Some Things to Keep in Mind Before Your Next Sip By Laura Cipullo and the Laura Cipullo Whole Nutrition Services Team
In honor of Labor Day Weekend, we wanted to share the following blog on drinking and alcohol. We wish you a healthy and happy holiday weekend!
In 2010, the new Dietary Guidelines for Americans included a recommendation to drink alcohol in moderation. Moderation here is defined as: one drink or less per day for women, and 2 drinks or less per day for men. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) notes that one alcoholic beverage is equal to 14 grams of alcohol. That means, one 5-ounce glass of wine, one 1.5 ounce serving of liquor (tequila, vodka, gin, and so on), or one 12-ounce bottle of beer. Alcohol can affect every person differently based on your height, weight, health status, family history, age and how often/how much you decide to drink.
Alcohol clocks in at 7.1 calories per gram, which is more calories per gram than protein and carbohydrates, but less than fat. So, how does alcohol breakdown in our body and is it a health risk? Contrary to popular belief, alcohol is considered a fat, not a sugar, when it is broken down in our body. The thermic effect (energy needed to breakdown foods/drinks) of alcohol is 15-22% versus the 12% for food. That means, it takes your body more energy to breakdown alcohol than food. Does that mean that people who drink will burn more calories and have a lower body weight? No. The research examining alcohol consumption and body weight regulation is mixed. Some studies concluded that alcohol consumption in women was related to a lower body weight, but the study could not control for exactly how many ounces these women drank. Another study found no correlation between alcohol and weight in women, but concluded that men who drank had a lower body fat percentage but not a lower waist-to-hip ratio (the ultimate indicator for heart health and diabetes risk). Most studies did not address long-term consumption either, so there is no evidence to see how one’s drinking habits affect them in the long run.
Extensive research from the American Institute for Cancer Research (aicr.org) has uncovered the link between alcohol consumption and breast cancer risk in women of all ages. The majority of the research found a 10% increased risk for breast cancer with every 10 grams of alcohol/day – that’s less than one drink. Alcohol is also an Oestrogen/Estrogen disruptor, as it influences the hormone levels and its receptors.
It’s also important to know that your body considers alcohol a toxin. When you consume it, all other metabolic processes slow down to get the alcohol out of your system more efficiently. And because alcohol is considered a fat (1 of the 3 macronutrients), other fat breakdown is significantly curbed at that time. Now, we shouldn’t start drinking alcohol on an empty stomach, rather we should be mindful of the foods we consume while we enjoy our drink. Alcohol can affect our mood and our brain function, which can ultimately affect our food choices. That’s why being mindful when we enjoy our drinks and food is important. The second we feel out of touch with ourselves from a cocktail, it may be time to stop sipping and stay present.
For a useful tool on calculating the amount of alcohol in your drink, check out:
I Scream, You Scream, We All Scream For Lycopene! By Alyssa Mitola, RD and the Laura Cipullo Whole Nutrition Services Team
What is Lycopene? Lycopene is a powerful antioxidant. Although chemically related to vitamin A, lycopene does not function in our bodies like the vitamin. Rather lycopene serves as the most powerful antioxidant of the >600 carotenoids, riding our body of harmful free radicals and oxidizing species. Lycopene is a red pigment found in fruits and vegetables. You may already know that tomatoes are a rich source of lycopene, but lycopene is also found in guava, papaya, watermelon, grapefruit, and apricots.
Lycopene is constantly being researched for its potential health benefits, most notably in relation to cancer and cardiovascular disease. The strongest research comes from lycopene’s role in preventing prostate cancer. Many studies have found that people with higher intakes of lycopene have reduced rates of prostate cancer (Giovannuci et. al 1995; Zu et. al 2011). In addition, a 2013 study published in the British Journal of Medicine showed people consuming higher amounts of lycopene had less incidences of cardiovascular disease. Researchers are also currently investigating lycopene’s role in sunburn, gingivitis, osteoporosis, asthma, and mental disorders.
