Category: Nutrition

Convenience Isn’t Healthy: Chronic Illness and Diet

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When I was diagnosed with fibromyalgia three years ago, my diet was all about convenience. I came to the conclusion that eating healthily was just a luxury that I could no longer have. I tried to generally to choose healthier convenience food options. For example, a whole-grain cereal instead of refined grain, or a low-fat frozen lasagna instead of full-fat. A typical day looked like this:

Breakfast: Multigrain Cheerios with a banana (251 Calories)

Snack: Yogurt (115 Calories)

Lunch: sandwich with deli meat, granola bar, carrot sticks (348 Calories)

Snack: Trail mix (352 Calories)

Dinner: Spaghetti (store bought pasta sauce) (344 Calories)

Snack: Slice of Toast (69)

Total: 1538 Calories (Calculated at Super Tracker www.supertracker.usda.gov)

So, calorie-wise not so bad. However, as any nutritionist can tell you, calories are only a small part of the nutrition story. If I ate 1500 calories in chocolate, it would only be delicious, not healthful.

What was wrong with my diet?

  • Grain heavy: I had a total of 240 g of grains, which is over the USDA recommendation of 170g or 6 oz for a woman my age. While grains provide benefits like fiber, eating too much of this food group can lead to weight gain.
  • Protein policy: in total, 16% of my food intake was protein. While this is within the acceptable range set by the USDA, dieticians recommend your protein daily allowance should be calculated using this formula: 0.8 x weight in kg (easily converted using any online converter). For me, this comes to 52 g per day. Protein should be distributed between all meals to help sustain energy. In my case, breakfast and dinner were primarily carb based. http://www.livestrong.com/article/343966-how-to-calculate-protein-rda/
  • Sugar high: in total, I had over 90 g of sugar! The World Health Organization recommends that less than 10% of your daily energy consumption should come from sugar, with added health benefits coming from less than 5%, or approximately 25 g. My sugar total was almost 4 times that much! This is bad news for my blood sugar levels and weight management, never mind long-term health consequences. http://www.who.int/mediacentre/news/releases/2015/sugar-guideline/en/
  • Nutrition deficient: I had less than four servings of fruits and vegetables (banana, carrots, raisins, tomato sauce). This means I was getting an inadequate amount of micronutrients (vitamins and minerals), and losing out on the many other benefits of these healthy foods such as antioxidants and fiber. Furthermore, the servings I did have were primarily starchy vegetables or high glycemic fruits, which only added to my blood sugar concerns and weight gain.

Overall, I gained 20 pounds in a year and went up a dress size. I was also permanently fatigued. For anyone coping with chronic illness, sustained energy is a significant challenge. Balancing macronutrients – carbs, protein and fat – along with factors such as fiber and sugar, is important for preventing spikes in blood sugar that inevitably lead to energy crashes. According to the Mayo Clinic, based on a 2000 calorie/day diet, the total daily allowances should be:

 

Nutrient Percentage Grams
Carbohydrates (vegetables, fruits, grains) 45-65% 225-325
Fiber   Female: 22-28; Male 28-34
Sugar   Female: 24g; Male: 36
Protein 10-35% 50-175
Fat 20-35% 44-78
Saturated Fat 7-10% 16-22

http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/how-to-eat-healthy/art-20046590?pg=1

Maximizing micronutrients (vitamins and minerals) is also key healthy eating. Adequate intake of nutrients like Iron and B vitamins have been linked to improved energy levels, while others like Vitamin D and Magnesium help reduce chronic pain. In addition, chronic illnesses like fibromyalgia have been linked to high rates of oxidation, so eating antioxidants is important to counteract these effects.

The USDA recommends at least 2 ½ cups of vegetables per day for women and 3 cups for men, and 1 ½ cups of fruit per day for women and 2 cups for men. The USDA recommendations have been critiqued, which is another post altogether, but provide guidelines that are much healthier than the Standard American Diet www.choosemyplate.gov.

The Magic Bullet of Nutrition?

