write. "Although the observed effect was rather small in our study when judged on the individual level, the effect of fiber on weight change observed in our study may be of public health relevance."
The DiOGenes (Diet, Obesity, and Genes) project, which was supported by the European Community, supported this study. The study authors have disclosed no relevant financial relationships.
Am J Clin Nutr. Published online December 16, 2009. Abstract
http://www.medscape.com/viewarticle/714651
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Strategy to combat cancer: Avoid meats and dairy products
Avoiding meats and dairy products is increasingly touted as helping to prevent the disease
Kimberly Hayes Taylor / The Detroit News
We've heard about ways to potentially prevent cancer and other diseases -- increase antioxidants, take vitamins, eat eight to 10 servings of fruits and vegetables daily and drink plenty of purified water.
We all know we're supposed to avoid salty and sugary foods, as well as foods loaded with fat and cholesterol -- and that we should exercise.
But what about the advice to avoid meat and meat by-products? After all, they are the only foods that contain cholesterol, and fruits and vegetables open the arteries while cholesterol-containing foods clog them.
Although some people find the idea of avoiding meat repulsive, a growing number of Metro Detroiters are embracing the idea so much they are taking classes to learn how to cook delicious yet simple meals without meat or dairy products such as milk, eggs, cheese, sour cream or yogurt.
They have good reason. A growing number of research studies on large groups of people indicate avoiding meat reduces the likelihood of battling cancer.
Last year, the National Cancer Institute released study results after examining 500,000 people for 10 years. The study concluded that eating large amounts of red and processed meats increased the likelihood of developing cancer. In the past few years, large studies in England and Germany showed that vegetarians were about 40 percent less likely to develop cancer compared to meat eaters. Additionally, Harvard studies showed that daily meat eaters have approximately three times the colon cancer risk, compared to those who rarely eat meat.
Vegetarianism also is suggested for cancer survivors.
When Mary Bobis of Farmington Hills was diagnosed with stage-four colon cancer in February 2007, her doctors recommended she stop eating meat, so she did. Now she's an expert at finding mouth-watering recipes that don't require any animal products.
"I've learned that 80 percent of cancer comes from the way we eat and the environment," says the 24-year-old. "And 20 percent is unexplained or genetic. I think because I was diagnosed at age 21, I fall into the latter group. I believe you can safely say most cancers are prevented by eating right and exercising."
It's not as difficult as you think to give up -- or greatly reduce -- meat intake, says James Tester, a Cancer Project educator who teaches a cancer-prevention cooking class Tuesday nights at Providence Park Hospital's Assarian Cancer Center in Novi. He says the key is learning the four new food groups -- fruit, vegetables, grains and beans.
"We promote changing all the way," he says. "It's a lifestyle change and you've got to go all the way. When you adapt this way of nutritious eating, you'll find an alternative for everything."
For example, Cheryl Heppard, a health coach based in Birmingham, advises clients who want to prevent cancer to switch from cow's milk to almond, coconut or rice milk. Soy products are abundant in grocery stores these days, but Heppard doesn't recommend them because of the bloating, gassiness and digestive problems they can cause.
Melinda Lewis, a certified health minister who teaches cooking classes at her Southfield home through Great Joy Health Ministries, suggests getting away from white processed sugar and trying natural sweeteners such as agave nectar and pure maple syrup.
Bobis, who was not expected to make it this long after a diagnosis more typical to people in their 60s, says changing the way she eats has sustained her.
"It changed my life," she says, "and makes me more aware of the causes of cancer and helps me feel better."
From The Detroit News: http://www.detnews.com/article/20100107/LIFESTYLE05/1070319/Strategy-to-combat-cancer--Avoid-meats-and-dairy-products#ixzz0hKsWFLJB
http://www.detnews.com/article/20100107/LIFESTYLE05/1070319/Strategy-to-combat-cancer--Avoid-meats-and-dairy-products
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Increasing Soda Consumption Fuels Rise in Diabetes, Heart Disease
FRIDAY, March 5 (HealthDay News) --Increasing consumption of sugary soft drinks contributed to 130,000 new cases of diabetes, 14,000 new cases of heart disease and 50,000 more life-years burdened with heart disease in the last decade, a new U.S. study finds.
"The finding suggests that any kind of policy that reduces consumption might have a dramatic health benefit," said senior study author Dr. Kirsten Bibbins-Domingo, an associate professor of medicine at the University of California, San Francisco, who was to present the finding Friday during the American Heart Association's Cardiovascular Disease Epidemiology and Prevention annual conference, in San Francisco.
The study used a computer simulation of heart disease that has been applied to other cardiovascular risk factors, such as obesity and dietary salt, Bibbins-Domingo explained. "We probably underestimated the incidence, because the rise is greatest among the young, and our model focuses on adults 35 and older," she said.
One plausible explanation is that the increased incidence of cardiovascular problems is due to a rising incidence of diabetes, Bibbins-Domingo said, while an increase in obesity might also be responsible.
"Whatever the mechanism, large population studies do suggest an effect of drinking large lots of sweetened beverages," she said. "No one argues that these drinks are not fine in moderation, but over the past decade their consumption has been on the rise, while consumption of other beverages has declined."
A statement by Maureen Storey, senior vice president for science policy for the American Beverage Association, noted that the study had not yet been published in a scientific journal, and therefore had not undergone review by outside, qualified scientists.
"What we do know is that both heart disease and diabetes are complex conditions with no single cause and no single solution," Storey said in the statement, which noted that consumption of sugar-sweetened beverages is not listed as a risk factor by the American Heart Association. "Rather, we need to continue to educate Americans about the importance of balancing the calories from the foods and beverages we eat and drink with regular physical activity."
But the study does suggest that any kind of policy that reduces consumption might have a health benefit, Bibbins-Domingo noted. One such policy is a proposed tax on sugar-sweetened drinks, she noted. "The reason why there is a current debate about a tax is that scientific evidence in populations has consistently shown that more than one drink a day increases your risk," she said.
The American Heart Association recommends limiting consumption of sugar-sweetened drinks such as soda pop, while "alternative choices are available," said Dr. Robert H. Eckel, a professor of medicine at the University of Colorado and a past president of the association.
"Juice from fruit itself is nutrient-rich, and its nutritional value goes beyond the carbohydrate content," Eckel said.
The recommended daily sugar intake amounts to just one can of sugar-sweetened soda a day for a man and slightly less for women, he said.
SOURCES: Kirsten Bibbins-Domingo, M.D., associate professor, medicine, University of California, San Francisco; Robert H. Eckel, professor, medicine, University of Colorado, Denver; March 5, 2010, presentation, American Heart Association's Cardiovascular Disease Epidemiology and Prevention annual conference, San Francisco
http://www.healthday.com/Article.asp?AID=636642
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Processed Meat May Harm the Heart
FRIDAY, March 5 (HealthDay News) -- Conventional wisdom has dictated that fat from red meat is a risk factor for heart disease, but a new analysis from Harvard researchers finds it's eating processed meat -- not unprocessed red meat -- that increases the risk for heart disease and even diabetes.
The term "processed meat" refers to any meat preserved by smoking, curing or salting or with the addition of chemical preservatives. The researchers defined "red meat" as unprocessed meats such as beef, hamburger, lamb and pork.
"To lower risk of heart attacks and diabetes, people should avoid eating too much processed meats -- for example, hot dogs, bacon, sausage or processed deli meats," said lead researcher Renata Micha, a research fellow at the Harvard School of Public Health. "Based on our findings, eating up to one serving per week would be associated with relatively small risk."
Micha was scheduled to present the finding Friday at an American Heart Association conference on cardiovascular disease in San Francisco.
For the study, Micha's team analyzed data from 20 studies that included more than 1.2 million participants. Among them, 23,889 had coronary heart disease, 2,280 had had a stroke and 10,797 had diabetes.
The researchers found that people who ate unprocessed red meat did not significantly increase their chances of developing heart disease or diabetes. However, eating processed meat was linked to an increased risk for the two conditions.
In fact, for every 50-gram (1.8-ounce) serving, the risk for heart disease jumped 42 percent and the risk for diabetes increased 19 percent.
Though neither unprocessed red meat nor processed meats were linked to an increased risk for stroke, the researchers pointed out that just three studies looked at the connection between eating meat and stroke, so the data was insufficient to draw a valid conclusion.
"When we looked at average nutrients in unprocessed meats and processed meats eaten in the U.S., we found that they contained similar amounts of saturated fat and cholesterol," Micha said. "In contrast, processed meats contained, on average, four times higher amounts of sodium and two times higher amounts of nitrate preservatives."
This suggests that salt and other preservatives, rather than fats, probably explain the higher risk for heart attacks and diabetes seen with processed meats, Micha said.
"Health effects of unprocessed red meats and processed meats should be separately considered," she said. "More research is needed into which factors in meats -- especially salt or other preservatives -- are most important for health effects."
Samantha Heller, a registered dietitian, clinical nutritionist and exercise physiologist in Fairfield, Conn., said that "scientists are looking into why processed meats are so hazardous to our health."
"They may never know the exact reason, but we do know that people should limit their consumption of foods such as bacon, hot dogs, salami and pepperoni to reduce the risk of chronic diseases," Heller said.
"In addition, studies show that eating unprocessed red meat does increase the risk for disease as well," she said. "A study of over 500,000 people found that people who ate the most both red and processed meats had a higher risk of mortality, cancer and cardiovascular disease than those who ate lesser amounts of these foods."
Both red and processed meat and other foods, such as butter and cheese, that are high in saturated fat have been linked to chronic disease, Heller said, adding that people should limit consumption of them as well.
"Going low- or no-fat with dairy products helps lower our intake of saturated fat," she said. "Choosing healthy protein sources -- such as white-meat poultry, low-mercury fish, soy, nuts and beans -- and focusing on moving in the direction of a more plant-based diet will help us all live longer, healthier lives."
Dr. Gregg Fonarow, a professor of cardiovascular medicine at the University of California, Los Angeles, said that "various studies have suggested that higher levels of consumption of red and processed meat is associated with higher risk of heart disease, stroke, diabetes, cancer and premature death."
However, the results have not always been consistent, and some earlier studies have suggested there may be differences in health risk between unprocessed red meat and processed meat, he said. More study is needed to verify the link and explore the mechanisms behind it, Fonarow said.
Although unprocessed red meat might not increase the risk for heart disease or diabetes, it might increase the risk for some cancers, according to a 2007 report from researchers at the U.S. National Cancer Institute.
They found elevated risks for colorectal and lung cancer with high consumption of both processed and unprocessed meats, along with borderline higher risks for advanced prostate cancer. High intake of red meat was also associated with an increased risk for esophageal and liver cancer and a borderline increased risk for laryngeal cancer. And high consumption of processed meat was linked to a borderline increased risk for bladder cancer and myeloma, a kind of bone cancer.
SOURCES: Renata Micha, R.D., Ph.D., research fellow, Harvard School of Public Health, Boston; Samantha Heller, M.S., R.D., dietitian, nutritionist and exercise physiologist, Fairfield, Conn.; Gregg Fonarow, M.D., professor, cardiovascular medicine, University of California, Los Angeles; March 5, 2010, presentation, American Heart Association's Cardiovascular Disease Epidemiology and Prevention annual conference, San Francisco
http://www.healthday.com/Article.asp?AID=636701
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Adding gluten early may cause constipation in babies
Rachael Myers Lowe
Tue Mar 9, 2010 3:54pm EST
NEW YORK (Reuters Health) - Giving gluten-containing foods to infants too soon may trigger long-lasting tummy troubles but more study is needed before changing recommendations for parents, Dutch researchers conclude.
Health
Writing in the American Journal of Gastroenterology, J. C. Kiefte-de Jong and colleagues at the Erasmus Medical Center in Rotterdam report that 2-year-olds introduced to gluten before 6 months of age had a "significantly higher" rate of "functional" constipation -- defined as fewer than 3 bowel movements per week and/or hard stools for 2 or more weeks -- than children who were introduced to gluten later.
At the same time, introducing other allergy-inducing foods in the first year of life such as peanuts, cow's milk, or hen's eggs was not linked to constipation.
Gluten is a protein found in wheat, barley and rye and, as a result, is present in many cereals and breads. It is not present in all grains, however. Wild rice, corn, buckwheat, millet, amaranth, quinoa, oats, soybeans, and sunflower seeds do not contain gluten protein.
Earlier studies implied a relationship between early gluten introduction and celiac disease, a digestive disorder caused by an abnormal immune response to gluten. The disease damages structures in the lining of the small intestine called villi, impairing the body's absorption of nutrients.
It can lead to severe health problems including anemia, poor bone health, fatigue and weight loss. There is no cure, and the only treatment is a life-long gluten-free diet.
The authors wanted to know whether gluten might also be linked to constipation, which is the main reason for up to 5 percent of all visits to pediatricians. It often develops around the time solid foods are added to an infant's diet, and when parents transition from breast milk or formula to cow's milk.
The Dutch researchers analyzed data from more than 4,600 children from birth until young adulthood. Parents completed a questionnaire at 6 and 24 months about their child's general health, breast feeding, the introduction of solid foods, medications, cow's milk allergy and other information.
At 24 months, 12 percent - about one in eight -- of the study's children had functional constipation.
After examining family traits and diets, Kiefte-de Jong concluded that introducing gluten in the first year of life was "a trigger for functional constipation" in some children. On the flip side, constipation may make cow's milk allergies last longer.
Still, researchers said the study had some weaknesses, including the need to rely on self-reporting by parents about food allergies and the lack of information about lifestyles and psychological factors, and said they would want to see more studies before making any new recommendations to parents.
Dr. Rita Steffen, a pediatric gastroenterologist at Cleveland Clinic Children's Hospital, agreed.
Parents are usually urged to introduce solids slowly, starting with rice cereal and moving to other grains after 6 months, Steffen told Reuters Health, while acknowledging that parents will do what they want, often jumping the gun on introducing other solids.
If a child is tolerating gluten, Steffen said, there's no reason yet to remove it from the diet.
"I wouldn't jump out and change the world based on this," she said. "There's not enough evidence to support removing gluten from diets."
SOURCE: American Journal of Gastroenterology, March 2010.
http://www.reuters.com/article/idUSTRE6284HZ20100309
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J Nutr Sci Vitaminol (Tokyo). 2007 Jun;53(3):232-8.
Dietary patterns associated with functional constipation among Japanese women aged 18 to 20 years: a cross-sectional study.
Okubo H, Sasaki S, Murakami K, Kim MK, Takahashi Y, Hosoi Y, Itabashi M; Freshmen in Dietetic Courses Study II Group.
Department of Nutrition Sciences, Kagawa Nutrition University, Saitama 350-0288, Japan.
Abstract
Although several nutrients and foods have been suggested to be preventive for constipation, all previous studies have examined a single nutrient or food in each analysis. In contrast, analysis of dietary patterns may provide new insights into the influence of diet on functional constipation. We conducted a cross-sectional examination of the association between dietary pattern and functional constipation in 3,770 Japanese female dietetic course students aged 18-20 y from 53 institutions in Japan. Diet was assessed with a validated self-administered diet history questionnaire with 148 food items, from which 30 food groups were created and entered into a factor analysis.
Functional constipation was defined using the Rome I criteria, which has previously been used in several epidemiologic studies on constipation. The prevalence of functional constipation was 26.0% (n=979). Four dietary patterns were identified: (1) "Healthy", (2) "Japanese traditional", (3) "Western," and 4) "Coffee and dairy products."
After adjustment for several confounding factors, the "Japanese traditional" pattern, characterized by a high intake of rice, miso soup, and soy products and a low intake of bread and confectionaries, was associated with a significantly lower prevalence of functional constipation. In comparison with the lowest quintile, the multivariate adjusted odds ratio (95% confidence interval) was 0.52 (0.41-0.66) in the highest quintile (p for trend < 0.0001). Other dietary patterns were not associated with functional constipation.
The Japanese traditional dietary pattern, characterized by a high intake of rice and a low intake of bread and confectionaries, may be beneficial in preventing functional constipation in young Japanese women.
PMID: 17874828 [PubMed - indexed for MEDLINE]Free Article
http://www.ncbi.nlm.nih.gov/pubmed/17874828
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Red meat linked to esophageal, stomach cancer risks
By Amy Norton
NEW YORK ' Fri Nov 5, 2010 11:34am EDT
NEW YORK (Reuters Health) - Red-meat lovers may have a greater likelihood of developing certain cancers of the throat and stomach than people who limit their intake of steaks and hamburgers, a new study suggests.
Researchers found that among nearly 500,000 older U.S. adults followed for a decade, only a small number developed cancers of the esophagus or stomach. However, the risks were relatively greater among those who ate a lot of red meat, or certain compounds generated from cooking meat.
Overall, study participants in the top 20 percent for red-meat intake were 79 percent more likely than those in the bottom 20 percent to develop esophageal squamous cell carcinoma -- a cancer that arises in the lining of the upper part of the esophagus.
Meanwhile, the risk of a type of cancer in the upper portion of the stomach near the esophagus (gastric cardia) was elevated among men and women with the highest estimated intake of one form of heterocyclic amine (HCA). HCAs are compounds that form when meat is cooked using high-temperature methods, such as grilling over an open flame; they have been found to cause cancer in lab animals.
The findings, reported in the American Journal of Gastroenterology, do not prove that red meat promotes the two cancers, the researchers emphasize.
But the results add to what has been an uncertain body of evidence on the link between red meat and esophageal and stomach cancers.
A 2007 research review by the World Cancer Research Fund and American Institute for Cancer Research, both non-profit groups, concluded that red and processed meats were associated with a "limited suggestive increased risk" of esophageal cancer.
The report also said there was a similar level of evidence for a link between processed meats and stomach cancer, and insufficient data on whether red meat intake is connected to the cancer at all.
However, most of the studies considered in the report were so-called case-control studies, where researchers ask patients with a given disease about their past lifestyle habits and other health factors, then compare them to a group of healthy individuals.
That type of study design can offer only limited evidence about whether a particular exposure -- like red meat in the diet -- is related to a disease risk, explained Dr. Amanda J. Cross, a researcher at the U.S. National Cancer Institute who led the new study.
Studies with prospective designs, which follow initially healthy people over time, provide stronger evidence.
In addition, most earlier research did not look at meat intake and different subtypes of esophageal and stomach cancers. That is important, Cross told Reuters Health, because the different subtypes seem to have different risk factors.
So for their study, Cross and her colleagues prospectively followed 494,979 U.S. adults ages 50 to 71 over roughly 10 years. At the outset, participants completed detailed questionnaires on their diets -- including the methods they typically used for cooking meat, and the usual level of "doneness" they preferred -- as well as other lifestyle factors.
Over the next decade, 215 study participants developed esophageal squamous cell carcinoma; that included 28 cases among the bottom 20 percent for red-meat intake, and 69 cases in the top 20 percent.
Another 454 men and women were diagnosed with gastric cardia cancer. There were 57 cases among participants with the lowest red-meat intake, and 113 in the group with the highest intake.
Continue full article here:
http://www.reuters.com/article/idUSTRE6A43IG20101105
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Digestive Diseases and Sciences
DOI: 10.1007/s10620-011-1700-4
Original Article
Is the Colonic Response to Food Different in IBS in Contrast to Simple Constipation or Diarrhea Without Abdominal Pain?
Michel Bouchoucha, Ghislain Devroede, Jean-Jacques Raynaud, Cyriaque Bon, Bakhtiar Bejou and Robert Benamouzig
Abstract
Colonic response to food (CRF) is abnormal in irritable bowel syndrome (IBS) patients.