The health benefits of lycopene are numerous and we should try to include sources of lycopene daily. However, this does not mean lycopene should be taken as a supplement. Rather lycopene should come from a diet rich in fruits and vegetables. Lycopene is actually more bioavailable (available to our bodies) when it is heated. Therefore foods like tomato puree, tomato sauce, tomato paste, and tomato juice are even richer sources of lycopene. When purchasing tomato-based products, be sure to look out for no sodium or low sodium products. Eating lycopene with a healthy, fat like olive oil, will also increase your body’s ability to absorb the lycopene. With tomatoes in season get your fill of lycopene. Serve your tomatoes with some olive oil or make some homemade salsa, a tomato salad, or a fresh pot of tomato sauce!
1) Giovannucci E, Ascherio A, Rimm EB, Stampfer MJ, Colditz GA, Willett WC. Intake of carotenoids and retinol in relation to risk of prostate cancer. J Natl Cancer Inst. 1995;87(23):1767-1776.
2) Fielding JM, Rowley KG, Cooper P, et al.: Increases in plasma lycopene concentration after consumption of tomatoes cooked with olive oil. Asia Pac J Clin Nutr 14 (2): 131-6, 20.
3) Holzapfel NP, Holzapfel BM, Champ S, Feldthusen J, Clements J, Hutmacher W. The Potential Role of Lycopene for the Prevention and Therapy of Prostate Cancer: From Molecular Mechanisms to Clinical Evidence. Int J Mol Sci. 2013;14(7): 14620-14646.
4) Zu K, Rosner BA, Clinton SK, Loda M, Stampfer MJ, Giovannuci E. Dietary Lycopene, Angiogenesis, and Prostate Cancer: A Prospective Study in the Prostate-Specific Antigen Era. JNCI J Natl Cancer Inst (2014) 106 (2).
5) Jacques P, Lyass A, Massaro JM, D’Agastino B. Relationship of lycopene intake and consumption of tomato products to incident CVD. British Journal of Nutrition (2013), 110, 545-551.
6) Story E, Kopec RE, Schwartz SJ, Harris GK. An Update on the Health Effects of Tomato Lycopene. National Institute of Health Annu Rev Food Sci Technol. 2010; 1: 1-24.
Don’t “Defriend” Fat By Laura Cipullo and the Laura Cipullo Whole Nutrition Services Team
In the 70’s, we banned fat. In the 90’s we banned carbs – and neither really worked to improve our lifestyles and relationships with food. As new research comes out regarding the best ways to eat for a healthy body, heart health, brain health – you name it – our food industry adjusts accordingly to provide these foods for us to eat. But what if we simply had a neutral relationship with food and a positive relationship with eating? It seems we would be more likely to eat exactly what our bodies need and avoid the foods our bodies can do without.
Recently, an article was published in TIME Magazine with the title “EAT BUTTER.” There’s something that will catch the reader’s eye, but what is behind the cover? For over 40 years, Americans have been on a low-fat craze because it was believed to be the best way to preserve our hearts from heart disease. Turns out, the research was misleading and the way we interpreted the research was not any better for our bodies. According to Marion Nestle, professor of Nutrition, Food Studies and Public Health at New York University, ideally we thought “that if people reduced saturated fat, they would replace it with healthy fruits and vegetables.” What really happened was people replaced those calories with processed foods and snacks like low-fat cookies, cakes, crackers and more.
We started regaling fats as “good” fats and “bad” fats, and we did the same with cholesterol. Giving these positive and negative titles to foods can lead to overeating and or food avoidance. It is important to understand that fats, like all foods, are neutral. They are essential in our diet for brain health, blood sugar regulation and for keeping us feeling full. Carbs (sugar, fruits, vegetables, grains, dairy) are also essential in our diet for energy, fiber, vitamins and minerals. Avoiding one or the other can lead to undernourishment and side effects like fatigue and mood swings.
In 1996, Dr. Walter Willet published research concluding that removing fat from our diets and replacing that void with carbohydrates does not reduce our risk for heart disease. It just so happens that around the time this study was published, the Mediterranean diet started gaining popularity. All fats are important. All carbs are important. All proteins are important. There is actually research supporting Mediterranean diets with 40% fat. But the fat source is mainly monounsaturated fats. Remember, when you eat fats like dairy, oils, nuts, and so on, you are typically getting a bit of saturated and unsaturated fat. So while the jury is still out, stick with moderation and try to eat more wholesome nutrition the majority of the time.
