Lactose intolerance, FODMAPs, and nightshades OH MY!

human-skeletal-system

 

In my A & P (anatomy and physiology) class this week, there were several topics we were exploring dealing with bones and the skeletal system. Part of the discussion was around bone health, which of course leads to calcium intake and vitamin D. The discussion transitioned to lactose intolerance. From there, I was curious about induced lactose intolerance because I think I did that to myself years ago. It was the early 90’s, at the height of the fat phobia that took over the country. I bought into it so steered clear of anything at all that had fat in it. Dairy fell into that category for me.

After not consuming dairy [other than in very small amounts periodically] for probably at least a year or so, I had a craving for chocolate milk. I bought non-fat milk [obviously] and some Ovaltine. I was drinking a HUGE glass of the stuff daily for about a week, and every day that week, well let’s just say I realized it must have been the milk that was creating some unpleasant symptoms.

Nowadays I do consume dairy, butter and cheese for example (I’m not a milk drinker) almost daily and I have no adverse reactions to it. Although I know that these foodstuffs have far less lactose in them than milk does. So that just might be the case (that I’m lactose sensitive, not lactose intolerant).

Lactose intolerance, also called lactase deficiency and hypolactasia, is the inability to digest lactose, a sugar found in milk and to a lesser extent milk-derived dairy products, like butter and cheese for example. It is not necessarily a disorder but more of a genetically-determined characteristic.

Lactose intolerant individuals have insufficient levels of lactase. Lactase is an enzyme that catalyzes the hydrolysis of lactose into glucose and galactose in the digestive system. In most cases this causes symptoms which may include abdominal bloating and cramps, flatulence, diarrhea, nausea, borborygmi (rumbling stomach), or vomiting [1] after consuming large amounts of it. Some studies have produced evidence that milk consumption by lactose intolerant individuals may be a significant cause of inflammatory bowel disease. [2, 3]

Most mammals normally stop producing lactase, becoming lactose intolerant, after weaning, [4] but some human populations have developed lactase persistence, in which lactase production continues into adulthood.

Here are some interesting statistics:

It is estimated that 75% of adults worldwide show some decrease in lactase activity during adulthood. [5]

The frequency of decreased lactase activity ranges from 5% in northern Europe through 71% for Sicily to more than 90% in some African and Asian countries. [6] This distribution is now thought to have been caused by recent natural selection favoring lactase-persistent individuals in cultures in which dairy products are available as a food source. [7]

While it was first thought that this would mean that populations in Europe, India, Arabia and Africa had high frequencies of lactase persistence because of a particular mutation, it was later shown that lactase persistence is caused by several independently occurring mutations. [8]

And this is interesting. While searching to find information about self-induced lactose intolerance I came across this…

As noted above, after infants are weaned there is a genetically programmed reduction in lactase synthesis which results in low lactase activity in adults. This is known as lactase non-persistence, and it results in the incomplete digestion of lactose. I found this terminology involved in lactose absorption/intolerance: [9]

  1. Lactase non-persistence (or lactase insufficiency) – indicates that brush border lactase activity is only a small fraction of the infantile level, a condition documented by analysis of brush border biopsies. Recently it has been shown that a genotype (C/C) of the lactase promoter gene is responsible for lactase non-persistence, and demonstration of this genotype can be used as indirect evidence of lactase non-persistence.
  2. Lactose malabsorption (LM) – indicates that a sizable fraction of a dosage of lactose is not absorbed in the small bowel and thus is delivered to the colon. Since such malabsorption is virtually always a result of low levels of lactase, there is a nearly one to one relationship of lactase non-persistence (or deficiency) and LM. LM is objectively demonstrated via measurements of breath H2 or blood glucose concentrations following ingestion of a lactose load.
  3. Lactose intolerance (LI) – indicates that malabsorbed lactose produces symptoms (diarrhea, abdominal discomfort, flatulence, or bloating). It should be stressed that this symptomatic response to LM is linked to the quantity of lactose malabsorbed (as well as other variables), i.e., ingestion of limited quantities of lactose does not cause recognizable symptoms in lactose malabsorbers, while very large doses commonly induce appreciable LI symptoms. As a result, the prevalence of lactase non-persistence or LM could far exceed the prevalence of LI symptoms in population groups ingesting modest quantities of lactose.

This source notes that a public health problem can result when folks self diagnose for lactose intolerance (and any other condition of course). This is because these folks might be lactase persisters or even lactase non-persisters that may actually have undiagnosed irritable bowel syndrome (IBS) or other intestinal disorders, given that symptoms are similar. [9]

I find this interesting because I do have digestive issues that I haven’t pinpointed the root cause of. And yes, I’m trying to diagnose myself. It’s part of my charm.

Considering the large quantities of milk did affect my system, that I know for sure based on my consumption of it and the results pretty soon after, and that now things like butter and cheese don’t bother me, I’m going to say that I am somewhere between lactose non-persistent and lactose malabsorption.

My newest diagnoses of my digestive issues are around FODMAPs and nightshades. I find eating these does make my symptoms worse.

FODMAPs are short chain carbohydrates (oligosaccharides), disaccharides, monosaccharides and related alcohols that are poorly absorbed in the small intestine. These include short chain (oligo) saccharide polymers of fructose (fructans) and galactose (galactans), disaccharides (lactose), monosaccharides (fructose), and sugar alcohols (polyols) such as sorbitol, mannitol, xylitol and maltitol.