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Do you remember the part in the Father of the Bride when the marriage is almost cancelled over a blender? The groom-to-be gifts his fiancee with a blender and she is furious because she takes it to mean he expects her to be a 1950s housewife!
My significant other remembers this and so it was with great reluctance that he bought me the birthday present that I asked for – a Nutribullet blender. But he wrote me a very romantic letter to make up for it!
I’m actually kind of a nutrition nerd so it’s a great gift from my point of view. I also have high hopes that it’s going to make me feel better.
First of all, what is a Nutribullet blender? It is a high powered blender that makes “a nutrient extracted drink designed to feed your system as many servings of easily absorbable fruits and vegetables as possible”.
I got the Nutribullet Pro blender. It comes with four BPA free plastic containers so you can choose the size of smoothie you want to make. The containers have lids for storage so you can take your smoothie with you. The blender has a powerful 900w motor so the smoothie is ready in seconds. The idea is to make the nutrients as bioavailable as possible by fully breaking down the veggies and fruits – and taking stress off the digestive system. Unlike juicing you get all the fibre in addition to the nutrients. The maker claims the Nutribullet doesn’t oxidize the smoothie as much as other blenders because of its speed and cyclonic action … But you have to drink it right away.
The blender comes with smoothie recipes, called Nutriblasts. The basic formula involved 2 cups of leafy greens, 2 cups of fruit, and a ‘boost’ of nuts or seeds, like chia seeds or almonds. It also comes with a recipe book that includes recipes for FM! It’s pretty affordable at around $115.
The best thing about the Nutribullet is the convenience. When I first got fibromyalgia I gave up on eating healthily because of all the work involved in cooking whole foods from scratch. As time has passed I have learned that the only way to manage this condition effectively is through lifestyle choices – making time for gentle exercise (walking, yoga, qi gong, tai chi), taking supplements, going for body work appointments (massage, physio, osteopath) … and eating well, most importantly. But my healthy eating choices have to be quick and easy to be viable. Throwing a cup of leaves, a banana and frozen berries into a plastic cup meets these criteria! I used to try to use my giant blender but it’s hard to clean, heavy and made more dishes. Most of the time it ended up in the fridge for a week with quickly separating smoothie servings left in it.
Although this particular product works for me, I think whether you use an old Oster work horse blender, a juicer or a vitamix, green smoothies are one if the best things you can incorporate day to day if you have chronic pain and fatigue.

Natural Treatments for Fibromyalgia: Healing Your Digestive Tract

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natural-treatment-for-fibromyalgia-healing-the-digestive-tract

I’ve just started a new naturopathic protocol, focusing on healing my digestive tract.My naturopath wants to start with the digestive tract for a couple of reasons. First of all, my IBS and pelvic pain symptoms suggest that my G.I. tract is inflamed. One cause of digestive problems is “leaky gut syndrome” – a colourful name for a condition in which the the digestive lining becomes too permeable, or “leaky”, allowing partially digested proteins and harmful substances/microbes into the bloodstream. These foreign particles are attacked by white blood cells, causing inflammation and overtaxing the immune system. Inflammation like this can prevent absorption of necessary nutrients and energy, which can in turn aggravate chronic illness symptoms. This might also affect my ability to absorb other supplements that I need, so it seems like a good place to start.

Secondly, the digestive tract is a critical part of the immune system. Inflammation, microflora (bacteria and other microbes) imbalance, and yeast overgrowth are probably all issues that I need to address. Having my immune system all tied up addressing these problems could be significantly impairing my body’s ability to function in other ways. Fatigue, pain, poor tissue repair, susceptibility to infection and other fibromyalgia and chronic fatigue symptoms can be aggravated by immune dysfunction. Freeing up my immune system from dealing with digestive inflammation and microbe imbalance could enable healing and re-energizing down the line. Here I want to share research on supplements that can help heal the digestive tract lining – an important step to help manage fibromyalgia symptoms. If you are interested in additional steps, I’ve written about the benefits of Probiotics and Fibro in a separate post and avoiding  foods that you are sensitive to, based on food sensitivity testing and/or an elimination diet.