Ultimately, the TIME article is not saying Americans should drop everything and start eating butter or loading up on saturated fat. The message seems to be implying that we should no longer be afraid of fat, and we can start incorporating all types of fat in moderation. It’s time we changed our thinking from exile to acceptance. Allowing ourselves to have access to all foods will decrease the desire to resist any particular nutrient or food group. We will all be healthier for it.
This coming Saturday night (7/26), thousands of people will walk together for Walk the Walk America’s 2nd Annual NYC Moonwalk. Participants will walk the streets of NYC in a fight against breast cancer. I was fortunate to have had the opportunity to speak to some of these participants last month. On June 26th, I spoke with Moonwalk participants about the importance of nutrition when completing a marathon. Please read on to see some of the items we discussed:
What to Eat Before a Marathon
2-3 Days Before:
•Mostly carbohydrates, moderate protein, and low fat •Carbs provide the muscles with adequate glucose (sugar) for glycogen storage 3–4 Hours Prior:
•Eat simple, easy-to-digest carbohydrates (moderate protein & low fat) •White bread, pasta, etc. •Avoid high-fiber foods to limit intestinal residue
•Prevent the need for bowel movements •Prevent bloating and gas
Pre-Competition Meal Ideas
•Cheerios with low-fat milk, fruit-flavored Greek yogurt, and banana
•Omelet with cheese and baked hash brown potatoes
•White English muffin with avocado, hummus, and applesauce
•Bagel with natural peanut butter and jam
•Turkey on white bread with a low-fat yogurt
•White pasta with pesto and shrimp
Hydration Before, During, and After
2 cups 2 hours before, and 2 cups during
•Recommended to drink 16 oz. of fluid at least 2 hours before event
•Remember to drink 2 cups for each hour of event
•If > 1 hr. replete electrolytes especially sodium and potassium
•Drink 16 oz./2 cups of electrolyte beverage for every pound of body weight lost during the event
Eating on the “Run/Walk”
•Eat 30–60 grams of carbs for every hour
•15 grams of carbs every 15 minutes
•Eat 90 grams of carbs for events lasting > 3 hrs
•Get carbs from your sports beverage (typically 6–8 percent carbs)or gel packs
What to Eat After
•Eat between 30 minutes and 1 hr. after
•Reload glycogen muscle storage
•Replenish your body with carbohydrates
•Eat protein (about 3 oz.) to help to repair your muscles
•Antioxidants repair free radical damage
•Muscle recovery lasts 30 minutes to 4 hours post-exercise
For more information on the 2014 NYC Moonwalk or Walk the Walk America, please click here to be redirected to their website.
It’s not Sunday, but we felt this was an important topic to discuss today with the current news. If you agree with the following post, please feel free to share:
Open Letter: J. Crew and The Little White Lie By Lauren Cohen and the Laura Cipullo Whole Nutrition Services Team
Dear Ms. Lyons & Mr. Drexler,
I love your brand. J. Crew composes the greatest portion of my closet. I am eternally grateful to your style guides and student discounts. You have taught me that looking presentable and feminine is a beautiful and professional step forward in this world. Because of your brand, I am brazenly unforgiving about my love of simple fashion and bold accents. Everyday I wear your clothes, I feel proud to be a woman.
This is my honest opinion of you. I believe I deserve the same respect.
I was deeply impressed by your response to Jenni Avins from New York Magazine in regards to that one-of-kind swimsuit (read here), along with a series of other accolades surrounding your customer service. I feel this is the most fitting platform to discuss my concerns and gain your attention regarding your newest brand update—the rollout of size 000.
A few years ago, there was a scandal surrounding J. Crew and vanity sizing. Since the United States has no national standards on size, size inflation can happen here with little regulation. Vanity sizing is the practice of lowering sizes to reflect a change against the average sizes of industry competitors. For example, while at Ralph Lauren, you may be a size 4; at J. Crew you might be a 2 or 0. The practice is founded in the hope that consumers’ perception that they are a smaller size will boost sales. As a consumer, and a woman, I don’t love being lied to by someone I trust and admire.
There is nothing regulating you to do otherwise, you have done nothing illegal. But now, you have found yourself in an odd situation. Your size 00 is roughly a 0-2 and your petite and Asian market can’t fit into your smallest sizes. To accommodate this, you had to introduce size 000. The Internet lost its cool. As a result, you have been under great fire.
