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Issue 64, March 2015  

Hello <<First Name>>,  

Do you know anyone struggling with inflammatory bowel disease?  This month we give you the lowdown on why diet is crucially important to help prevent relapses.  Encourage them to subscribe and you both benefit!

Read on to also to learn:

  • Why you should love limes
  • Smart foods to drop cholesterol
  • Which carbs are best on your plate
  • How to keep your kitchen knives in tip top condition

And more...


Inflammatory Bowel Disease: Tummy-Taming Foods You Should Be Eating

Your gastroenterologist has just diagnosed you with inflammatory bowel disease. You ask: “What can I eat?” and “Do I need to change my diet?”.  The answer you will likely receive is “Just eat a normal diet” or “Diet has no influence on IBD”.

But this could not be further from the truth based on new and emerging international scientific research.

Evidence is mounting to suggest your diet has a significant influence on your microbiome, which is implicated in the development of IBD.  What is a microbiome you ask?  Keep reading!

A westernised diet, which typically consists of foods high in refined fats/oils, sugar and animal protein while lacking unrefined plant foods, has been identified as the food that harmful gut bacteria just love to eat.  Eat more ultra-processed foods and red meat, and you will grow and maintain more of the bacteria in your guts that can promote this disease.  The latest thinking is: your usual diet regularly impacts on the number and type of microorganisms living in your intestines.  A diet that favours the bad bacteria will result in more inflammation of your bowels and impaired immunity, along with other health problems.

The human microbiome

So then, what is the microbiome?  It is the total environment of trillions and trillions of microflora (bacteria and other microorganisms) living in your body, including those in your intestines.  But it’s more than just the bacteria themselves – it also includes the products these bacteria produce from the food you eat (and feed them!).  The bacteria can either be harmful (they will promote inflammation) or helpful (the products they produce can dampen inflammation and help maintain the cell integrity of your colon wall).  Because the type of food you consume will either feed up healthy or harmful bacteria, it’s good to also know that without their preferred food source, the harmful bacterial species will die off and your microbiome will change.  Phew! But how fast?  Changes to your microbiome will start occurring within one day of changing your diet!  So every meal matters.  Which bacteria are you feeding?

A study of people with Ulcerative Colitis revealed they had 30 times lower levels of bifidobacteria (the helpful type which keeps people well) compared to levels found in healthy people!  Eating a plant-based diet can promote the growth of bifidobacteria.

What is inflammatory bowel disease?

Inflammatory bowel disease (IBD) is a group of inflammatory conditions of the colon and small intestine.  The two main types are Crohn’s Disease and Ulcerative Colitis.

Crohn’s Disease can affect the entire digestive tract from mouth to rear end and typically disturbs the small intestine and/or colon.  Ulcerative colitis affects the colon and rectum (which are your large intestine).  Both can be characterized by the presence of blood in the stool resulting from lesions or ulcers, which develop after prolonged inflammation.  Common symptoms of IBD include stomach cramps, abdominal pain, diarrhoea, urgency to evacuate your bowels, bloody stools, fever, weight loss, loss of appetite and/or iron deficiency anaemia (because you can’t absorb iron from your food properly).

If your IBD is not managed, longer-term complications can also arise, such as ongoing intestinal bleeding, bowel rupture, strictures or bowel obstructions, fistulas (abnormal passages that sprout up), toxic megacolon (life-threatening extreme dilation of the colon) or malnutrition from nutritional deficiencies.  Severe damage to your bowel may also mean your doctor needs to recommend a bowel resection (removal of a section of your bowel), or multiple resections over time, which can lead to life long issues with bowel regularity and malnutrition.

Before you start planning what to eat for dinner, it’s first important to understand the two main phases of IBD:

  1. Acute Phase – this is when you are in a flare up.  You are likely experiencing all the typical symptoms, such as abdominal pain, nausea and loose/bloody stools.
  2. Remission Phase – this is when your symptoms have settled and you find foods more tolerable without triggering symptoms.  At this stage you might even think you don’t have the disease, so some people get lax with healthy eating, thinking it doesn’t matter.