Aims
The aim of this study was to compare CRF in patients who complain of abnormal defecation pattern according to the presence or absence of abdominal pain.
Methods
One hundred forty-nine patients and 50 controls were studied: 96 IBS patients (46 IBS-C, 13 IBS-D, 15 IBS-M, and 22 IBS-U not included), 43 patients with functional constipation (group C) and ten with functional diarrhea (group D). Clinical evaluation and visual analog scales about four items (constipation, diarrhea, abdominal bloating and abdominal pain) were filled by all subjects. Colonic transit time (CTT) was measured in fasting conditions and after eating a standard 1,000-cal test meal. CRF was quantified by calculating the variation in number of markers between the two films.
Results
The frequency of meal-related symptoms did not vary among the different groups of patients but was significantly higher than in controls. Compared to IBS-C patients, constipated patients of the group C had longer total and segmental colonic transit time, and compared to IBS-D patients, diarrheic patients of the group D had shorter oro-anal and segmental colonic transit time except in the recto-sigmoid area. CRF was different in patients and controls, and differed between IBS and non IBS patients with similar transit abnormalities. Stool output was greater in patients of the group D than in patients of the IBS-D group.
Conclusion
The different subgroups of IBS patients have different CRF patterns, distinct from subjects with constipation and diarrhea, but without abdominal pain.
http://www.springerlink.com/content/r171452531017984/
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Soluble Fiber Appears Key to Trimming 'Bad Fat'
For every 10-gram daily increase, belly fat cut by nearly 4 percent over five years, researchers say
FRIDAY, July 1 (HealthDay News) -- Increasing daily soluble fiber intake may help you lose dangerous visceral fat, which produces hormones and other substances linked to a host of chronic diseases, according to a new study.
Unlike the subcutaneous fat found just under the skin, visceral fat is located deep in the belly and wraps around a person's vital organs. Researchers at Wake Forest Baptist Medical Center found the way to hone in on this deep belly fat is to get moderate amounts of regular exercise and to eat more soluble fiber from vegetables, fruits and beans.
"We know that a higher rate of visceral fat is associated with high blood pressure, diabetes and fatty liver disease," said the study's lead researcher, Dr. Kristen Hairston, assistant professor of internal medicine at Wake Forest Baptist in a news release from the medical center. "Our study found that making a few simple changes can have a big health impact."
Researchers analyzed 1,114 black and Hispanic Americans since those populations are at higher risk for high levels of visceral fat as well as developing high blood pressure and diabetes. The study, published in the June 16 online issue of the journal Obesity, examined whether certain lifestyle factors, such as diet and exercise habits, were associated with a change in the participants' belly fat over a period of five years.
Using CT scans to measure subcutaneous and visceral fat, researchers found that increased intake of soluble fiber was associated with a reduction in belly fat, but not subcutaneous fat.
In fact, for every 10-gram increase in soluble fiber eaten per day, visceral fat was reduced by 3.7 percent over five years. In addition, regular moderate exercise (30 minutes of vigorous exercise two to four times per week) resulted in a 7.4 percent reduction over the same time period.
So what exactly does a person need to eat to get 10-grams of soluble fiber each day? The researchers noted this could be achieved by eating two small apples, one cup of green peas and one-half cup of pinto beans daily.
The study pointed out, however, that more research is needed to explain the link between soluble fiber intake and reductions in visceral fat. "There is mounting evidence that eating more soluble fiber and increasing exercise reduces visceral or belly fat, although we still don't know how it works," said Hairston.
"Although the fiber-obesity relationship has been extensively studied, the relationship between fiber and specific fat deposits has not," Hairston added. "Our study is valuable because it provides specific information on how dietary fiber, especially soluble fiber, may affect weight accumulation through abdominal fat deposits."
More information
The National Institutes of Health provides more information on soluble fiber.
-- Mary Elizabeth Dallas
SOURCE: Wake Forest Baptist Medical Center, news release, June 27, 2011.
Copyright © 2011 HealthDay. All rights reserved.
http://consumer.healthday.com/Article.asp?AID=654356
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Helpful Gut Microbes May Differ Based on Diet
By Jenifer Goodwin
HealthDay Reporter
THURSDAY, Sept. 1 (HealthDay News) -- You are what you eat -- especially when it comes to the microbes that live in your gut.
New research shows that people who eat a diet that's high in fats and animal proteins have a certain group of bacteria that flourish in their digestive tract, while the guts of people who eat a more plant-based, higher carbohydrate fare favor other microbes.
What that means for human health is still unknown. But there's increasing evidence that the "microbiota" that live in the human gut may play an important role in health, including possibly contributing to obesity and other ailments, researchers said.
The findings are published in the Sept. 1 issue of Science.
In the study, researchers asked 98 healthy, non-obese America adults to report on their usual diet and the diet they ate in the week prior to giving a stool sample. From each sample, researchers then isolated the DNA of the bacteria present.
The analysis showed that participants could be generally grouped into one of two categories, or "enterotypes", based on the prevalence of certain species of bacteria in the gut. People in the first group had high levels of the bacteria Bacteroides. In type 2, Prevotella was more prevalent.
"You could see the people who consumed more animal protein and fat tended to fall into an enterotype characters by Bacteroides, whereas those who tended to have a diet high in carbohydrates [more plant-based] fell into an enterotype characterized by Prevotella," said study co-senior author Dr. James Lewis, a professor of medicine and epidemiology at University of Pennsylvania Perelman School of Medicine.
In a second experiment, researchers had 10 participants, all of whom fell into the Bacteroides group, stay in a research lab for 10 days. Both groups were fed an identical diet and an identical amount of calories, with one exception: one group was put on a high fat/low fiber diet, while the other group was put on a low fat/high fiber diet.
The dietary change did impact bacteria levels in the gut, the study found, but not enough to move the Bacteroides group into the Prevotella group.
That suggests that long-term dietary habits, rather than any short term changes, have a bigger impact on gut microbiota, Lewis said.
The next step for researchers is getting a better handle on how the bacteria that resides in our gut may influence the development of disease, said Justin Sonnenburg, an assistant professor of microbiology and immunology at Stanford University School of Medicine. He praised the researchers for being able to correlate specific enterotypes with actual human diets.
Though no one has yet proven a cause-and-effect relationship, researchers have linked altered microbiota with many diseases and conditions, including obesity, inflammatory bowel disease, irritable bowel syndrome and potentially colorectal cancer.
What's almost certain is that gut microbes play a significant -- and underestimated -- role in human health, he added.
One theory is that our immune systems may react to certain bacteria in the gut, triggering an inflammatory response that could contribute to several diseases, Lewis said.
"There's also a whole another line of research that's looking into to what extent the bacteria living in our intestines is related to the host's risk of becoming obese, perhaps by influencing the efficiency of absorbing nutrients," he said.
It's known that the bacteria living in the gut help humans harvest energy from the food we eat. If the bacteria there are really good at that, some people may be getting more calories from a given food that others, he theorized.
Prior studies in mice have shown that if you transplant the bacteria in the intestines from an obese animal to an ordinary mouse, that second one will become obese.
"The major question that springs from this work is, will long-term dietary change be able to move somebody out of their dietary enterotype?" Sonnenburg said. "This study suggests that dietary change will not do it in the short term, but may require a long term change in diet and lifestyle."
The U.S. National Institutes of Health has more about how gut microbes may impact metabolic syndrome.
SOURCES: James D. Lewis, M.D., professor, medicine and epidemiology, University of Pennsylvania Perelman School of Medicine; Justin Sonnenburg, Ph.D., assistant professor, microbiology and immunology, School of Medicine, Stanford University, Stanford, Calif.; Sept. 1, 2011, Science.
Copyright © 2011 HealthDay. All rights reserved.
This is a story from HealthDay, a service of ScoutNews, LLC.
http://generic.e-healthsource.com/index.php?p=news1&id=656479
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ACG and Campaign to End Obesity Join to Highlight Link Between High BMI and Colorectal Cancer
Written by Rob Kurtz ' March 16, 2012
The American College of Gastroenterology and the Campaign to End Obesity have announced they have joined together to bring attention to the potentially deadly link between higher body mass index and colorectal cancer, according to a news release.
The two organizations are working together in March, which is Colorectal Cancer Awareness Month, on a goal to educate the public about obesity as a major risk factor for colorectal cancer and the importance of colorectal cancer screening in patients with high BMI.
"Dietary and other modifiable risk factors may account for as many as 90 percent of colorectal cancers, and recent studies suggest that about one-quarter of colorectal cancer cases could be avoided by following a healthy lifestyle," said ACG President Lawrence R. Schiller, MD, FACG, in the release. "Consumers need to understand the link between a higher BMI and colorectal cancer, take this risk factor seriously and talk to their doctor about colorectal cancer tests."
Related Articles on Colorectal Cancer Prevention:
ASGE Provides Tips for a Quality Colonoscopy
Gastroenterologist David Keisler Shares 10 Observations on Reducing Colorectal Cancer in Local Publication
NJAASC Promotes Colon Cancer Awareness
© Copyright ASC COMMUNICATIONS 2012.
http://www.beckersasc.com/gastroenterology-and-endoscopy/acg-and-campaign-to-end-obesity-join-to-highlight-link-between-high-bmi-and-colorectal-cancer.html
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Eating fish tied to lower risk of colon polyps
By Kerry Grens
NEW YORK ' Tue Jan 31, 2012 1:25pm EST
(Reuters Health) - Women who eat about three servings of fish per week have a somewhat lower chance of having polyps found during a routine colonoscopy than women who eat just one serving every two weeks, according to a new study.
The research doesn't prove that seafood protects against polyps, but it "does increase our confidence that something real is going on," said Dr. Edward Giovannucci, a professor at the Harvard School of Public Health in Boston, who was not involved in this study.
A polyp, also called an adenoma, is a mushroom-shaped tag of tissue that grows in the colon and can develop into colorectal cancer.
The idea researchers have been pursuing is that the omega-3 fats in fish might have an anti-inflammatory effect, similar to aspirin, that could prevent the development of polyps.
Giovannucci said that earlier experiments in animals have showed that omega-3 fats can reduce the risk of this cancer, but that studies of humans have had mixed results.
In the latest study, the researchers surveyed more than 5,300 people about their eating habits. All of the participants had come in to the researchers' practices for a colonoscopy.
The team then compared more than 1,400 women without polyps to 456 who had adenomas detected during the procedure.
Among women with adenomas, 23 percent were in the bottom fifth among fish eaters, while 15 percent were in the top fifth. That means people who eat lots of seafood are somehow protected against polyps, because otherwise the percentages should have been the same.
After accounting for differences like age, smoking and aspirin use, women who ate the most fish -- three servings a week -- were 33 percent less likely to have a polyp detected than those who ate the least -- less than a serving a week.
Of course, it's never possible to rule out that other factors could explain the findings. For instance, it's possible that fish lovers have other healthy behaviors that decrease their risk of polyps.
What's more, the study didn't follow the women to see whether either group was more likely to go on to develop cancer. But Dr. Harvey Murff, the lead author of the study and a professor at Vanderbilt University in Nashville, Tennessee, said polyps are a reliable predictor for cancer risk.
"Adenomas are generally believed to be the precursor" to cancer, Murff told Reuters Health. "You would think most things that would reduce adenoma risk would subsequently reduce cancer risk."
A 33 percent lower risk is not enormous, but Giovannucci said "it is important because colorectal cancer is a common cancer."
About 140,000 new cases of colon and rectal cancer are diagnosed each year in the United States, and more than 50,000 people will die from the cancer. The lifetime risk of developing the disease is about 20 percent, according to the American Cancer Society.
The men in Murff's study who ate a lot of fish did not see the same reductions in polyp risk as women, however.
Murff said he doesn't have a good explanation for that, but perhaps men are less sensitive to the omega-3s in fish and need to eat more to get any benefit. It could also be that men might eat more omega-6 fats, counteracting the effects of the omega-3s.
Omega-6 fatty acids are related to the production of a hormone called prostaglandin E2, which is associated with inflammation.
Murff explained that eating omega-3 fatty acids tamps down the body's levels of omega-6 fatty acids. In turn, the body then has reduced levels of prostaglandin E2.
He and his colleagues demonstrated this by showing that the women in the study who ate more fish -- and presumably, more omega-3s -- had lower levels of prostaglandin E2.
"We know people who have higher levels of this (hormone) are more likely to develop colorectal cancer. So in essence, by eating more omega-3 fatty acids, it's almost like taking an anti-inflammatory medication," Murff told Reuters Health.
There is still more work to be done to prove that the omega-3 fatty acids are actually the reason for the reduced colorectal cancer risk.
But, Giovannucci said, "I think this (association) has a pretty strong biologic rationale."
SOURCE: bit.ly/zWMCyQ The American Journal of Clinical Nutrition, January 25, 2012.
http://www.reuters.com/article/2012/01/31/us-fish-polyps-idUSTRE80U1T120120131
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Lactose Intolerance is a Global Problem
More adults are lactose intolerant than lactase persistent
Reviewed By: Robert Carlson, M.D
By: Charles Poladian
Published: Apr 26, 2012 01:59 pm
Drinking milk as an adult may seem like a common practice but or most of the world, it is not. The reason is due to most adults stop producing the enzyme lactase which breaks down lactose.
Milk can be quite beneficial and is a source of Vitamin D and calcium. A milk allergy or lactose intolerance can lead to some serious health consequences but there are ways to get past this common problem.
Lactose Intolerance is More Common than Uncommon
According to a 2009 study from the University College London, the ability for adults to break down lactose follows the history of dairy production in Europe. The domestication of cows which led to the cultivation of milk occurred approximately 7,500 years ago. Through natural selection, lactase persistence became common among Europeans.
Lactase persistence is the ability to produce the enzyme lactase throughout one's life. Most individuals stop producing lactase after a child is weaned off of their mother's milk. Because of this, most adults around the world are lactose intolerant.
According to the National Institute of Child Health and Human Development (NICHD), between 30 to 50 million Americans are lactose intolerant. That may seem like a large number, but it is actually quite small compared to stats across the globe.
Lactose intolerance affects approximately 95 percent of Asians, 50 to 80 percent of Hispanics, nearly 100 percent of Native Americans and 60 to 80 percent of African Americans. Lactose intolerance only affects approximately two percent of individuals of Northern European descent.
That means that the ability to break down lactose is not normal rather than the inability to break down lactose. Next time you are drinking milk, think about how strange that is compared to the rest of the world.
Dealing with Lactose Intolerance
Lactose intolerance can lead to stomach pain, gas, cramps, diarrhea or vomiting. The symptoms are not life threatening but can quite problematic which will lead to people avoiding dairy products.
While many individuals have lactose intolerance, that is not the same as a milk allergy.
A milk allergy is a response to a protein and not lactose, which is a sugar. The protein in question is casein and the body reacts much the same way it would to other allergens such as dust mites, grass pollen or tree pollen. Milk allergy may trigger hives, stomach pain, vomiting, wheezing, itchy eyes and anaphylaxis.
Approximately two to five percent of all infants have a milk allergy. Luckily, most grow out of this by the age of three however some children may have a lifelong allergic reaction to milk.
For children with a milk allergy, there are ways to treat the allergy and reduce the symptoms. One approach is through immunotherapy which exposes the allergy sufferer to a small dose of the allergen, gradually increasing the dose over time. This causes the immune system to alter its response to the allergen and reducing symptoms.
A small study conducted by the Johns Hopkins Children's Center showed the benefits of dry milk powder to reduce allergy symptoms. The study involved 30 children, 10 children received liquid drops of milk extract under the tongue, 10 children received one gram of milk protein a day and 10 children received two grams of milk protein a day.
Reviewed by:
Robert Carlson, M.D
Review Date:
Monday April 23, 2012
Last Updated:
Thursday April 26, 2012
Citation:
University College London, "The Origins of Lactase Persistence in Europe"
Asthma and Allergy Foundation of America, "MILK ALLERGY"
Johns Hopkins Children's Center, "Milk Powder Better than Liquid Drops to Treat Milk Allergies"
National Institute of Child Health and Human Development, "Lactose Intolerance: Information for Health Care Providers"
National Center for Biotechnology Information, "Vitamin D"
Office of Dietary Supplements, "Calcium"
Source: dailyRx
http://www.dailyrx.com/feature-article/more-adults-are-lactose-intolerant-lactase-persistent-18700.html
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Starchy foods cut bowel cancer risk
by: Sheradyn Holderhead
From: The Advertiser
April 25, 2012 11:00PM
EATING more corn, lentils, peas, beans and other legumes can reduce the risk of developing bowel cancer, research shows.
These foods are high in resistant starch, a type of fibre that cannot be digested and instead passes through to the bowel where it is fermented - which tends to be lacking in the Australian diet.
CSIRO Food Futures Flagship Dr David Topping said even though Australians eat more dietary fibre than many other western countries, bowel cancer was still the second most commonly reported cancer - what he called the "Australian paradox".
"We have been trying to find out why Australians aren't showing a reduction in bowel cancer rates and we think the answer is that we don't eat enough resistant starch, which is one of the major components of dietary fibre," Dr Topping said of the findings published in the latest issue of The Journal of Nutrition.
"We studied various sources of resistant starch, including corn and wheat, and the results suggest they could all protect against DNA damage in the colon, which is what can cause cancer."
Resistant starch is sometimes called the third type of dietary fibre and is found in legumes, some wholegrain breads and cereals, firm bananas and cooked potatoes, pasta and rice.
The recommended daily intake of resistant starch is about 20g - equivalent to three cups of cooked lentils - almost four times more than the amount consumed in a typical Western diet.
CSIRO Preventive Health Flagship colorectal cancer researcher Dr Trevor Lockett said they had been able to develop a strain of wheat with increased levels of resistant starch.
"If this is introduced to grains grown popularly then there will be an additional set of grains with high levels of resistant starch in commonly consumed foods," he said. "Having a wheat high in resistant starch greatly expands the opportunity for people to eat it because it can be used in bread and other baked goods so more people will be increasing their intake and realising the health benefits.
"It takes about 15 years from the first bowel cancer-initiating DNA damage to full-blown cancer, so the earlier we improve our diets the better."
http://www.adelaidenow.com.au/starchy-foods-cut-bowel-cancer-risk/story-e6frea6u-1226338353712
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By Julie Deardorff
Chicago Tribune
According to one lab that tests for "toxic food syndrome," eating green peppers may cause bloating or lethargy. Lemons might trigger headaches. Other common foods like corn, soy, egg whites, whey and chicken "may act like a poison in your body," the website warns.
This company and others promise to detect such hidden problems with blood tests that can range from hundreds to thousands of dollars, depending on how many foods are tested for.
Other health practitioners may say they can diagnose food sensitivities by assessing muscle strength, by analyzing hair, gastric juice or body tissue, or by reading the body's "energy pathways." Consumers are told that dietary triggers can cause gastrointestinal complaints such as heartburn or irritable bowel syndrome as well as fatigue, attention deficit problems, autoimmune diseases and arthritis.
But allergists and gastroenterologists say that although food intolerance does occur — most of it involving specific food sugars like lactose or fructose — the tests being marketed to consumers have no scientific basis. Blood tests for food sensitivities are prone to false positives that can lead people to eliminate harmless foods from their diets, they say.
The best way to test for the problem is to eliminate various foods from the diet until the symptoms clear, then reintroduce them one at a time, experts say. None of the other tests is recommended by U.S. or European allergy or immunology societies or the National Institutes of Health.
