If you are a Facebook person, please do go to my Facebook Page Kate Arnold Nutrition and first of all “like” it (if you do!) and then feel free to express yourself on all aspects of health and nutrition. There are loads of recipes, articles and up to date research for you to read and comment on. See you there!
SIBO – Some of you may have heard of this but most may not and it has become important in identifying one of the underlying causes of irritable bowel syndrome (IBS). In recent years SIBO has also been linked with fibromyalgia, acne rosacea and other health problems which is why it is a fascinating condition to diagnose and treat. Before you rush out to your GP, getting tested is not simple and it is not widely available on the NHS. SIBO is currently mostly diagnosed privately, some GP’s have never heard of the condition and some consultants are dubious as to it’s relevance in relation to IBS and other related health issues. In essence it is still quite controversial but if you would like to find out more, please read on as it may be one of the answers to your unanswered health problems.
What is SIBO?
Small Intestinal Bacterial Overgrowth is a chronic bacterial infection of the small intestine. The infection is due to bacteria that normally live in the gastrointestinal tract but have abnormally overgrown in a location not meant for so many bacteria. The bacteria can interfere with our normal digestion and absorption of food. It can also lead to deficiencies in iron and vitamin B12, causing certain anaemias.
After eating food, the bacteria produce gas within the small intestine which in turn can cause abdominal bloating, abdominal pain, constipation, diarrhea or both. This can get confusing because of course these are the symptoms of irritable bowel syndrome (IBS). SIBO has been shown to exist in up to 84% of IBS patients. However for my part, I have not seen this higher percentage and I find about 30% of IBS patients have a positive SIBO test. Apart from IBS, SIBO has been linked controversially to a whole host of other conditions. These include:
Other symptoms
How do I get SIBO?
The gastrointestinal tract is a continuous muscular tube which digesting food travels along on its way to the colon. Normally, the coordinated action of the muscles of the stomach and small intestine propels the food from the stomach, through the small intestine and into the colon. This muscular action also sweeps bacteria out of the small intestine and limits the numbers of bacteria in the small intestine. However when a condition interferes with the normal activity in the small intestine this can result in SIBO. By allowing bacteria to stay longer and multiply in the small intestine the lack of normal muscular activity also may allow bacteria to spread backwards from the colon into the small intestine. Possible causes are:
Long term use of PPI’s (proton pump inhibitors eg omeprazole)
“It is mandatory to consider SIBO in all cases of complex non-specific dyspeptic complaints (bloating, abdominal discomfort, diarrhea, abdominal pain), in motility disorders, anatomical abnormalities of the small bowel and in all malassimilation syndromes (malabsorption, maldigestion).”J.Bures et al 2010.
Getting Tested for SIBO
SIBO is measured by a breath test. This measures the hydrogen and methane gas produced by bacteria in the small intestine that has diffused into the blood, then lungs, for expiration. The gas is graphed over a transit time of 2 or 3 hours and compared to a baseline. Patients drink a sugar solution of lactulose after a 1 or 2 day preparatory diet. The diet removes much of the food that would feed the bacteria, allowing for a clear reaction to the sugar drink. The test is performed either at home with a take home kit or a breath testing machine in hospital, doctors office, or lab. It takes 1-3 hours in the morning after a 12 hour fast the night before and a special diet needs to be adhered to the day before the test.
Who should get tested?
If you have IBS symptoms that have not got better despite seeing your GP and are also suffering from a range of unexplained symptoms, acne rosacea, fibromyalgia etc it may certainly be worth ruling SIBO out as a cause for your symptoms.
Breath tests are available- these are priced £150. – Please call me on 01323 737814 for more information.
What happens if the test is positive?
If the SIBO test is positive the best approach is antibiotic therapy taken over 7-10 days. The antibiotics will vary but this is usually enough to stop the problem and will mean you will be able to eat a normal diet again, if you have been eliminating suspect foods. Antibiotics used can include: tetracycline, amoxicillin, metronizadole, neomycin, cephalexin, and trimethoprim-sulfamethoxazole.
There is only one study using herbal “antibiotics” for the treatment of SIBO, which used enteric coated peppermint oil (ECPO). Besides this, herbal antibiotcs have not been studied for the reduction of SIBO. The question is whether they will target the bacteria that is overgrown. However, it has been suggested that some herbal antimicrobials do not kill our beneficial bacteria, certainly a unique and desirable quality. Herbal antibiotic formulas abound in the supplement industry. These include: Garlic, Cinnamon, Oregano, Goldenseal, and Barberry.
What about special diets?