How do I manage my symptoms with diet?

While there is no proven dietary approach that’s suitable to keep everyone in remission, the goal of nutrition therapy is to promote changes in the types of colonies of bacteria that live in your gut from “bad” to mostly “good” and to dampen any inflammation.  Eating a healthy diet can also improve your immunity to fight back.

When you are in the acute phase (with active symptoms) the primary goal is to achieve remission.  Your gastroenterologist will usually try and beat your IBD into submission using various potent medications.  Diet may not play a major role in this phase, although sometimes specialists like to give you ‘bowel rest’, meaning you get to fast for a few days.  But certain alterations to your eating pattern can still help relieve your symptoms.

Commonly, a diet low in lactose and moderate in fibre content is recommended during the acute phase.  

6 tips for managing symptoms in the acute phase of IBD:

  1. Avoid deep fried foods, such as fried chicken or chips, pies and other takeaways
  2. Avoid processed snack foods like biscuits, donuts and cakes
  3. Avoid common trigger foods, such as alcohol, caffeine and spicy foods
  4. Limit sugary foods and artificial sweeteners, such as soft drinks and lollies
  5. Avoid dairy products, such as cow’s milk, cream, sour cream and cheese, or use lactose-free dairy products
  6. Limit very high fibre foods (e.g. legumes) temporarily, especially if these appear to be making your stools worse

However, you should plan to progress to a high-fibre, anti-inflammatory diet as soon as tolerated with the assistance of an Accredited Practising Dietitian (APD).  The reason for this is that a plant-based dietary pattern may help keep you in remission for longer.

What should I eat to prevent a flare up?

An anti-inflammatory diet that includes prebiotic carbohydrates (good foodstuff for good bacteria) and focuses on unrefined plant foods is the answer.  This is the food to feed up your healthy gut bacteria to ensure you are protected from another bout of symptoms.

So what does this type of eating look like?  Here are a few quick food examples.

Carbohydrates                   

Wholegrains: brown rice, corn, oats, rye, barley, polenta, quinoa and millet

Legumes: lentils, chickpeas, kidney beans, black beans, baked

beans, four bean mix

Protein

Plant-based protein: legumes (as above), TVP (soy mince), tofu/tempeh, veggie burger, veggie sausages, soy luncheon meats.  Speak to your dietitian about red meat and other animal proteins.

Fats

Walnuts, linseeds, chia seeds, oily fish e.g. sardines, extra virgin olive oil

Fruits & Vegetables

A variety of brightly coloured produce throughout the week and also include mushrooms, which are technically not a vegetable.

To help keep yourself in remission, aim for at least 40 grams of fibre per day and drink 6-8 glasses of water. Research suggests consuming adequate fibre every day is paramount in the management of IBD if you want to stay out of hospital and in remission for as long as possible.  Fibre moves through your gastrointenstinal tract largely undigested and will feed those good guys in your intestines.  However, it is the byproducts of their fermentation of the fibre that will provide the anti-inflammatory properties you want and prevent your tummy feeling like it’s going to burst.  One group of these beneficial products is called short chain fatty acids (SCFAs), for example butyrate which has been strongly shown to dampen the effects of inflammation in people with IBD.  One study from Japan showed adopting a semi-vegetarian diet (which includes an abundant source of fibre) resulted in a 92% remission rate two years after discharge from hospital among Crohn’s patients!

Everyone’s gut is different

But don’t hate your guts!  Every person is different.  And your diet may need to be fine-tuned as you go, as you have a colony of microorganisms within you that are in constant flux, according to what you feed them. That’s why it’s a good idea to stay in touch with your dietitian in the long term.  Your dietitian can review your overall dietary pattern, detect missing nutrients and identify any additional intolerances, such as from chemicals found in certain foods.  They can also advise on the right dose and type of omega-3 supplements and probiotics just for you. Plus, you’ll gain that all-important helping hand to stay inspired to eat healthy! 

