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"Travel as much as you can life is not meant to be lived in one place"

“FOOD  INTOLERANCE, Management Plan” by Dr. Sue Shepherd and Dr. Peter Gibson

30/6/2016

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ALL ABOUT FOOD
Food allergy or food hypersensitivity are quite uncommon. These are reactions to a protein in the food and involve the immune system. With food allergies, the body reacts to the allergen by producing an antibody knows as immunoglobulin E (IgE)...
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  • When the antibodies and the allergen meet, they trigger the release of histamine and other defensive chemicals into the body.Symptoms include hives (Urticaria), asthma, a runny nose and mouth swelling.
  • Food intolerances, they are very common. These reaction do not involve the immune system, but can also cause other symptoms, such as headaches and fatigue.
COELIAC DISEASE
What is it?
Coeliac disease is an extreme example of food hypersensitivity. It is the result of an immune reaction to gluten that severely injures the body, and has been called an auto-immune disease (because the body turns on itself). Gluten is the main protein in wheat, rye, barley and oasts. When someone with coeliac disease eats foods cointaing gluten, the lining of their bowel is damaged by the white blood cells of their immune system (not by antibodies as in a food allergy).
Symptoms
These range from none at all to nausea, wind, bloating, altered bowel habits, fatigue and even skin rashes and liver or neurological problems. It can cause vitamin and mineral deficiencies and can also cause malnutrition through weight- loss and loss of muscle mass.
Treatment
The only way to treat coeliac disease is with a gluten free diet for life: no wheat, rye, barley or oats, and no products derived from them, ever.
About one in 20 people with IBS have coeliac disease.
Diagnosis
The diagnosis of coeliac disease is through blood tests to measure certain types of antibodies that  occur only in people having coelic disease. If blood test is positive then there are more test to do.
IBS
Irritable bowel syndrome is one of a group of conditions called  “functional gastrointestinal disorders”. This means that they cause disturbances in the function of the gut but don’t have any identifiable physical features. The diagnosis of IBS relies upon the types of symptoms experienced and their context, such as how long they have been experienced and when they occur.
The symptoms of IBS are most commonly triggered by a food intolerance. If you suffer from IBS, you very have a food intolerance.
It says that people can be diagnosed as having IBS if they say they have suffered symptoms of a functional gut disorder for at least six months and have experienced for at least three months of the
year mid or lower abdominal pain or discomfort associated with abdominal bloating or distension, along with changes in bowel habits.
What cause IBS?
  • Genetic factors
  • Gut infections
  • Stress and other psychological factors
  • Abnormal balance of bowel bacteria
 
 
FODMAPs (Fermentable-Oligosaccharides-Disaccharides-Monosaccharides And Polyols)
Many carbhydrates in food are poorly digested and are not absorbed by the small bowel. Dietary fibre is one example.
Some fibre, know as insoluble fibre, cannot be fermented by bacteria, and other fibre, knows as soluble fibre, can be fermented by bacteria. Some sugars, oligosaccharides and sugar alchohols are also indigestible and or cannot be absorbed by the bowel, but can be broken down by intestinal bacteria to produce gas.
One way to reduce the amount of gas in the bowel is to eat minimal amount of carbohydrates, except for those that are readily digested, such as sucrose (cane sugar) or glucose.
A much better and more practical approach is to determine which carbohydrates are the major contributors to the production of gas in the bowel and to avoid them.
These are the carbohydrates that are easily and rapidly fermented by bacteria-the molecules we call FODMAPs. We know from our scientific studies that FODMAPs can cause diarrhea, gas production and excess wind. We ha also found that the LOW-FODMAP Diet reduces bloating, distension and wind in most of people.
General eating Advise
A part from following the Low-FOMDMAP Diet, there are some simple rules you can observe:
  • Don’t overeat, and enjoy your meals while eating
  • Avoid excessive intake of fats, caffeine and alcohol
  • Avoid stress – filled meals
  • Don’t skip meals-eat regularly
 
