June 22, 2015

The Low FODMAP Diet: Is It Right For You? (Paleo, Gluten Free, Grain Free, Health Information)

Hi everyone! I hope you are having a good day.

If you are a follower of the blog you may remember that a few weeks ago I joined the 2 Strong Guys for a podcast, and one of the topics we discussed was FODMAPS and the low FODMAP diet. So I decided it was time I put together a post dedicated to this topic since the scientific evidence supporting a low FODMAP diet is slowly starting to increase.

So first of all, what are FODMAPS? FODMAPS is an acronym that stands for Fermentable, Oligosaccharides, Dissacharides, Monosaccharides And Polyols. Yes it's a mouthful. Let's break each of these down to examine each one individually.

Fermentable: These carbohydrates are sugars that are broken down and digested by bacteria in the intestines, producing gas and other by-products.

Oligosaccharides: These are short chains of carbohydrates that are linked together. There are two types: fructans (a chain of fructose molecules) and galacto-oligosaccharides (a chain of galactose molecules). Fructans are found in foods like wheat, rye, onions and garlic. Galacto-oligosaccharides are found in legumes and it is known that humans have a hard time breaking these molecules down in the small intestine. 

Dissacharides: Disaccharides are two carbohydrate molecules linked together, and lactose, the sugar found in milk and dairy products, is a type of disaccharide composed of glucose and galactose.

Monosaccharides: These are single carbohydrate molecules, and fructose, the sugar found in many fruits and some vegetables, is a monosaccharide. Fructose does not require any digestion before it is absorbed. When foods containing equal amounts of fructose and glucose are eaten, glucose helps fructose get absorbed. However, when fructose is present in a greater proportion than glucose, fructose absorption depends upon the activity of sugar transporters located in the intestinal wall. The ability to absorb excess fructose varies from person to person and in people with fructose malabsorption, the capacity of sugar transporters is limited and excess fructose travels to the colon where fermentation occurs.

AND

Polyols: Polyols, or sugar alcohols, are a type of carbohydrate that humans can only partially digest and absorb in the small intestine. Examples include sorbitol, mannitol, xylitol, maltitol and isomalt. 
These sweeteners have a much slower absorption rate than traditional sugar, and only a small amount of what is eaten is actually absorbed.



Okay so now we know what FODMAPS stands for, but what is the big deal? 


Well, FODMAPS have been linked scientifically to irritable bowel syndrome (IBS), unexplained abdominal pain (Goebel-Stengel et al., Melchior et al.) and intestinal symptoms in patients with inflammatory bowel disease (Crohn's and Ulcerative Colitis) (reference and reference). And a low FODMAP diet has been found in multiple studies (reference) to help relieve the symptoms of IBS, functional abdominal pain and symptoms in Crohn's or Colitis patients. And since IBS is the most common digestive disorder worldwide, affecting anywhere from 5-20% of the population (reference), which currently does not have a known cure, any dietary strategy to help patients with this condition is a big deal. 

And why does this diet work do you ask?

Well, on reaching the small intestine and large intestine, FODMAPs increase the osmotic pressure in the bowel (this is a fancy term meaning they draw water toward them) and provide a substance for bacterial fermentation which ultimately leads to gas production, abdominal distension and abdominal pain or discomfort. So by eliminating these problematic foods these symptoms are reduced and the abnormalities that have developed in the intestinal cells can be restored. 

Yep that's right, the most common digestive disorder in North America has scientific evidence linking foods as a culprit. And treating patients with IBS, functional abdominal pain and inflammatory bowel disease with a low FODMAP diet helps improve or eliminate symptoms (Magge et al.Halmos et al.de Roest et al). I love it when science supports what so many patients intuitively know!

There is also very recent evidence showing that a low FODMAP diet can alter the type of bacteria in the gut (reference) which we know can have a huge impact on not only bowel symptoms, but many other chronic diseases as well. Remember that a healthy gut equals a healthy body. And more and more systemic and chronic diseases are being linked to abnormalities in the gut flora. Diseases from thyroid problems, rheumatoid arthritis, inflammatory bowel disease, allergies, multiple sclerosis, lupus, autism, obesity, diabetes etc... the list goes on and on! So if you haven't had success with the paleo diet alone, you might consider trying a low FODMAP diet to help restore your gut flora and achieve greater healing. 





So now that you know what FODMAPS are, here is a list of foods that should be avoided while on a low FODMAP diet: 


High FODMAP Foods (Unsafe to Eat) 



   Fructose: Honey, Agave, Apples, Mangos, Pears, Watermelon, Blackberries, Nectarines, White peaches, Apricots, Plums, Peaches, Pruines, Mango, Persimmons, Canned fruits, Orange juice,  High Fructose Corn Syrup (which we aren’t eating on a whole foods diet anyways – right?)