  • L – glutamine is an amino acid (protein building block) produced in the body, stored in muscles and the lungs.* It has a number of functions in the body, including eliminating excessive ammonia waste, helping to provide nitrogen and carbon ‘fuel’ to cells, and helping in the synthesis of other amino acids and glucose, among others. Although the body usually produces adequate amounts of glutamine, in times of stress or illness the body’s production may be insufficient. Glutamine is included in this supplement in order to supply a source of fuel and precursors for growth to the rapidly dividing cells of the intestinal lining”.
  • deglycyrrhizinized licorice (DGL) licorice has been traditionally used in many cultures to promote health. This form removes an element in licorice called glycyrrhizin which can cause water retention, edema and hypertension issues. DGL is effective for treating gastric irritation, ulcers (one study found it to be as effective as a common over-the-counter medicine), heartburn, and other digestive problems. It also may be helpful for treating adrenal gland problems and reducing fatigue.**
  • aloe helps to heal inflamed intestines and can promote the integrity of the digestive lining. Aloe has a few properties which ease this process, which include balancing the pH of the G.I. tract, and antimicrobial properties which aid in healing.*** This may counteract leaky gut symptoms.

 

These ingredients are all included in a supplement called Metagenics Glutagenics. My dose is 1/4 teaspoon two times daily (of powder mixed into water).

*http://umm.edu/health/medical/altmed/supplement/glutamine

**http://www.huffingtonpost.com/julie-chen-md/dgl-supplements_b_2976260.html

***http://www.crohns.net/Miva/education/aboutaloe.shtml

http://www.webmd.com/digestive-disorders/features/leaky-gut-syndrome

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Trying to Digest

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Stomach Pain

I thought that I would blog about something that is very close to my, …er, stomach. During the course of the last year, I’ve had to come to terms with adding irritable bowel syndrome (IBS) to my list of conditions. This isn’t all that unusual; according to the Chronic Pain Research Alliance, several chronic pain syndromes often co-occur in patients, and these include chronic fatigue syndrome, endometriosis, fibromyalgia, interstitial cystitis, irritable bowel syndrome, temporomandibular disorders, and vulvodynia. The CPRA points out that none of these conditions are understood well, and the relationships between them are equally unclear. Consequently, many physicians are inadequately trained to treat chronic pain syndromes, resulting in the misdiagnosis or incorrect treatment of patients.

In my case, the first gastrointestinal problems began about two years ago when I started having severe cramps when I had to ‘go’ to the bathroom during my menstrual cycle (I’m trying to keep this as non-graphic as possible, but any post on IBS is going to have TMI). My gynecologist thought it was most likely endometriosis and put me on the birth control pill, which did significantly reduce the pain. Over the next year, my fibromyalgia symptoms blossomed, so I was put on long-acting tramadol (synthetic opioid). One of the downsides of narcotics is constipation. Other than that, I have had the regular IBS symptoms of bloating, abdominal pain and irregularity. The usual culprits are whole grains, cruciferous veggies (broccoli, cauliflower, brussels sprouts), some beans and too many citrus fruits. Finally, last summer (2012) I started having episodes that are similar to stomach flu. They typically last for about 24 hours and include frequent urges to ‘go’, sleeplessness, sweats and chills (but no fever), and skin tingling or crawling. These are probably among the worst experiences I’ve ever had. In total, I’ve had about five of these episodes. The triggers seem to be eggs and beef. A naturopath did a food sensitivity test for me once and I have a food intolerance to eggs. The beef I can’t explain.