Patients who come to me with suspected SIBO issues are already on severely restricted diets – avoiding wheat, gluten, dairy, lactose, large amounts of carbohydrate and all manner of different variations of elimination diets. It is advisable to eradicate SIBO quickly and get back to eating as normally as possible rather than staying on restricted diets long term which may lead to different health issues. It is commonplace for patients to think they have multiple food intolerances and lists of foods they cannot eat when in fact it may be only a few foods and the problem they are suffering from is SIBO not from the food itself. Often people with SIBO tell me it does not matter what they eat – even a glass of water can make them feel bloated. This should ring alarm bells, if it’s not the food there is something going on in the gut. Time to get tested. There are a few diets that can help symptoms of SIBO and IBS as well. These include the Specific Carbohydrate Diet and Low FODmap diet which I will be discussing in the next issue as well as the GAPS diet which has found huge popularity recently.
For more details on tests and consultations visit www.katearnoldnutrition.co.uk or call Kate Arnold on 01323 737814 for more details.
 Headaches? Tired All the Time? IBS? Fuzzy thinking? Aches and Pains? Not feeling your best? I am offering my two hour 1-1 MOT service (normal price £165) for £120 from 1st January to 31st January. Start the new year the healthiest you have been! Call me for more details on 01323 737814. |
Kate’s 12 Festive Food Tips
It’s very usual for the average person to gain 4-6/lbs over Christmas and I know those of you following my weight loss programmes are beginning to panic even more than usual. As much as Christmas seems to be about excess fundamentally it is about having a break from work and being with family more than how much ginger wine and chocolate brazils you can consume! Here are a few easy tips to follow that will help prevent weight gain:
4. Don’t forget to drink water and if that’s too boring try a cordial instead: here are some healthy alternatives to alcohol: Belvoir raspberry and rose cordial, Belvoir organic ginger beer, Belvoir spiced winter berry is a great alternative to mulled wine. Watch out for the ingredients list – avoid anything with glucose syrup/fructose/glucose fructose syrup.
you can get some longish walks in with the family that would be even better, far healthier than slouching in front of the tv all day!
WELCOME TO MY NOVEMBER NEWSLETTERThe pros and cons
I am offering from 1st to 31st December a full consultation for £55 (normal price £75) – this will be an hour and an half – if you want to know more please call 01323 737814.
Nutrition Workshops restarting Tuesday 8th October 6.30pm to 8.00pm at The Cookshelf.
For more details and to sign up please go to www.TheCookshelf.co.uk.
At The Cookshelf we are great believers in the positive benefits of a healthy diet. Our qualified nutritionist has developed a special four week nutritional workshop that is perfect for anyone who want to improve their knowledge of nutrition and healthy eating. Upon completion of the workshop series you will be confident in your ability to make healthy nutritious food choices.
The next set of workshops will run in the evenings from 18.30-20.00 from October 8th 2013 covering 4 key areas of nutrition . A range of healthy and nutritious snacks will be served.
Week One
General Nutrition; the myths of balanced diet
Week two
Beat the Bloat: Probiotics, IBS and gut disorders
Week Thee
Weight Loss: Why we get fat and how to shift weight for good
Week Four
Food labelling and supplements: How to shop healthily
£50.00 per person for 4 week course. To book 01323 732280
The Cookshelf
Nutrition Workshops 2013
As part of Eastbourne’s new and exciting cookery school The Cookshelf, we are running four week courses on nutrition. These are designed to be fun, informative and give you a chance to ask questions. Cookshelf’s founder Kate Guindi is passionate about great food that is locally sourced and free from additives. She has teamed up with Kate Arnold, Nutritionist and will be offering a chance for people to obtain expert nutritional advice on a range of subjects.
The four week course will consist of four one and a half sessions taking place one evening a week. Kate will talk for an hour and will leave half an hour for questions. The course will be £40 including hot and cold drinks and delicious home made snacks.
Week One
General Nutrition; The myths of a balanced diet
Week Two
Beat the Bloat; Probiotics, IBS and gut disorders
Week Three
Weight Loss; Why we get fat and How to shift weight for good
Week Four
Food Labelling and supplements; How to shop healthily
If you would like to come and join us please contact Kate Guindi at kate@thecookshelf.co.uk
Had a very pleasant day the The Royal Society of Medicine seminar on Eggs. Last month my newsletter was on this very subject so if you think eggs raise cholesterol and are not too sure about how many to eat, read on…
Welcome to my February Newsletter
I’ve been asked again to cover mental health and nutrition in my monthly newsletter – as this is a huge topic, I will be continuing next month focusing on the gut/brain connection. This month I’ll take you through the basics of how what we eat can affect our mental health. I know this is a subject very close to peoples hearts as so many of us have either suffered from mental health issues or know someone who is suffering. An astonishing one in four of us are likely to suffer with some sort of mental health problem in our life time. In real terms this will account for around 300 people out of 1,000 experiencing mental health problems; 230 of these will visit a GP, 102 of these will be diagnosed as having a mental health problem, 24 of these will be referred to a specialist psychiatric service and 6 will become inpatients in psychiatric hospitals. A few years ago Mind embraced the wonderful work Amanda Geary did with her Food and Mood project (www.mind.org.uk for more info), highlighting how what we eat can change our mood and behaviour patterns. Most of this research and information is not new but has been buried and lost somewhere in the passage of time. For those of you who would like more help with food and behaviour ie for dyspraxia, dyslexia, adhd, and autistic spectrum disorders you may be interested in www.fabresearch.org. For the first time I’ve enclosed a brief case history of a sectioned patient of mine, which I hope helps you envisage a little better what can be done to help.
