While Laura Cipullo and the Laura Cipullo Whole Nutrition Team work on some new and exciting projects, you may notice less posts on the Eating and Living Moderately Blog. We have created a “blog shelf” below to keep you entertained and educated. Get caught up on the latest nutrition education by clicking on each year below. We will send you nutrition updates, but we will not be inundating your mailboxes on a weekly basis. If you want weekly “love” and inspiration, subscribe to our Mom Dishes It Out blog for weekly posts and recipes. Mom Dishes It Out provides expert advice from mom Registered Dietitians and mom Speech Pathologists on the “how to” of health promotion!
The EALM Blog Shelf
Please feel free to peruse our posts organized by year below. Or take a look at the categories listed at the bottom of the page to find a post in the desired.
FODMAPS: A Look at their Role in Managing IBS By Laura Cipullo and the Laura Cipullo Whole Nutrition Services Team
Can you recall the last time you felt bloated, gassy, abdominal cramping, diarrhea or constipation? For most people, these symptoms are mild and once in a blue moon, but for people with Irritable Bowel Syndrome (IBS), there is no cure for this gut disorder and these symptoms are chronic issues that can disrupt the quality of life. The great news is that you can help manage your symptoms through nutrition!
When people think of gut symptoms like those mentioned above, one of the most common suggestions is limiting irritating food triggers like caffeine, alcohol, and fatty foods, as well as increasing fiber intake and fluid intake. However, when dealing with IBS, since these gut symptoms are broad and can vary from person to person, managing them with a one-size-fits all approach is not ideal. While there are various treatment suggestions for those suffering from IBS, following a low-FODMAP diet is the new nutrition therapy approach in town that has the potential to manage symptoms in most people with IBS.
Last month, we were fortunate enough to attend the Nutrition Grand Rounds at New York-Presbyterian Hospital to learn more about FODMAPs and their potential benefits in the treatment of IBS. The presentation featured two speakers Dr. Julie Khlevner, M.D., an expert in pediatric gastroenterology who oversees the new Pediatric Gastrointestinal Motility Center at NewYork-Presbyterian/Morgan Stanley Children’s Hospital, and Patsy Catsos, MS, RD, LD, author of the book IBS – Free at Last!. While Dr. Khlevner and Patsy both discussed treatment options for people with IBS, each speaker touched on very different areas and treatment options. Dr. Khlevner explained the process of testing, diagnosing and treatment in children and young adults. In terms of treatment options, Dr. Khlevner suggested keeping a food log, keeping an eye on trigger foods, taking probiotics, as well as IBS hypnotherapy. Patsy educated the audience on a food-based approach to treating IBS and the potential benefits of this dietary therapy.
Patsy Catsos explained dietitians play a starring role in the management of IBS. A high fiber intake has been a common recommendation for treating IBS symptom management, however, research has found that few people find the increased fiber to be helpful. Thankfully the use of FODMAPs has been becoming increasingly popular in the management of IBS symptoms and with a relief in symptoms. In fact, evidence has shown a FODMAP-elimination diet to reduce symptoms in 3 out of 4 people with IBS1.
What is IBS?
To start, lets give a background on Irritable Bowel Syndrome. IBS is classified as a Functional Gastrointestinal (bowel) Disorder and can consist of a variety of symptoms. Dr. Khlevner explained the symptoms as the “ABCs of IBS” –
Abdominal pain or discomfort
Change in bowel habit
Stool urgency or straining
These symptoms often greatly impact a patient’s quality of life, especially in children and adolescents. Treatment for IBS can vary greatly per patient; however, common treatment options can include the use of probiotics, increased fiber intake, pharmacological interventions, psychological therapy, and lifestyle and dietary modifications.
What is a FODMAP?
FODMAPs are short-chain carbohydrates that tend to be malabsorbed in people with IBS and can trigger or exacerbate symptoms. FODMAP is an acronym that stands for:
Fermentable (Produce Gas) Oligosaccharides (Fructans and Galacto-oligosaccharides) Disaccharides (Lactose) Monosaccharides (Fructose) And Polyols (Sorbitol and Mannitol)
How do FODMAPs affect IBS?
The origination of IBS symptoms can, too, be caused by a number of factors, some including, chemicals found in packaged foods, such as nitrates or sulfites, as well as FODMAPs. The ingestion of FODMAPs are not the cause of IBS, rather what can trigger the troublesome symptoms like abdominal pain or bloating. Patsy spoke about the use of FODMAP elimination trials in patients with IBS. This idea behind FODMAPs is that when people with IBS consume sugars that their body can’t properly breakdown, it contributes to their symptoms. The FODMAP approach includes a 1-2 week elimination of all FODMAPs, which Patsy called the Elimination Phase. The FODMAPs are then reintroduced into the diet one at a time to allow for proper monitoring of the patient’s tolerance. It can help you determine which sugars you may be sensitive to, and what foods to limit in quantity or what foods to avoid altogether.
