Want to take a LEAP?

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Have you ever tried to cut foods out of your diet to feel better only to not feel any different? Or, only a little better? Or worse? A lot of people I talk to cut out gluten thinking that’s what’s causing the problems. And, they feel a little better. Or, they cut out dairy and get the same results.

Using an untargeted elimination diet is like using a shotgun to hit something tiny, say, a fly. You scatter your attempts over a large area and you might find the food or foods that are causing your symptoms. Or, probably not. If you were trying to shoot something small, like a fly, wouldn’t it be better to use something that you could aim at that small target? Like a laser?

Although there isn’t a gold standard for food sensitivity testing, I’ve started using Mediator Release Testing (MRT) in my practice. MRT looks at the mediators, or chemical messengers, your immune cells give off when exposed to food and chemicals. The test looks at 120 foods and 30 chemicals. These mediators then cause you not to feel good – headaches, migraines, fatigue, brain fog, or digestive issues just to name a few of the issues they can cause.

One of the reasons I like MRT is that the test quantifies the response of your immune cells to foods and chemicals. We can then develop an elimination diet based on how your immune system responds to the tested foods and chemicals. We start with the foods that have the smallest reaction. You eat those foods for a couple of weeks, until you start to feel better. Most people begin to feel better within a few days to a couple of weeks.

After you feel better, we add foods back in to your diet and start adding in untested foods. Before you know it, you feel better, know what foods to eat to keep you feeling that way, and know what foods cause you to feel worse.

So, what would you rather use – a shotgun or a laser – to shoot something small? I’d rather use a laser. And, with MRT I have a laser in my toolbox to help you feel better. If you want to know more, just click here to contact me.

I’m so confused! Where do I start?

When you’re dealing with digestive issues, figuring out where to start to get your symptoms under control can be overwhelming. There are so many choices and approaches. So much information on the web. A lot of it conflicting. What works for one person may not work for you. All you want is to get well. To get your symptoms under control so you can get your life back.

I’ve been there. As a Registered Dietitian with a PhD in Kinesiology I was so frustrated! Understanding how the body works and how food works in the body is my job! My area of expertise. And, I couldn’t figure out my own symptoms. Once I’d finally had enough, I became obsessed with getting my symptoms under control and my life back.

In my research and training specific to digestive issues I learned about the “5 Rs of Gut Restoration”. The 5 Rs are:

  • Remove
  • Replace
  • Repair
  • Reinoculate
  • Rebalance

The 5Rs have become an integral part of my practice when working with clients who have digestive issues. (If you want more details about the 5Rs, I’ve done a series of blog posts. You can start here with an overview of them). I also created a graphic you can download to get more information about each “R” and how they fit together.

When I use the 5 Rs in my practice I start with the first one – Remove. Why? There is usually one or more foods that are causing problems. And, I want my clients to start getting better NOW! I know when I was dealing with digestive issues, I wanted to feel better NOW.

In the Remove step, there are three basic ways to figure out what needs to be removed:

  1. Food sensitivity testing
  2. Basic elimination diet
  3. Structured elimination diet

All are great places to start. And, they can be used in combination.

Food Sensitivity Testing

Food sensitivity starts when decide which testing to use and send in a blood sample. Let lab analyzes your sample and sends the results to your practitioner. Then, you meet, develop a plan and start on your elimination diet. The main downsides:

  • There’s no gold standard for food sensitivity testing. I use both ALCAT and LEAP in my practice. Food sensitivity testing, regardless of the test used, is not fool-proof. It is a starting place though.
  • It takes time – usually 2 to 4 weeks – before you can start on the plan.
  • It can be expensive. Depending on the type and amount of testing and amount of counseling needed food sensitivity testing can run from a few hundred to a few thousand dollars.

Basic Elimination Diet

When using a basic elimination diet, you choose what food and drinks to eliminate and how long to eliminate them. You could eliminate diary, gluten, eggs, soy, nuts, peanuts alcohol, and other foods you believe may be causing problems for anywhere from a week to a month. Then, you introduce the foods one-by-one to determine which is causing the problems.

  • A basic elimination diet can also be a good place to start. Some of the downsides are:
  • It can be very restrictive and hard to stick to. Depending on what you choose to eliminate it can be difficult, if not impossible, to eat out or at other people’s homes.
  • You may or may not get the foods that are causing the issues eliminated. I’ve known people who did an elimination diet down to, basically, chicken and rice only to find out later that rice is a food that triggers their symptoms.
  • The reintroduction period can be hard. If you’ve been on a strict elimination diet for a couple of weeks to a month, when you get into the challenge/reintroduction phase it’s really easy to go wild and eat everything you’ve been denying yourself.