 
FRUCTANS
Fructans are chains of fructose molecules with a glucose molecule at the end. The main dietary source of fructans include wheat products and some vegetables (onions).
No one is able to digest fructans, and if you have IBS you should minimize your intake of them. Fructans are probably the most common FODMAP to cause symptoms of IBS, probably because most of people eat a lot of them.
HIGH – FRUCTAN FOODS  (better to avoid them)
FRUITS                       custard apple, nectarines, persimmon, rambutan, watermelon, white peaches
VEGETABLES              Artichokes, asparagus, beetroot, brussel sprouts, cabbage, chicory, dandelion leaves, fennel, garlic, leeks, okra, onions, peas, radicchio, spring onions
CEREAL, GRAINS        wheat-based products, bread, pasta, couscous, crackers, biscuits , rye and barley
LEGUMES                   chickpeas, lentils, all the beans
NUTS                           pistachios
DRINKS                       chicory-based coffee-substitues, dandelion tea
LOW-FRUCTAN ALTERNATIVES (to eat)
FRUITS                        all except the one mentioned before
VEGETABLES              alfalfa, avocado, bamboo shoots, bean shoots, bok choy, broccoli, capsicum, carrots, cauliflower, celery, chives, choy sum, cucumber, eggplant, endive, ginger, green beans, lettuce, marrow, mushrooms, olives, parsnips, potatoes, pumpkin, snowpeas, spinach, sweet potatoes, taro, tomatoes, turnips, yams, zucchini
CEREAL, GRAINS        amaranth, arrowroot, buckwheat, corn, millet, oats, potato, quinoa, rice, sorghum, tapioca
DRINKS                       Herbal teas and infusion
FOOD SUPPLEMENTS chia, linseed, sunflower, almond mix, nuts and seeds, oat bran, psyllium, rice
GALACTO-OLIGOSACCHARIDES (GOS)
GOS, are chain molecules formed from galactose sugars joined together with a fructose and glucose at the end. Raffinose and stachyose are the most common GOS found in food. They occur in legumes, such as baked beans, lentils and chickpeas.
Like FRUCTANS, GOS cannot be digestes or absorbed by anybody and they should be avoided if you have IBS.
DISACCHARIDES-LACTOSE
Only one disaccharide can potentially act as a FODMAP in food-lactose.
Lactose is a double sugar that occurs naturally in all animal milks. Made up of two digestible sugars called glucose and galactose, it is broken down in the small bowel into its component sugars by an enzyme called lactase. Lactose-intollerante people, have low levels of lactase and can only break down a very small amount of the lactose they consume.
MONOSACCHARIDES-FRUCTOSE
The only important monosaccharide that can potentially act as a FODMA in food is fructose.
Fructose, a single sugar, is often referred to as the “fruit sugar”. It is found in every fruit, in honey, and high-fructose corn syrup. It is a component of sugar and is also found in some vegetables and grains. When fructose occurs with glucose, it is well absorbed because it is “piggybacked” across the bowel lining by the glucose. If fructose is found in higher concentrations than glucose, its absorption is slow or incomplete. This situation is called fructose malabsorption.
FOOD CONTAINING EXCESS FREE FRUCTOSE (to avoid)
FRUITS                        Apples, cherries, mangoes, nashi pears, pears, persimmon,   rambutan, watermelon
VEGETABLES              Sugar snap peas
HONEY                        all types
SWEETENERS             high-fructose corn syrup, corn syrup solid, fruit juice concentrate
FOOD CONTAING LOW-FRUCTOSE OR BALANCE ALTERNATIVES (to eat)
FRUITS                        apricots, avocados, bananas, blackberries, blueberries, boysenberries, cranberries, cumquats, durian, grapefruit, grapes, honeydew melon, kiwifruit, lemons, limes, longons, lychees, mandarins, nectarines, oranges, passionfruit, paw paw, peaches, pineapple, plums, raspberries, rhubarb, rockmelon, star fruit, strawberries, tangelos, tomatoes
VEGETABLES              all except sugar snap peas
HONEY                        golden syrup, maple syrup, molasses, rice syrup, treacle, yeast extract, peanut butter, cho-nut spread, jam and marmalade in small quantities
SWEETENERS             sucrose (table sugar, cane sugar) including caster sugar, icing sugar, brown sugar, raw sugar, glucose
POLYOLS (sugar alcohols)
Polyols occur naturally in some fruits and vegetables. They ara often used in food manufacturing as humectants (water binging agents) and artificial sweeteners, particularly in “sugar-free” chewing gums, mints and confectionery.
Food are considered a problem for IBS sufferers if they contain more than 0.5 grams of polyols per serve.
HIGH-POLYOL FOODS
FRUITS                                               Apples, apricots, blackberries, cherries, longons,
Lychees, nashi pears, nectarines, pears, peaches, plums, prunes, watermelon
VEGETABLES                                     avocados, cauliflower, mushrooms, snowpeas
SUGAR-FREE OR LOW CARB              gums, mints, lollies, dairy dessert and other products                                                                 containing polyol additives
ADDITIVES                                         sorbitol (420), mannitol (421), maltitol (965), xylitol
 