"Blood testing is confusing to patients," said Elana Lavine, a pediatric immunologist in Toronto who now spends part of her time counseling parents whose children have undergone food sensitivity testing. Armed with their itemized results, which list dozens of forbidden foods, they ask her what to feed their children.
Part of the confusion lies in the difference between food intolerances and allergies.
In an allergic reaction, the immune system overreacts to a food by producing an antibody called Immunoglobulin E that causes hives, vomiting, diarrhea and respiratory problems, among other symptoms. To diagnose an allergy, allergists use a blood test that checks for IgE, skin prick testing and other methods. The gold standard is an oral food challenge, which involves eating small doses of the suspect food under medical supervision.
Food intolerances are unpleasant reactions that do not involve the immune system, according to the National Institute of Allergy and Infectious Diseases. They can be caused by enzyme deficiencies, sensitivities to food additives such as sulfites and monosodium glutamate, or reactions to naturally occurring chemicals.
For example, people who lack an enzyme needed to digest sugar in milk have lactose intolerance. Sulfites used to preserve dried fruit, canned goods and wine trigger asthma attacks in sensitive people.
Adverse reactions to wheat or the protein gluten come in several forms. Celiac disease is an immune system reaction to gluten that causes inflammation in the small intestine. A wheat allergy is an allergic reaction to wheat, almost always caused by the gluten. And gluten sensitivity means a person has symptoms after ingesting gluten but doesn't have either of the other conditions, said Stefano Guandalini, founder and medical director of the University of Chicago's Celiac Disease Center.
Read more here: http://www.miamiherald.com/2012/04/17/2752309/doubts-cast-on-food-intolerance.html#storylink=cpy
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Published June 04, 2012
NewsCore
A vegetarian diet provides adequate nutrition to adults and children and can also reduce health problems, an Australian study has found.
The scientific research review, "Is a vegetarian diet adequate?" published in the Medical Journal of Australia on Monday, puts to rest the long-held belief a vegetarian diet lacks sufficient protein and iron, The Advertiser reported.
The study found those who adopted a vegetarian diet are receiving adequate levels of protein, iron and zinc, and are less likely to suffer from heart disease, colorectal cancer, type 2 diabetes and obesity.
Nutritionist Rosemary Stanton said there were no significant health differences in babies born to vegetarian mothers and no noticeable differences in the growth of vegetarian children compared to children who consumed meat as part of their diet.
Although vegetarians who do not eat fish may be receiving less Omega 3 fatty acids than considered desirable, vegetarians do not exhibit signs of clinical deficiency.
Deficiencies in vitamin B12 were noted in vegans -- vegetarians who shun any animal based product including milk and eggs -- and as B12 is required to help make red blood cells and to keep nerves functioning, the study recommends they either take a daily supplement or eat more B12-fortified foods.
Stanton said the average meat-eating Australian consumes significantly more protein than required, and the study almost certainly proves it is not necessary to eat meat daily.
"Not everyone needs or wants to become vegetarian, but eating more plant-based meals is a good recipe for our own health and that of the planet," Stanton said.
Read more: http://www.foxnews.com/health/2012/06/04/vegetarian-diet-provides-good-nutrition-health-benefits-study-finds/#ixzz1xu0kCaXs
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Ask Dr. K: High levels of fructose can damage liver
Anthony Komaroff
Q I hear that fructose and high-fructose corn syrup are bad for my health. Is fructose worse than other sugars?
A Short answer, yes. I'm not an expert on sugar metabolism, but I'll tell you what the experts at Harvard Medical School say. Fructose and glucose are the most abundant sugars in our diet. Such sugars are a source of energy for our cells.
In the early 1900s, the average American took in only about 15 grams of fructose, also called fruit sugar, a day. Most of it came from eating fruits and vegetables. Today we average four or five times that amount. And almost all of it comes from sweetened foods and beverages such as breakfast cereals, sodas and fruit drinks.
Human beings have been on Earth for tens of thousands of years and our bodies got used to a certain diet. In the last 100 years, our bodies have been exposed to much higher levels of fructose. Common sense might say that such a sudden and significant dietary change might be hard for the body to adjust to. And yes, there is considerable evidence that today's high levels of fructose are harmful.
Virtually every cell in the body can break down glucose for energy. In contrast, about the only cells that can get energy directly from fructose are liver cells. What the liver does with fructose, especially when high levels enter it, has potentially dangerous consequences for our health.
When fructose enters the liver, it goes through changes. One such change is that the liver uses fructose, a carbohydrate, to create fat. Give the liver enough fructose, and tiny fat droplets accumulate in liver cells. This buildup is called nonalcoholic fatty liver disease. It looks like what happens in the livers of people who drink too much alcohol.
The breakdown of fructose in the liver also elevates triglycerides; increases LDL (bad) cholesterol; promotes the buildup of fat around organs; increases blood pressure; and makes tissues insulin-resistant, a precursor to diabetes. None of these changes are good for the arteries and the heart.
There is evidence that people who have more fructose in their diets have higher rates of nonalcoholic fatty liver disease, obesity, diabetes and heart disease. However, fructose has not been proven to be a cause of these conditions.
Still, it's worth cutting back. But don't do it by giving up fruit. Fruit is good for you. It's only a minor source of fructose for most people. Instead, cut back on refined sugar and high-fructose corn syrup. For starters that means limiting sugar-sweetened drinks, pastries and breakfast cereals.
http://www.goerie.com/article/20120530/LIFESTYLES06/305309984/Ask-Dr-K%3A-High-levels-of-fructose-can-damage-liver
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Buddhist mindful eating practices enter the mainstream
Monday May 28, 2012, 6:30 AM
BY SACHI FUJIMORI
STAFF WRITER
The Record
They're the antithesis of the lunchroom coffee klatsch.
A group of employees at Valley Hospital in Ridgewood have recently started a weekly lunch date to eat together in silence, drawing on Buddhist meditation practices.
Gathering in a wordless conference room on a recent afternoon, Linda Buckley said it took her more than 30 minutes to finish half of her chicken salad sandwich. "Eating quietly is a different experience. It's really slowing down and noticing each bite. You can really be attentive to the flavors, textures and smells," said Buckley, a registered dietitian who spearheaded the mindful eating lunch group.
Tips for beginners
Linda Buckley, a nutritionist at Valley Hospital in Ridgewood, offers some tips on practicing mindful eating:
Before taking that first bite, take one deep breath.
Chew slowly. It doesn't have to be 40 times, but remember to breathe and take your time chewing.
Practice eating in silence, with no television, music or conversation.
What should you be thinking about ? Nothing in particular. Just focus on the moment and the sensation of tasting the food.
It takes 20 minutes until your stomach sends the message to your brain that you're full. Eating slowly will allow you to better intuit when you're full.
For more information:
The Center for Mindful Eating offers a basic introduction: tcme.org
Zen Garland, a Buddhist and interfaith spiritual center in Airmont, N.Y.: zengarland.org
Buddhists have been practicing mindfulness — being fully aware and in the moment — while eating for thousands of years. But in recent times, these principles have entered culture and medicine. The Center for Mindful Eating, a national nonprofit organization backed by doctors, psychologists and nutritionists, seeks to educate the public that how you eat is as important as what you eat. Slowing down and eating without distraction can help fight stress, overeating and indigestion, and is particularly useful for diabetics and cardiac patients, said Buckley.
Zen master Thich Nhat Hahn, the author of "Savor: Mindful Eating, Mindful Life," advocates chewing your food up to 40 bites and stopping eating when you're 80 percent full.
Oprah has her own mindful eating coach, the author Geneen Roth, and has touted the movement on her show. At Google's campus in Palo Alto, Calif., a monthly, hour-long, silent, vegan lunch is especially popular among its engineers.
For local Buddhist priest Roshi Paul Genki Kahn, the challenge is applying these ancient principles to modern life. "People should not just ape the mindful methods used in a monastery," said Kahn, a Franklin Lakes native who founded the Zen Garland spiritual center in Airmont, N.Y., last fall. Sharing meaningful conversation, cooking and shopping together are ways of bringing these principles into households, he said.
Throughout the year, the center hosts retreats where students can practice traditional Zen rituals, meditate, eat together and perform chores. "Zen is the realization that the sacred is in each and every moment of life — in the most ordinary actions like eating, sleeping, even sweeping the floors."
During their meditative dining ritual, Oryoki — which means "just enough"— participants seated on floor pillows eat from a set of small lacquer bowls while chanting prayers of gratitude. After the meal is finished, they pour water into the bowls, drink a small amount of the liquid and sprinkle the remainder outside on plants. "Nothing is wasted," said Kahn. "We end as we begin."
Fred and Morrie Shafer of New Milford try to practice mindfulness at most meals, but admit it can be challenging with a 4-year-old daughter. No televisions or screens are allowed at their dinner table, and they begin each meal observing a few seconds of silence. On a recent evening they had a couple over for dinner, and they engaged in a conversation about the source of their homegrown garden salad. "It makes you more self-aware," said Fred Shafer. "It's a different way of looking at it. I think you have better digestion and are more relaxed."
Continue reading this story:
http://www.northjersey.com/news/154952025_Mindful_eaters_find_meaning_at_table_.html
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Milk fat may lead to bowel diseases by altering gut bacteria
Saturated milk fats commonly found in Western processed foods could be leading to changes in the gut ecosystem that result in higher risks of inflammatory bowel diseases, warn researchers.
http://www.bakeryandsnacks.com/Formulation/Milk-fat-may-lead-to-bowel-diseases-by-altering-gut-bacteria-Study
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By Todd Neale, Senior Staff Writer, MedPage Today
Published: June 27, 2012
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner
Consuming a low carbohydrate-high protein diet -- like the Atkins diet -- may be associated with a greater risk of cardiovascular disease in women, researchers found.
Decreases in carbohydrate intake and increases in protein intake, as well as in a score combining carbohydrate and protein intake, were all associated with significantly greater risks of incident cardiovascular disease events in young Swedish women, according to Pagona Lagiou, MD, PhD, of the University of Athens in Greece, and colleagues.
The findings, which were reported online in BMJ, "do not answer questions concerning possible beneficial short-term effects of low carbohydrate or high protein diets in the control of body weight or insulin resistance," the authors wrote.
"Instead, they draw attention to the potential for considerable adverse effects on cardiovascular health of these diets when they are used on a regular basis, without consideration of the nature of carbohydrates (complex versus refined) or the source of proteins (plant versus animal)," they wrote.
Low carb-high protein diets have become popular because of the short-term effects on weight control, but concerns have been raised about the potential cardiovascular effects over the long term. Studies exploring the issue have given mixed results, with a U.S. study showing no relationship between such a diet and rates of ischemic heart disease.
But three European studies showed a greater risk of cardiovascular mortality with such a diet.
Lagiou and colleagues examined data from the Swedish Women's Lifestyle and Health Cohort, a prospective study conducted among women living in the healthcare region of Uppsala. The current analysis included 43,396 women, ages 30 to 49 at baseline, who completed a comprehensive questionnaire on lifestyle and dietary factors, as well as medical history. They were followed for an average of 15.7 years.
The researchers scored each participant according to their carbohydrate and protein consumption. Carbohydrate intake was scored from 1 (very high) to 10 (very low). Protein intake was scored from 1 (very low) to 10 (very high). A combined carbohydrate-protein score ranged from 2 (very high consumption of carbs and very low consumption of protein) to 20 (very low consumption of carbs and very high consumption of protein).
During follow-up, there were 1,270 incident cardiovascular events, which included ischemic heart disease, ischemic stroke, hemorrhagic stroke, subarachnoid hemorrhage, and peripheral arterial disease.
After adjustment for energy intake, saturated and unsaturated fat intake, and numerous cardiovascular risk factors, each one-point decrease in carb intake was associated with a relative 4% increase in cardiovascular events (95% CI 0% to 8%). A one-point increase in protein intake also was associated with a relative 4% increase in events (95% CI 2% to 6%).
Each two-point increase in the low carbohydrate-high protein score -- equivalent to a 20-gram decrease in daily carb intake and 5-gram increase in daily protein intake -- was associated with a relative 5% increase in cardiovascular events (95% CI 2% to 8%).
There was a suggestion that the associations were stronger for women whose protein came mostly from animal sources, but the test for interaction did not reach statistical significance for nearly all of the individual outcomes.
"Although these results are based on an observational study, their biological plausibility seems self evident," according to Anna Floegel, MPH, of the German Institute of Human Nutrition Potsdam-Rehbruecke, and Tobias Pischon, MD, MPH, of the Max Delbrück Center for Molecular Medicine Berlin-Buch.
"A low carbohydrate diet implies low consumption of whole-grain foods, fruits, and starchy vegetables and consequently reduced intake of fiber, vitamins, and minerals. A high protein diet may indicate higher intake of red and processed meat and thus higher intake of iron, cholesterol, and saturated fat," they explained in an accompanying editorial.
"These single factors have previously been linked to a higher risk of major chronic diseases, including cardiovascular disease, in observational studies, so it is not surprising that this combination of risk factors is linked to a higher incidence of disease and mortality," they said.
Lagiou and colleagues acknowledged that their study was limited by the possible misclassification of diet based on participant self-report only at the beginning of the study, the lack of information on cardiovascular medication use and blood cholesterol levels, and the possibility of residual confounding.
The study was supported by grants from the Swedish Cancer Society and the Swedish Research Council.
The study authors and the editorialists reported no conflicts of interest.
http://www.medpagetoday.com/Cardiology/MyocardialInfarction/33495?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&eun=g379602d0r&userid=379602&email=heather@helpforibs.com&mu_id=5372841
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Greete drinking linked to abnormal heart rhythm
By Amy Norton
NEW YORK ' Tue Oct 23, 2012 4:58pm EDT
(Reuters Health) - Older women who regularly drink green tea may have slightly lower risks of colon, stomach and throat cancers than women who make no time for tea, a large study suggests.
Researchers found that of more than 69,000 Chinese women followed for a decade, those who drank green tea at least three times a week were 14 percent less likely to develop a cancer of the digestive system.
That mainly meant lower odds of colon, stomach and esophageal cancers.
No one can say whether green tea, itself, is the reason. Green-tea lovers are often more health-conscious in general.
The study did try to account for that, said senior researcher Dr. Wei Zheng, who heads epidemiology at Vanderbilt University School of Medicine in Nashville.
None of the women smoked or drank alcohol regularly. And the researchers collected information on their diets, exercise habits, weight and medical history.
Even with those things factored in, women's tea habits remained linked to their cancer risks, Zheng noted.
Still, he said in an email, this type of study cannot prove cause-and-effect.
What's more, past studies have so far come to conflicting findings on whether green-tea drinkers really do have lower cancer risks. All of those studies are hampered by the fact that it's hard to isolate the effect of a single food in a person's diet on the risk of cancer.
Really, the only types of studies that can give strong evidence of cause-and-effect are clinical trials, wherein people would be randomly assigned to use green tea in some form, or not.
But few clinical trials have looked at whether green tea can cut cancer risk, and their results have been inconsistent, according to the National Cancer Institute.
There is "strong evidence" from lab research - in animals and in human cells - that green tea has the potential to fight cancer, Zheng's team writes in the American Journal of Clinical Nutrition.
Green tea contains certain antioxidant chemicals - particularly a compound known as EGCG - that may ward off the body-cell damage that can lead to cancer and other diseases.
For their study, Zheng and his colleagues used data from a long-running health study of over 69,000 middle-aged and older Chinese women. More than 19,000 were considered regular green-tea drinkers. (They had the beverage at least three times per week.)
Over 11 years, 1,255 women developed a cancer of the digestive system. In general, the risks were somewhat lower when a woman drank green tea often and for a long time.
For example, women who said they'd regularly had green tea for at least 20 years were 27 percent less likely than non-drinkers to develop any digestive system cancer. And they were 29 percent less likely to develop colorectal cancer, specifically.
None of that proves you should start drinking green tea to thwart cancer.
Women who downed a lot of green tea in this study were also younger, ate more fruits and vegetables, exercised more and had higher-income jobs. The researchers adjusted their data for all those differences - but, they write, it's not possible to perfectly account for everything.
If you want to start drinking green tea, it's considered safe in moderate amounts, says the National Center for Complementary and Alternative Medicine. But the tea and its extracts do contain caffeine, which some people may need to avoid.
Green tea also contains small amounts of vitamin K, which means it could interfere with drugs that prevent blood clotting, like warfarin. Since many older people are on multiple medications, it's wise for them to talk with their doctors before using green tea as a health tonic.
SOURCE: bit.ly/OZXHcT American Journal of Clinical Nutrition, November, 2012.
http://www.reuters.com/article/2012/10/23/us-green-tea-idUSBRE89M1GB20121023
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Bloomberg News
Taming Stomachs With Fodmap Diet Spurs $8 Billion Market
By Jason Gale on October 29, 2012
Sue Shepherd says she never expected to become famous for taming cantankerous stomachs.
The 38-year-old Australian dietitian invented a food regimen with a bizarre name in her early 20s to relieve symptoms of bloating and stomach cramps. It's now being adopted internationally, changing the way doctors manage a set of digestive troubles known as irritable bowel syndrome.
Shepherd initially set out to help the 1 percent of people with a gluten intolerance causing celiac disease. She found even those without the condition felt better when they avoided the grain-protein and foods containing certain sugars named Fodmaps, an abbreviation for potentially tough-to-absorb molecules. Shepherd's diets low in gut irritants have spurred an $8.3 billion market, encouraging the likes of Abbott Laboratories (ABT) to introduce products devoted to food intolerance.
"This approach has really revolutionized the way we treat a common condition," said Jason Tye-Din, a gastroenterologist at the Royal Melbourne Hospital and celiac researcher at the Walter and Eliza Hall Institute. "The significance has been realized around the world."
Screening for celiac disease in Australia alone has increased 25 percent over the past four years, according to Tye- Din, who runs two of Australia's four celiac disease clinics. That's bolstered demand for gluten-free foods and other products for so-called functional gastrointestinal disorders.
"Gluten-free food is flourishing," said Ewa Hudson, head of health and wellness food and beverages research at London- based Euromonitor International Ltd., who predicts retail sales of food intolerance products will reach $10.5 billion worldwide by 2017, especially as more grocery chains carry them.
Food 'Revolution'
The market in developed nations "has undergone a revolution," Hudson said in an e-mail. "Prior to that, gluten- free had been the preserve of pharmacies and specialist health- food stores."
Abbott and Mead Johnson Nutrition Co. (MJN) have about 7 percent each of the global food-intolerance market by value, according to Euromonitor. Abbott, which sells intolerance products under the Vital and Ensure labels, introduced a limited-ingredient, gluten-free nutrition bar called Perfectly Simple in June.
"We expect to launch an additional 20 products and formulations this year and have more than 30 clinical studies," Abbott said Oct. 17, when it reported third-quarter earnings.
Shepherd said she's sold almost 200,000 copies of her eight cookbooks, which include Irresistibles for the Irritable, that help people choose bowel-friendlier foods. The recipes avoid sugars that aren't well absorbed in some people's bowels, found in products ranging from onions to yoghurts.
Too Much Gas
These foods can cause bloating, excess gas, abdominal discomfort and diarrhea in some people -- hallmarks of irritable bowel syndrome experienced by at least 10 to 15 percent of adults, according to the International Foundation for Functional Gastrointestinal Disorders, a research and education group in Milwaukee, Wisconsin.
"I pieced together what was an experimental diet," said Shepherd, who began teaching the regimen in her private dietetics practice in early 1997. "I wasn't randomly picking these foods -- they all had something in common: they were all potentially not absorbed in the small intestine."
