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Smell the coffee

23/5/2017

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Until recently, I had avoided coffee for many years, because I noticed that just one cup a day caused my heart to go all a flutter.  For some reason, though, I can now enjoy the occasional cappuccino, and not get, what at the time, were worrying palpitations – I now understand, of course, that for most of us these are not actually a sign of disease.
 
Some say their morning brew of roasted coffee beans is “essential” to a routine – the day would otherwise not run smoothly without a kick-start from that bitter liquid.  So it can be a disappointment to find that coffee is a trigger of their gut problems.  
 
My IBS patients who have their suspicions about coffee, report contrasting symptoms, ranging from bowel urgency to constipation.  As with most problem foods or drinks, tolerance can be dose-related, so one cup of coffee might be okay for some people, but exceeding that threshold brings on trouble.
 
Is it always the coffee itself that is the culprit in that aromatic brew?  A milky coffee, such as a latte delivers several potential suspects to an irritable gut: coffee components, such as caffeine; lactose which is the sugar naturally present in milk; and A1 protein, present in the majority of cows’ milk available in the UK.
 
Simple experimentation can help pin-point the source of the trouble in that hot drink.  Does drinking it black trigger symptoms?  If not, try coffee with A2 milk – this does not contain A1 protein.  No better?  Then try it with lactose-free milk.  It’s important to wait until symptoms have settled before moving on to testing the next milk – and remember to ensure that all other suspected triggers are avoided during the experiment.
 
If black coffee does upset your gut, then it might be time to start the day with a different beverage.  And who knows, giving the gut a ‘coffee break’ for a few months or so might be what it needs to develop tolerance to some coffee in the future.  It worked for my heart!

Tony Hirving, RD

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Chew on this ...

4/4/2017

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During my childhood, chewing gum, or eating food whilst walking down the street, was viewed as rather rude by many people. This was certainly the view of our mother.  Few, apparently harmless, habits annoyed her more than the sight, and sound, of the smacking of lips, whilst giving the world and his wife fleeting glimpses of "chewing gum bouncing in their gob”. 
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​It was a “disgraceful” habit and, as kids, we’d never let her see us chew a stick of Wrigley’s Juicy Fruit, which we did with such vigour, to fully enjoy the flavour, which was there one minute and disappointingly gone the next.  As an adult, I do get her point.  The sight and sound of someone chewing gum, especially open-mouth lip smackers, is not nice.  

And it may be detrimental to our well-being. Putting aside the benefit it can have on our dental health, gum chewing can be a source of gut trouble for some people. The action of chewing produces saliva. Although this has wonderful bacteria-busting properties, excess saliva must be swallowed (the other option would send mother into a red-faced rage), and the more we swallow, the more we are likely to swallow air.

Swallowed air has to go somewhere.  A small amount of it may be absorbed into the blood stream, and the rest will be burped (pardon me) or travel south to be expelled (it wasn’t me, honest). Also, swallowed air awaiting its fate, might be a source of discomfort, contributing to other causes of tummy trouble, such as eating a very large meal.

Chewing gum sweetened with sugar alcohol may bring double trouble.  Sorbitol, xylitol and mannitol are among the FODMAPs that cannot be digested by our own gut enzymes, which means that these sweeteners end up in the colon where they are fermented by the resident bacteria.  Gas is one of the products of colonic fermentation – and the gas, of course, is expelled as wind.  

Even if you don’t chew gum, it’s worth paying attention to how you eat. Those who chomp through meals quickly, or eat with their mouth open, are more likely to swallow more air than normal. Carbonated drinks, drinking through a straw, slurping tea and sucking sweets are other ways by which air finds its way into the digestive tract.  Also, talking too fast and anxiety can lead to mouth breathing, which makes air swallowing more likely.

So, some gut-friendly habits to adopt: eating at a leisurely pace, whilst keeping the mouth closed and not talking too much (at least not with a mouthful of food!).  Addressing sources of anxiety is a positive step for both mind and body well-being, just try to find a way of managing this that doesn’t involve chewing gum!

Tony Hirving, RD
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Blessed nuts ...

3/3/2017

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“Blessed are the cracked, for they let in the light" captures the duality of much in life. We all know a nut when we see one, don’t we?  I don’t talk to myself.  No, I just sometimes talk aloud!!!  Nuts come in all shapes and sizes, from coconut to peanut, through to chestnuts and walnuts. You may love them, be indifferent to them or even cross the road to avoid them, but they are a true wonder to behold.
It’s not really surprising that nuts are packed with energy and nutrients, when you consider the raison d’etre of these little things – they become huge things.  Nuts are loaded with protein, fats, carbohydrate, vitamins, minerals and many other components needed to kick-start tree growth. Putting the allergenic protein content aside, certain nutrients in nuts can bring on gut trouble when consumed beyond individual tolerance.

Although the majority of the fat in nuts is the ‘healthy’ unsaturated type, this is as much of a challenge to our digestive system as are ‘less heathy’ saturated types when it comes to breaking them down for absorption.  Nuts are also rich in fibre. Too much of any type of fat or fibre can be problematic.

How much is too much? Your own gut can tell you this.  Getting enough fibre is a ‘healthy’ eating target for everyone, but for some of us, consuming even a little more than the recommendation may be the tipping point that leads to production of loose and frequent stools.  And the same for fat, of course.  Our own gut is the best way of figuring out how much is too much.

The tricky bit can be knowing where the starting point should be when modifying fat and fibre intake.  Making better choices, such as those suggested as part of the Starter diet recommended by Eat2beat IBS, and doing the gut-friendly habits we also encourage, may be all someone with bloating, tummy pain, and other gut symptoms, needs do to get satisfactory relief.

And where do nuts fit into this?  As said, these are a truly nutritious food, and if the intake of fat from far less wholesome fare, such as crisps, cakes, biscuits and the rest is cut-back, then nuts, in moderation, are usually well-tolerated – just be aware that ‘healthy’ foods, as well as junk, can be a source of gut trouble!

Tony Hirving, RD
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    A Registered Dietitian fascinated and curious about all things living (especially humans!), what makes them tick and what keeps them in good nick.

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