LOW-POLYOL ALTERNATIVES
FRUITS                                               bananas, blueberries, boysenberries, cranberries,
Durian, grapefruit, grapes, honeydew melon, kiwifruit, lemons, limes, mandarins, mangoes, oranges,
Passionfruit, paw paw, pineapple, raspberries, rhubarb, rockmelon, star fruit, strawberries, tangelos
VEGETABLES                                     all except avocados, cauliflower, mushrooms, snowpeas
SUGAR-FREE OR LOW CARB              regular chewing gum sweetened with sugar, regular
                                                           Regular sugar sweetened mints and confectionery
ADDITIVES                                         aspartame, saccharine, stevia
FOODS SUITABLE FOR A LOW-FODMAP DIET
FRUITS                                  bananas, blueberries, durian, carambola, grapefruit, grapes,                     honeydew melon, kiwifruit, lemons, limes, mandarins,
                                               Oranges, passionfruit, paw paw, raspberries, rockmelon,
                                               Strawberries, tangelos, tomatoes
VEGETABLES                      alfalfa, bamboo shoots, beans shoots, bok choy, broccoli,
                                               Capsicum, carrot, celery, choko, choy sum, corn, cucumber
                                               Eggplant, green beans, lettuce, marrow, olives, parsnip
                                               Potato, pumpkin, silverbeet, spinach, spring onion
                                               (green part only), squash, swedes, sweet potato, taro
                                               Tomatoes, turnips, yams
MILK PRODUCTS                lactose free milk, hard cheese, including brie and
                                               Camembert, lactose free yoghurt, butter…
GRAIN FOODS                     gluten free bread and cereal products, amaranth
                                               Arrowroot, buckwheat, corn, millet, oats, polenta
                                               Quinoa, rice, sorghum
SWEETENERS                     sugar, glucose, stevia, any other artificial sweeteners not
                                               Ending in -ol
OTHER                                  garlic- infused oil as an onion and garlic substitute,
                                               Fresh and dried herbs and spices, chives, ginger, maple
                                               Syrup and golden syrup as honey substitutes
If you have been diagnosed with IBS, or if you have experienced bloating and abdominal discomfort with or without a change in your bowel discomfort, you should follow the Low-FODMAP Diet. At the beginning of the diet is best to avoid all FODMAPs for at least two months. If your symptoms have improved after this time, you can, if desired, gradually reintroduce one FODMAP group at the time to see if you tolerate it.
Here some important point to keep in mind:
  • Consider all the FODMAP groups.
  • No one can absorb fructans, GOS or polyols well; which means you should always avoid them when first implementing the Low- FODMAP diet.
  • Only some people have lactose or fructose malabsorption (a breath hydrogen test will tell you).
  • Some FODMAPs cause more trouble in some people than others.
  • You should eat no more than one serve of “suitable” fruits per meal. One serve is usually one metric cup of cut-up fruit, or one whole piece of fruit. You can enjoy many fruit serves per day, but you should allow two to three hours between each serve.
  • Eat table sugar should not cause symptoms if eaten in moderation.
  • You must avoid eating wheat and rye in large quantities
  • Avoid eating onions and garlic at least for two months. Onion is one of the greatest contributors to IBS symptoms. Garlic-flavour oil provides a good flavour subsitute
  • Keep a food diary
 
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  • Home
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        • On the route
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