If you, or someone you love, has IBD but hasn’t yet seen an APD don’t procrastinate any longer.  Book in today to see one of our friendly dietitians and tame that tummy once and for all!


Quote

“Some people drink from the fountain of knowledge.  Others just gargle”.  Robert Anthony


What’s Cooking? – Smart Foods to Drop Your Cholesterol & Sugar, Naturally!

Would you like to avoid medication for your cholesterol or blood sugar?  Or prevent a rise in the dose you currently take? 

You can but you will need to make some (delicious!) meal swaps.  We can show you how to do this easily.

Join us for this popular cookshop to see how to use certain food ingredients to work as medicine and drop your blood sugar and cholesterol naturally – without any nasty side effects!  From traditional ways with okra for your main plates to modern tricks with psyllium for your desserts, you’ll leave inspired and ready for positive results, such as body fat loss, improved regularity and more energy!

This event is ideal if you have high cholesterol or a family history of stroke or heart attack, diabetes, insulin resistance or you are overweight and in search of greater satiety.

But please don’t eat before coming!  You will get to taste delicious dishes throughout the evening, from entrée to dessert (plus take-home recipes and nutrition handouts).

When: Tuesday 31st March 2015, 6.30 pm – 8:30 pm

Learn more about this cookshop        

Call TODAY on (02) 9899 5208 to book your place.  Bring your partner for a date night!


What’s Fresh? – Lime

“Put the lime in the coconut and drink it all up,” says Harry Nilsson in his famous “Coconut” song.  Limes are in season in Australia, so you can start drinking them up now!

These green citrus fruits may be small, but they’re loaded with nutrients and have a unique fresh scent and vibrant flavour.  There is key lime, Persian lime, Tahitian lime, kaffir lime and desert lime.  Mmmmm.

In 1788, the First Fleet brought orange, lime and lemon seeds from Brazil, introducing the lime to NSW for the first time.  English sailors were nicknamed “Limeys” because they were commonly given limes (which are high in vitamin C) to prevent scurvy – a disease caused by deficiency of vitamin C.  Persian and Tahitian limes have been grown in Australia since 1824, originally making their way to us from Persia, South America and California.

Like all citrus fruits, limes are a rich source of vitamin C.  Just 100 ml of lime juice – an amount you could easily use in salad dressing – has 47 mg of vitamin C, which is more than the recommended minimum daily requirement.  Limes also contain pectin, a soluble fibre that can help lower your cholesterol and keep your bowels functioning regularly.  They are low in FODMAPs (carbohydrates that are poorly tolerated by people with irritable bowel syndrome), so if you have a fussy tummy you can safely enjoy a lime or two.  These fruits are also low in sugar, which is the reason for their sour tangy flavour.  And it means they are low in calories, perfect for weight control!

Limes are best priced during their peak season, which is between January and August in Australia, but they are generally accessible all year round.  To choose the best lime, look for one that is vibrant and glossy in colour and feels heavy.  The heavier the fruit, the more delicious juice it will contain.  It’s best to store your lime in a fruit bowl until required (or seven days) and place any cut lime in the fridge.  Generally speaking, you can refrigerate citrus to extend its shelf life.

5 lovely ways to put lime to good use:

  1. Squeeze some lime juice with a drizzle of extra virgin olive oil, pinch of salt (optional) and pepper over your salads for a light dressing
  2. Add slices of lime to your water for a zing
  3. Mix up ½ cup lime juice, 2 tablespoons soy sauce, 2 tablespoons honey and 2 cloves of garlic for a delicious marinade for tofu or chicken
  4. Highlight your limes in desserts e.g. key lime pie, lime tart, lime custards or just drizzle some lime on your fruit salad
  5. See how Sue Radd freshens up papaya with lime – good enough for a dinner party! Fresh Papaya Drizzled with Lime

Food Matters with Sue Radd – Cleaning Up Your Carbs

Has your head been spinning with all the anti-carb messaging in social media?  Should you avoid carbs entirely or are there any carbs left you can eat?  Read Sue Radd’s short article to discover why certain carbs are actually important for good health and how you can cook them.