The term FODMAP is an acronym, deriving from Fermentable, Oligo-, Di-, Mono-saccharides And Polyols. The restriction of these FODMAPs from the diet has been found to have a beneficial effect for sufferers of irritable bowel syndrome and other functional gastrointestinal disorders. [10, 11] FODMAPs that are not absorbed in the small intestine pass into the large intestine, where bacteria ferment them. The results are production of gas, and the resulting bloating and flatulence associated with that gas production.

FODMAP examples include fruits like apples and cherries, grains like wheat and rye, lactose containing foods (we’ve touched on that already), legumes like chickpeas and lentils, artificial sweeteners, vegetables like artichokes and brussel sprouts and avocados. There are many others in each of these categories too.

Nightshades belong to the Solanaceae family which includes over 2,000 species. They also include some of the most popular foods consumed today, and many of my favorites, unfortunately. Examples include tomatoes, potatoes, all types of peppers, and eggplant. The Solanaceae family contains cholinesterase inhibiting glycoalkaloids and steroid alkaloids including, among others, solanine in potato and eggplant, tomatine in tomato, nicotine in tobacco, and capsaicin in garden peppers. The glycoalkaloids in potatoes are known to contribute to IBS and negatively affect intestinal permeability. [12, 13]

  1. http://digestive.niddk.nih.gov/ddiseases/pubs/lactoseintolerance/
  2. http://www.ncbi.nlm.nih.gov/pubmed/10759141
  3. http://www.ncbi.nlm.nih.gov/pubmed/10453452
  4. http://www.ncbi.nlm.nih.gov/pubmed/14616060
  5. http://www.ncbi.nlm.nih.gov/pubmed/10812376
  6. http://www.ncbi.nlm.nih.gov/pubmed/17934640
  7. http://www.ncbi.nlm.nih.gov/pubmed/14634648
  8. http://www.ncbi.nlm.nih.gov/pubmed/19034520
  9. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0008310/
  10. http://www.kcl.ac.uk/medicine/research/divisions/dns/projects/fodmaps/index.aspx
  11. http://www.ncbi.nlm.nih.gov/pubmed/20136989
  12. http://www.ncbi.nlm.nih.gov/pubmed/12479649
  13. http://www.ncbi.nlm.nih.gov/pubmed/20198430

Are you D-ficient? Vitamin D. What’s the deal?

vitamin-d-sources

There is a lot of hype nowadays around vitamin D. Sure, I think most of us know it’s needed for bone health, and there are other supposed benefits as well. What’s the deal? I studied nutrition and dietetics undergrad a VERY long time ago and I recall learning that the need for vitamin D supplementation was rare in developed countries. Has the science really changed or is this [another] case of the ‘machine’ making health claims to make a buck? Research time!

First of all, what is it? Vitamin D is a group of fat-soluble secosteroids (secosteroids are very similar in structure to steroids except that two of the B-ring carbon atoms of the typical four steroid rings are not joined, whereas in steroids they are). It is responsible for enhancing the intestinal absorption of calcium and phosphate (important minerals for bone health). The most important compounds in this group are vitamin D3 (also known as cholecalciferol) and vitamin D2 (ergocalciferol). [1] Cholecalciferol and ergocalciferol can be obtained from diet, and from supplements. [1, 2, 3] The body can also make vitamin D (specifically cholecalciferol) in the skin, with exposure to sunlight.

Although vitamin D is called a vitamin, it is not actually an essential dietary vitamin because it can be made in adequate amounts via exposure to sunlight. FYI, a substance is only considered ‘essential’ when it cannot be made in sufficient quantities by the body, and must be obtained from diet. Synthesis of vitamin D from exposure to sunlight, combined with dietary intake of it, generally contributes to the maintenance of adequate serum concentrations of vitamin D (that means how much of it is in your blood). Evidence (fancy scientific studies) indicates the synthesis of vitamin D from sun exposure is regulated by a negative feedback loop that prevents toxicity. That means your body can figure out by itself what to do with it to keep it ‘on the level.’

Some history. Vitamin D was discovered in an effort to find the dietary substance lacking in rickets, the childhood form of osteomalacia. [4] Like other compounds called vitamins, in the developed world, vitamin D is added to staple foods, like milk, to avoid disease due to deficiency. Beyond its use to prevent osteomalacia, the evidence for other health effects of vitamin D supplementation is inconsistent (ya don’t say). [5, 6] A United States Institute of Medicine, (IOM) report noted that outcomes related to cancer, cardiovascular disease and hypertension, diabetes and metabolic syndrome, falls and physical performance, immune functioning and autoimmune disorders, infections, neuropsychological functioning, and preeclampsia could not be linked reliably with calcium or vitamin D intake. [7] The best evidence of benefit is for bone health [7] and a decrease in mortality in elderly women. [8]

In 2013, the US Preventive Services Task Force did not find enough evidence to determine if healthy women should use supplemental calcium and vitamin D to prevent fractures. [9, 10] Another 2013 meta-analysis did not find evidence that vitamin D supplementation increases bone density and therefore it did not recommend general use to prevent osteoporosis. [11] Here’s that science-y stuff again, noting that supplementation of vitamin D is um, maybe not good?!?!