FODMAPs

Finally, you can use a structured elimination diet like FODMAPs. I’m going to talk specifically about FODMAPs because it was developed by a university (Monash University in Australia) and has been the subject of at least 100 research studies. FODMAPs has been shown to help reduce the symptoms of people with Irritable Bowel Syndrome. In my practice, I’ve found that it helps those who have a broad range of digestive issues.

FODMAPs removes certain sugars from your diet. Specifically, FODMAPs stands for Fermentable Oligo-, Di-, Mono-saccharides And Polyols. These are types of sugars that some people have problems digesting. When doing the FODMAPs diet, you go through an elimination period (one week to a month) of following a diet with little to no FODMAPs. Then, you go through a Challenge Phase where you test out each type of FODMAP in various amounts. This is critical because you may be able to digest one FODMAP but not another, or you may be able to digest a small amount but not a lot. This program allows you to figure out how much of each type of FODMAP you can tolerate without causing symptoms. The Challenge Phase can take 5 to 8 weeks or more, depending on how you choose to do it.

As with any of these approaches, the FODMAP elimination diet has some downsides. These are:

  • Figuring out which protocol to follow. There are a lot of FODMAP resources out on the web. This is good and bad. It’s great to have a lot of information. And, it can also be overwhelming.
  • Finding information that is up-to-date can be a challenge. Given the plethora of information on the web about what is and isn’t FODMAP-safe, a lot of it is out-of-date and requires you double check it with the latest information put out by Monsh University.
  • As with the basic elimination diet, the challenge period can be hard. You need to continue following the FODMAP elimination diet during the challenge phase.
  • It’s common to eat everything you’ve been restricting when you finish the elimination phase and not finish the program. Then, you’re right back where you started.

Where To Start?

With any of these approaches, you should assess how you feel before you start and then several times through the process. If you’d like the form I use with my clients, you can get it here.

In my practice, I usually use a combination of approaches. Typically, I’ll use the FODMAP plan to get people started. Then, we’ll decide whether to do food sensitivity testing. I use this approach because most people with digestive issues who follow the FODMAP plan start feeling better within a few days. And, I’ll use food sensitivity testing to refine the foods they can and can’t have. We can always do food sensitivity testing after we see how they respond to the FODMAP diet.

The difference between food sensitivity testing and FODMAPs is that food sensitivity testing identifies foods that are causing an immune reaction. Food sensitivities cause an immune reaction that isn’t as severe as an anaphylactic reaction, but is still causing your immune system to react. It can be important to get these foods out of your diet in order to reduce inflammation as well as other symptoms including digestive issues, migraines, arthritis, joint aches, muscle aches, etc.

FODMAPs on the other hand are sugars that your body has a hard time digesting. They don’t cause an immune reaction. They can cause digestive issues including gas, bloating, constipation and diarrhea. This is because when they pass into the small intestine they aren’t broken down, usually due to a lack of the enzymes that are needed to break them down. This causes additional fluid to be pulled into the small intestine to dilute these sugars. Then, when the sugars pass into the large intestine (or colon) some of the microbes in your microbiome love to eat them, and eat them quickly. Then, the microbes release gas into your intestines which causes further discomfort. It could be one or more FODMAPs that don’t get along with you. A well designed FODMAP program will help you figure out if it’s one or more FODMAPs that don’t get along well with you and the amounts of the ones you do get along with that you can eat without causing symptoms.

If you’re having digestive issues and are ready to take control of your symptoms, the best place to start is by figuring out what you need to remove. Then, you can move into the other Rs from there.

If you’d like to get started with a FODMAP protocol, here are the FODMAP Resources I use with my clients.

The Food Demolition Crew

Stomach Ache

Last week, I talked about how hydrochloric acid (HCl) in the stomach helps break down your food. This week, I’m going to talk about digestive enzymes – the Food Demolition Crew.

Digestive enzymes break your food down into carbohydrates, proteins and fats so that you can then absorb them. Digestive enzymes start their job in your mouth and continue all the way through your small intestine.

Some people don’t produce enough digestive enzymes which means they don’t get the benefit of the food their eating. They body isn’t breaking down the food into the carbohydrate, protein, and fat molecules it can absorb. So, those things from the food don’t get absorbed and end up in the toilet.