The most relevant article I’ve found to explain these episodes is called ‘Food intolerance is linked to different disorders’ by Science Nordic. The article focuses on research by Arnold Berstad and colleagues at Lovisenberg Diaconale Hospital in Oslo. Berstad conducted a study with 84 participants who had unexplained digestive problems that they attributed to food intolerances. The research team administered a provocation test in which the patients were given a non-digestible carbohydrate called lactulose to eat. The provocation test re-created the symptoms of digestive distress experienced by the patients, proving that their complaints were not psychosomatic. Researchers suspect that the indigestible carbohydrates were not absorbed in the small intestine, but fermented by intestinal microbes in the large intestine, resulting in the digestive problems. One result of this study was that patients were observed to get chills as part of their reaction to the provocation test, in addition to digestive upset (bloating, gas, and pain). This is the only mention in all of my research to food intolerance reactions which includes both G.I. tract distress and body wide symptoms like chills. Significantly, the researchers found that all but one of the participants were symptomatic of IBS, 84% were symptomatic of chronic fatigue syndrome and 71% were symptomatic of fibromyalgia. The authors of the study suggest that an imbalance in intestinal microbes might be part of a common disease mechanism for all three overlapping conditions. Other researchers dispute the claim that the cause of the three chronic pain diseases is intestinal, but agree that it might play a role.

This article was significant for me to understand the confusing and extremely unpleasant symptoms that I was experiencing. I still believe that some of my episodes result from eggs, not only difficult to digest carbohydrates, just because often the only food preceding an episode that differed from my usual diet has contained eggs – like lemon meringue pie or ranch dressing. My solution has been to focus more on taking care of my fussy intestines. I’ve been taking a probiotic called Align which is specifically formulated for IBS. It has a patented bacteria called Bifidobacterium infantis 35624, which has been clinically proven to reduce IBS symptoms. It’s a little bit pricey, so taking generic probiotics that include Bifidobacterium might also be helpful. I think eating foods rich in probiotics are beneficial. I like yogurt the best, but some people swear by miso and other fermented soy products. You’re probably better off with supplements though if you have a sensitivity to dairy or soy. I’ve also been feeling much better eating a high soluble fiber diet. There are two kinds of fiber – soluble and insoluble. Soluble fiber creates a gel in the intestinal tract, made up of the unabsorbed fiber dissolved in water, which helps with both kinds of irregularity. It slows down the transmission time of food in the gut but also creates enough bulk to ensure passage. In contrast, insoluble fiber just pushes through the gut, and can create problems with loose digestion, and also cause bloating or gas. High soluble fiber foods include oatmeal, squash, carrots, apples, oranges, flaxseed, potatoes, some beans/lentils and (according to some) French bread and white pasta. Also Metamucil (without irritating artificial sugars) is very helpful because it contains psyllium husks that are high in soluble fiber. Of course avoiding trigger foods is also key. IGG Food sensitivity tests, although critiqued by some, can help give you an idea. For me, the test that helped identify a food intolerance to eggs was totally right on.Lastly, I eat a plant-based diet that is focused on high nutrition, created by Dr. Fuhrman, and adapted to accommodate my IBS. I’ll write more about that another time, but the focus is on phytochemicals, antioxidants, micronutrients, anti-inflammatories and all the other benefits of fruits, veggies, grains, nuts and seeds, to give my body a fighting chance. I’m also big advocate of moderation, and not obsessing too much over rigidly following supplements and diets – I love food too much (even though we have a complicated relationship) to kill my enjoyment with dogmatism!

References:

About Bifantis. 2013. Retrieved May 7, 2013 from http://www.bifantis.com.

Chronic Pain Research Alliance. 2009. Retrieved May 7, 2013 from http://www.overlappingconditions.org.

Feinmann, J. 2010. Eating Fibre May NOT Be So Good For Your Stomach. In Mail Online. Retrieved May 7, 2013 from http://www.dailymail.co.uk/health/article-1228402/Eating-fibre-NOT-good-stomach.html.

Spilde, I. (2012). Food Intolerance is Linked to Different Disorders. In Science Nordic. Retrieved May 7, 2013 from
http://sciencenordic.com/food-intolerance-linked-different-disorders.

Image courtesy of Marin at FreeDigitalPhotos.net