In those with osteoporosis there does not appear to be a decreased risk of fractures from vitamin D supplementation, except possibly among those in long-term care facilities where vitamin D with calcium may prevent hip fractures. [12] Supplementation with higher doses of vitamin D in those older than 65 years of age may decrease fracture risk. [13] But again, this appears to apply more to people in institutions rather than those living independently. [14] So maybe there’s a little benefit for a small portion of the population. A portion that IS NOT who the ‘machine’ is trying to sell these supplements to. I digress.

Ok, science smchience. Let’s talk food! Very few foods in nature contain vitamin D (bummer I know). The flesh of fatty fish (such as salmon, tuna, and mackerel) and fish liver oils are among the best sources. Small amounts of vitamin D are found in beef liver, cheese, and egg yolks.

Anyway, based on the available literature, I’m going with my hypothesis that the ‘machine’ is trying to make a buck in selling us supplements we don’t really  need. What do you think?

Oh, by the way, if you are taking vitamin D supplements, and they were prescribed by your doctor, there’s probably a legit reason to be taking them. It’s always good to talk to your doctor before you start taking any supplements, and it never hurts to inquire if you are already taking them!

1.    http://www.ncbi.nlm.nih.gov/pubmed/16529140

2.    http://www.ncbi.nlm.nih.gov/pubmed/15671233

3.    http://www.ncbi.nlm.nih.gov/pubmed/18689389

4.    http://www.ncbi.nlm.nih.gov/pubmed/18689389

5.    http://www.ncbi.nlm.nih.gov/pubmed/20194237

6.    http://www.ncbi.nlm.nih.gov/pubmed/20629479

7.    Ross AC.; Taylor CL.; Yaktine, AL.; Del Valle, HB. (2011). Dietary Reference Intakes for Calcium and Vitamin D. Washington, D.C: National Academies Press. p. 435.

8.    http://www.ncbi.nlm.nih.gov/pubmed/21735411

9.    http://www.uspreventiveservicestaskforce.org/uspstf12/vitamind/finalrecvitd.htm

10.  http://annals.org/article.aspx?articleid=1655858

11.  http://www.ncbi.nlm.nih.gov/pubmed/24119980

12.  http://www.ncbi.nlm.nih.gov/pubmed/19370554

13.  http://www.ncbi.nlm.nih.gov/pubmed/22762317

14.  http://www.ncbi.nlm.nih.gov/pubmed/22184690

Inflammation nation

I don’t think anyone can dispute the fact that we are a nation plagued with chronic disease. And many of these chronic conditions have lifestyle related factors associated with them. Cardiovascular disease, diabetes, obesity, cancer. We hear more and more about autoimmune diseases (like arthritis) nowadays as well, and chronic pain.

What do these different conditions have in common other than the fact that they have lifestyle components associated with them? I’ll give you a sec to guess.

What did you guess? If you guessed inflammation, you’d be right! These diseases are actually examples of chronic inflammation (inflammation that lasts awhile, months to years for example). There are acute forms of inflammation as well which are shorter in duration, such as ingrown toenails, the flu, or appendicitis.

Inflammation is your body’s attempt to protect itself, so it’s not necessarily a bad thing. Inflammation works to remove the harmful stimulus and associated damaged cells, irritants or pathogens from your body in order to begin the healing process.

Initially inflammation is beneficial. Again, its main function is to protect your body. BUT sometimes inflammation can cause additional inflammation and then it becomes a cycle of more inflammation being created in response to the existing inflammation. You following? Good!

Chronic inflammation is a problem because it can eventually lead to diseases and conditions including some forms of cancer, rheumatoid arthritis, and cardiovascular disease (as noted above).

Obesity is an example of a lifestyle related condition that increases the risk of inflammation. Some studies have shown that obese men have more inflammatory markers (white blood cells) than men of the same age who are not obese or overweight. Increases in white blood cell levels can be linked to a higher risk of developing various illnesses, including cardiovascular disease. Another similar study noted that inflammation decreases when women lose weight. Researchers found that postmenopausal overweight or obese women that lost 5% or more of their body weight had significant decreases in inflammation markers.

Autoimmune disorders result in inflammation too. An autoimmune disorder is when the body starts an immune response to healthy tissue. The healthy tissue is mistaken for pathogens or irritants. There are tons of autoimmune disorders. Examples include rheumatoid arthritis, celiac disease, Crohn’s disease and lupus, just to name a few.

Treatment for inflammation varies. Even though some inflammation is good as we’ve mentioned above, sometimes it’s necessary to reduce it. There are medications of course that can accomplish this. Examples include NSAIDs (Advil/ibuprofen), acetaminophen (Tylenol), and corticosteroids.

Some natural/herbal remedies have anti-inflammatory properties too. Turmeric, ginger and even cannabis are being studied for their potential anti-inflammatory benefits.

Other treatments include applying ice to the area of inflammation, consumption of fish oil (omega 3), and even green tea.

How can you do your part to help your body fight the vicious cycle of chronic inflammation? How can you potentially prevent the occurrence (in some cases) of some of the most common chronic conditions that have lifestyle related factors AND inflammation associated with them? EAT. REAL. FOOD. Just sayin’.