Where are FODMAPs Found?1
Fructans, galactooligosaccharides (GOS), and inulin
Vegetables: cauliflower, button mushrooms, and snow peas
Sweeteners: sorbitol, mannitol, xylitol, maltitol, and isomalt (often found in sugar-free products like gum, mints, cough drops, and medications)
Important to Note:
Many foods contain FODMAPs and they may be very hard to avoid. You’ll likely find hundreds of food lists and suggestions of foods to avoid, which can lead to both confusion and restriction. Because of this, it’s very important to understand that the FODMAPs approach is not recommended for everyone to follow and is certainly not a weight loss diet or a cleanse, but a nutrition therapy that has the potential to help people with IBS figure out what foods trigger symptoms (…because let’s face it, constant bloating and gas isn’t fun for anyone or anyone around you!). If you’re still unsure about how to treat or manage your IBS symptoms, speak with your doctor, your dietitian, and/or check out the resources below:
And yes, there is an app for that! The research team at Monash recently launched a smartphone application: The Low FODMAP Diet. The app provides a list of hundreds of foods using traffic light signals i.e., (Red = Avoid and Green = Eat without fear) and according to serving sizes since smaller portions may be better tolerated.
The Scoop on Coffee By Laura Cipullo and the Laura Cipullo Whole Nutrition Services Team
We’ve heard it before: “Coffee boosts your metabolism. Too much coffee causes dehydration.” But, do these sayings hold any truth? Does drinking a cup or two of java each morning really affect your metabolism? And what about your hydration? Research has linked coffee to numerous health benefits, including aiding in degenerative diseases, like Alzheimer’s disease, boosting our mood, and the list goes on. We took to the books to find the scoop on coffee. Here is what we found.
Q: What’s the deal with caffeine? A: Coffee stimulates our feel good hormones in the brain!! Makes you feel good (in moderation, of course).
According to a Harvard Health Letter published in Harvard Medical School’s Health Publications, caffeine is absorbed in the stomach and small intestine. It is then circulated throughout the body, including the brain. The caffeine circulation reaches its highest point roughly 30-45 minutes following ingestion. Once absorbed, caffeine affects the dopamine activity in the brain. Dopamine is a brain chemical that involves thinking and pleasure. Think about it that first cup of coffee in the morning – part of that morning rush is associated with caffeine stimulating our dopamine receptors just like sugar and even drugs.
Q: Can coffee be beneficial to brain function? A: Caffeine is linked to better memory!
A study published in 2012 tested the effect of caffeine on older adults with “mild cognitive impairment, or the first glimmer of serious forgetfulness, a common precursor of Alzheimer’s disease”2. The study found that those older adults with little caffeine in their bloodstreams were far more likely to develop Alzheimer’s disease than those who had a few cups of coffee per day2.
Q: Is filtered coffee healthier than unfiltered coffee? A: Choose filtered coffee more often.
If you’re drinking unfiltered coffee on a daily basis, you may want to consider switching to filtered. Coffee naturally contains a substance known as cafestol, which has been shown to stimulate LDL (bad) cholesterol levels. However, when brewed with a paper filter, the cafestol doesn’t transfer to the coffee. While drinking unfiltered coffee on occasion isn’t terrible for you, if you are someone with high cholesterol, filtered coffee would make the better choice.
Q: Can too much coffee be dehydrating? A: Caffeine stimulates your bladder, while alcohol actually dehydrates.
A recent study published by University of Birmingham in the United Kingdom tested coffee’s effect on the fluid balance of habitual male coffee drinkers and found no significant loss of fluid balance in men that drank a maximum of 4 cups of coffee per day1.
Q: Does coffee consumption impact blood pressure? A: Coffee can up our pump; think twice if you have already high blood pressure.
It can. According to a study performed by Harvard University, continued caffeine consumption (via coffee) can lead to a slight increase in blood pressure. While coffee hasn’t been directly associated with an increased risk of hypertension, it is typically recommended that those with hypertension, specifically those who are finding it difficult to control, should switch to a decaffeinated coffee.
Q: Can coffee really boost our metabolism? A: Coffee boosts our central nervous system, but it usually takes more than 1 cup.
A study published in the Journal of Physiology and Behavior, the metabolic rate of regular coffee drinkers was found to be about 16% higher than decaf coffee drinkers. The reasoning? Caffeine is known to stimulate the body’s central nervous system, which can increase both breathing and heart rate.
Q: So, what’s the takeaway? A: We will see you at Starbucks!
As the research we’ve highlighted shows, coffee drinking can benefit our brain health, boost our metabolism, and even help improve our mood. However, too much of a good thing can be harmful – drinking too much coffee can increase our blood pressure and drinking more than 4 cups per day can negatively affect our fluid balance. Though, like most things, coffee can be a part of a healthy diet when consumed in moderation. A cup or two of coffee per day could be beneficial to our health, but it is encouraged to limit coffee drinking to a maximum of 4 cups per day to avoid any negative side effects.
Laura recently traveled to Peru and came across a great coffee brand known for both their sustainability and commitment to the environment, Puro Coffee. Puro Coffee is sourced from Fairtrade co-operatives made up of hundreds of farmers together to grow the coffee naturally. They even use solar panels and recycle the heat from the coffee roasting process to power their factory!
For more information on Puro Coffee and their sustainable processes, please take a look at the following links:
Killer, Sophie C., Andrew K. Blannin, and Asker E. Jeukendrup. “No Evidence of Dehydration with Moderate Daily Coffee Intake: A Counterbalanced Cross-Over Study in a Free-Living Population.” PloS one 9.1 (2014): e84154.
Santos, Roseane M.M., Tracy Hunter, Nick Wright, Darcy R.A. Lima. “Caffeine and Chlorogenic Acids in Coffee and Effects on Selected Neurodegenerative Diseases.” J Pharm Sci Innov. 2013; 2(4): 9-17.