   Fructans: Artichokes, Asparagus, Sugarsnap peas, Cabbage, Cauliflower, Pumpkin, Mushrooms, Green peppers, Garlic, Leeks, Onions (brown, white, Spanish, Onion powder), Spring Onions (the white part), Shallots, Wheat, Rye, and Barley (although as usual I recommend avoiding all grains)

   Lactose: Dairy products 

   Galacto-Oligosaccharides (GOS): Legume beans (eg. baked beans, kidney beans, bortolotti beans), Lentils and Chickpeas


   Polyols: Apples, Apricots, Avocados, Cherries, Nectarines, Pears, Plums, Prunes, Mushrooms, sorbitol, mannitol, xylitol, maltitol, and isomalt


Yes I realize there are a lot of foods listed there. So what can you still eat? A lot! 
Here is a list of suggested foods to continue eating:

Low FODMAP foods (Safe To Eat) 

Vegetables and Legumes
  • Alfalfa
  • Bean sprouts
  • Bok choy
  • Broccoli – avoid large servings
  • Brussel sprouts
  • Butternut squash 
  • Carrots
  • Corn / sweet corn- if tolerable and only in small amounts – 1/2 cob
  • Courgette
  • Chilli – if tolerable
  • Chives
  • Cucumber
  • Eggplant / aubergine
  • Fennel
  • Green beans
  • Ginger
  • Kale
  • Leek leaves
  • Lettuce
  • Okra
  • Olives
  • Parsnip
  • Parsley
  • Bell peppers, except green 
  • Potatoes
  • Scallions / spring onions (green part)
  • Spinach, baby
  • Squash
  • Sweet potato – 1/2 cup
  • Tomato – avoid cherry tomatos
  • Turnip
  • Zucchini

Fruit
  • Bananas
  • Blueberries
  • Boysenberry
  • Canteloupe
  • Cranberry
  • Clementine
  • Dragonfruit
  • Grapes
  • Honeydew and Galia melons
  • Kiwifruit
  • Lemon including lemon juice
  • Lime
  • Mandarin
  • Orange
  • Passion fruit
  • Paw paw
  • Papaya
  • Pineapple
  • Raspberry
  • Rhubarb
  • Strawberry

Meats and Eggs
  • All unprocessed meats are allowed (chicken, lamb, pork, turkey, bison, duck etc.) 
  • Eggs 

Fish and Seafood
  • Canned tuna or salmon 
  • Fresh fish
  • Seafood (e.g. Crab, Lobster, Shrimp, Mussels, Oysters)

Sweets
  • Maple syrup
  • Coconut sugar
  • Coconut butter, coconut flakes, shredded coconut - **NOTE: coconut is a grey area food in the low FODMAP diet, some experts say it's tolerated, and others don't so you will have to see for yourself

It is generally recommended that you eliminate the high FODMAP foods for 6-8 weeks. If your symptoms improve you know you don't tolerate FODMAPS. However, you may not need to eliminate all the FODMAP foods forever. Some people tolerate certain subgroups of the FODMAPS better than others. Once the 6-8 weeks are up I recommend adding one food back in at a time for a period of 3-5 days and watching for symptoms. Start with a small amount and gradually increase over that 3-5 day period. If your symptoms come back, you know you can't have that particular food, or only in small amounts. This is a great time to use a food journal and chart what you are eating. And remember, symptoms may not appear the same day that you eat the food, you need to monitor for symptoms for a few days after re-introcuding each food item. This is why the food journal is so crucial to the food re-introduction process. It will also allow you to keep track and remember how you felt a few days or months down the road when you are staring at a particular FODMAP and wondering whether to eat it or not! 

I hope this was helpful! Please let me know if you try this diet and how it goes for you! As you know I always love hearing from you. And if you have any questions please let me know.