Peter Gibson, gastroenterology professor at Melbourne's Monash University, helped coin the term Fodmap to describe the molecules people with irritable bowel syndrome have difficulty stomaching -- fermentable oligosaccharides, disaccharides, monosaccharides and polyols found in dozens of everyday things from apples and wheat to milk, high-fructose corn syrup, and sugarless chewing gum.
'Fell Off My Chair'
Shepherd, who has celiac disease, tested her diet on 25 people, preparing all their meals herself for 22 weeks in a study that formed part of a PhD thesis at Monash. She found the diet quelled symptoms in at least 70 percent of participants, compared with 12 percent given a placebo meal resembling typical Australian fare.
"I honestly nearly fell off my chair because it looked just too good to be true," said Shepherd, who now employs 13 dietitians in a practice that sees about 4,000 people a year. "I still pinch myself at how successful it is and how big it's become. It's literally gone global."
The research drew attention to the role of diet in medicine and gastroenterological diseases especially, said Josh Butt, a gastroenterology fellow at Monash.
http://www.businessweek.com/news/2012-10-28/taming-stomachs-with-fodmap-diet-spurs-8-billion-market
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(CBS News)
There are 160,000 fast food restaurants in the United States, serving over 50 million customers daily and the bulk of the food offerings are loaded with calories from fat and added sugar.
"We're all guilty, and every now and then you have to splurge, but the problem is that so many people are getting into eating fast food, especially kids, as their staple, and I think that's the point," said Dr. Drew Ordon of "The Doctors" and author of the book, "Better in 7."
"The Doctors" revealed study findings that found regular consumption of fast food items like fried chicken and onion rings are particularly bad for your liver, and these fried foods have many surprising complications and dangers for the people that consume them.
"The amount of fat and saturated fats creates a condition called fatty liver," said Ordon.
What's interesting about the new information is that even after just a month of consistently eating fatty foods from fast food restaurants, there are significant changes in your liver. The fried foods do not just impact your cholesterol and waist line.
Ordon describes the changes in the liver enzymes as being surprisingly similar to the damage that is seen by hepatitis, which can ultimately lead to liver failure.
They found that french fries, in particular, are one of the most dangerous foods, because of all the added ingredients to the potato.
"We know that they are adding salt, and cooking it in fat, but they're also putting sugar on them too. Why sugar? Because it helps get them golden crispy," advised Ordon. "It's three strikes."
He also warns that consumers should be wary of items at fast food establishments marked healthy or fresh because there aren't clear regulations for these items, and the food can often have added chemicals, especially salads.
"Some places actually put propylene glycol on the salads, which is anti-freeze, the reason behind that is that it prevents wilting," said Ordon. "And although they say a little anti-freeze isn't going to hurt you, obviously given a choice you don't want to be eating anti-freeze."
© 2013 CBS Interactive Inc. All Rights Reserved.
http://www.cbsnews.com/8301-33816_162-57569746/fried-foods-have-similar-impact-on-your-liver-as-hepatitis/
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Fluids may prevent constipation better than anything
By Kathryn Doyle
NEW YORK ' Tue May 7, 2013 12:08pm EDT
(Reuters Health) - Everyone knows that getting enough fiber is a secret to staying "regular," but a large new study finds that people who got plenty of fluids were the least likely to suffer constipation.
The results highlight the importance of hydration, but shouldn't discount fiber or other lifestyle factors, according to lead author Alayne Markland, of the Department of Veterans Affairs Medical Center in Birmingham, Alabama.
"I still think that diet, fiber, exercise and increased fluid should remain the recommendations," Markland told Reuters Health.
Estimates of how many people regularly experience constipation are as high as 14 percent worldwide, but they range widely. How researchers define the problem and ask people about it are partly to blame for inconsistent responses, Markland's team writes in the American Journal of Gastroenterology.
Often, constipation is defined as having fewer than three bowel movements a week, the researchers point out. But some studies have found that asking about stool consistency provides a more accurate measure of slow "transit times" of stool through the intestine, which is the source of uncomfortable blockages.
To determine how many people have "hard or lumpy stool consistency" - the type associated with slow transit - and what lifestyle factors might influence that, Markland and her colleagues analyzed responses from more than 8,000 men and women who participated in the National Health and Nutrition Examination Surveys in 2006 and 2008.
Based on survey responses about stool consistency, exercise habits and what participants ate, the researchers found that seven percent of the respondents fit the definition for constipation.
The problem was more common among women and less educated people, but it did not increase with age, as some other studies have suggested.
Neither vigorous exercise nor fiber intake was linked with a person's likelihood of having constipation.
But among the people who consumed the least amount of liquid daily from food and drinks, 8 percent of men and 13 percent of women were constipated, compared to 3 percent of men and 8 percent of women who got the most liquid.
"I scratch my head on that, it's interesting," Dr. Amy Foxx-Orenstein, of the Department of Gastroenterology and Hepatology at the Mayo Clinic in Rochester, Minnesota, told Reuters Health.
Past research indicates that extra fluid only alleviates constipation if the person is dehydrated to begin with, but once you're adequately hydrated more fluid probably just makes you urinate more often, said Foxx-Orenstein, who was not involved in the study.
She encourages patients in her practice to drink enough water and try to get 25 to 30 grams of fiber daily, if not from food then from a supplement, and to eat a breakfast that includes caffeine shortly after waking, as those factors can stimulate bowel movements.
The new study included a large number of participants, but didn't distinguish between different types of fiber and when they were consumed or ask about physical activity in enough detail, Foxx-Orenstein said, and she thinks it's unlikely doctors will change what they tell patients based on these results.
Foxx-Orenstein agreed that the definition of constipation varies widely.
"We used stool consistency, so we took a validated scale and defined constipation as those with the hardest stool," Markland said. That could have made liquids in the diet, which influence stool consistency but not necessarily frequency or amount, seem more important, she acknowledged.
Exercise and fiber may have more of an impact on frequency, Markland added.
The study doesn't mean that those factors are "bogus," she said, just that future studies need to define the weekly thresholds where each factor becomes meaningful.
"It just begs for more research on the role of fiber," Markland said.
SOURCE: bit.ly/17BY1oy American Journal of Gastroenterology, April 9, 2013.
http://www.reuters.com/article/2013/05/07/us-fluids-constipation-idUSBRE9460NZ20130507
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Limiting FODMAPS may help ease irritable bowel syndrome
By Kate Scarlata, R.D., L.D.N., Environmental Nutrition Newsletter Premium Health News Service
4:30 a.m. CDT, May 22, 2013
Some foods, from beans to sugar-free gum, contain carbs called FODMAPs, which may trigger symptoms if you have irritable bowel syndrome.
FODMAPs are a group of carbohydrates known to contribute to IBS symptoms, including gas, bloating, abdominal pain, diarrhea and/or constipation. The FODMAP family includes:
1. Lactose, found in milk and milk products
2. Fructose, when found at higher levels in foods than glucose, such as the case in apples, pears, honey and agave syrup
3. Fructans, found in foods like wheat, onion and garlic
4. Galacto-oligosaccharides (GOS,) found in beans, lentils and soybeans
5. Polyols, such as sorbitol and mannitol, found in fruits such as cherries, apricots, and apples, and a sweetener added to sugar-free gum and mints
A low FODMAP diet can help manage the symptoms of irritable bowel syndrome (IBS,) a condition that afflicts one out of five people in the U.S. The low FODMAP diet was first described in 2005 by researchers from Australia's Monash University; since then, evidence is mounting on the diet's effectiveness in managing IBS.
Unlike simply limiting lactose or sorbitol consumption to minimize IBS distress, the low FODMAP diet reduces all poorly absorbed FODMAPs as they cumulatively impact symptoms.
Why low FODMAP?
A 2006 study in Journal of the American Dietetic Association found that 75 percent of IBS patients who followed a low FODMAP diet noted symptom improvement. In a follow up study, those with improvement in IBS symptoms experienced exacerbation of symptoms when the FODMAPs, fructose or fructans, were reintroduced (Clinical Gastroenterology Hepatology, 2008.)
In a 2011 study in the Journal of Human Nutrition and Dietetics, researchers found the low FODMAP diet conferred 86 percent better symptom response than traditional IBS diet therapy.
People with Crohn's disease and ulcerative colitis may also benefit from a low FODMAP diet. A study in the Journal of Crohn's and Colitis in 2009 evaluated the effectiveness of a low FODMAP diet in individuals with these disorders, and found that overall abdominal pain, bloating, gas and diarrhea improved.
How do FODMAPs impact IBS symptoms?
When people have problems absorbing FODMAPs, extra water is drawn into their intestines, contributing to diarrhea. In addition, these carbohydrates are fermented by intestinal bacteria, causing gas. In a 2010 study in Alimentary Pharmacology Therapeutics, researchers evaluated stool output in a small group of individuals who required an ileostomy bag, finding that water content in their ileostomy bag increased by 20 percent on a high FODMAP diet compared to a low FODMAP diet.
Scientists also demonstrated that intestinal gas levels increase in both healthy individuals and those with IBS following a high FODMAP diet, with higher levels among those with IBS (Journal of Gastroenterology Hepatology, 2010.)
Who can't handle FODMAPs?
Everyone, whether they have IBS or not, may have some problems absorbing FODMAPs. Humans lack the enzymes to break fructans and GOS into digestible sugars. And lactose is malabsorbed in people who are lactose-intolerant and lack the intestinal enzyme lactase. Fructose is malabsorbed in 30 percent to 40 percent of individuals, likely because of its slow absorption in the intestine.
Fructose is best absorbed when glucose is also present in a similar amount in the food, such as is found in fruits like bananas, cantaloupe and grapes. Polyols are large sugar molecules that are poorly digested by most people.
Not all individuals will malabsorb all FODMAPs. If you have IBS, it's a good idea to see a health care professional, who can determine (through a breath test) whether you malabsorb fructose or lactose.
People with adequate absorption of these carbohydrates will not need to restrict them. Individuals with IBS seem to be more vulnerable to the aftermath of poorly digested FODMAPs, perhaps because of the greater amount of gas produced in their intestine, or because the disordered movement of their intestine traps gas and fluid.
How to start a FODMAP diet?
If you suffer from IBS, you may want to consider trying an elimination diet, in which all FODMAP food sources are removed from your diet for two to six weeks. Then foods from each FODMAP group are re-introduced methodically to identify which ones trigger symptoms, so that you're not avoiding all FODMAPs unnecessarily.
Due to the complexity of the low FODMAP diet, it may be helpful to consult a registered dietitian knowledgeable with this diet.
(Reprinted with permission from Environmental Nutrition, a monthly publication of Belvoir Media Group, LLC. 800-829-5384. http://www.EnvironmentalNutrition.com.)
Copyright © 2013, Tribune Media Services
http://www.chicagotribune.com/health/sns-201305210000--tms--premhnstr--k-h20130522-20130522,0,3699301.story
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People who limit how much meat they eat and stick to mostly fruits and vegetables are less likely to die over any particular period of time, according to a new study.
"I think this adds to the evidence showing the possible beneficial effect of vegetarian diets in the prevention of chronic diseases and the improvement of longevity," said Dr. Michael Orlich, the study's lead author from Loma Linda University in California.
In 2012, a Gallup poll found about 5 percent of Americans reported to be vegetarians.
Previous research has found that people who eat mostly fruits and vegetables are less likely to die of heart disease or any other cause over certain periods of time (see Reuters Health stories of March 14, 2012 and January 31, 2013 here: reut.rs/14opIgy and reut.rs/14opJBa.)
Another study from Europe, however, found British vegetarians were just as likely to die at any point as meat eaters, so it's still an "open question," Orlich said.
For the new study, he and his colleagues used data from 73,308 people recruited at U.S. and Canadian Seventh-day Adventist churches between 2002 and 2007.
At the start of the study, the participants were asked about their eating habits and were separated into categories based on how often they ate dairy, eggs, fish and meat.
Overall, 8 percent were vegans who didn't eat any animal products while 29 percent were lacto-ovo-vegetarians who didn't eat fish or meat but did eat dairy and egg products. Another 15 percent occasionally ate meat, including fish.
The researchers then used a national database to see how many of the participants died by December 31, 2009.
Overall, they found about seven people died of any cause per 1,000 meat eaters over a year. That compared to about five or six deaths per 1,000 vegetarians every year.
Men seemed to benefit the most from a plant-based diet.
Orlich cautioned, however, that they can't say the participants' plant-based diets prevented their deaths, because there may be other unmeasured differences between the groups.
For example, Alice Lichtenstein, director of the Cardiovascular Nutrition Laboratory at Tufts University in Boston, said the participants who were vegetarians were healthier overall.
"It's important to note that the vegetarians in this study were more highly educated, less likely to smoke, exercised more and were thinner," Lichtenstein, who was not involved with the new study, told Reuters Health.
Those traits have all been tied to better overall health in the past.
SHOULD YOU GO VEG?
Dr. Robert Baron, who wrote an editorial accompanying the new study in JAMA Internal Medicine, said the new evidence doesn't mean everyone should switch to a plant-based diet.
"I don't think everybody should be a vegetarian, but if they want to be, this article suggests it's associated with good health outcomes," said Baron, professor of medicine at the University of California, San Francisco.
Instead, he writes limiting added sugars, refined grains and saturated fats trumps whether or not to include a moderate amount of dairy, eggs, fish or meat.
Previous research has found that people who were on a mostly plant-based diet still had lower cholesterol while eating a small amount of lean beef (see Reuters Health article of January 2, 2012 here: reut.rs/14oPRMr.)
"It's like everything else, you have to think about it in terms of the whole package," Lichtenstein said.
SOURCE: bit.ly/MbBLb9 JAMA Internal Medicine, online June 3, 2013.
http://www.reuters.com/article/2013/06/03/us-health-vegetarian-idUSBRE95215220130603
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Skip Breakfast, Fuel Insulin Resistance
By Todd Neale, Senior Staff Writer, MedPage Today
Published: June 17, 2013
Reviewed by F. Perry Wilson, MD, MSCE; Instructor of Medicine, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse Planner
Note that this small cross-over study demonstrated that skipping breakfast may be associated with a less favorable insulin profile around lunchtime.
SAN FRANCISCO -- Overweight or obese women who did not eat breakfast had impaired metabolic responses after eating lunch, a small crossover study showed.
On the days the women skipped breakfast, there were greater spikes in insulin and glucose levels after lunch compared with those seen on the days the women only had water in the morning, according to Elizabeth Thomas, MD, of the University of Colorado School of Medicine in Aurora.
In addition, not eating breakfast was associated with significantly higher levels of free fatty acids before lunch because lipolysis was occurring, she reported at the Endocrine Society meeting here.
"It's possible that insulin resistance over time may predispose to further metabolic derangements and possibly progression to type 2 diabetes," she said, noting that longitudinal studies have identified a relationship between skipping breakfast and both increased weight gain and risk of type 2 diabetes.
"Learning about these mechanisms does give us better data to recommend eating habits to people, and I think our society is having trouble with eating habits," said Lisa Fish, MD, an endocrinologist practicing in Minneapolis and a member of the society's Advocacy and Public Outreach Core Committee.
Fish said that many people eat only one or two meals a day and then snack.
"People may be doing that to try and eat less but they end up with a dysfunctional use of fuel for their bodies that causes them to actually gain more weight and develop more insulin resistance," she said.
An estimated 10% to 20% of the population skips breakfast, and that practice has been associated with increased body mass index (BMI) in both adolescents and adults.
Some short-term studies -- mostly in lean individuals who habitually ate breakfast -- have looked at the metabolic effects of skipping breakfast and produced varying results: impaired insulin sensitivity; no change or an increase in energy intake; increased hunger; decreased satiety' and worse lipid profiles.
Thomas and colleagues explored the issue in a crossover study involving 10 women, ages 25 to 40 (mean 29), who had a BMI of 27 to 35 kg/m2 (mean 31.4). Eight of the women regularly ate breakfast and two regularly skipped the meal.
The study took place on 2 separate days, 1 month apart, during the follicular phase of the women's menstrual cycles. The women were told to not exercise the day before each assessment. The night before each study day, the researchers provided the women with a standardized dinner -- 15% protein, 30% fat, and 55% carbohydrates -- that provided 35% of the total daily energy requirements.
On the morning of the first study day, the women were randomized to either eat a standardized breakfast -- with the same macronutrient breakdown as the dinner the night before -- containing 25% of daily energy requirements or to consume only a glass of water. On the second study day, the women did the opposite.
Four hours after eating breakfast or drinking the glass of water, the participants were given a standardized lunch providing 35% of daily energy requirements.
Pre-lunch insulin levels were similar in both the breakfast and no-breakfast groups, but insulin levels increased to higher levels after lunch in women who did not eat breakfast that day. The area under the curve (AUC) was significantly greater in the no-breakfast group (P=0.001).
The findings were similar for glucose, for which the AUC was significantly greater in the women who did not eat breakfast that day (P=0.004).
The level of free fatty acids before lunch was higher in the no-breakfast group, and eating lunch resulted in a rapid drop. However, the AUC was still significantly higher in the women who skipped breakfast (P=0.03).
Fish noted that one potential limitation of the study was the use of a healthy breakfast with a mix of protein, fat, and carbohydrates, which doesn't reflect a typical American breakfast consisting mostly of carbohydrates.
"It may be helpful for [the researchers] to look, in addition, to things that are more realistic for what's actually going on," Fish said.
Thomas disclosed support from an NIH grant, an NIH/NCRR Colorado CTSI grant, the Endocrine Fellows Foundation (Fellows Development Research Grant Program in Diabetes, Obesity, and Fat Cell Biology), and a Colorado Nutrition Obesity Research Center Pilot Grant.
She did not report any conflicts of interest.
Primary source: The Endocrine Society
Source reference:
Thomas E, et al "Metabolic effects of skipping breakfast in obese women" ENDO 2013; Abstract OR09-2.
http://www.medpagetoday.com/meetingcoverage/endo/39883
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A Tale of Two Fibers
By Tamara Duker Freuman
June 25, 2013 RSS Feed Print
Tamara Duker Freuman
Tamara Duker Freuman
There's much ado about fiber these days, and for good reason. But for all you hear about fiber's benefits, I've found that it remains one of the more misunderstood dietary components.
Most of the confusion about fiber rests in the fact that there are numerous different types of fiber, each with its own physical properties. These properties influence how fiber behaves in the body and account for its multiple – and often conflicting – functions. All fiber has one thing in common: By definition, it is indigestible by human enzymes. But beyond this, fiber can wear many different physiological hats.
For example, some types of fiber speed up digestive transit time – a polite way of saying that it helps move poop through your pipes faster. Other types of fiber can actually slow down digestive transit time, enabling the absorption of excess water in the colon, so that stool is less watery and more formed when it comes out. Some types of fiber are more likely to produce gas than others. And different types of fiber nourish different resident bacterial species in the gut, therefore, diets with a variety of different fibers from multiple food sources may promote a more diverse gut flora than diets with less fiber variety.
In other words, not all fiber is created equal. In my practice, where I'm routinely called upon to help patients manage irregular bowel patterns like diarrhea or excessively urgent bowel movements, I've found that the most important distinction to make is that between soluble fiber and insoluble fiber.
Soluble fiber is a type of fiber that dissolves in water, and in so doing, transforms into a gooey, gummy, spongy mass that travels the length of the gut on its own timetable. But don't confuse this fiber's tendency to downshift digestive transit time with a constipating effect; rather, it is regulating.