My mother always warned that lies, no matter how small, would eventually get you into trouble. (Eli and His Little White Lie by Goldie Golding is available for purchase—used—from Amazon here should you need a refresher.) What started as perhaps an innocent lie to promote body image, shifted to full-blown dishonesty that enforces an unhealthy and popular desire to be thin enough to fit a size. We experience this pressure from all other forms of media, we don’t need—or expect it—from you. You are better than that.
This could have been avoided a number of ways. If you wanted to stand out, adapt your own sizing method. Use European sizes. Offer to custom make clothes as part of your “collection” approach to higher quality and standards. I say all of this because a 000 in other markets is smaller than teenage girls clothes. Women should dress like women, not teenage girls—J. Crew taught me that.
I hold you to a higher standard, it’s true, but it is a standard you have met time and time again. You can be the brand that promotes womanhood and positive body image without lying; I truly believe that.
With love and metallic pumps,
Clinical Nutrition and Dietetics MS Candidate
By Laura Cipullo and the Laura Cipullo Whole Nutrition Services Team
Do scare tactics work?
I know the new documentary Fed Up declares that scare tactics have worked for decreasing tobacco sales. Personally, I worry that scare tactics will actually contribute to more fat shaming, diet shaming and finger pointing.
I was really surprised that Katie Couric narrated this film directing negative attention toward Michelle Obama, food companies and one evil — sugar. My surprise is specific to Katie’s history of an eating disorder.
As a certified eating disorder specialist, I know and hope Katie knows that deprivation and shaming lead only to more binging, overeating and weight gain. This black and white delineation simply contributes to the eating disorder mentality.
In addition, I personally don’t think scaring people into not eating sugar is any better than scaring them into not eating fat back in the 80s. That particular scare tactic definitely didn’t work. We all got “fatter”.
If we isolate just one macronutrient, people will continue to eat it secretly. Meanwhile, food companies easily reformulate their products to meet the new standard. Scaring and blaming merely nurture the “poor health epidemic” we have today.
That’s right! Here’s another very important point. First, let’s rename the “obesity epidemic”. Let’s call it the “processed food epidemic” or the “ill health epidemic.” Obesity is usually just the most visible symptom of a much larger problem.
As Fed Up points out, there are “skinny” fat people who are just as unhealthy. So why do we call this problem an obesity epidemic? It’s about health not size.
This post is an excerpt from a previously published blog post on YourTango, to see the original post click here.
In a world of external focus where a scale determines your worth and your salary defines your success, you need to turn inward to find wellness and well-being. In order to survive and create balance, start connecting with your inner core — your true self. But how can you make this connection when everything around you points to the polar opposite of looking outward?
Here are my favorite ways to self-care that allow for connecting with yourself and feeling the best. The beautiful thing is that you don’t need to shell out money in order to utilize these methods. All of the following tips ultimately affect food intake, so pay close attention. They will help lead you on your journey to feeling and being well.
1. De-Stress Your Nervous System
That’s right! Rid pain, inflammation and more with my favorite at home self-care set. It is the “melt method” and props. This method is not about melting away your love handles. It’s about ridding pain while also restoring balance to your nervous system ultimately affecting digestion, energy levels and more.
I was first introduced to this method by my master gyrotonic and pilates instructor, Michelle Spinner, at Kinected Studios in NYC. Michelle, as well as my rolfing practitioner, Marie Zahn, always told me, it starts in our feet. If your feet are “off,” your body will be “off.” It makes perfect sense, yet most people never think about their feet when contemplating well-being.
So start from the tips of your toes, and work your way up. Use the melt hand and foot treatment with the melt balls. These little balls may not exactly feel heavenly the first time you use them, but they work. I started using them last Fall, and by the time winter rolled around, I noticed remarkable change.
This was the first year that I was able to ski pain-free since 1996! I used the melt method every night after skiing. The best thing about this new tool? The balls are travel-friendly! You can easily transport the balls with you wherever you go. The melt balls enable you to be proactive with your own form of manual therapy!
Composting in the City! By Laura Cipullo and the Laura Cipullo Whole Nutrition Services Team
Composting and CITY living don’t seem like they should go together but let’s make it work in spite of their differences.