And as always I would love it if you visited my social media pages: Instagram, FacebookPinterest and  Twitter

And here are a few resources to help you with recipes and more specific advice on how to implement the low FODMAP diet:

The Low FODMAP 28 Day Plan

The Quiet Gut 

The Complete Low FODMAP Diet

The Everything Guide to the Low FODMAP Diet

Monash University Low FODMAP Diet Guide

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Banana Coconut Crunch Cereal (Paleo, GAPS, SCD, Gluten Free, Dairy Free, Nut Free, Egg Free)




Hi friends! How are you doing? Fabulous I hope. I know I sure am. You want to know why? Because I am on vacation! Yep it has been 11 months since I have had a vacation. I cringe just writing that. Horrendous isn't it? Well I am making up for some lost time with two whole weeks at the lake. In the sun. Getting a tan. Sounds glorious doesn't it? I'm not trying to make you jealous or anything (ok maybe I am just a little) but I am sure a happy girl at the moment. Yes I still call myself a girl. What age do you think that is no longer appropriate? Woman just sounds so old. I'm not ready to be old yet. Not at all. I will be holding onto that girl title for as long as I can. Maybe once my patients finally stop mistaking me for a medical student will I be forced to accept that I am really getting older. Hopefully that isn't any time soon. 


In some other very exciting news I found out on Friday that I passed my internal medicine exams! I can officially call myself an FRCPC now! You have no idea how relieved I am by this. This has been the most challenging year of my life by far. Physically, emotionally and intellectually. And I would not have gotten through it without the help of my amazing study group, family and boyfriend. I seriously cannot thank these people enough (you know who you are). Now I can finally relax and start focussing on more enjoyable things like friends, family, the blog and whatever else I choose. Oh the freedom! Plus I will finally have something else to talk about on here. I know it was getting very monotonous hearing about the same thing with every darn blog post!




Today I am sharing a cereal recipe that was inspired by this recipe that I posted months ago. Although I made some major modifications by cutting out the eggs, decreasing the added sweetener and using bananas instead, adding some coconut milk and coconut flour. And I am pretty pleased with how this one turned out I must admit. This is not only a great breakfast option, but works well for snacks as well. Add it to some mixed nuts and dried fruit for a paleo friendly trail mix option. Or add nut milk or coconut milk, top with some fresh fruit and eat it for breakfast. Or just snack on it plain. This recipe only lasted a few days in my fridge before I had eaten the entire batch so if your taste buds are anything like mine you should enjoy it! Plus this one is nut free, dairy free, egg free and compatible with both the SCD and GAPS diets. So it should be able to please all of your dietary needs!


I really hope you like this one! I would love to hear what you think of it. And as always I would be thrilled if you stopped by my social media pages on Instagram, FacebookPinterest and  Twitter

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Banana Coconut Crunch Cereal Recipe (Paleo, GAPS, SCD, Gluten Free, Egg Free, Nut Free)


Ingredients

1 1/2 cups raw sunflower seeds (or pumpkin seeds)
1 1/2 cups finely shredded coconut
1/4 cup coconut flour
1 cup pureed ripe bananas (I used 2 large bananas)
1/4 cup coconut milk
2 TBSP honey
2 TBSP coconut oil
1 tsp vanilla extract 
2 tsp ground cinnamon
1/2 tsp baking soda
pinch sea salt



Directions

1. Preheat your oven to 350F
2. Place the sunflower seeds and shredded coconut into your food processor and process until you have a fine flour
3. Transfer the flour mixture to a bowl
4. Add the remaining dry ingredients and stir well to combine
5. Add the wet ingredients and mix well with a spoon or pastry blender

Now you have 2 options depending on if you want square cereal or round cereal (see below) 

Option One: Square Cereal (this is the easier version)
1. Line 2 baking sheets with parchment paper
2. Transfer half the dough to each baking sheet and cover with another piece of parchment paper
3. Using your rolling pin, roll the dough until it is about 3-4mm thick
4. Using a knife, cut 1 inch squares into the dough
5. Place in the oven and cook for 24-28 minutes (NOTE: if you are like me and don't roll the dough evenly, the edges may cook quicker so I recommended checking at 20 minutes and taking out the edge pieces if they are browning)
6. Remove from oven and allow them to cool to crisp up
7. Serve and enjoy! 

Option Two: Round Cereal 
1. Line 2 baking sheets with parchment paper
2. Form 1-1.5 cm round balls of dough with your hands and place on the baking sheets (this should make enough for 2 baking sheets)
3. Place in the oven and cook for 14-18 minutes (until they are browned or crisp on the outside) 
4. Remove from the oven and let cool to crisp up 
5. Serve and enjoy!

Print Recipe


NOTE: This cereal can be stored in the fridge for at least one week. And because of the bananas it may turn a slight green colour. Don't be alarmed it is still okay to eat!