Now let’s get to the meat of this article. Yes, pun intended.

There are some foods that are considered anti-inflammatory that may have the capability to reduce inflammation. And on the flip side, there are inflammatory foods that may trigger your body to produce an inflammatory response, which in turn increases your risk of chronic disease.

The “anti-inflammatory diet” is made up of whole, nutrient dense and unrefined foods. Hmmm… sounds about right doesn’t it? It’s also about cutting back on junk food (obviously, otherwise I wouldn’t be bothering to write this post).

What foods have anti-inflammatory properties? Wow, I’m so glad you asked! Here’s a list of some great ones.

Fruit and vegetables! Whole fruit and berries like strawberries and blue berries, and green and brightly colored veggies like broccoli, chard, spinach, carrots and squashes.

fruit and veggies

Protein sources include most fish and seafood. Oily fish like salmon and tuna are best because they are high in omega 3s. Walnuts, almonds, pecans and brazil nuts are also recommended. Note that nuts are a source of protein and fat.

salmon

Fats and oils. Love me my fats! Omega 3s from oily fish, flax seeds, olive oil, walnut oil, avocados and nuts are some examples in this category. Note again that nuts are a source of fat and protein.

nutsolive oil

Fluids! Hydrate my friends, hydrate! WATER, real fruit or vegetable juice.

water

What foods should be avoided like the plague? Another great question, thank you for asking! Junk food, sugar, and highly processed foods may increase your risk for inflammation. Trans-fats, white flours found in bread and pasta, sodas, candy… I think you get the picture. And yes, here’s a picture of what to avoid, so again pun 100% intended. I’m so punny!

junk food

I find this one particularly interesting to be on the list of inflammatory foods. Ready for this one? Nightshades. Eggplant, tomatoes, and peppers fall into this category. There isn’t any formal research on this one, but some people report relief from their inflammation symptoms when they remove nightshades from their diet. Why is this particularly interesting to me? Another fantastic question! Because I’ve found I have some digestive sensitivities to nightshades, so this provides me with even more motivation to keep them off my plate and out of my mouth. But I digress.

nightshades

Bottom line? A diet that consists of real food can help your body maintain normal inflammatory responses to stimuli that your body SHOULD be creating inflammatory responses to. It can also help you ward off conditions that have lifestyle related components to them. What’s the moral of this story? Just eat real food!

Resources:

http://www.medicalnewstoday.com/articles/248423.php http://nutrition.about.com/od/dietsformedicaldisorders/a/antiinflamfood.htm

By the hair of my skinny skin skin

skin

It shouldn’t be a huge surprise that what you eat can affect your skin. Who HASN’T heard that chocolate or French fries will make you break out? Maybe you haven’t, but I’d have to accuse you of living under a rock if that was the case. No offense of course. Just passing out a little fun-loving judgment.

The truth is, what you eat can absolutely affect the condition of your skin. I can definitely speak for myself when I say I’ve been visited by the acne, dermatitis and rosacea fairies many times in my 40 years. A review of the literature shows that these conditions, as well as psoriasis and eczema, can all be dramatically improved in many folks when changes in diet are made. That means that paying attention to what you eat is a great way to start to identify what may be causing your skin conditions.

The standard American diet (SAD), as we know, is chock full of junk like processed foods, sugar, and unpronounceable chemicals that somehow are supposed to qualify as ingredients. Hydrogenated oils, trans fats, high fructose corn syrup, white flour, among many others. These items are not food, yet somehow they’ve made their way into our food system, and subsequently into our bodies. These anti-nutrients wreak havoc on our systems and create a perfect storm for all kinds of health related issues to ensue. Can I get a big fat YUCK?

Over time, continued consumption of these anti-nutrients create a buildup of ick in the body. While your body is efficient at filtering out ick (your kidneys and liver play major roles here), over time that ick builds up and there is only so much your body can do to keep the ick at bay. Once that ick builds up, it can start to affect your organs, including your skin! ICK!

By the way, did you know that your skin is an organ? It’s actually the largest organ in your body. It’s made up of multiple layers of tissue and functions to protect your muscles, bones and internal organs. Here is a list of functions your skin performs for you.

1. Protection: an anatomical barrier from pathogens and damage between the internal and external environment in bodily defense

2. Sensation: contains a variety of nerve endings that jump to heat and cold, touch, pressure, vibration, and tissue injury

3. Thermoregulation: sweat glands and dilated blood vessels aid heat loss, while constricted vessels greatly reduce cutaneous blood flow and conserve heat

4. Control of evaporation: the skin provides a relatively dry and semi-impermeable barrier to fluid loss

5. Storage and synthesis: acts as a storage center for lipids and water

6. Absorption: oxygen, nitrogen and carbon dioxide can diffuse into the epidermis in small amounts (related to respiration)

7. Water resistance: The skin acts as a water-resistant barrier so essential nutrients aren’t washed out of the body

Now back to some of these common skin conditions. Acne, psoriasis, eczema and rosacea are forms of inflammation to your skin. Certain foods can cause inflammatory responses in the body. Therefore, a good place to start when trying to remedy your skin conditions, along with consulting a medical professional of course, is to change what goes into your mouth!