Why might you not produce enough digestive enzymes? Here are some reasons:

  • Aging – As we get less young (remember I don’t like “old” or “older) our bodies may produce less digestive enzymes.
  • Problems with the pancreas or liver may reduce the amount of digestive enzymes that are produced.
  • Issues in the small intestine like Celiac disease can also reduce the amount of digestive enzyme production.
  • Inflammation in the digestive tract – often caused from food intolerances.
  • Bacteria living in the digestive tract where they aren’t supposed to be.
  • Stress may also play a role in digestive enzyme production.

How do you know if you aren’t producing enough digestive enzymes? The symptoms are similar to hypochlorhydira – not producing enough HCl in your stomach. Symptoms include:

  • Gas and bloating after meals
  • Stools that float
  • Feeling like you’ve got sand in your stomach
  • Feeling full after only a few bites of food

What do you do if you think you aren’t producing enough digestive enzymes? The best way is through stool testing. However, if that isn’t possible, you can add in some high quality digestive enzymes and see if you notice a difference in how you feel. I have some specific recommendations. If you’d like to find out more, just send me a quick note.

Logging your food can also help you figure out if low digestive enzymes could be the problem and, if so, which foods may be the culprit. Then, you can target the right digestive enzyme rather than taking a broad one.

If you want to track your food and symptoms, I’ve created a Symptom Log for Digestive Wellness based on my years with IBS and working with clients with digestive issues. I also created a series of videos to go along with the log to help you learn how to use it, figure out what may be triggering your symptoms, and other resources to get a happy and healthy gut. If you want the Symptom Log and other goodies, you can sign up to get it here.

It’s a Washing Machine for Your Food

Washing Machine

Now that you’ve had a tour of your digestive tract let’s talk about what can go wrong in different parts, and some ideas how to fix it. (If you missed the tour of your digestive tract, you can find Part 1 here and Part 2 here.

We’re going to start with the stomach. I call the stomach the “washing machine for your food”. Your stomach acts like a front load washing machine mixing up the food with hydrochloric acid (HCl) and digestive enzymes. This washing machine action gets the food broken into smaller and smaller pieces so there is more area for the HCl and digestive enzymes to attack. You want your food to get broken down into tiny pieces so that the basic nutrients – carbs, protein, fat, vitamins, minerals, and phytochemicals – can be absorbed into your body.

Two of the main things that can go wrong in your stomach are: 1) not having enough HCl, and 2) not having enough digestive enzymes. In this post, I’ll talk about hypochlorhydria – or low stomach acid. Next week, I’ll talk about low digestive enzymes.

You need HCl in your stomach for several reasons. HCl helps you digest – break down – proteins, and it helps you absorb iron, calcium, zinc, copper and all of the B vitamins.

Why might you be low in HCl? As we get less young (I don’t like to say “old” or “older”), our bodies may produce less HCl than when we were younger. Proton pump inhibitors (PPI’s) -prescription drugs that treat acid reflux – reduce the production of HCl. An H. pylori infection -which may cause stomach ulcers – may also reduce the production of HCl.

How do you know if you have hypochlorhydria? Symptoms that may indicate that you have low stomach HCl include: indigestion; heartburn; poor quality finger nails; hair that is brittle or won’t grow; feeling full after only eating a small amount especially if it contains protein; feeling like your stomach heavy or is “filled with sand” after eating; experiencing bloating, gas, and/or belching after eating; morning diarrhea or diarrhea after eating; or constipation. That’s quite a list! And, a lot of those symptoms can be caused by other things. How do you know low HCl is the cause of your symptoms?

You can do a medical test where you swallow a device that measures the levels of stomach acid. Or, you can add in some HCl supplements and see what happens. You should NOT take HCl if you are on any PPI (more on this below).  When working with clients, I have specific protocols I use to add in HCl and determine the dose. Logging your food and symptoms can also help you figure out which foods are causing problems. I’ve got a log that can help. The information on how to get it is below.

If you are on PPIs, there are protocols to follow that can help you wean off of them. You do NOT want to stop PPIs abruptly. Since PPIs reduce your body’s production of HCl, taking HCl and PPIs together can spell trouble.

One of the best ways to get a happy gut is to track your food and symptoms. I’ve created a Symptom Log for Digestive Wellness based on my years with IBS and working with clients with digestive issues. I also created a series of videos to go along with the log to help you learn how to use it, figure out what may be triggering your symptoms, and other resources to get a happy and healthy gut. If you want the Symptom Log and other goodies, you can sign up to get it here.