Soluble fiber still contributes to fecal bulk and is able to hold onto water, therefore contributing to stools that are soft, well-formed and easy to pass – the Platonic ideal of a poop. Generally, soluble fiber is found in the flesh of fruits, root vegetables and in cooked grains. Examples include beta glucan in oats and barley and pectin in apples and citrus fruits.
Insoluble fiber is what you might call "roughage." When combined with water, its physical properties generally change very little; this is because it doesn't absorb water well. Therefore, insoluble fiber contributes bulk to the feces, helping to put pressure on the colon walls to stimulate a bowel movement. In this manner, insoluble fiber speeds up digestive transit time and is especially helpful when constipation is at issue. Insoluble fiber is found in the form of cellulose and hemicellulose from leafy veggies, fruit and vegetable skins or the bran layer of most whole grains; it's found in lignans from sesame or flax seeds and some mature vegetables. (A third type of fiber, called resistant starch, has some properties of both soluble and insoluble fiber. It's found in foods like beans, unripe bananas and potatoes that have been cooked and cooled.)
A variety of different fibers from different foods sources will deliver a variety of different and important health benefits. Therefore, in healthy people without bathroom woes, the ideal diet would contain a mix of both fiber types. Certain types of soluble fiber help lower cholesterol levels. Insoluble fiber has been credited with helping to prevent colon cancer, since it helps speed toxins and cancer-causing food compounds out of the body without haste. Some fermentable types of both soluble and insoluble fiber help increase calcium absorption from the diet and stimulate the growth and activity of the gut's most beneficial bacterial populations. Both types of fiber also help delay stomach emptying after a meal and therefore tend to help improve blood sugar control.
Generally, when constipation is a problem, a mix of both fiber types is helpful and well tolerated. But among people prone to diarrhea, urgent loose stools or "hyperdefecation" (increased frequency of bowel movements, even if they're not diarrhea), the mix of fiber in the diet may deserve more careful management. I often tell my patients with chronic diarrhea that soluble fiber in particular is their best friend: It helps slow down stool that's racing through the gut too quickly and can often consolidate trips to the bathroom for people who experience multiple, incomplete bowel movements in rapid succession.
Lots of insoluble fiber, conversely, can make things a whole lot worse (particularly if it's not balanced out by some soluble fiber), exacerbating a pre-existing tendency toward urgent, loose bowel movements. For these patients, it can be helpful to think of soluble fiber as the "anchor" of each meal, ensuring that a fruit, veggie, grain and/or seed rich in soluble fiber plays a starring role in the mix.
At the risk of overstating the benefits of this approach to dietary fiber manipulation, I will share that my patients routinely describe the effect of so-called soluble fiber therapy as "life changing." Furthermore, the timing of fiber intake can play a role in managing symptoms. For people prone to urgent, loose bowels in the morning specifically, limiting insoluble-rich foods like salads at dinner and including a soluble-rich veggie (squash, skinless sweet potato), cooked grain (rice, pearled barley, quinoa) and/or soluble fiber supplement (Citrucel, Benefiber) can help smoothe out choppy morning bowel patterns. If symptoms tend to occur in the afternoon or evening, having a super-soluble breakfast (like oatmeal, chia seeds and banana) can help keep things flowing smoothly later on in the day.
As you can see, there's a lot more to fiber than meets the eye – and more to know than what a typical nutrition label reveals. If you need help figuring out how to tweak the fiber content of your diet to optimize your health and digestive tolerance, consult a registered dietitian to help you navigate the supermarket shelves to your advantage.
Hungry for more? Write to eatandrun@usnews.com with your questions, concerns, and feedback.
Tamara Duker Freuman, MS, RD, CDN, is a NYC-based registered dietitian whose clinical practice specializes in digestive disorders, Celiac Disease, and food intolerances. Her personal blog, www.tamaraduker.com, focuses on healthy eating and gluten-free living.
http://health.usnews.com/health-news/blogs/eat-run/2013/06/25/a-tale-of-two-fibers
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Scientists learn how soy foods protect against colon cancer
EurekAlert!, 08/06/2013
University of Illinois scientists have evidence that lifelong exposure to genistein, a bioactive component in soy foods, protects against colon cancer by repressing a signal that leads to accelerated growth of cells, polyps, and eventually malignant tumors. "In our study, we report a change in the expression of three genes that control an important signaling pathway," said Hong Chen, a U of I professor of food science and human nutrition. The cells in the lining of the human gut turn over and are completely replaced weekly, she noted. "However, in 90 percent of colon cancer patients, an important growth–promoting signal is always on, leading to uncontrolled growth and malignancies. Our study suggests that the aberrant Wnt signaling during the development of colon cancer can be regulated by soy–rich diets." "The good news is that a diet rich in soy genistein represses those signals through epigenetic modifications at the regulatory regions of those genes," said Yukun Zhang, a doctoral student in Chen's laboratory.
http://www.mdlinx.com/gastroenterology/newsl-article.cfm/4761097/ZZ956160859472514387259/?news_id=522&newsdt=080613&subspec_id=155&utm_source=Newsletter&utm_medium=DailyNL&utm_content=General-Article&utm_campaign=Article-Section
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Spicy Foods and IBS
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Coconut Oil for IBS?
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By Denise Reynolds RD G+ August 19, 2013 - 12:45pm for eMaxHealth
At the entrance to your stomach is a valve, a ring of muscle called the lower esophageal sphincter or LES. Normally, the LES closes as soon as food passes through, however, if it does not, digestive acids produced by the stomach can move back up – or reflux – back into the esophagus. This can lead to burning chest pain called heartburn. If these acid reflux symptoms happen more than twice a week, you have acid reflux disease, also known as GERD.
Common risk factors for acid reflux disease include:
• Eating large meals or lying down right after a meal
• Being overweight or obese
• Snacking close to bedtime
• Smoking
• Being pregnant
• Taking aspirin, ibuprofen, certain muscle relaxers, or blood pressure medications
Doctors Jamie Koufman MD and Jordan Stern MD, along with French master chef Marc Bauer, have written the book Dropping Acid: The Reflux Diet Cookbook & Cure." Included are 75 healthy recipes that include foods that are good for patients with reflux disease.
Oatmeal
Oatmeal is a bland grain that is filling in small amounts. Eating too large of a meal out of hunger can often lead to reflux, but the fiber in oats can help keep you full longer without "filling up." If eating plain oatmeal is just too bland to be palatable, try adding a spice such as cinnamon (as long as that isn't a reflux trigger) or even a little sugar. Remember to use low-fat milk or water, as high-fat dairy can lead to symptoms.
Ginger
Ginger is an anti-inflammatory and has been used throughout history as a treatment for gastrointestinal conditions, including nausea. A 2007 study found that ginger extracts can be just as effective as acid-blocking medications.
Ginger root can be peeled, sliced, diced or shaved using a grater. Add it to your favorite dish, steep it into a tea, or add it to a smoothie.
Aloe Vera
The leaves of the aloe vera plant is often used topically to relieve pain. Just as it eases burning of the skin, aloe vera juice can help treat the burning within the body from GERD. WARNING, though…aloe vera juice can be a powerful laxative. Long-term use is not recommended.
Salad
When you choose a salad over fried fast foods, you aren't only avoiding a potential GERD trigger, you are also consuming a food that is low in fat, calories and could help ease symptoms. Leafy greens are another filling food that will not leave you "over-full." But beware of high fat dressings, cheese, and fried croutons on your salad. Plus you may also want to avoid onions or tomatoes, as these can be triggers as well.
Banana
Bananas are neutral pH (5.6) and another food that is filling and bland, making them a great snack for those with acid reflux. They also contain substances that help suppress acid secretion in the stomach. The most effective bananas are those that are fresh and yellow; overripe bananas do not provide the same benefits.
Keep in mind, though, that every person with GERD has different triggers, and there are about 1% of patients that actually find bananas to worsen their condition. Keep a food diary so that you find your own personal reflux triggers.
Melon
Melons have a pH of 6.1 which makes them weakly acidic. However, they are a great source of magnesium, a mineral that is found in many reflux medications. Melons that seem to be particularly good for reflux sufferers include honeydew, cantaloupe and watermelon. But, as with bananas, there is a small percentage of patients who find melon to worsen symptoms instead of helping.
Fennel
Fennel may help improve stomach function. Steep it into a tea by adding two teaspoons of fennel sliced thin (the white bottom part) to boiling water. Strain after five minutes and drink. Fennel is also a great addition to salad and in chicken dishes.
Chicken and Turkey
Speaking of chicken, as long as you don't eat it fried and avoid the skin, chicken and turkey are a low fat, high-protein bland source of filling nutrients that are good for patients with reflux disease. Try it boiled, baked, grilled or sautéed.
Fish and Seafood
Here is another example where whole foods are better than supplements. Taking fish oil capsules may actually trigger symptoms, but if you eat the whole fish, it can be heartburn soothing. Again, eat it broiled, baked or grilled versus fried.
Celery
You might have heard of celery as a negative food – it burns more calories that it contains. That may not be entirely true, however it is true that celery is mostly water and fiber. It can work as an appetite suppressant to keep you from overeating.
Parsley
For thousands of years, parsley has been used as a medicinal herb to settle the stomach and aid digestion. But most people ignore that little green garnish. Use parsley as a seasoning for foods instead of leaving it on the side.
Couscous, Rice and Potatoes
Complex carbohydrates are perfect foods for reflux sufferers. You may think that you should eat very bland grains, but that isn't true. Fibrous grains are not anymore likely to cause symptoms. Try couscous, bulgur and brown rice in soups and stews to make them more filling.
Potatoes are also a filling complex carb to include with meals. Just avoid the high fat sour cream and butter.
Fresh Pineapple
Fresh pineapple is rich in enzymes, particularly bromelain, which help aid digestion, alleviate inflammation and can help with the process of healing. Keep in mind that only fresh pineapple is recommended – not the juice, and not canned fruit in heavy syrup.
Papaya
Papayas contain papain, which helps the stomach to better digest protein. Papaya also has anti-inflammatory benefits and is a powerful source of antioxidant nutrients. Try mixing diced papaya in salad or blend into your favorite fruit smoothie.
Chamomile
Chamomile is traditionally known for its calming and sedative properties. It may also help aid digestion, decrease stomach acid, and relieve irritation in the esophagus due to its high calcium content.
Apple Cider Vinegar (use at your own risk)
There are many who swear by a teaspoon of apple cider vinegar a day for reflux or other digestive problems. It is highly acidic, so obviously is not recommended in large doses. Small doses are thought to potentially help improve digestion, but there are no medical studies to back this claim.
This method certainly is safe to try unless you have ulcers (which the acidic nature of vinegar will aggravate) or if you are on certain medications (including diuretics, laxatives, heart disease medication, or diabetes medication). Apple cider vinegar may also damage tooth enamel.
Resources Include:
"Dropping Acid: The Reflux Diet Cookbook and Cure" by Jamie Koufman, Jordan Stern and Marc Michel Bauer. 2010
WebMD: Treating Acid Reflux Disease with Diet and Lifestyle Changes
Doctor Oz: Say Goodbye to GERD
Journal Reference:
Mugur N Siddaraju, Shylaja M Dharmesh Inhibition of gastric H+, K+-ATPase and Helicobacter pylori growth by phenolic antioxidants of Zingiber officinale. Mol Nutr Food Res. 2007 Mar;51(3):324-32. PMID: 17295419
http://www.emaxhealth.com/1506/16-foods-may-help-fight-acid-reflux
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Barrett's esophagus risk linked to heavy consumption of meat, fats
Jiao L. Aliment Pharmacol Ther. 2013;doi:10.1111/apt.12459.
eptember 3, 2013
Patients who consumed the largest amounts of meat and saturated fats were at the greatest risk for developing Barrett's esophagus in a recent case-control study.
Researchers administered the 110-item Block food frequency questionnaire (FFQ) to 151 patients with Barrett's esophagus (BE) and 777 controls. Consumption of carboxymethyl lysine (CML) advanced glycation end-products (AGE) was determined for 216 foods included in the FFQ.
All participants were aged 40 to 80 years and had been treated at a medical facility in Houston between February 2008 and July 2011. Controls included patients who received elective esophagogastroduodenoscopy (EGD) (endoscopy controls; n=521) and patients who received EGD during a screening colonoscopy (colonoscopy controls; n=256).
Mean CML-AGE consumption did not differ significantly between groups (6,871 KU/1,000 Kcal for cases vs. 6,803 KU/1,000 Kcal for controls; P=.73). Investigators noted significant positive correlations between CML-AGE consumption and consumption of total meat (r=0.61) and fat (r=0.54), cholesterol (r=0.56), saturated fat (r=0.53), protein (r=0.51) and eggs (r=0.27), while an inverse but not significant correlation was observed with dark green vegetables (r=–0.05, P=.13).
BE patients were more likely than controls to consume greater amounts of meat (OR=1.91; 95% CI, 1.07-3.38 for highest vs. lowest intake tertile) and saturated fat (OR=1.8; 95% CI, 1.02-3.16), while BE risk was numerically but nonsignificantly elevated with CML-AGE consumption (OR=1.63; 95% CI, 0.96-2.76). Adjustment for CML-AGE consumption attenuated the total meat (OR=1.61; 95% CI, 0.82-3.16) and saturated fat (OR=1.54; 95% CI, 0.81-2.94) associations with BE.
Li Jiao, MD, PhD
Li Jiao
"Higher intake of total meats and saturated fat may be associated with increased risk of [BE]," researcher Li Jiao, MD, PhD, department of medicine at Baylor College of Medicine, told Healio.com. "[AGE] and proinflammatory and pro-oxidant compounds found in meats may partially explain such an association."
Jiao said a previous study suggested an inverse association between BE risk and consumption of dark green vegetables. "These two studies should prompt clinicians to advise their patients with GERD [to follow] a prudent diet that includes more consumption of leafy vegetables and less meats and fats," he said.
http://www.healio.com/gastroenterology/esophagus/news/online/%7B734fe4b6-e99e-41c3-a37f-38a8aa1e88cf%7D/barretts-esophagus-risk-linked-to-heavy-consumption-of-meat-fats
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Non-Celiac Wheat Sensitivity May Be an Allergy
Last Updated: November 08, 2013.
Non-celiac wheat sensitivity may be a non-immunoglobulin E-mediated food allergy, according to a review published online Nov. 5 in the American Journal of Gastroenterology.
FRIDAY, Nov. 8 (HealthDay News) -- Non-celiac wheat sensitivity (NCWS) may be a non-immunoglobulin E-mediated food allergy, according to a review published online Nov. 5 in the American Journal of Gastroenterology.
Antonio Carroccio, M.D., from the University of Palermo in Italy, and colleagues reviewed both the literature and data collected from 276 patients diagnosed with NCWS during a double-blind placebo-controlled wheat challenge. The role of serum immunoglobulin G antibodies and the basophil activation assay in food allergy, as well as histology findings in the food allergy diagnosis, were reviewed.
When comparing patients with irritable bowel syndrome (IBS) not due to NCWS and patients suffering from NCWS and IBS, the researchers found that NCWS was significantly associated with a personal history of food allergy in the pediatric age (P = 0.01), coexistent atopic diseases (P = 0.0001), positive serum anti-gliadin (P = 0.0001) and anti-betalactoglobulin (P = 0.001) antibodies, positive cytofluorimetric assay revealing in-vitro basophil activation by food antigens (P = 0.0001), and a presence of eosinophils in the intestinal mucosa biopsies (P = 0.0001).
"NCWS can now be considered the cause of gastrointestinal symptoms, which overlap those commonly attributed to functional disorders," Carroccio said in a statement. "However, many doubts remain and it must be underlined that we must utilize the double-blind placebo-controlled challenge method to confirm the suspicion of NCWS and then study the pathogenesis of that specific clinical manifestation. A confident NCWS diagnosis must exclude a placebo effect."
Copyright © 2013 HealthDay.
http://www.doctorslounge.com/index.php/news/pb/42292
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NPR
Chowing Down On Meat, Dairy Alters Gut Bacteria A Lot, And Quickly
by Michaeleen Doucleff
December 11, 2013 1:34 PM
Looks like Harvard University scientists have given us another reason to walk past the cheese platter at holiday parties and reach for the carrot sticks instead: Your gut bacteria will thank you.
Switching to a diet packed with meat and cheese — and very few carbohydrates — alters the trillions of microbes living in the gut, scientists Wednesday in the journal Nature.
The change happens quickly. Within two days, the types of microbes thriving in the gut shuffle around. And there are signs that some of these shifts might not be so good for your gut: One type of bacterium that flourishes under the meat-rich diet has been linked to inflammation and intestinal diseases in mice.
"I mean, I love meat," says microbiologist , who contributed to the study and is now at Duke University.
"But I will say that I definitely feel a lot more guilty ordering a hamburger ... since doing this work," he says.
While no one's sure which foods are good for our microbiomes, eating more veggies can't hurt.
Dreaming of slimming gut microbes?
Benjamin Arthur for NPR
Scientists are just beginning to learn about how our decisions at the dinner table — or the drive-through — tweak our microbiome, that is, the communities of bacteria living in our bodies. But one thing is becoming clear: The critters hanging out in our intestine influence many aspects of our health, including weight, immunity and perhaps even .
And interest in studying the links between is growing. Previous research in this field had turned up tantalizing evidence that eating fiber can alter the composition of gut bacteria. But these studies had looked at diets over long periods of times — months and even years. David and his colleagues wanted to know whether fiber — or lack of it — could alter gut bacteria more rapidly.
To figure that out, the researchers got nine volunteers to go on two extreme diets for five days each.
The first diet was all about meat and cheese. "Breakfast was eggs and bacon," David says. "Lunch was ribs and briskets, and then for dinner, it was salami and prosciutto with an assortment of cheeses. The volunteers had pork rinds for snacks."
Then, after a break, the nine volunteers began a second, fiber-rich diet at the other end of the spectrum: It all came from plants. "Breakfast was granola cereal," David says. "For lunch, it was jasmine rice, cooked onions, tomatoes, squash, garlic, peas and lentils." Dinner looked similar, and the volunteers could snack on bananas and mangoes.
"The animal-based diet is admittedly a little extreme," he says. "But the plant-based diet is one you might find in a developing country."
David and the team analyzed the volunteers' microbiomes before, during and after each diet. And the effects of all that meat and cheese were immediately apparent.
"The relative abundance of various bacteria species looked like it shifted within a day after the food hit the gut," David says. After the volunteers had spent about three days on each diet, the bacteria in the gut even started to change their behavior. "The kind of genes turned on in the microbes changed in both diets," he says.
In particular, microbes that "love bile" — the Bilophila — started to dominate the volunteers' guts during the animal-based diet. Bile helps the stomach digest fats. So people make more bile when their diet is rich in meat and dairy fats.
A study last year that blooms of Bilophila cause inflammation and colitis in mice. "But we didn't measure levels of inflammation in our subjects," David says. "That's the next step."
Instead, he says, his team's data support the overall animal model that Bilophila promotes inflammation, which could ultimately be controlled by diet.
"Our study is a proof of concept that you can modify the microbiome through diet," David says. "But we're still a long ways off from being able to manipulate the community in any kind of way that an engineer would be pleased about."
Even just classifying Bilophila as "bad bacteria" is a tricky matter, says Dr. , a gastroenterologist at the Mayo Clinic in Minnesota.
"These bacteria are members of a community that have lived in harmony with us for thousands of years," says Kashyab, who wasn't involved in the study. "You can't just pick out one member of this whole team and say it's bad. Most bacteria in the gut are here for our benefit, but given the right environment, they can turn on us and cause disease."