Some of the most common dietary culprits related to these skin conditions include gluten and diary. Removing them from your diet could help improve, and even cure your skin conditions. Do remember though, that results may not be immediate. Patience is a virtue! I know, it’s not a virtue I have either, but sometimes there isn’t a choice. Your body needs time to heal the damage that’s been done to it and that can take some time. You might see positive results in a few days, or it might be a few weeks. If you have intolerances to gluten for example, it can even take from 2-5 years for your gut to heal once you remove it from your diet. Even then, sometimes longer if you’ve been eating it for decades! Skin conditions like eczema or rosacea may take months for a full recovery.

Note however that it’s not just fake, processed junk that might be affecting your skin. While this junk is a likely culprit, food allergies, intolerances and sensitivities can play a role in the condition of your skin (and overall health) too. For example, strawberries, tomatoes and eggplant have been shown to exacerbate psoriasis in some folks.

Here’s a list of some common skin offenders to help get you started.

·         Food additives: including monosodium glutamate (MSG), artificial sweeteners, preservatives, artificial flavors, and all artificial food colorings.

·         Alcohol: including beer, wine, and hard alcohol, but also including things like vanilla extract, Angostura bitters, mouthwash, cough medicine, and even     homeopathic medicines that contain alcohol.

·         Citrus fruits: oranges, tangerines, grapefruit, limes, lemons, and other citrus fruits.

·         Shellfish: including lobster, crab, mussels, clams, scallops, and other shellfish.

·         Nuts: tree nuts, including cashews, pecans, walnuts, pistachios and other tree nuts; as well as groundnuts (peanuts).

·         Corn: including corn oil, high-fructose corn syrup, vegetable oil, corn chips, popcorn, corn starch, and other corn-containing foods.

·         Dairy: including milk, cheese, butter, cottage cheese, whey, yogurt, kefir, sour cream, and other dairy foods.

·         Soy: in all its forms, including textured soy protein, tofu, tempeh, edamame, soy sauce, and soy milk.

·         Eggs: both the yolk and the whites.

·         Gluten: a protein found naturally in grains of the wheat tribe, but also present through contamination in many other foods. Avoid pasta, flour, breads, cereals, cookies, and other foods made with gluten grains. Grains found to contain gluten include wheat, kamut, spelt, triticale, barley, rye, and sometimes oats.

·         Sweeteners: honey, maple syrup, white sugar, brown sugar, fructose, dextrose, maltose.

So what’s next? Get started! Play around with your diet. Try removing some of the commonly known skin offenders, and load up on that real food! And don’t forget, it’s best to seek the advice of a knowledgeable health care professional (doctor, dermatologist, dietitian, nutritionist) because they have the medical and clinical knowledge needed to appropriately and personally guide you on your journey to better skin and better overall health!

Something to keep in mind in addition to removing some of the commonly known offenders from your diet to treat skin conditions, is that the best diet for optimal health AND clear healthy skin is a diet composed of real food! That means eating real food EVERY DAY and doing what you can to shun the SAD and it’s so called food substances. Sorry folks, that stuff isn’t food and it has no business being called food, let alone being put into your mouth!

Go! Really. Go now and stock up on real food. This article is done. No more to read here. Happy real food eating!

Resources:

http://en.wikipedia.org/wiki/Skin

http://www.dermaharmony.com/skinnutrition/eliminationdietforskinconditions.aspx

Fatty liver. Fat isn’t always where it’s at.

Fatty fat fat. My usual motto is “fat is where it’s at!” when it comes to including healthy, real food, paleo style fats in your diet. HOWEVER, I have to modify this statement for this post. While consuming healthy fats is good for you for zillions of reasons, well maybe not quite zillions but a lot of reasons for sure, one thing you don’t want to have is a fat[ty] liver!

I know, random topic. Here’s the deal. I was talking to a friend of mine over the weekend, having dinner and drinking wine, and we got on the topic of fatty liver. Talking about fatty liver while drinking alcohol sounds appropriate don’t you think? Given we were curious about the subject based on recent rumblings amongst our circle of friends, I decided to so some R.E.S.E.A.R.C.H.!

Having some fat in your liver is normal. Some people with excess fat in the liver simply have what’s called a fatty liver. While this is not normal, it is not serious if it doesn’t lead to inflammation or damage. But if fat makes up more than 5% to 10% of the weight of your liver, you may have alcoholic or nonalcoholic liver disease, both of which can lead to serious complications.

Fatty liver (FL), also known as fatty liver disease (FLD), is a condition where triglycerides accumulate in the liver. Triglycerides are a type of fat found in your blood and your body uses them for energy. There are many causes, but FLD generally occurs in those that consume alcohol in excess, and in those who are obese. FLD can be associated with other diseases that influence fat metabolism, and metabolic syndrome. Metabolic syndrome is a combination of high blood pressure, high blood sugar, too much fat around the waist, low HDL cholesterol, and high triglycerides. Metabolic syndrome increases your risk for heart disease, diabetes, and stroke. There may be nutritional factors contributing to FL as well, such as gastric bypass, diverticulosis, and bacterial overgrowth. FL can be also be related to drugs and toxins, and other things like HIV, IBD (irritable bowel disease) and hepatitis C.  So while you may think FLD is most commonly associated with alcohol consumption, there can be other causes as well.