Let’s Take A Ride (Part 2)

Roller Coaster

 

The more I learn about the GI tract, the more I see how it is the center of our health and healing. This is the second post in series about the GI tract, it’s parts, how it works, what can go wrong, and how to keep it healthy. In last week’s blog post, we started on a tour or “ride” of the digestive tract. Here’s a link to Part 1.

Part 2

“We’ve now entered the small intestine. Lots to look at here. The average small intestine is about 22 feet long! Yes, 22 feet! You see that hole up there? Yes, up in the top above your head? That’s where digestive enzymes from the pancreas and the gall bladder come in to continue digesting, or breaking down, the food from the stomach. The gallbladder holds bile which helps digest fats. The gallbladder stores the bile until your body detects that there’s fat in the small intestine. Then, the gallbladder contracts and releases the bile to break down the fats. You don’t have your gallbladder? Then, there’s nowhere to store the bile. It drips directly from the pancreas into the small intestine all the time. If you eat a fatty meal and have diarrhea soon after it’s because your body can’t handle that much fat because your gallbladder is gone. This first part of the small intestine is called the duodenum. You’ll notice on the sides there’s some additional fluid coming in. That neutralizes the stomach acid so that it doesn’t damage the small intestine.”

“Moving along now, we enter the next section of the small intestine – the jejunum. You see all those folds there? Those are called villi. On the villi are more small folds on the folds called microvilli. The villi and microvilli increase the surface area of the small intestine. Remember how we talked about increasing the surface area of the food by chewing and digestion to allow the digestive enzymes to break the food down into smaller parts? In your small intestine we want a lot of surface area to be able to absorb the nutrients from the food. If you flattened-out all the villi and microvilli of your small intestine, you could cover about two tennis courts. That’s a lot of surface area! It’s in this part of the small intestine that most of the absorption of sugars, amino acids from proteins, and fats happen. Also, this is where a lot of your immune system resides. About 70% of your immune system is in this part of your small intestine. Why? Since you’re absorbing things here – this is where the parts from the food pass into your body – we want to let what we need in and keep things we don’t need or that may be harmful out. The immune cells here act like bouncers at a night club. They let the good things in and keep the bad things out. The next section of your small intestine, the part we are now entering is the ileum. You can see we still have the folds. In this section we absorb vitamins and bile salts that are recycled into more bile in the pancreas. Ahead, you’ll see we’re reaching another sphincter – the ileocecal valve. This valve is between the small and large intestines. We’ll stop here for a minute and let you take a look back.”

“Ready to move on? Here we go into the large intestine. The average large intestine is about 5 feet long. Our microbiome lives in our large intestine. A healthy microbiome weighs about 5 pounds. These little microbes do a lot to help us out. They digest the fiber we’ve been eating and produce some vitamins and other things our body and digestive tract need to stay healthy. So far, they’ve identified about 10,000 species of microbes in a healthy microbiome. You can see all the microbes along the walls of the large intestine here. If this person had taken antibiotics, there’d be hardly any microbes here because the antibiotics often kill off most or all of the microbes. Then, we have to repopulate them through supplements and food. Our large intestine absorbs water and all the good things that the microbes produce through their digestion. Don’t be afraid of the microbes. They’re really friendly. See? That one is waving to you!”

“Finally, we find ourselves in the rectum and anus. This is where the waste products are stored until you are ready to go to the bathroom. And, out we pass and we’re back safely into the ride loading area. Your cabin cover is unlocked. Just lift on that handle and it will lift up. Same for your safety bar. Please stand and exit to your left. I hope you enjoyed this tour of your GI tract! We’ve got some great snacks out in the lobby for you to enjoy. See you next time!”

Now that you’ve toured your GI tract, I hope you have a better understanding of the various parts and functions. In next week’s post, we’ll talk about some things that can go wrong in your GI tract.


I’ve got something for you if you have an unhappy gut. One of the best ways to get a happy gut is to track your food and symptoms. I’ve created a Symptom Log for Digestive Wellness based on my years with IBS and working with clients with digestive issues. I also created a series of videos to go along with the log to help you learn how to use it, figure out what may be triggering your symptoms, and other resources to get a happy and healthy gut. If you want the Symptom Log and other goodies, you can sign up to get it here.