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June 15, 2015

Healing Orange Smoothie (SCD, AIP, GAPS, Paleo, No Added Sweetener)



I don't know about where you live, but it's starting to feel a lot like summer around here! That makes me a very happy girl I must say. And the warmer weather means I am craving cooler foods. Like smoothies. Now I am not normally a smoothie lover. Something about the lack of crunch that never leaves me quite as satisfied as real food. But, for the last few weeks smoothies have been making a regular appearance in my diet. Not sure why, but I'm just going with it. And this smoothie in particular I have made multiple times now, so I decided it was time to share it with you folks. And you should be happy to know that pretty much whatever healing diet you are on, this smoothie should fit within your limitations. Because it is SCD, GAPS, AIP and Paleo compatible. It's not very often I can post a recipe that meets all of these needs. You're welcome.

And this smoothie not only contains fruit (bananas and oranges) and vegetables (squash or sweet potato) but it also contains healing ingredients like coconut, cinnamon and turmeric.

Cinnamon is a powerful little spice that can help regulate blood sugar, has anti-inflammatory effects, anti-bacterial properties, can help with brain function and reduce your risk of colon cancer (reference). Pretty impressive for such a delicious little spice isn't it?




And turmeric (or curcumin) is another spice powerhouse. It has very strong anti-inflammatory properties and anti-oxidant effects and is useful for treating a number of diseases including arthritis, inflammatory bowel disease, cancer, heart disease and neurological diseases (reference). If my patients are reluctant to take traditional anti-inflammatories (NSAIDs) such as Advil, Naproxen, etc. I often recommend turmeric or curcumin supplements instead. There is evidence that they can help with pain control and inflammation in patients with arthritis (a topic I am going to discuss in more detail in a future post) without some of the unwanted side effects that comes with certain medications. That being said, I would never recommend that people stop taking their disease modifying arthritis drugs and replace them with turmeric or curcumin. Sadly, I have seen the devastating results that doing this can have. So always discuss your medication plans with your doctor please.




In other, non-food related news... do you want to know what I have learned these last 10 days since my exams finished? There is so much time in a day! Man is it glorious. I honestly forgot what it was like to have evenings and weekends free. I have been to so many spin classes, visited with friends I haven't seen in almost a year (yes pathetic I know), gone to the movies, been out for dinner, gone to the mall. Yep life is finally enjoyable again!  Other than the anxiety of not knowing whether or not I passed yet. That is still not an enjoyable feeling. Everyone say a little prayer for me please. I don't think I could survive another year of that horrible studying. Honestly.

What have you all been doing for fun lately? I am looking to try some new things now that I have time again. Or have you read any good books lately? I am going on vacation soon and plan on doing a lot of reading by the pool. In the sun. Doesn't that sound fabulous? It sure does to me. So please give me your book recommendations, health-related or fiction are all welcome options. I will pretty much read anything. Well besides romance novels. Those I pretty much avoid.

Alright I know you don't come here to listen to me talk about books. Let's be honest, you are here for the food. So I will leave it at that for today. As always I would be thrilled if you visited my social media pages including Instagram, FacebookPinterest and  Twitter

And if you are interested you can sign up for the blog newsletter below. No spam I promise. Only information on new posts, deals and giveaways. 




Healing Orange Smoothie (SCD, GAPS, AIP, Paleo)


Ingredients

1 ripe banana
2 navel oranges, peeled and broken into pieces
1/3 cup cooked squash or sweet potato (I used butternut squash in mine)
1/4 cup full fat coconut milk (I recommend this brand
1/4 cup coconut butter or manna (I use this kind

1/4 -1/2 tsp ground cinnamon, to taste (I use this brand
1/4 - 1/2 tsp ground turmeric, to taste (I used this kind
2 TBSP grassfed gelatin collagen hydrolysate (I use the Great lakes brand - green container which you can buy here



Directions

1. Place all the ingredients, except the spices and gelatin into your blender and blend until smooth
2. Stir in the spices and gelatin until combined 
3. Serve and enjoy!

Yield: 2-4 servings (depending on serving size) 

** TIP: If you put this in the fridge for 30-60 minutes before enjoying this will make an even thicker smoothie (which I personally prefer) 


Print Recipe






                           

June 08, 2015

The Best Exercise for Your Health (Fitness, Paleo, Health)

Hey everyone. Guess what?!?!?! I AM DONE MY EXAMS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! (and yes that deserved that many exclamation points)
You have no idea how amazing this feels. Now I still don't know if I passed yet, but it's like a huge weight has been lifted off my shoulders. No more feeling guilty for not studying every spare second of everyday. Pure bliss I tell you. And more time for blogging again. I hope that makes you as happy as it makes me. I have missed this place, and you guys.