First let’s address alcohol related fatty liver disease. There are some interesting stats. At least I find them interesting. But I also just like stats in general. That’s kinda how I roll.

*More than 15 million people in the U.S. abuse or overuse alcohol.

*Almost all of them, between 90% to 100%, develop fatty livers.

*Fatty liver can occur after drinking moderate or large amounts of alcohol.

* Fatty liver can even occur after a short period of heavy drinking (acute alcoholic liver disease).

Genetics or heredity can play a role in alcoholic liver disease too [feel free to thank your folks]. This is because genetics and heredity can affect how much alcohol you consume and your likelihood of developing alcoholism. They also can have an effect on the levels of liver enzymes you have that are involved in the metabolism of alcohol. Obesity and diet can also contribute to the development of alcoholic fatty liver disease.

Ok, so what about nonalcoholic fatty liver disease (NAFLD)? NAFLD is now the most common cause of chronic liver disease in the U.S.! Some people with NAFLD have what’s called nonalcoholic steatohepatisis (NASH). Steatohepatisis is when there is inflammation and liver damage present. NASH is similar to alcoholic liver disease, but people with this type of fatty liver disease drink little or no alcohol. NASH can lead to permanent liver damage (cirrhosis), and is one of the leading causes of cirrhosis.

More stats, yay! These are in relation to NAFLD and NASH.

*Up to 20% of adults may have either NAFLD or NASH.

* More than 6 million children have one of these conditions. Yes, children!

The cause of NAFLD is not clear, but certain factors tend to increase risk. In some cases no risk factors are present. NAFLD tends to run in families. Studies also show that an overgrowth of bacteria in the small intestine, and other changes in the intestine may be associated with NAFLD. Some researchers now suspect this may play a role in the progression of NAFLD to NASH.  NAFLD also shows up most often in people who are middle-aged and overweight or obese, and in those with high cholesterol, high triglycerides (dietary sugar and alcohol consumption contribute here), diabetes and prediabetes or insulin resistance. Yep, lifestyle. Boom. Given many other identified health issues that have come to rise in the last several decades that can be attributed to lifestyle related factors, this does not surprise me. Of course I’m referring at least in part to the standard American diet (SAD). Oh the havoc that thing has wreaked!

Fatty liver disease often has no symptoms. If the disease advances, which usually occurs over the course of years or even decades, it can cause problems like fatigue, weight loss or loss of appetite, nausea, weakness, brain fog (confusion, trouble concentrating), pain in the center or right upper part of the abdomen, an enlarged liver and even skin discoloration (usually on the neck or underarm area).

With alcoholic liver disease, symptoms may worsen after episodes of heavy drinking, and with NAFLD, the disease process can stop or reverse, or it may worsen. If cirrhosis develops, signs and symptoms can include fluid retention, muscle wasting, internal bleeding, jaundice (yellowing of skin and eyes), and eventually liver failure.

Diagnosis often occurs during a routine checkup. The doctor might notice that your liver is slightly enlarged, or she might see signs of fatty liver on a blood test, because during routine blood tests, elevations in certain liver enzymes may show up. A fatty liver may also show up on imaging tests, such as an abdominal ultrasound. The only way to confirm a diagnosis of fatty liver disease is with a liver biopsy.

The treatment of fatty liver depends on its cause. In general, treating the underlying cause will reverse the worsening of the condition if implemented at an early stage. Again to be clear, we can gather that the two main known causes of fatty liver disease are an excess consumption of alcohol and diet (both of which can be exacerbated by genetics).

If you have alcoholic liver disease and you are a heavy drinker, quitting drinking is the most important thing you can do. Even for those with NAFLD, avoiding alcohol may help.

If you are overweight or obese, do what you can to lose weight in a healthy way. Avoid diets rich in refined, rapidly digested carbohydrates. Yes, that means sugar and processed food/carbohydrates. This includes limiting foods such as bread, grits, rice, potatoes, corn, and concentrated sugar. In other words, EAT REAL FOOD! And get some exercise too.

Avoiding unnecessary medications is also important. The liver is a detoxification filter for your body, so putting any sort of chemical weirdness into your body adds stress to the liver as it works to cleanse your system. Medications can be hard on the liver. If you don’t need to take them, don’t. Of course talk to your doctor before stopping (or starting) any medications. Even vitamin and mineral supplements can cause health problems and adversely affect the liver, especially if your liver is already compromised. The best way to get the benefits of vitamins and minerals is through sources of REAL FOOD that contain those vitamins and minerals. Again, talk to your doctor about any medications and/or supplements you are taking if this topic is of concern.

[In case you were wondering, not only does your liver detoxify your body, it also functions in protein synthesis, and produces biochemicals needed for digestion. You can’t survive without a liver!]

If liver cirrhosis becomes severe, the treatment is liver transplant. And that ain’t gonna be no fun.

The moral of the story is this. EAT REAL FOOD, get your workout on, and depending on your condition, either drink in moderation or better yet STOP DRINKING. And make sure your doctor is kept in the loop.

fatty liver

http://www.webmd.com/hepatitis/fatty-liver-disease

http://en.wikipedia.org/wiki/Fatty_liver

http://www.webmd.com/cholesterol-management/tc/high-triglycerides-overview

http://en.wikipedia.org/wiki/Liver

http://www.livestrong.com/article/134444-foods-avoid-fatty-liver/

Niacin supplements, naughty or nice?