Nevertheless, Kashyab thinks the Nature study is exciting because the findings unlock a potentially new avenue for treating intestinal diseases. "We want to look at diet as a way of treating patients," Kashyab says. "This study shows that short-term dietary interventions can change microbial composition and function."
Of course, figuring out exactly how to do that will take much more research.
"The paper has made the next leap in the field," Kashyab says. "With discovery comes responsibility. Once you make this big finding, it needs to be tested appropriately."
http://www.npr.org/blogs/thesalt/2013/12/10/250007042/chowing-down-on-meat-and-dairy-alters-gut-bacteria-a-lot-and-quickly
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15-Jan-2014
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Contact: Michael kennedy
m.kennedy@utoronto.ca
416-946-5025
University of Toronto
Popular blood type diet debunked
Researchers from the University of Toronto (U of T) have found that the theory behind the popular blood type diet--which claims an individual's nutritional needs vary by blood type--is not valid. The findings are published this week in PLoS One.
"Based on the data of 1,455 study participants, we found no evidence to support the 'blood-type' diet theory," said the senior author of the study, Dr. Ahmed El-Sohemy, Associate Professor and Canada Research Chair in Nutrigenomics at the U of T.
"The way an individual responds to any one of these diets has absolutely nothing to do with their blood type and has everything to do with their ability to stick to a sensible vegetarian or low-carbohydrate diet," said El-Sohemy.
Researchers found that the associations they observed between each of the four blood-type (A, B, AB, O) diets and the markers of health are independent of the person's blood type.
The 'blood-type' diet was popularized in the book Eat Right for Your Type, written by naturopath Peter D'Adamo. The theory behind the diet is that the ABO blood type should match the dietary habits of our ancestors and people with different blood types process food differently. According to the theory, individuals adhering to a diet specific to one's blood type can improve health and decrease risk of chronic illness such as cardiovascular disease. The book was a New York Times best-seller that has been translated into 52 languages and sold over 7 million copies.
The U of T researchers took an existing population of mostly young and healthy adults who provided detailed information about their usual diets and provided fasting blood that was used to isolate DNA to determine their ABO blood type and the level of cardiometabolic risk factors, such as insulin, cholesterol and triglycerides. Diet scores were calculated based on the food items listed in Eat Right for Your Type to determine relative adherence to each of the four 'blood-type' diets.
El-Sohemy says that a previous lack of scientific evidence doesn't mean the diets didn't work. "There was just no evidence, one way or the other. It was an intriguing hypothesis so we felt we should put it to the test. We can now be confident in saying that the blood type diet hypothesis is false." Last year, a comprehensive review published in the American Journal of Clinical Nutrition found no evidence to support the 'blood-type' diet and called for properly designed scientific studies to address it.
http://www.eurekalert.org/pub_releases/2014-01/uot-pbt011514.php
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Soda pop and IBS
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Dairy and IBS
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IBS diet quick tip - HOW to eat for IBS
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Pilot Study of Diet and Microbiota: Interactive Associations of Fibers and Polyphenols with Human Intestinal Bacteria
Adriana Cuervo †, Lorena Valdés ‡, Nuria Salazar ‡, Clara G. de los Reyes-Gavilán ‡, Patricia Ruas-Madiedo ‡, Miguel Gueimonde ‡, and Sonia González *†
† Department of Functional Biology, Facultad de Medicina, University of Oviedo, C/Julián Claverı́a s/n, 33006 Oviedo, Asturias, Spain
‡ Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias − Consejo Superior de Investigaciones Cientı́ficas (IPLA-CSIC), Paseo Rı́o Linares s/n, 33300 Villaviciosa, Asturias, Spain
J. Agric. Food Chem., 2014, 62 (23), pp 5330–5336
DOI: 10.1021/jf501546a
Publication Date (Web): May 23, 2014
Copyright © 2014 American Chemical Society
*(S.G.) Phone: +34 985 10 42 09. Fax: +34 985 10 35 34.
Several studies have addressed the use of dietary fibers in the modulation of intestinal microbiota; however, information about other highly correlated components in foods, such as polyphenols, is scarce.
The aim of this work was to explore the association between the intake of fibers and polyphenols from a regular diet and fecal microbiota composition in 38 healthy adults. Food intake was recorded using an annual food frequency questionnaire (FFQ). Quantification of microbial populations in feces was performed by quantitative PCR.
A negative association was found between the intake of pectins and flavanones from oranges and the levels of Blautia coccoides and Clostridium leptum.
By contrast, white bread, providing hemicellulose and resistant starch, was directly associated with Lactobacillus. Because some effects on intestinal microbiota attributed to isolated fibers or polyphenols might be modified by other components present in the same food, future research should be focused on diet rather than individual compounds.
http://pubs.acs.org/doi/abs/10.1021/jf501546a
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The Journal of Nutrition
Nutrition and Disease
Fermentable Carbohydrate Restriction Reduces
Luminal Bifidobacteria and Gastrointestinal
Symptoms in Patients with Irritable
Bowel Syndrome
Full article:
http://jn.nutrition.org/content/early/2012/06/26/jn.112.159285.full.pdf
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Review identifies patient-targeted dietary recommendations for IBD
Hou JK. J Clin Gastroenterol Hepatol. 2014;12:1592-1600.
September 26, 2014
The recent, rapid increase in the incidence and prevalence of ulcerative colitis and Crohn's disease suggests an environmental trigger for inflammatory bowel disease, one of which could potentially be dietary, according to a recently published review.
Researchers reviewed the limited evidence behind patient-targeted dietary information for IBD from Internet searches and popular defined diets and summarized the data supporting the rationale for dietary intervention and the recommendations of poorly evidenced, popular diets.
Diet's effect on gut inflammation
Mechanisms of dietary influence on gut inflammation may include direct dietary antigens, changes in gut microbiota and increased gastrointestinal permeability, the researchers wrote. Studies that support these disease mechanisms have shown:
IBD development is consistently associated with dietary fatty acid and protein composition.
Dietary fiber has been associated with lower risk for CD but not UC (HR=0.59; 95% CI, 0.39-0.9).
Recurrence of CD "inflammation after ileal resection is dependent on exposure of the neoterminal ileum to the fecal contents."
High-fat diets may increase bowel permeability through changes in the gut microbiome.
UC relapse is associated with greater consumption of meat (especially red and processed), eggs, protein and alcohol, and UC endoscopic activity is associated with sulfite consumption.
Exclusive enteral nutrition induces mucosal healing and prolonged clinical remission of CD but not UC
Exclusion diets have improved disease activity and prolonged time to relapse.
Patient-targeted diet recommendations
The review did not advocate any particular diet, but compiled the details and theories behind three defined diets commonly supported in lay literature: the specific carbohydrate diet (SCD), the fermentable oligosaccharides, disaccharides and monosaccharides (FODMAP) diet, and the Paleolithic diet.
The SCD is based on the theory that disaccharide and polysaccharide carbohydrates are poorly absorbed by the GI tract, causing overgrowth of bacteria and yeast that lead to excess mucus and small bowel injury. The diet restricts all but simple carbohydrates, or the monosaccharides glucose, fructose and galactose.
The FODMAP diet also is based on the notion that poorly absorbed carbohydrates cause bacterial overgrowth, but unlike the SCD, it restricts many fruits and vegetables.
The Paleolithic diet is based on the hypothesis that foods that were not present when human beings evolved can lead to modern diseases due to the GI tract's inability to handle foods resulting from modern agriculture. This diet emphasizes lean game meats and noncereal plant-based foods.
There are no formal studies published about SCD or Paleo, but small pilot studies have tested FODMAP in patients with IBD, one that showed improved IBD symptoms (P<.02).
How to advise patients
"There is scientific evidence that dietary factors may influence both the risk of developing IBD and intestinal mucosal inflammation," the researchers concluded. "However, there is a lack of large prospective controlled trials to provide the dietary recommendations patients desire. Taken together, studies of exclusive enteral nutrition, exclusion diets, and semivegetarian diets suggest that minimizing exposure of the intestinal lumen to selected food items may prolong the remission state of patients with IBD. Even less evidence exists for the efficacy of the SCD, FODMAP, or Paleo diets."
http://www.healio.com/gastroenterology/inflammatory-bowel-disease/news/online/%7B58142a64-b85a-4155-b4ab-9fa18ef0f8e0%7D/review-identifies-patient-targeted-dietary-recommendations-for-ibd
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Low-FODMAP diet not superior to traditional diet for reducing GI symptoms of IBS
November 24, 2014
Traditional dietary advice for irritable bowel syndrome had comparable efficacy to a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols — or FODMAP — in improving gastrointestinal symptoms, according to data presented at UEG Week.
"The aim of the study was to perform a randomized controlled trial to compare the effect on IBS symptoms of a low-FODMAP diet compared with traditional dietary advice in outpatients with IBS in a setting resembling standard clinical practice, and to perform this study in a single-blinded design," Lena Böhn, PhD student in the department of internal medicine and clinical nutrition, Center for Person-Centered Care at Sahlgrenska Academy, Sweden, told Healio Gastroenterology.
Sixty-five patients with IBS (54 women; median age, 43 years [range, 19-68]) from three hospitals in Sweden were assigned to traditional dietary advice for IBS (n=33) or low-FODMAP dietary instructions (n=32), to which they were masked. Symptom intensity was measured using the IBS Severity Scoring System (IBS-SSS) at baseline and at the end of the 4-week treatment period.
At the end of the treatment period, 56% of the low-FODMAP group responded to treatment compared with 52% of the traditional diet group, and comparable response was consistent in analysis of patients with moderate and severe IBS. Both low-FODMAP (P=.001) and traditional diet (P<.001) reduced IBS-SSS scores with comparable efficacy overall, and in abdominal pain severity and frequency, dissatisfaction with bowel habits and quality of life. However, there was a trend for greater reduction in abdominal distension with traditional diet (P=.08).
"Providing dietary advice to patients with IBS is efficient in reducing gastrointestinal symptoms," Böhn said. "However, both a low-FODMAP diet and traditional IBS diet improved IBS symptoms, without any clear differences between the two strategies. This means that a combination of the two diets is [preferable], on an individual basis."
For more information:
Böhn L. Abstract OP007. Presented at: UEG Week; Oct. 18-22, 2014; Vienna.
Disclosure: The researchers report no relevant financial disclosures.
http://www.healio.com/gastroenterology/irritable-bowel-syndrome/news/online/%7B82469680-7ac4-480d-9710-c65c7b83842b%7D/low-fodmap-diet-not-superior-to-traditional-diet-for-reducing-gi-symptoms-of-ibs
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Review
Am J Gastroenterol advance online publication 27 January 2015; doi: 10.1038/ajg.2014.427
Intestinal Microbiota And Diet in IBS: Causes, Consequences, or Epiphenomena?
Open
Mirjana Rajilić-Stojanović PhD1, Daisy M Jonkers PhD2, Anne Salonen PhD3, Kurt Hanevik MD, PhD4, Jeroen Raes PhD5, Jonna Jalanka PhD6, Willem M de Vos PhD3,6,7, Chaysavanh Manichanh PhD8, Natasa Golic PhD9, Paul Enck PhD10, Elena Philippou PhD11, Fuad A Iraqi PhD12, Gerard Clarke PhD13, Robin C Spiller MD, PhD14 and John Penders PhD15
Abstract
Irritable bowel syndrome (IBS) is a heterogeneous functional disorder with a multifactorial etiology that involves the interplay of both host and environmental factors. Among environmental factors relevant for IBS etiology, the diet stands out given that the majority of IBS patients report their symptoms to be triggered by meals or specific foods. The diet provides substrates for microbial fermentation, and, as the composition of the intestinal microbiota is disturbed in IBS patients, the link between diet, microbiota composition, and microbial fermentation products might have an essential role in IBS etiology. In this review, we summarize current evidence regarding the impact of diet and the intestinal microbiota on IBS symptoms, as well as the reported interactions between diet and the microbiota composition. On the basis of the existing data, we suggest pathways (mechanisms) by which diet components, via the microbial fermentation, could trigger IBS symptoms. Finally, this review provides recommendations for future studies that would enable elucidation of the role of diet and microbiota and how these factors may be (inter)related in the pathophysiology of IBS.
Continue to full article: http://www.nature.com/ajg/journal/vaop/ncurrent/full/ajg2014427a.html
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Research finds little evidence to support FODMAPS elimination diet's use
FRIDAY, Aug. 7, 2015 (HealthDay News) -- There's little evidence that eliminating certain types of carbohydrates from their diet will benefit people with irritable bowel syndrome (IBS), a new study finds.
The researchers looked at the published studies on a specific diet called the low FODMAP diet. This diet is based on the theory that certain carbohydrates are poorly absorbed by the small intestine and that IBS symptoms worsen when people with the disorder eat these types of carbohydrates.
The types of carbohydrates eliminated in this diet are found in wheat, onions, legumes, milk, honey, apples, high-fructose corn syrup, and the artificial sweeteners sorbitol and mannitol.
Some guidelines suggest that a low FODMAP diet might be appropriate for IBS patients who have had no success with other treatments. But this should only be done under the supervision of a dietitian who specializes in this type of therapy, according to the review published online Aug. 6 in Drug and Therapeutics Bulletin.
"However, we believe that patients should be advised that there is very limited evidence for its use, the ideal duration of treatment has not been assessed in a clinical trial, and its place in the management of IBS has not been fully established," wrote Dr. James Cave, editor-in-chief of Drug and Therapeutics Bulletin.
The review did find some evidence that patients believe the diet reduces some IBS symptoms. And, one study indicated that the diet alters the bacteria population in the digestive tract, but the implications and long-term effects of that are unclear, the researchers said.
Overall, claims that the low FODMAP diet helps control IBS symptoms are "based on a few relatively small, short-term unblinded or single-blinded controlled trials of varying duration," wrote Cave.
IBS affects up to 20 percent of people, and women are twice as likely as men to have the disorder, which causes symptoms such as abdominal pain/discomfort, bloating and changes in bowel habits.
More information
The American Academy of Family Physicians has more about irritable bowel syndrome.
SOURCE: Drug and Therapeutics Bulletin, news release, Aug. 6, 2015
-- Robert Preidt
Last Updated: Aug 7, 2015
Copyright © 2015 HealthDay. All rights reserved.
http://consumer.healthday.com/gastrointestinal-information-15/digestion-health-news-200/cutting-certain-carbs-might-not-ease-irritable-bowel-syndrome-702120.html
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Fiber-Rich Diet May Boost Lung Function
Authors note an association with intake of fruits and veggies
by Salynn Boyles
Contributing Writer
Action Points
Low dietary fiber intake was associated with reduced lung function, suggesting that eating a diet rich in fiber may protect against lung diseases like chronic obstructive pulmonary disease and asthma.
Note that fruit and vegetable consumption was more strongly associated with higher lung function than consumption of whole grains in the analysis, and this association was independent of antioxidant intake.
Low dietary fiber intake was associated with reduced lung function, suggesting that eating a diet rich in fiber may protect against lung diseases like chronic obstructive pulmonary disease (COPD) and even asthma, researchers said.
In an analysis of National Health and Nutrition Examination Surveys (NHANES) data, adults with the highest fiber consumption were more likely to have normal lung function and they were less likely to have airway restrictions compared with adults whose diets contained the least fiber, reported Corrine Hanson, PhD, RD, of the University of Nebraska Medical Center in Omaha, and colleagues.
These associations were found to be consistent, even when controlling for important covariates for poor lung function, including smoking and high body mass index (BMI), they wrote in the Annals of the American Thoracic Society.
Fruit and vegetable consumption was more strongly associated with higher lung function than consumption of whole grains in the analysis, and this association was independent of antioxidant intake, which has previously been shown to be positively associated with lung function.
"These findings are pretty consistent with several other [observational] studies examining fiber and lung function. The difference in the studies has been in the types of fiber that appear to be protective," Hanson told MedPage Today in a telephone interview. "We found an association with fruits and vegetables, but not cereal grains. Other studies suggest that cereal grains may be more important."
The researchers wrote that there is extensive research linking high fiber intake with a lower risk for heart disease and certain cancers, but less evidence linking fiber intake to lung health.
"Dietary fiber has been shown to exhibit both anti-inflammatory and anti-oxidant properties, which have been implicated in both the development and progression of lung disease," they wrote.
To test their hypothesis that lower fiber intake is associated with reduced lung function, the researchers examined data on adults surveyed for in NHANES cycle 2009-2010. In addition to information on dietary intake, the survey included spirometry measures.
The analysis included 1,921 adults, ages 40 to 79, with available pre-bronchodilator spirometry measurements. The Global Initiative for COPD (GOLD) classification was used to establish the presence and severity of airflow obstruction based on spirometry measures. Dietary intake was determined from two interviewer-administered, 24-hour recalls, developed by the U.S. Department of Agriculture.
All participants were asked about their smoking history, and smoking status was defined as: never, former (>100 cigarettes in a lifetime, not current), and current (>100 cigarettes, smoking currently).
The primary outcomes were lung function measurements, including FEV1, FVC, and percent predicted FEV1 and FVC. The researchers also conducted a categorical analysis of fiber intake and airflow restriction and obstruction based on GOLD and Spirometry Grade (SG) classifications.
Multivariable regression models were used to examine the association of lung function measurements with dietary fiber intake after adjustment for relevant confounders. All analyses accounted for the weighted data and complex design of the NHANES sample.
The analysis revealed that surveyed participants in the highest quartile intake of fiber had mean FEV1 and FVC measurements that were 82 mL and 129 mL higher that the lowest quartile of intake (P=0.05 and 0.01, respectively), and mean percent predicted FEV1 and FVC values that were 2.4 and 2.8 percentage points higher (P=0.07 and 0.02, respectively).
Also, in the categorical analysis, higher fiber intake was associated with a higher percentage of participants with normal lung function (P=0.001) and a significant decline in the proportion of participants with airflow restriction (P=0.001).
With increasing daily fiber intake, the percentage of those with normal lung function increased -- 50.1% versus 68.3% for quartile 1 (Q1) versus Q4 (P=0.001) -- although the effect was attenuated at quartiles 3 and 4. For increasing daily fiber intake, there was a significant decline in the proportion of participants with airflow restriction (29.8% versus 14.8% for Q1 versus Q4, P=0.001) which again was attenuated at the higher quartiles.
The authors also reported that participants with a higher fiber intake tended to have a lower BMI, and a higher intake of fruits, vegetables, and whole grains.
"Intake of fruits, vegetables and legumes were associated with lung function in our study independent of intake of antioxidants previously associated with lung function," they pointed out. "Several studies have found stronger associations with intakes of whole fruit when compared to individual fruit-related nutrients."
The association between high dietary intake and lung function was independent of antioxidant intake, intake of cured meat and other possible dietary risk factors, the authors noted.
The cross-sectional nature of the NHANES data was a study limitation, precluding the establishment of a causal relationship between higher fiber intake and better lung function.
"It could be proposed that fiber is a surrogate measure for overall healthy lifestyle," they wrote.
A study strength was the use of spirometry measurement to identify airflow limitations, "as opposed to the self-reported diagnosis of COPD used in many epidemiological studies," the researchers wrote.
Hanson told MedPage Today that the consistent finding in the observational data of a possible protective benefit for high-fiber intake in lung function could have important public health implications for the public at large and very high-risk groups, such as smokers.
"There are very few interventional strategies for the prevention of COPD, with the exception of not smoking or smoking cessation," she said. "This is a non-invasive, very inexpensive strategy that may be good for your lungs."
