Dear Patients and Friends:
Over the past year I’ve had several patients ask about a new diet called the FODMAP diet. I wasn’t familiar with this diet, but realized many so-called diets are more fad than fact, so I did a little research and will present my findings in this newsletter.
FODMAP is an acronym for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. This diet has been around since 2001 when Dr. Peter Gibson and Dr. Sue Shepard developed an elimination diet which attempts to improve symptoms in people with irritable bowel syndrome (IBS) or persons who are sensitive to gluten but do not have celiac disease. IBS can present with either chronic constipation or diarrhea, or alternating constipation and diarrhea. Often times people with IBS have a lactose (milk sugar) intolerance. There are advertisements on TV touting different pharmaceutical drugs to control IBS symptoms (all of which have potential side effects).
The FODMAP diet is based upon the idea that fermentable carbohydrates are osmotic (meaning they pull water into the intestinal tract), may not be digested or absorbed well and could be fermented upon by bacteria in the intestinal tract when eaten in excess. It is important to note that not all carbohydrates are considered FODMAPs. Although the American College of Gastroenterology has published guidelines on treatment of functional bowel problems, there has been little evidence or research supporting specific diet therapy for this condition. As more information is becoming available there may be multiple mechanisms by which FODMAPs worsen symptoms in functional bowel disorders.
This diet also limits some high fiber foods that are high in certain complex carbohydrates the body cannot digest in foods such as beans, certain fruits (ones that contain pits), and certain vegetables and whole grains.
As in other types of elimination diets, a person should eliminate high FODMAPs foods for eight weeks, and then introduce these foods back into the diet, one at a time, eliminating those that cause abdominal bloating, gas, diarrhea or constipation. A partial list of high FODMAP content foods is listed below:
HIGH FODMAP FOODS – AVOID
|Oligosaccharides||Disaccharides (Lactose)||Monosaccharides (Fructose)||Polyols|
|Artichokes||Cow, sheep, goats milk||Apples||Cherries|
|Asparagus||Ricotta and cottage cheeseAnd other soft cheeses||Pears||Plums|
|Broccoli||Yogurt (except Greek yogurt)||Mango||Prunes|
|Peas||High Fructose Corn Syrup||Sorbitol|
|Wheat and Rye||Dried fruits||Xylitol|
LOW FODMAP FOODS
|Oligosaccharides||Disaccharides (Lactose)||Monosaccharides (Fructose)||Polyols|
|Green beans||Sorbet and gelato||Grapes||Raspberry|
|Lettuce||Honeydew melon||Sugar, glucose, sucralose, aspartame do not contain,But I don’t advise to eat|
|Gluten-free cereals or Breads||Strawberry|
This is by no means a complete list, and more information can be obtained on books that have been published on this subject. Does the diet work? I don’t know as I’ve had no experience directly with it but it may be worth a try if you have irritable bowel type symptoms.
Tea As A Medicine
Drinking tea as a medicine goes back at least 5,000 years ago in ancient China. According to legend, a Chinese emperor by the name of Shen Nung was a skilled ruler, creative scientist and discoverer of multiple medicinal plants. He was called “The Divine Healer.” His edicts required, among other things, that all drinking water be boiled as a hygienic precaution. One day while boiling water to drink, dried leaves from a nearby bush were blown into the water, creating a brown liquid that had a refreshing quality when he drank it. And so the legend of how tea was created was born. In ancient times tea was used as a general tonic, a treatment for high blood pressure, to aide digestion and as an intestinal cleanser. It was also used as an antidote to poisonous herbs and poured around plants as a fertilizer.
Tea is made from the leaves of an evergreen shrub native to Asia known as Camellia sinensis, and tea is the second most popular beverage worldwide, after water. What was observed in persons who consumed tea throughout the day that it gave a person a sense of calm but at the same time allowed them to be mentally alert (Ginseng can also provide this effect).
Both green and black tea have beneficial effects in humans. Black tea is oxidized whereas green tea is not. The oxidation does not destroy black tea’s bioactivity for some reason. We know tea itself contains beneficial antioxidants. Researchers at the USDA (United States Department of Agriculture) reported that five cups of black tea a day can lower LDL cholesterol and total cholesterol in people with mild elevations. Green tea, the most popular beverage in Japan, has undergone more scientific research. One of the reasons green tea has many benefits may be due to a non-essential amino acid, L-theanine, which is unique and is only found in tea and mushrooms.