I called it. Self fulfilling prophecy? Maybe (and thankfully I dodged that bullet). My [alkaline] water man has ventured into deep waters. So deep I can’t find him. Darn (sarcasm). Huh? I know, here. Read this.

http://alliefitfoodie.com/2013/10/13/for-the-love-of-water/

In a nutshell (food pun intended), he kept insisting on dropping off water for me. I have water. My water hasn’t been run through a $2,000.00+ water filter to make it alkaline, but I assure you I’m fairly well hydrated. My water comes out of my sink. I know many may think that’s gross but I do drink out of the faucet.  I also have an in-the-door fridge water filter. So thanks Mr. Water, I’m good to go. I really don’t need you to drop off water at my gate. I appreciate it but modern plumbing allows me to retrieve my own water from… my pipes.

Good bye water. Hello niacin! No I didn’t meet niacin man this week. A friend of mine is interested in holistic and Eastern based medicine and she’s been hearing a lot about niacin lately (and its use as a supplement for energy). She asked me what the deal was. Honestly I didn’t know.

RESEARCH TIME!

Niacin is also known as vitamin B3. It’s an essential human nutrient. That means the body doesn’t make it on its own. It comes from the ingestion of niacin containing nutrients and compounds (food). Niacin is most important for assisting the body with the production of energy (ok I see why my friend has heard of niacin supplementation for energy). It helps convert the foods we eat into energy that the body uses to function.  Niacin also helps our bodies use calcium. It gives us healthy skin, hair and nails, and can be prescribed for the purposes of cardiovascular health, such as lowering cholesterol levels. Because niacin is a water-soluble vitamin, the body doesn’t store it. That means you need a consistent stream of it in your diet for it to do its thing.

Niacin can be found in a variety of foods. Animal foods have the highest levels of niacin. Think liver, chicken, beef, and fish. Cereal, peanuts and other legumes (not paleo, just sayin’) are also sources of niacin. Fruits and vegetables contain small amounts of it.

niacin-food-sources

Because niacin is so important in the production of energy in the body, one of the first signs of deficiency is fatigue. Some other side effects of niacin deficiency include scurvy, and vitamin D deficiency. Niacin deficiency is SOMETIMES seen in developed countries. It’s usually apparent however with alcoholism, and in conditions of poverty and malnutrition. Mild symptoms of niacin deficiency can also lead to a red, swollen tongue or canker sores in the mouth. Serious cases of deficiency can lead to pellagra, which is a disease that is almost nonexistent nowadays. Pellagra causes skin problems, cloudy or fuzzy thinking, diarrhea, and can lead to death if untreated.

There can be side effects to niacin supplementation that include skin flushing, itching, nausea and vomiting. In large doses and in severe cases, niacin can also damage the liver.

Now that I’m reading the research I can honestly say I have no clue why my healthy 30 something year old female friend would be interested in niacin supplementation. It seems to me that if you eat a diet composed of a variety of REAL FOODS, you’re covered.

I did find a resource that notes of a trend in folks using niacin as a detoxifying agent. Maybe the perception is that since it causes flushing of the skin, people just focus on the word “flushing” and think that means it will clean out their systems? Beats me. But in this case flushing refers to redness of the skin, not a flushing of toxins from the body.

Since I mentioned flushing and detoxifying (aka cleansing), I thought I’d briefly address that. I DO NOT believe in cleanses. How do you detox your body and flush out the toxins? Listen folks, the only way to keep your system clean is to STOP putting crap into it in the first place. If you don’t put crap in, there is no crap that needs to come out. Normal elimination of course is the exception. If you are aware enough to think “Hmmm, I’m going to eat this cake and this pasta all week, and THEN next week I’ll just detox and do a cleanse…” then you should be aware enough to know the smart thing to do is just not eat that stuff in the first place! Cleanse shmeanse. Your body is perfectly equipped to cleanse itself. Not taking my word for it? How about the word of Dr. Oz? I do love me some Dr. Oz! He notes how we hear about the benefits of cleansing (or detox diets) and the associated promises of losing 20 pounds in less than that number of days. Such rapid weight loss on what can be called starvation diets can rob your body of vital nutrients and calories. Sure you’ll lose weight. You’ll also slow down your metabolism, and when you start eating again, guess what. The weight comes back.

Our bodies are naturally chock full of enzymes that have the job of breaking down toxins we come into contact with such as those found in the foods we eat. Examples are pesticides, microbes, and mercury. Toxins are also in the air we breathe, in the form of disinfectants and deodorizers for example. The enzymes in our bodies break down these toxic substances so the body can NATURALLY flush them out. Dr. Oz’s “cleanse” (and I LOVE this) involves eating whole foods that are packed with nutrients believed to boost the activity of the enzymes and nourish the body’s most important detoxifying organs. Which organs are these? The liver, the lungs, the kidneys, and the colon!

NO I AM NOT RECOMMENDING A CLEANSE, NOR AM I RECOMMENDING DR. OZ’S CLEANSE. I’m just pointing out that a healthy diet of real food IS A CLEANSE in itself and is the only type of cleanse your body really needs to keep functioning at optimal levels. And if you don’t believe me, believe Dr. Oz! End cleanse rant.