Reviewed by Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner
last updated 01.27.2016
Primary Source
Annals of the American Thoracic Society
Source Reference: Hanson C, et al "The relationship between dietary fiber intake and lung function in NHANES" Ann Am Thorac Soc 2016; DOI: 10.1513/AnnalsATS.201509-609OC.
http://www.medpagetoday.com/Pulmonology/SmokingCOPD/55857?xid=nl_mpt_DHE_2016-01-27&eun=g379602d0r
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Fructose malabsorption, symptom severity, IBS subtype predict response to low FODMAP diet
Irritable bowel syndrome patients experienced greater benefits from a low FODMAP diet if they had a positive fructose breath test, greater symptom severity at baseline, and a mixed IBS subtype, according to data presented at the British Society of Gastroenterology Annual Meeting.
"Hydrogen breath testing can identify those with poor absorption of lactose or fructose, who may therefore benefit more from their dietary exclusion as part of the low FODMAP diet," Anna Cox, BSc, from University College Hospital in London, told Healio Gastroenterology.
Anna Cox
Cox and colleagues sought to determine whether a hydrogen breath test for lactose and fructose intolerance would identify responders to a low FODMAP diet, and also whether patients with diarrhea-predominant IBS (IBS-D) would experience greater improvement compared with constipation-predominant IBS (IBS-C) or mixed IBS (IBS-M) subtypes.
At baseline and a mean of 61 days after treatment, they evaluated IBS symptom severity scores ranging from 0 to 500 based on pain, bloating, constipation and diarrhea in 228 consecutive IBS patients who completed low FODMAP dietary education therapy. Forty-five percent had IBS-D, 33% had IBS-C and 22% had IBS-M, most of whom were women.
Moreover, patients underwent hydrogen breath testing with 30 g fructose and 30 g lactose and were blinded to breath test results until follow-up. Thirty-six percent had positive lactose breath tests, 35% had positive fructose breath tests, and 17% were positive for both.
All patients experienced improvement in symptom severity (–36; P < .001) and 31% were considered responders with more than 50-point improvements.
IBS-M patients experienced greater symptom improvement (–56; P < .001) compared with IBS-D (–37) and IBS-C patients (–29).
A positive fructose hydrogen breath test predicted the greatest response compared with a test negative for both fructose and lactose (–47 vs. –33; P = .008). There were no significant associations observed with tests positive for lactose or both lactose and fructose.
Finally, the researchers found that response mildly correlated with symptom severity at baseline (P = .002), but this relationship was not responsible for differences in response between breath test and IBS subtype groups.
"We found that a positive fructose [breath test], seen in about one-third of IBS patients, predicted a greater response to the low FODMAPs diet, while no association was found for lactose. This suggests that fructose intolerance is an important aspect of FODMAP sensitivity and that fructose breath testing may be useful clinically, both to identify potential responders and to inform re-introduction of fructose following the full low FODMAP elimination period," Cox said. "We also observed the greatest response in the mixed IBS subtype and in those with diarrhea more than constipation. This is likely due to a reduction in fiber intake with the low FODMAP diet and the subsequent lack of fiber's laxating effects." – by Adam Leitenberger
Reference:
Cox A, et al. Abstract #OC-022. Presented at: British Society of Gastroenterology Annual Meeting; June 20-23, 2016; Liverpool, UK.
Disclosures: The researchers report no relevant financial disclosures.
Editor's note: This article was updated on June 22 with additional data and comments from the presenter.
http://www.healio.com/gastroenterology/irritable-bowel-syndrome/news/online/%7B7822de7a-a169-41d6-a9d1-e1851b0f76d9%7D/fructose-malabsorption-symptom-severity-ibs-subtype-predict-response-to-low-fodmap-diet
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Gut microbiome profiles predict response to low FODMAP diet in IBS
November 2, 2016
Gut microbiota profiles in stool samples of patients with irritable bowel syndrome predicted response to a low FODMAP diet, according to research presented at UEG Week 2016.
"Dietary intervention may reduce IBS symptoms and impact gut microbiota, but the degree to which diet affects gut microbiota is not fully elucidated. Furthermore, factors predicting response to dietary intervention are largely unknown," Sean M. P. Bennet, MSc, from the University of Gothenburg, Sweden, said during his presentation.
Bennet and colleagues analyzed data from a previous study in which 75 patients with at least moderately severe IBS symptoms were randomly assigned to follow a traditional IBS or low FODMAP diet for 4 weeks. Ultimately, significant improvements in IBS symptoms were reported in comparable proportions in both groups.
"However, there was an unknown impact and involvement of the gut microbiota," Bennet said. "We therefore wanted to investigate the fecal microbiota composition before and after a low FODMAP diet and traditional IBS dietary advice."
He and colleagues performed multivariate discrimination analysis relative to a healthy reference group to characterize patient bacterial profiles, which were created using a GA-Map 16S rRNA Dysbiosis Testing of stool samples collected before and after the intervention period.
They found that patients who followed a traditional IBS diet had similar fecal bacterial profiles before and after the intervention, while patients on a low FODMAP diet had different fecal bacterial profiles before and after the intervention.
Nonresponders in the low FODMAP group had more severe dysbiosis than responders, both at baseline (P = .007) and after the intervention (P = .03), but patients who followed a traditional IBS diet had comparable dysbiosis irrespective of responsiveness.
Dysbiosis improved after a traditional IBS diet compared with the low FODMAP diet; among the traditional diet group, 33% had improved dysbiosis, 47% had no change and 20% had worsened dysbiosis, and among the low FODMAP group, these figures were 13%, 45% and 42%, respectively.
"This might be because we saw a significant reduction in Bifidobacterium [P = .0005] after a low FODMAP diet, irrespective of responsiveness," Bennet said. "However, the traditional IBS diet intervention had no effect on the abundance of Bifidobacterium."
An evaluation of predictive models showed responders could be discriminated from nonresponders before the low FODMAP intervention, but not the traditional IBS diet, based on bacterial profiles.
"In conclusion, fecal bacterial profiles predict IBS patient responsiveness to a low FODMAP diet," Bennet said. "The ability of fecal bacteria composition to predict response to a low FODMAP diet in IBS may help in selection of which patients to give this dietary advice." – by Adam Leitenberger
References:
Bennet SMP, et al. Abstract #3474. Presented at: United European Gastroenterology Week; Oct. 15-19, 2016; Vienna.
Disclosures: The researchers report no relevant financial disclosures.
http://www.healio.com/gastroenterology/irritable-bowel-syndrome/news/online/%7B865c905a-80be-4e2e-a98c-b667454086ab%7D/gut-microbiome-profiles-predict-response-to-low-fodmap-diet-in-ibs
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Gluten-free diet could increase cardiovascular risk in people without celiac disease
Lebwohl B, et al. BMJ. 2017;doi:10.1136/bmj.j1892.
May 2, 2017
Researchers found that long-term consumption of gluten was not associated with coronary heart disease risk, and recommended against a gluten-free diet for people without celiac disease as it could limit their intake of "heart-healthy" whole grains.
"Gluten is clearly harmful for people with celiac disease, but popular diet books, based on anecdotal and circumstantial evidence, have pushed the notion that a low-gluten diet is healthy for everyone," Benjamin Lebwohl, MD, MS, assistant professor of medicine and epidemiology at Columbia University Medical Center, director of clinical research in the Celiac Disease Center at Columbia University, and gastroenterologist at NewYork-Presbyterian/Columbia University Medical Center, said in a press release. "Our findings show that gluten restriction has no benefit, at least in terms of heart health, for people without celiac disease. In fact, it may cause some harm if they follow a low-gluten diet that is particularly low in whole grains because those grains appear to have a protective effect against heart disease."
Benjamin Lebwohl, MD, MS
Benjamin Lebwohl
While the prevalence of celiac disease (affecting about 1 in 100 Americans) and non-celiac gluten sensitivity is relatively low, about a third of Americans are attempting to reduce their gluten intake by some estimates, Lebwohl added.
Therefore, he and colleagues evaluated the link between gluten consumption and coronary heart disease using data on 64,714 women enrolled in the Nurses' Health Study and 45,303 men enrolled in the Health Professionals Follow-up Study. All study participants had no history of coronary heart disease nor celiac disease, and completed food frequency questionnaires every 4 years from 1986 through 2010.
"We decided to look at heart disease because it's a leading killer, and because it's generally understood that heart health can be affected by diet," Lebwohl said in the press release.
Overall, 2,431 women and 4,098 men developed coronary heart disease — defined as a fatal or non-fatal myocardial infarction — over 26 years of follow-up. Participants in the lowest fifth of gluten consumption had a coronary heart disease incidence rate of 352 per 100,000 person-years, while those in the highest fifth had an incidence rate of 277 per 100,000 person-years. Adjusted analysis showed there was no significant association between gluten intake and coronary heart disease.
"Even those with the lowest amount of gluten consumption experienced the same rate of heart disease as those who were consuming the most gluten," Andrew T. Chan, MD, MPH, gastroenterologist and chief of the Clinical and Translational Epidemiology Unit in the Massachusetts General Hospital division of gastroenterology, and associate professor of medicine at Harvard Medical School, said in the press release.
Andrew T. Chan, MD, MPH
Andrew T. Chan
Additional analyses suggested that avoiding gluten could also limit consumption of whole grains, which have been linked to a lower cardiovascular risk.
"Based on our data, recommending a low-gluten diet solely for the promotion of hearth health does not appear warranted," Chan said.
The investigators plan to further study the effect of gluten consumption on other health outcomes like cancer and autoimmune disease, according to the press release. –by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.
http://www.healio.com/gastroenterology/malabsorption/news/online/%7B24378853-8326-46ed-8483-c9d611c98d6a%7D/gluten-free-diet-could-increase-cardiovascular-risk-in-people-without-celiac-disease?utm_source=selligent&utm_medium=email&utm_campaign=gastroenterology%20news&m_bt=428850516595
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High-fat diet leads to same intestinal inflammation as a virus
UCLA Health System News
A new study by scientists at UCLA found that when mice eat a high–fat diet, the cells in their small intestines respond the same way they do to a viral infection, turning up production of certain immune molecules and causing inflammation throughout the body. The scientists also found that feeding the mice tomatoes containing a protein similar to that in HDL, or "good cholesterol," along with the generic cholesterol drug ezetimibe, reversed the inflammation.
The results could lead to new types of drugs, targeting the intestinal cells, to reduce people's risk of heart attacks and strokes, or to treat other conditions linked to inflammation, including cancer and inflammatory bowel disease.
Researchers already knew that prolonged obesity can cause inflammation of the liver and fat tissues, and that this inflammation contributes to the development of diabetes and heart disease. Studies have also shown that higher levels of high–density lipoprotein, or HDL, cholesterol, reduces a person's risk of heart disease.
The UCLA research team, led by Alan Fogelman, chair of the department of medicine at the David Geffen School of Medicine at UCLA, previously developed genetically engineered tomatoes that contained 6F, a protein resembling the main protein in high–density lipoprotein. In early experiments on 6F, they found that the compound was active in the small intestines of mice, and that it reduced inflammation. But exactly how it did this was unclear.
The scientists fed either a standard chow or a high–fat, high–cholesterol Western diet to mice that were especially prone to developing clogged arteries. They also treated some of the mice with either 6F, in the form of a tomato concentrate containing the protein, ezetimibe, or both. After two weeks, cells from the small intestines of the mice were collected and blood samples were taken. The researchers measured cholesterol levels as well as the levels of inflammatory and immune molecules in both the intestines and throughout the body.
The findings shed light on the molecular details of how high–fat diets cause inflammation in the body, by making the intestines activate the pathway normally triggered by a virus. This suggests that blocking this immune reaction – as 6F and Ezetimibe do – may treat inflammatory diseases and decrease people's risk of heart attack and stroke.
The authors of the study are all faculty and researchers at UCLA, affiliated with the Department of Medicine; Department of Molecular and Medical Pharmacology; Department of Human Genetics; Department of Microbiology, Immunology & Molecular Genetics; Department of Pathology and Laboratory Medicine; Department of Obstetrics and Gynecology; Semel Institute for Neuroscience and Human Behavior; and Department of Molecular, Cell and Developmental Biology. The first author is Pallavi Mukherjee; Fogelman is the senior author.
The study was published June 7, 2017, in the Journal of Lipid Research.
https://www.mdlinx.com/internal-medicine/top-medical-news/article/2017/06/23/7223355?utm_source=in-house&utm_medium=message&utm_campaign=mh-june17-im
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Can a Western diet permanently alter the immune system?
Healthline/Medical News Today
The immune system's response to the Western diet is similar to how it reacts to infection by dangerous bacteria, according to new research led by the University of Bonn in Germany and published in the journal Cell.
Another disturbing result of the study is that, in the longer-term, a Western diet can make the immune system become hyper-responsive to inflammation triggers.
According to the findings, even changing to a healthful diet does not seem to undo the damage.
The long-term changes may contribute to type 2 diabetes, arteriosclerosis, and several other conditions wherein inflammation is thought to play a part, and which have been linked to consumption of a Western diet.
For the study, the researchers fed atherosclerosis-prone mice on a Western diet, comprising high-calorie, high-fat, low-fiber, and fast food.
The Western diet altered gene expression
After just 1 month, the mice showed changes throughout their bodies that are similar to the strong inflammation reactions that occur in bacterial infections.
"The unhealthy diet," says lead study author Anette Christ, a postdoctoral fellow at the University of Bonn, "led to an unexpected increase in the number of certain immune cells in the blood of the mice, especially granulocytes and monocytes."
This led the team to explore what might be happening further upstream, in the bone marrow, where the precursors, or progenitors, of these particular types of immune cell are located.
The researchers compared major immune cell bone marrow progenitors from mice that had been fed on a Western diet with those of control mice that had been fed on a more healthful, normal cereal diet.
They found that the Western diet had switched on many genes in the progenitor cells, including some that increase proliferation and enhance responses from the innate immune system.
The innate immune system is a part of the immune system that reacts with a rapid, broad response to infection, which is later followed by a more specific reaction from the adaptive immune system.
Healthful diet did not reverse gene activation
The acute inflammation response died down in the Western diet mice after they were placed on their normal cereal diet for 4 weeks.
But, switching to the more healthful diet failed to reverse the fundamental alterations in the innate immune system, and many of the genes that had been activated by the Western diet stayed active.
"It has only recently been discovered," notes senior study author Professor Eicke Latz, the director of the Institute for Innate Immunity of the University of Bonn, "that the innate immune system has a form of memory."
There is a process called "innate immune training," he explains, which is normally triggered by bacterial infection, but in the case of the mice in the study, it was triggered by a Western diet.
Innate immune training ensures that after infection, the body remains "in a kind of alarm state," so its defenses can "respond more quickly to a new attack," Professor Latz adds.
Protein sees the Western diet as a pathogen
The team also discovered that a protein called NLR family pyrin domain containing 3 (NLRP3) is the immune system sensor that recognizes the Western diet as a pathogen and, therefore, triggers the inflammatory response.
In addition, it seems that as well as triggering inflammatory responses through NLRP3, the Western diet also causes long-term epigenetic changes in the packaging of genetic material, so that parts of DNA that are normally difficult to access are easier to read.
"The immune system consequently reacts even to small stimuli with stronger inflammatory responses," explains Professor Latz.
In a final set of tests, the team confirmed the role of NLRP3 by showing that mice bred to lack the protein did not develop systemic inflammation from a Western diet, and neither did they show some of the other longer-term changes involving the protein.
The researchers conclude that NLRP3 brokers the trained immunity that follows from a Western diet and "could thereby mediate the potentially deleterious effects of trained immunity in inflammatory diseases."
Professor Latz says that the findings highlight the dramatic impact that the wrong kind of food can have, and that they have important implications for society.
"Children have a choice of what they eat every day. We should enable them to make conscious decisions regarding their dietary habits," he adds.
"The foundations of a healthy diet need to become a much more prominent part of education than they are at present."
Professor Eicke Latz
https://www.mdlinx.com/gastroenterology/top-medical-news/article/2018/01/16/7500319/?utm_source=in-house&utm_medium=message&utm_campaign=epick-gastro-jan18
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Fecal Profiling May Predict Dietary Response in IBS
Baseline VOCs correlate with symptom relief in patients on low-FODMAP diet
by Diana Swift, Contributing Writer
March 15, 2018
Fecal profiling of volatile organic compounds may provide a low cost, non-invasive tool to predict the responses of irritable bowel syndrome (IBS) patients to probiotics and diets low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs).
Note that this approach can potentially shed light on the pathophysiology of IBS, and has the potential to advance its clinical management with more precisely personalized nutrition regimens.
Fecal profiling of volatile organic compounds (VOCs) may provide a low cost, non-invasive tool to predict the responses of irritable bowel syndrome (IBS) patients to probiotics and diets low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs), according to British researchers.
Modeling baseline fecal VOCs, and using key features of VOC profiles, correctly predicted response to a low-FODMAP diet in 100% of patients and in 89% of patients receiving a probiotic, reported Megan Rossi, PhD, RD of King's College in London, and colleagues.
This approach can potentially shed light on the pathophysiology of IBS, and advance its clinical management with more precisely personalized nutrition regimens, they wrote in Clinical Gastroenterology and Hepatology.
Multiple randomized trials have indicated that the low-FODMAP diet is effective in 50%-80% of IBS patients. "However, predicting response is clinically important because the diet requires intensive dietary counselling and impacts on both the gut microbiota and nutrient intake, and, therefore, avoiding this intervention in the 20%-50% who are unlikely to respond would be an important clinical advance," Rossi's group noted.
New approaches are definitely needed, according to William D. Chey, MD, of the University of Michigan in Ann Arbor.
"Only about half [of patients] get better on the diet, which has associated shopping costs and inconvenience to the patient, plus input from a dietitian and an extended three-step period of time to work through its stages," Chey told MedPage Today. "This often gets glossed over but it's not a trivial thing."
Chey, who was not involved in the study, further explained that little is known about the long-term nutritional and microbiotic downsides of this restrictive diet. "By excluding prebiotic carbohydrates, you are very likely to have effects on the microbiome, so it's important to identify strategies that enrich the likelihood of response and maximize choosing the right treatment for the right patient," he said.
Rossi's group used data and samples from patients with IBS-diarrhea, IBS-mixed, and IBS-unsubtyped treated at two major London hospitals and participating in a previous clinical trial. A total of 95 patients (majority white), whose age ranged from early to late 30s, completed the study. Of these, 93 (63 women) provided sufficient fecal sample for analysis and were randomized for 4 weeks to a low-FODMAP diet (n=46) or a sham diet plus dietary advice (n=47).
In 2-by-2 factorial fashion, patients in both dietary groups also received either a multi-strain probiotic supplement (n=49) or a placebo supplement (n=44).
Gas chromatography assessed VOCs in fecal samples at baseline and at study completion. The clinical endpoint was the IBS Severity Scoring System (IBS-SSS), which records abdominal pain, distension, stool frequency and consistency, and interference with life over a 10-day period.
All 93 participants were deemed compliant with diet, and 86 were classified as compliant with supplementation. At the end of the study, those in the low-FODMAP arm had a significantly lower total FODMAP intake (20+8 g/day) compared with those on the sham diet (33+16 g/day, P<0.001).
In terms of response, more patients reacted clinically to the low-FODMAP diet (37/46, 80%) than the sham diet (21/47 45%, P<0 .001), with a mean change in IBS-SSS score of –130 and –49 (P<0.001), respectively.
There was no difference in clinical response between patients given the probiotic (31/49, 63%) versus placebo (27/44, 61%, P=0.850), with no synergistic or antagonistic effects observed with supplementation. In addition, there was no difference in the mean change in IBS-SSS score between recipients of probiotic (–88) and placebo (–90, P=0.921).