Need a Dietitian Who is Also an Exercise Physiologist? – Meet Robynne Jeftha

We’re excited to share the news that Robynne Jeftha has joined our Clinic.  Robynne can help you with all things culinary to better manage your medical condition but she also is ideal if you’re goal is improved health and fitness!  Whether your daughter is an elite gymnast or you want to bulk up, Robynne’s training as both an APD and accredited exercise physiologist will help you perform at your best!  Read more about Robynne.


Food InFocus – Is Your Body Running Like Clockwork?

Did you know your body has more than 20 clocks located in your genes, to keep you running like clockwork?  When the clocks get out of sync, there is opportunity for disease to initiate.  Watch this TV episode with Sue Radd to learn why the timing of when you eat your meals – especially carbohydrate foods – is important to help keep your clocks in sync.


Kitchen Tips – How to Use a Knife Sharpening Steel

When was the last time you sharpened your kitchen knives?  Ahem.  Having a sharp knife is not only safer but it makes cooking more pleasurable and efficient.

Sharpening knives can seem like an onerous task but it is one that can benefit your health if it helps you enjoy cooking more.  Dull or blunt knives are more dangerous in the kitchen because they are much more prone to slipping which could result in the ever-so-feared chopping injury. Ouch! Keeping your knives in good condition will not only deter accidents, but speed up your meal prep, as a sharper knife cuts with far more ease and requires less effort from the chef within.

So you want a quick easy way to keep your knives razor-sharp?  Try a knife sharpening or honing steel.  If you have never used one before, or need a refresher, here are the basic steps.  (By the way, a honing steel looks like a long knife with a handle, but instead of the blade it has a thick metal ‘chopstick’ looking steel attached.)

Step 1. Hold the steel rod in one hand on top of a steady surface (e.g. wooden chopping board) with the point of the rod meeting the board and the handle pointing up.

Step 2. Hold the knife in the other hand and run one edge of its blade against the steel rod at a 20 degrees angle, starting from the top of the rod and working down the length of the steel.

Step 3. Repeat the process with the other edge of the knife on the opposite side of the steel to sharpen the other side.

Step 4. Stroke the blades about 8-10 times or until you feel your knives are sharp.

As this procedure is difficult to explain in words, we’ve created a mini video just for you!  Watch our quick video here.  And please ‘like’ us on Facebook for more kitchen tips and tricks!

Quick tips:

  • Make sure the sharpening steel is the same length as your knife.  Usually steels are longer than most knives.  This will make sharpening a lot quicker as you will only need one long stroke to cover the entire length of the blade.
  • Choose a high quality steel that features a rough surface for a more efficient hone e.g. Wustfhof.
  • Rinse and wipe your sharpened knives until dry to remove any metal debris and avoid it ending up in your food.
  • Do not wait until your knives are dull before sharpening them.  This will require more of your time and effort!  Instead, sharpen after each use.  Or at least once a month.  That way, your knives will always remain in tip top condition.

Tell Your Friends! 

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Published by the Nutrition & Wellbeing Clinic, Copyright 2015.

Suite 10, 80 Cecil Avenue, Castle Hill NSW 2154 Ph: +61 2 9899 5208 Fx: +61 2 9899 2848 www.nwbc.com.au

We are a boutique Dietitians clinic in Sydney, Australia, offering one-on-one consultations, culinary medicine cooking workshops, motivational health seminars and nutrition advisory services to businesses in the local and global area.


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