Before we approach the difficult nature of composting in our city, let’s first address why composting is something to get into in the first place. There are two major reasons; 1) it’s a great way to use and decrease waste which is a big help to our environment and 2) you can grow your own food—which comes with a series of great benefits including cost efficiency and access to healthy/organic foods. When we see the advantages, it’s hard to wonder why everyone doesn’t compost! Except for that one major reason—it’s kind of gross, isn’t it?
Composting is the breakdown of organic material-waste. Organic waste that we breakdown comes in two different forms—dry material and wet material. Dry materials are generally referred to as “recyclable” and they include newspaper, cardboard, certain plastics etc. Wet material-waste includes fruits and vegetables, eggshells, coffee grinds, tea bags, etc. We use both to compost, but the wet material is the most crucial.
Now, lets get into the dirt:
Step 1: Find a space to compost. It can either be a pile in your backyard or a terracotta pot (with a lid) on your balcony. Either way, you want a controlled space.
Step 2: Separate your organic waste into dry and wet. Collect leaves, twigs, weeds and garden waste—or get some dry organic fertilizer from your local hardware store—and combine the waste in your compost pile or pot.
Step 3: The process happens naturally but to help it move along, you can add lime-juice or yogurt to assist the initiation of decomposition.
Step 4: Continue to add to the top of the pile and wait it out. The soil will become dark and rich at the bottom—that’s the good stuff! Even if you don’t use it, you have already done something great for the environment by reducing your waste.
Step 5: Use it! The dark, rich soil is great to sprinkle over your garden to help enhance its growth and fill your produce and plants with an incredible healthy dose of vitamins and minerals. It will give them great color, taste, and nutrient density.
I pride myself on my cleanliness so I really needed to research the health and safety benefits of composting in my tiny New York City apartment. I was very curious about the smell. While it would seem that composting would generate quite the stench, if appropriately assembled, there should be no smell at all. Another worry of mine was my lack of outdoor space, which I’m sure rings true to many other city dwellers. Because composting is the chemical breakdown of organic waste and it requires live cultures to properly biodegrade, access to outdoor space—even just a fire escape—is important. This brings us to our first set of tips!
Tip 1: If you don’t have outdoor space—like me—get creative! All buildings have a roof. Rally some of your neighbors to talk to building management about starting an urban garden. They may be more receptive to the idea then you think!
Tip 2: If composting doesn’t seem realistic for you, check out local Farm Shares (you can do this through a google search) to support your regional farmers and seasonal produce. This is also cost effective and environmentally friendly.
Now, what’s the point of composting? The product of breaking down this wet organic-waste is compost, or soil. We can use this soil to then grow our own fruits, vegetables, herbs, and flowers. The nutrition community is always talking about eating clean and buying local and organic in an attempt to better understand where our food is coming from. What better way to do this then growing food yourself? You can’t get more local then that! This brings us to our next tip.
Tip 3: Don’t be afraid to get your hands dirty! Even though the idea of using waste to generate compost to then grow more food seems dirty—it is actually the greatest example of clean eating out there!
Composting and growing food allows you to know exactly where your produce is coming from. It is a great money saver and an even better gift to the environment. It is a wonderful activity for children—especially the picker eaters out there. Research shows that if kids know where their food comes from and play a role in preparing their meals, they will be more likely to try something new. Growing food gives children such an integrative and profound understanding of where their food comes from—and it’s also fun! This brings us to our final tip.
Tip 4: Save your leftovers! We could all learn a few lessons from some of the NYC schools. A lot of them are saving students lunch left overs to use towards composting.
There are so many reasons to give composting and urban gardening a shot so let’s get our hands dirty NYC!
Fueling Your Passion Ensuring Adequate Nutrition for the Athlete By Laura Cipullo Whole Nutrition Services Team
In this post, please note that another name for sugar is glucose.
Calling all athletes!
Whether you’re running the NYC marathon or your first triathlon, nutrition is an important key to performance excellence. Knowing the best foods to eat before, during, and after you compete is essential for a successful event and, of course, not “bonking out”! Here’s the lowdown for fueling your race.