Today it's time to talk fitness. I hope you don't mind the break from food. And if you do, don't worry the recipes will be back soon! But I am a firm believer that total health is more than just what you eat, it is also about physical health and emotional health. So today we are focusing on the physical aspect of your health.

Fitness has always been a very important part of my life. Growing up I tried almost every sport, but eventually gravitated to competitive swimming and basketball. For years these two sports dominated my life. Before school, after school, weekends - almost every spare moment was spent at the pool or on the court. My parents loved it because I was too busy to get into trouble. But after high school I made the decision to quit competitive sports and focus on my studies. But fitness and staying active has remained extremely important to me. Whether it be training and competing with the triathlon club, going to spin class, road biking, running outside, finding high intensity workouts to do at home, I make a concerted effort to keep fitness a priority. I not only feel better physically when I am working out regularly, but I rely on it for stress relief. I am one miserable girl if I can't workout for more than a few days. But I know for many of you out there, fitness is a foreign concept. And the thought of starting an exercise routine is daunting. Especially if you are battling a chronic disease, working full time, raising a family etc etc.

Now, many health experts out there will tell you you need to be doing a specific type of exercise for a specified amount of time each week. Most health organizations and medical guidelines say that adults should do 30-60 minutes of moderate intensity aerobic activity on most days of the week (could they be more vague?). But many paleo bloggers will tell you that crossfit is the way to go, and that focusing on aerobic activity is not ideal. Still, others will say that yoga or pilates are the best type of exercises because they focus on core strength and flexibility. It's no wonder most of you are left totally confused and too overwhelmed to attempt any kind of physical activity at all. Well I am here to simplify things for you.

When my patients ask about exercise I give them one simple rule:

"Do something you enjoy"

Yep that's my advice. There is a ton of evidence (I could post references if you like but the list would be never-ending) showing that any physical activity, even small amounts, is better than none at all. Most people, when first starting out cannot imagine finding an extra 30-60 minutes a day to fit in exercise (like our medical guidelines suggest). So they simply don't do any. Well I am here to tell you that you don't have to.  Fifteen minutes is still better than no minutes. You see what I am getting at here? If you start off slow and set small goals that you are actually likely to achieve you will be able to feel good about reaching those goals and are more likely to continue, rather than quit. Especially if you are doing an activity that you like.



My goal is to have my patients start (and continue) any type of activity that they see as the best fit for them. This way they are more likely to actually see the physical, emotional and mental health benefits that occurs with sticking to an exercise routine. Because sadly, study after study has shown that more than 50% of people will stop a physical fitness routine within 6 months of starting. Those are not good statistics. And that's not what I want to see. I want to see you make physical activity something that you look forward to and enjoy. Not something that is a chore.

So what is the best exercise for your health? Again I repeat:

"Something you enjoy"

Remember we are keeping it simple here folks. I am asking for baby steps. Not leaps and bounds. At least not initially. Remember, any activity is better than no activity.
And while I realize that some of you reading this may be fitness enthusiasts and may find this advice completely ridiculous, but it is not you I am worried about. It is the 30-50% (the numbers vary depending on which study you read) of the population that isn't doing any activity at all. Including most of the patients I see. These are the people I worry most about. And these are the people we need to focus on if we want to see changes on a population level.

Ok so now that I have given you my advice I will give you some ideas of things you can try. No pressure here. Some of these are things I enjoy, and some are things I have never tried. Feel free to try as many (or few) as you like. And if you mix it up even better.

1. Walking
2. Skipping
3. Playing a sport: tennis, soccer, baseball, basketball, badminton, volleyball etc. etc.
4. Yoga
5. Pilates
6. Dance classes
7. Martial arts
8. Kickboxing
9. Crossfit
10. Olympic lifting
11. Biking
12. Rollerblading
13. Swimming
14. Gymnastics
15. Running
16. Triathlon
17. Playing frisbee (or joining an ultimate frisbee team)
18. Golf
19. Bowling
20. Water aerobics

Now you will notice that many of these activities require little to no equipment. Again, I want to keep things simple for you. Plus I realize that cost may be a barrier for many of you. Items like skipping ropes and frisbees cost almost nothing yet can have so many uses. I never want cost to be a barrier to starting a fitness routine. Never. No excuses here people. That being said I do recommend investing in a quality pair of running shoes or cross trainers. This is to help prevent injuries. And quality footwear is crucial for this.



Alright everyone that's it for today. I hope I have given you something to think about. And if you have any more suggestions for activities please let me know and I will add them to the list.

As always I would be thrilled if you visited my social media pages where I share even more health information, deals and giveaways:   Instagram, FacebookPinterest and  Twitter

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