L-theanine Causes a Calmness Without Drowsiness
Although tea can have as much caffeine as coffee, L-theanine neutralizes the bad side-effects of caffeine without reducing it mind-energizing features. Scientific studies using EEG tracings of brain activity showed a significant increase in alpha brain wave activity when taking an L-theanine supplement. Alpha waves are associated with a relaxed mind and also associated with mental alertness. In other words, the body is relaxed, the mind is calmed, but no drowsiness occurs.
L-theanine and Sleep
Every day, millions of Americans get their caffeine dose in coffee, energy drinks, or over-the –counter drugs. These megadoses of caffeine keep people alert during the day. But at what price? Caffeine can stay around for up to 10 hours if your liver is functioning normally. That Red Bull you had with lunch may stick around until midnight if you drink alcohol or take cimetidine. I often see patients in my medical practice who have difficulty sleeping at night, especially as they get older. According to the New York Times, 60 million prescriptions were written for sleep aids in 2011. And sleeping pills don’t work for everyone. They can have undesirable side effects and can become habit forming. The primary reason people have sleep disturbance is stress, followed by illness, inactivity, side effect of medications or bad sleep environment.
Can L-theanine help sleep? Researchers in Japan gave subjects 200mg of L-theanine daily and recorded their sleep patterns. What they found was the L-theanine didn’t cause the subjects to sleep longer but did allow them to have a better quality of sleep. What L-theanine does is affect brain neurotransmitters, including serotonin, GABA, and dopamine. L-Theanine crosses the blood-brain barrier and researchers believe that L-theanine may act as a glutamate antagonist, reducing the harmful effects of stress hormones that can cause brain chemistry imbalances. Glutamate-activated signals not only affect mood, but can affect learning and memory.
Another Benefit of L-theanine
Another benefit of L-theanine is that it can boost glutathione levels. In a published study from Japan using mice, L-theanine was shown to counteract the effects of alcohol on the liver. The liver is a major organ of production of glutathione and is the body’s most important antioxidant, and is used in all phases of detoxification. Drinking alcohol causes a depletion of glutathione. Alcohol causes the production of free radicals as well as a toxic chemical called acetaldehyde (similar chemically to formaldehyde). In the Japanese study mice were given L- theanine both before and after drinking alcohol, demonstrating a reversal of the damage alcohol caused by boosting glutathione.
One cup of tea contains about 40mg of L-theanine and it might take multiple cups of tea consumed throughout the day to have a “theanine-effect.” Another option would be to take an L-theanine supplement. We carry a very high quality L-theanine product at the Center in a therapeutic 200mg per veggie-capsule dose. It can be taken one to three times daily. We have had multiple patients tell us they feel calmer, often in 30 minutes, and that they do not feel “sedated.”
[Some of the information in this article was obtained from Life Extension.]
Patient Success Story – Nausea Relieved With IV Glutathione
Ms. C is a 71 year old patient who was being seen to go over the results of her Spectracell lab study. She felt well in general except for some fatigue and AM nausea recently. Her only medications were bio-identical hormones prescribed by her gynecologist and Trazadone for sleep. She was not experiencing fevers or abdominal pain, nor did she notice specific foods triggering the nausea. Of interest, she was exercising routinely and working out with a personal trainer.
Ms. C’s physical exam and routine lab work including liver function tests were all normal. Her Spectracell lab test did show a functional Glutathione deficiency. As noted in previous newsletters, Glutathione is your most important antioxidant and it is made within the cells of the body. It is needed for both detoxification of wastes and chemicals, and supports the immune system. Ms. C was given an IV with 1000mg of Glutathione and also B vitamins. Within 24 hours this patient’s nausea was completely gone and “I feel wonderful” was her comment at her follow-up visit.
Patient Success Story – Excess Flatulence Resolved
Mrs. D is a 61 year old patient who consulted me after experiencing a six week history of excessive gas. She was embarrassed with this problem and started taking Intestimax, a probiotic, and digestive enzymes – none of which helped. Her chiropractor gave her a Standard Process product called Cholacol to support biliary function, as the patient previously underwent a gall bladder removal. She couldn’t tolerate the Cholacol due to its bile salt content causing itching. Other abdominal surgeries included C sections and a hernia repair. Dietary history revealed she was eating a lot of fermented foods. Her physical exam was unremarkable. Mrs. D was asked to stop fermented foods and to limit her cruciferous vegetables. She was placed on Florastor®, a beneficial probiotic yeast, and taken off her probiotic that contained different friendly bacteria. Within one month her flatulence totally resolved with a change in dietary habits and on the Florastor®.