The researchers found that baseline VOC profiles contained 15 features that explained 25% of response variation to the low-FODMAP diet with a mean accuracy of 97% (95% CI 96%-99%), as well as 10 features that explained 30% of response variation to the probiotic, with a mean accuracy of 89% (95% CI 86%-92%). At end of treatment, nine observed compounds explained 31% of variation in response to low-FODMAP and 11 compounds explained 27% of variation with the probiotic.
As to how VOCs predict response, the authors pointed out that many of these compounds are created from indigestible food substrates in the colon through both microbial metabolic activity and diet. VOC patterns at baseline may reflect the pathophysiology of an individual's IBS and eating a high-FODMAP standard diet may, in the presence of IBS-associated dysbiosis, generate fermentation products that cause symptoms. Once the normal diet has been replaced, there is less substrate for bacterial metabolism and gas production and associated symptoms are reduced.
Study limitations included the relatively small sample size, its exploratory nature and the lack of data to inform a power calculation. Also, since the device that assessed fecal VOCs identified patterns of VOCs, not individual VOCs, detailed investigation of the potential mechanisms of individual VOCs could not be done. Finally, the 2-by-2 factorial design may have clouded the results.
Chey noted that, in his experience, about half of patients improve on the low-FODMAP diet, a remarkably high rate of success for a dietary therapy. Also, some of his patients have been following a reduced-FODMAP diet since his institution began introduced it in 2008.
"And up to 85% can move to a less restrictive diet after the phase of determining sensitivities," Chey said.
This study was funded by the National Institute of Health Research.
Rossi and Chey disclosed no relevant relationships with industry. Two co-authors disclosed being co-inventors of a mobile application for the low-FODMAP diet.
Reviewed by Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner
last updated 03.15.2018
Primary Source
Clinical Gastroenterology and Hepatology
Source Reference: Rossi M, et al "Volatile Organic Compounds in Feces Associate With Response to Dietary Intervention in Patients With Irritable Bowel Syndrome" Clin Gastroenterol Hepatol 2018; DOI:10.1016/j.cgh.2017.09.055.
https://www.medpagetoday.com/gastroenterology/irritablebowelsyndrome/71777
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Diet, lifestyle outweigh genetic impact on gut microbiome
Rothschild D, et al. Nature. 2018;doi:10.1038/nature25973.
March 16, 2018
Genetics play a surprisingly minor role in shaping the gut microbiome, while environmental factors like diet and lifestyle appear to have the greatest impact, according to new research published in Nature.
These findings provide strong new evidence supporting the concept of modifying the gut microbiota to improve human health, investigators from the Weizmann Institute of Science in Israel concluded.
"We cannot change our genes, but we now know that we can affect — and even reshape — the composition of the different kinds of bacteria we host in our bodies," study investigator Eran Segal, PhD, of the departments of computer science and applied mathematics, and molecular cell biology at Weizmann, said in a press release. "So, the findings of our research are quite hopeful; they suggest that our microbiome could be a powerful means for improving our health."
To test the hypothesis that differences in gut microbiota composition between individuals is largely determined by their genes, Segal and colleagues analyzed genotype and microbiome data from 1,046 healthy Israelis who participated in a longitudinal nutrition study. As the Israeli population is highly diverse, the study included participants with varied genetic ancestry, making this setting ideal for the genetic aspect of the study, investigators noted.
They found that the gut microbiome did not significantly correlate with genetic ancestry, and that an individual's genes play only a minor role in determining their gut microbiota composition, accounting for just about 2% of the variation observed between populations.
Further, they found genetically unrelated people who lived in the same household showed significant similarities in gut microbiota composition, while relatives with no history of living together shared no significant similarities in their microbiomes.
In contrast, they found that environmental factors like diet, drugs and anthropometric measurements accounted for more than 20% of the gut microbiota variation observed between individuals. They also showed that gut microbiome composition was as good or superior to genetics for predicting clinical measures like BMI, fasting glucose levels, glycemic status, high-density lipoprotein levels, cholesterol, waist and hip circumference, waist-hip ratio and lactose consumption.
"Our results demonstrate that the gut microbiome is predominantly shaped by environmental factors, and is strongly correlated with many human phenotypes after accounting for host genetics," Segal and colleagues concluded. This suggests that modulating the microbiome to improve clinical outcomes should work across diverse genetic backgrounds, they added. – by Adam Leitenberger
https://www.healio.com/gastroenterology/nutrition/news/online/%7Bf8eaf908-ecc4-47bb-81d3-0df8edf7423b%7D/diet-lifestyle-outweigh-genetic-impact-on-gut-microbiome?utm_source=selligent&utm_medium=email&utm_campaign=gastroenterology%20news&m_bt=428850516595
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Prebiotics vs a Diet Low in Fodmaps in Patients with Functional Gut Disorder
Quick Summary:
Prebiotic supplementation could replace the low FODMAPs diet as a treatment for functional gut disorders (IBS, constipation, functional dyspepsia, etc.). A 4-week study compared the effects of a prebiotic supplement plus Mediterranean-type diet, versus a placebo supplement plus low FODMAP diet for 2 weeks. Fecal microbiota composition, intestinal gas production, and digestive sensations were measured outcomes. After 4 weeks, both groups showed improvements in GI symptoms but only the prebiotic group showed significant improvements in microbial composition. (The FODMAP group actually showed an increase in pathogenic-associated bacteria). Two weeks after the intervention, improvement persisted in the prebiotic group but not in the FODMAP group.
The low FODMAP diet was created as a diagnostic tool for IBS, not as a therapeutic diet. While it may alleviate symptoms, it does not treat the condition at its root and may deplete the gut microbiome of beneficial gut bacteria – the very thing we want to increase in those with functional GI disorders. This study illustrates that well.
Quote
Formal Abstract
Prebiotics and diets low in fermentable residues (low-FODMAP diet) might reduce symptoms in patients with functional gastrointestinal disorders, despite reports that some non-absorbable, fermentable meal products (prebiotics) provide substrates for colonic bacteria and thereby increase gas production. We performed a randomized, parallel, double-blind study of patients with functional gastrointestinal disorders with flatulence.
We compared the effects of a prebiotic supplement (2.8 g/day Bimuno containing 1.37g B-GOS) plus a placebo (Mediterranean-type diet; prebiotic group, n=19) vs a placebo supplement (2.8 g glucose) plus a diet low in fermentable oligo-, di-, mono-saccharides and polyols (low-FODMAP group, n=21) for 4 weeks; patients were then followed for 2 weeks. The primary outcome was effects on composition of the fecal microbiota, analyzed by 16S sequencing. Secondary outcomes were intestinal gas production and digestive sensations. After 4 weeks, we observed opposite effects on microbiota in each group—particularly in relation to the abundance of Bifidobacterium sequences (increase in the prebiotic group and decrease in the low-FODMAP group; P=.042), and Bilophila wadsworthia (decrease in the prebiotic group and increase in the low-FODMAP group; P=.050).
After 4 weeks, both groups had statistically significant reductions in all symptom scores, except reductions in flatulence and borborygmi were not significant in the prebiotic group. Although the decrease in symptoms persisted for 2 weeks after patients discontinued prebiotic supplementation, symptoms reappeared immediately after patients discontinued the low-FODMAP diet. Intermittent prebiotic administration might therefore be an alternative to dietary restrictions for patients with functional gut symptoms. ClinicalTrials.gov no: NCT02210572.
Key words
intestinal gas
microbiota
functional intestinal disorders
https://www.sciencedirect.com/science/article/pii/S0016508518346870
Study Source:
Effects of Prebiotics vs a Diet Low in Fodmaps in Patients with Functional Gut Disorder
Author links-
WalterHuaman12MarianelaMego1ChaysavanhManichanh1NicolauCańellas34DanielCańueto3HegoiSegurola5MartaJansana6CarolinaMalagelada1AnnaAccarino1JelenaVulevic7GeorgeTzortzis7GlennGibson8EstebanSaperas2FranciscoGuarner1FernandoAzpiroz1
1
Digestive System Research Unit, University Hospital Vall d'Hebron; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd); Universitat Autňnoma de Barcelona, 08193 Bellaterra (Cerdanyola del Vallčs), Spain
2
Department of Gastroenterology, University Hospital General of Catalonia, San Cugat del Valles, Barcelona, Spain
3
Metabolomics Platform, Universitat Rovira i Virgili, Campus Sescelades; Tarragona, Spain
4
Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas (Ciberdem)
5
Nutritional Support Unit, University Hospital Vall d'Hebron, Barcelona, Spain
6
Department of Endocrinology and Nutrition, University Hospital General of Catalonia, San Cugat del Valles, Barcelona, Spain
7
Clasado Research Services Ltd, Science and Technology Centre, University of Reading, Early Gate, Reading, UK
8
Food Microbial Sciences Unit, Department of Food and Nutritional Sciences, The University of Reading, Whiteknights, Reading, UK
Received 27 February 2018, Revised 19 June 2018, Accepted 22 June 2018, Available online 30 June 2018.
https://doi.org/10.1053/j.gastro.2018.06.045
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Insufficient evidence to support gluten-free diet for IBS
Dionne J, et al. Am J Gastroenterol. 2018:doi:10.1038/s41395-018-0195-4.
August 7, 2018
New research revealed a lack of evidence to support initiating a gluten-free diet to alleviate symptoms of irritable bowel syndrome.
However, Joanna Dionne, MD, MSc, FRCP, PhD, of the division of gastroenterology at McMaster University in Hamilton, Ontario, and colleagues found that a diet low in fermentable oligo-, di- and monosaccharides and polyols (FODMAPs) did help reduce symptoms in patients with IBS.
Because of the dietary triggers of IBS, Dionne and colleagues wrote that many patients turn to dietary approaches to treat their symptoms.
“It is important to give patients evidence-based advice on which diets may be effective in reducing their symptoms,” they wrote. “Initial approaches that based dietary recommendations for food sensitivities had disappointing efficacy in randomized trials, but recent dietary approaches have shown more promise.”
Dionne and colleagues conducted a systematic review and meta-analysis of the literature and searched for randomized controlled trials that evaluated an exclusion diet vs. an alternative or usual diet. Inclusion required that the trials had to assess improvement in either global IBS symptoms or abdominal pain.
Nine studies that fit their criteria: two centered on a gluten-free diet (n = 111) and seven assessed a low-FODMAP diet (n = 397).
Dionne and colleagues found that a gluten-free diet was associated with reduced global symptoms compared with a control diet (RR = 0.42; 95% CI, 0.11-1.55). However, the link was not statistically significant.
Additionally, they found that a low-FODMAP diet was associated with reduced symptoms compared with control diets (RR = 0.69; 95% CI, 0.54-0.88).
Although they found evidence to support the use of a low-FODMAP diet for IBS, Dionne and colleagues wrote that the quality of data was not strong because the trials used different comparator groups and included a relatively low number of patients.
“The findings of this review demonstrate that, at present, there is insufficient evidence to recommend a [gluten-free diet] to reduce global IBS symptoms,” the researchers wrote. “There is very low-quality evidence that a low-FODMAP diet is effective in reducing global symptoms in IBS patients. More data are needed, but of the available dietary interventions, a low-FODMAP diet currently has the greatest evidence for efficacy in IBS.” â€" by Alex Young
https://www.healio.com/gastroenterology/irritable-bowel-syndrome/news/online/%7Be0111ecd-2409-42da-89af-70133e78f21b%7D/insufficient-evidence-to-support-gluten-free-diet-for-ibs
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American College of Physicians Internal Medicine Meeting
'Complicated' relationship exists between irritable bowel syndrome, low FODMAP diet
April 17, 2019
PHILADELPHIA — The FODMAP diet may offer benefits for some patients with irritable bowel syndrome, but is not a fit for all patients, a speaker at the American College of Physicians Internal Medicine Meeting suggested.
Patients following the low-FODMAP eating pattern (fermentable oligo, disaccharides, monosaccharaides and polyols) can consume certain fruits, vegetables, meats and nuts; most gluten-free pasta products and lactose-free dairy products; certain cheeses; and artificial sweeteners that do not end in -ol, according to the U.S. Department of Agriculture website.
Though pharmaceutical options such as Amitiza (lubiprostone, Takeda), Linzess (linaclotide, Allergan) and Trulance (plecanatide, Synergy Pharmaceuticals) have strong recommendations and high or moderate levels of evidence to support their use as IBS treatment, "low FODMAP ... is becoming increasing popular for patients with IBS. Though there are certainly patient subsets who would absolutely benefit from it, we don't know how to pre-emptively identify them yet," Brooks D. Cash, MD, FACP, chief of gastroenterology, hepatology and nutrition at McGovern Medical School at the University of Texas Health Science Center, told attendees.
"The theory behind the low FODMAP diet is both somewhat complicated and also pretty simple," Cash continued. "The low FODMAP diet produces an osmotic effect from poorly digested carbohydrates that impacts motility, biomass and the microbiome, and perhaps leads to gastrointestinal symptoms such as bloating, flatulating, visceral sensations and cognitive symptoms. Our microbiome loves these types of foods and that's where the foods make a lot of gas as they digest or metabolize these poorly digested carbohydrates."
Cash discussed the limited research examining the link between low FODMAP and IBS.
In a study of approximately 80 participants, where about half ate a low FODMAP diet and the others ate a modified NICE diet (eating healthy foods, decreasing or eliminating alcohol and fats and avoiding huge portions and eating late at night), more of those following low FODMAP saw significant improvements in their abdominal pain, bloating and scores on quality of life questionnaire, but global IBS outcomes between the groups were not significantly different. In a second study, 19 in the low-FODMAP group had a 50% or greater reduction in their IBS severity vs. 17 in the modified NICE group.
"These studies are hard to recruit for, and it can be hard to mask the foods. ... This data is somewhat waffly in terms of significance, but it shows how low FODMAP can play an important role in these patients," he said.
The long-standing philosophy of healthy eating occasionally gets detoured when it comes to irritable bowel syndrome and the low fermentable oligo, disaccharides, monosaccharaides and polyols, or FODMAP, diet, a speaker at the American College of Physicians Internal Medicine Meeting suggested.
"But that's not to say there are not issues with low FODMAP," Cash continued. "What is the cutoff for FODMAP content? Resources differ on low FODMAP diets, most patients can't stick to the diet, there are theoretical nutritional issues with its longterm use, and it can be time-consuming to counsel patients."
The complexity and improved understanding of how diet affects health shows the need for consultation when suggesting such a diet, he said.
"When I was a fledging gastroenterologist I used to [show the patient] Google and say, 'here try this.' I know now that is not fair to our patients and I no longer do this. I would urge you all to do what I do: use a dietician or nutritionist to help with these patients," Cash said. – by Janel Miller
References: Cash BD. "Irritable bowel syndrome: New hope for an old problem." Presented at: American College of Physicians Internal Medicine Meeting; April 11-13, 2019; Philadelphia.
U.S. Department of Agriculture. "Digestive diseases and disorders." https://www.nal.usda.gov/fnic/digestive-diseases-and-disorders. Accessed April 15, 2019.
https://www.healio.com/family-medicine/gastroenterology/news/online/%7B97a61530-8392-41b5-91df-8b356ba2f2dd%7D/lsquocomplicatedrsquo-relationship-between-irritable-bowel-syndrome-low-fodmap-diet-
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When chronic illness leads to eating disorders in young people
By Naveed Saleh, MD, MS ' Medically reviewed by Amanda Zeglis, DO, MBA '
Published June 27, 2022
Diseases that require patients to follow lifelong diets can warp a child’s relationship with food, which could result in disordered eating and eating disorders.
Disordered eating can impair a young person’s health-related quality of life and lower their psychosocial health.
To combat the risk of eating disorders, physicians should screen to combat negative body image and disordered eating early, and learn more about how to treat disordered eating.
Here’s a sad thought: Not every child can enjoy the occasional ice cream cone or candy bar with reckless abandon.
For those with type 1 diabetes or chronic gastrointestinal disease, diets have to be closely monitored.
Strict diets, however, can place young patients down a path that begins with altered perceptions about food and possibly ends with a life-altering eating disorder.
It’s important for physicians to be aware of these outcomes and work to optimally manage food perceptions.
Proposed mechanism
Authors of a review published in Advances in Nutrition hypothesized how treatment of diet-related chronic health conditions (DRCHCs) such as inflammatory bowel disease (IBD), type 1 diabetes mellitus (T1DM), cystic fibrosis (CF), and irritable bowel syndrome can eventually result in eating disorders.
These diseases require patients to follow a lifelong diet. The diets place pressure on kids that can result in destructive perceptions of food and body weight, as well as unhealthy eating habits.
Increased concern over body weight and diet in children with DRHCs compared with their healthy cohorts could then lead to disordered eating such as binging, purging, or extreme dieting, which could lead to eating disorders.
“Although it remains unclear whether the prevalence of eating disorders is higher in those with DRCHCs compared with the general population,” the authors wrote, “overall findings suggest that young people with DRCHCs may be at risk of endorsing disordered eating behaviors that may lead to diagnosis of an eating disorder and other health problems over the course of their treatment.”
In a review published in the International Journal of Eating Disorders, researchers found that diet-treated chronic illness was related to disordered eating as well as eating disorders.
Treating chronic illness with diet preceded disordered eating in diabetes, celiac disease, and GI disordersâ€"but not IBD.
The researchers found that disordered eating alongside unhealthy weight management increased the risk that children would experience poor clinical outcomes.
Repercussions
Results of a systematic review and meta-analysis published in PLOS ONE showed that disordered eating attitudes and behaviors predicted lower health-related quality of life (HRQOL) in children and teens compared with their healthy peers.
Similarly, disordered eating correlated with diminished psychosocial health.
The authors suggested that “health programs for promoting healthy eating and reducing disordered eating behaviors among school children and adolescents may help to enhance the HRQOL and overall health status of these individuals.”
What can be done
Authors of the review published in Advances in Nutrition mentioned interventions intended to curb the risk of eating disorders in children with DRHCs.
At routine visits, children can be screened early to combat negative body image and disordered eating. When identified, providers can intervene before harmful attitudes and behaviors change into eating disorders.
“Healthcare providers should be aware that young people with DRCHCs may be at risk of eating disorders, and carefully monitor psychological changes and the use of unhealthy weight control methods.”
â€" Quick, et al.
Clinicians can also be better trained on how to detect and treat disordered eating. Previous research has demonstrated that physicians who treat T1DM, for instance, have limited training in eating disorder management.
The authors stressed that it’s imperative to develop effective intervention and screening tools. These could cease the progression to eating disorders and mitigate detrimental health outcomes in younger people with DRCHCs.
Authors of the review published in International Journal of Eating Disorders pointed out the conundrum that clinicians face. Diet-treated chronic illness needs young people to closely consider diet and weight, but doing so may increase the odds of disordered eating.
“Future research is needed to elucidate the mechanisms that transform standard treatment practices into pathological eating, including characteristics and behaviors of the child, parents/care providers, family, and treatment providers.”
â€" Conviser, et al.
What this means for you
It’s tough when your younger patients have to deal with DRHCs. While their peers are enjoying sugary, salty, or high-calorie treats, kids with illnesses such as diabetes or CF cannot partake. This can lead to distorted perceptions of food, disordered eating or even eating disorders. As a physician, it’s important to screen them for disordered eating and remain informed of appropriate interventions to decrease the risk of future eating disorders.
https://www.mdlinx.com/article/when-chronic-illness-leads-to-eating-disorders-in-young-people/6rg4upMtkLWZpM7hSzmI2l
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