You can catch the full article from Dr. Oz here.

http://www.oprah.com/health/Dr-Oz-on-Cleansing-Do-You-Need-a-Cleanse

Anyhow, I think we can put a fork in this one (another intended food pun). I’m going to recommend to my friend that she follow a lifestyle that incorporates eating real, whole food (since that’s where her needed energy will come from) and steer clear of niacin supplements, unless there is some reason her doctor prescribed them to her that I’m not aware of.

Resources:

http://scientopia.org/blogs/neurodynamics/2011/03/21/fun-with-false-claims-niacin-for-detox-edition/
http://www.livestrong.com/article/39072-niacin-benefits-side-effects/

http://en.wikipedia.org/wiki/Niacin

For the love of water

I met a man! This one isn’t into superfoods (I don’t think), and his diet consists of more than kale, seeds, nuts and berries. Don’t know what I’m referring to? Check out my last post on superfoods.
So this new man is into alkaline water. Yep, alkaline water. He’s part of a multi-level marketing scheme [I mean program] and sells the stuff. On our first “date” he sat me down, showed me promo videos, and sent me home with several huge jugs of alkaline water. I know, there is always some sort of baggage. It’s just a matter of finding someone whose baggage my stuff can fit in. Does my stuff fit in an alkaline water bag? I don’t know yet. So I thought I’d do a little research to see if this relationship has a fighting chance. Oh heck, forget about fighting, let’s just see if there is a chance.
I’ve seen a lot of information out there lately on alkaline versus acidic foods and how they affect your body, digestion, and health. I’ve also been seeing lots of promos for alkaline diets.
Why an alkaline diet? As the story goes, it’s based on our body’s pH, which is a measure of how acidic versus alkaline our bodies are. The pH scale goes from 0 which is completely acidic, to 14 which is completely alkaline. So a pH of 7 is completely neutral.
Different parts of our bodies have different pHs. Your stomach is extremely acidic, around 1.35 – 3.5 and you need your stomach to be so acidic in order for it to digest the food you eat. Which of course is REAL FOOD right? No pressure, no guilt, just make sure you eat that real food ok? Ok. Good. While your stomach is very acidic, your blood for example, is always (should always be) more alkaline with a pH of 7.35 – 7.45.  The body does regulate pH on its own. And it makes sense that it does, since different parts of the body have different pH levels. The body would have to “know” what pH your stomach should be versus your blood.
With the alkaline diet (and by drinking alkaline water I’d assume), the premise is that you can help your body maintain an ideal pH which promotes optimal health. Ok, but since different parts of your body have different pHs, what is AN ideal pH, and how does eating a certain way affect your body’s pH [given the fact that it's different throughout your body]?
Alkaline promoting foods include fresh vegetables and fruits, soy products, nuts, grains, and legumes. I am not a fan of soy as you might already know, so that alone makes me cringe. Promoters of alkaline diets discourage eating acid-promoting foods including meat, fish, poultry, dairy products, processed foods, white sugar, white flour, and caffeine. No meat? I’m cringing again.
There are reported benefits of this diet that include lowering the risk of kidney stones, slowing bone loss and muscle waste, increasing growth hormone and lessening the risk of some chronic diseases. There are also claims that this diet can prevent cancer. There is no concrete evidence to support these claims however.
“Clinical studies have proved without a doubt that people who eat more fresh fruits and vegetables and hydrate properly do have lower rates of cancer and other diseases, but it probably has nothing to do with blood pH.” Interesting [since I started this random rant about water] that those who properly HYDRATE seem to have lower rates of cancer and other diseases. So does it really matter if the WATER is alkaline or is it just that it’s water? Also, I notice here that the foods included in this diet, while many are not paleo, are in fact REAL FOODS. Ya think that might have something to do with the reported benefits as well? Hmmm…
“There are some pitfalls to following an alkaline diet. Such a diet can overly restrict protein.” Yeah, now that’s what I’m talking about. I. EAT. MEAT. And a lot of it. Restriction of protein is SO not my thing. Just keeping it paleo over here.
While I do suspect that the standard America diet (SAD) can create an overly acidic environment in the body, I still believe that the body does have the ability to regulate pH as needed and kick SAD booty! I don’t know if there is a point at which the anti-nutrients kick in and take over, leaving the body unable to continue to regulate pH on its own however.
Studies have clearly shown the SAD and all that it’s made up of is a major culprit in many chronic diseases, but is the pH factor also a piece of that puzzle? That I don’t know. I do believe a diet composed of real food can fight many chronic diseases that have lifestyle related components to them, and maybe pH is a part of that.
So does my baggage fit in an alkaline water bag? I don’t think so. Is it worth drinking the Kool Aid (proverbially of course) for a little while to see what might transpire? I do think so. I should mention, this man is also a chiropractor. And who doesn’t need a massage or a little adjustment on a regular basis?
Stay tuned. Or not. With my track record for relationships this one could be kaput before my next weekly blog post. But I might have some alkaline water left to remember the experience by, several huge jugs that I can brew some kombucha in, and maybe, just maybe I can achieve perfect alignment.
Resources