2 to 3 days before the event:
Consume a meal consisting mostly of carbohydrates, moderate amounts of protein plus some amounts of fat; it’s the most favorable repast for athletes before entering a competition. Eat simple, easy to digest (lower in fiber) carbohydrates such as white bread and pasta approximately two to three days before you compete. Louis Burke, PhD, recommends this lower residue intake to minimize intestinal contents —and therefore prevent the need for bowel movements during the event.1 Eating this way is a key element of running free from bloat and gas during the competition.
This meal focuses on carbohydrates because they are digested faster than protein and fat, thus providing the muscles with adequate glucose (sugar) for glycogen stores (your body’s storage form of glucose). This gives athletes enough energy reserves to maintain higher and longer levels of intensity during the event.2 Adequate glucose storage in the muscles will prevent you from experiencing weakness and fatigue when participating in events requiring extra endurance.
Eating your pre-event meal three to four hours before the game or race is another key element to performing at your very best. A balanced meal will provide you with the maximum available energy you need for competition. Giving your body enough time to digest the meal is key.3
Here are some good examples of pre-competition meals—to be consumed 3 to 4 hours before the event:
Cheerios with low-fat milk and fruit-flavored Greek yogurt with banana
Omelet with cheese and baked hash brown potatoes
White English muffin with avocado and hummus and an applesauce side
Keeping yourself well hydrated both before and during exercise is essential to successful performance. Drinking two cups of fluid (8 oz. per cup) at least two hours before your event can be helpful in preventing dehydration. It’s also important to make sure that you drink another two cups of water for every hour you are competing.5 Preventing dehydration can keep you from feeling fatigued and can prevent your muscles from cramping during your competition. If you’re an athlete participating in an event lasting over an hour, you should also think about electrolyte depletion. Excessive sweating causes you to lose important electrolytes such as sodium and potassium—and can adversely affect your performance. To replace lost electrolytes, consider choosing a sports drink such as Gatorade which will aid in electrolyte repletion and rehydration. Sports drinks usually contain carbohydrates, sodium and potassium. Gatorade (and other sports drinks formulated especially for athletes include water, glucose/sugar and electrolytes) provides the ideal ratio for rehydration and repletion of electrolytes and glycogen stores.6
Recovery foods to consume at your post-event meals are just as important as your pre-event meals. During exercise, your body breaks down its muscle glycogen stores. When your body uses the available glucose in your blood, it needs to switch to reserves. It can quickly break glycogen down into glucose which causes the glycogen stores to become depleted. Due to this breakdown, replenishing your body with carbohydrates is crucial for adequate recovery.7 Make sure you eat enough carbohydrates to restore the glycogen in the muscles that was depleted during the event. Protein will help to repair the muscles that were stressed. Antioxidants are also beneficial at this time; they aid in repairing any free radical damage that occurred during your intense exercise. In general, consuming carbs and proteins within thirty minutes of your workout is ideal for muscle recovery. This muscle recovery period will last for about 30 minutes to four hours post exercise.
Here are some post-event meal ideas to help you recover and prepare for your next workout:
Oat bagel toasted with almond butter and fresh strawberries
Whole grain wrap with grilled chicken, hummus and tricolor peppers
Whole-wheat burrito with white rice, beans and veggies
Grilled salmon and quinoa with steamed squash
Smoothie with low-fat milk, banana, peanut butter, protein powder and wheat germ
Spaghetti and meatballs with spinach
On average, it’s recommended that a female athlete (about 5’4” and 140 lbs.) consume approximately 500 grams of carbohydrates and 76 to 89 grams of protein per day. It’s recommended that a male athlete (about 6’0” and 180 lbs.) consume approximately 700 grams of carbohydrates and 98 to 113 grams of protein per day.7
Providing yourself with the proper energy foods both before and after your competition can make a huge difference in your performance. Eating a low residue, carbohydrate rich diet is important for your pre-event meal while eating within thirty minutes of a competition is crucial for your post-event recovery. What you feed your body both before and after competition can be the most important key for turning an adequate performance in your event into an excellent one!
What do you eat before and after an event? What foods work for your body? Do you have any secrets to your success that you can share with our readers?
Don’t miss out on our giveaway! Click here to enter for your chance to win some great fitness prizes!
7. The Position Statement from the Dietitians of Canada, the American Dietetic Association, and the American College of Sports Medicine, Canadian Journal of Dietetic Practice and Research in the Winter of 2000, 61(4):176-192. Accessed April 13, 2014.
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.