Characteristics of the modern diet
Todays modern diet has changed beyond recognition. Whilst some people may be more informed as to what is good to eat, it is difficult ploughing through the marketing and hype and getting to the truth about our food. Producing cheap food has been catastrophic for not only peoples health but for the quality of the food produced. This has left us with a diet that is hardly recognisable from that of our grandparents.
Todays diets contain:
A high concentration of long chain saturated fats
A high glyceamic load due to the presence of refined sugars and grain products
A low nutrient density with regards to vitamins, minerals, antioxidants, fibre, phytochemcials, amino acids, and unsaturated fatty acids
An omega 3 to omega 6 fatty acid ratio thats differs from our ancestors
Low amounts of pre and probiotics
A high salt content A high level of environmental contaminants such a mercury dioxins, PCB’s phthalates etc
In short modern diets have all the required characteristics to impair both brain function as well as general health. That’s quite a statement I’m making!
How can nutrition help with mental health issues?
In my mind modern diets are a recipe for madness. If, on the most basic level are brains are made of 70% water and 30% essential fat, is it any wonder with our fast and furious way of living in the 21st century that our mental health is not supported with diets that quiet frankly leave much to be desired. Nutrition can certainly play a supportive role alongside medication from doctors and psychiatrists. One of the most common conditions I see in my clinic is depression, which can range from mild anxiety to bi -polar disorder. It is easy to over generalise and say that all people with mental health problems have bad diets. That is not the case. However a good three quarters of people with mental health issues may well have, poor blood sugar control, vitamin and mineral deficiencies and food allergies. It’s also not the case that eating five portions of fruit and vegetables per day and taking a few supplements is going to “cure” your mental health issue. Obviously people who have lived through trauma/loss/grief etc will have a cause for their illness, or indeed low levels of serotonin, but these people can still be supported through their process by good nutrition. This is really the time to say that what you eat can change your mood greatly. A fantastic out of print book called Not All In the Mind by Richard Mackarness highlighted this back in the 1970’s. As you can imagine with the growth of processed food, and millions of nutrient deficient people, mental illness appears to be on the increase. Of course our hurried stressed lifestyles do not help, together with the throw away celebrity culture that has ingrained itself into our every days lives, being happy and contented is sometimes hard in the 21st century.
So how does food affect my mood?
Your feelings are generated by tiny brain chemicals called neurotransmitters. These include dopamine, serotonin and adrenaline, glutamate, GABA and acetylchoine. Neurotransmitters are responsible for dictating your mood and are greatly affected by what you eat. Serotonin is associated with a reduction in stress and tension and feelings of happiness, whereas dopamine and adrenaline have different mood effects by boosting concentration and alertness. The influence of food is extremely relevant when neurotransmitter production is considered. Amino acids found in proteins provide the raw materials needed to make neurotransmitters and a low protein diet is often at the route of neurotransmitter imbalance. You may be interested in the fact that over the last 17 years, in all the thousands of food diaries I have seen, barely any are high in protein, but nearly 70% are high in sugar and caffeine. Some foods directly stimulate a neurotransmitter response e.g. carbohydrates influence serotonin production and caffeine stimulates adrenaline synthesis. There are many other specific vitamins and minerals that have a powerful effect on your mood. Without proper neurotransmitter balance brain function and mood can be seriously affected. Feelings of anxiety and stress are commonplace in today’s society. The body’s stress response has not yet evolved to deal efficiently with modern life, meaning the slightest emotional stress still causes a powerful release of chemicals. Two minerals, calcium and magnesium play an important role in regulating your nervous system. By making sure you have adequate dietary intake of these two nutrients you can help yourself combat feelings associated with stress and induce calmness and relaxation. Serotonin has received much publicity as a key factor in boosting mood and getting rid of the blues. This neurotransmitter is important to maintain feelings of happiness and positivity. There is now a huge amount of research which links reduced serotonin levels with lowered feelings of self-esteem and poor accomplishments. Serotonin is formed from the amino acid tryptophan, with the help of the ‘good’ omega-3 oil and vitamin B6. Tryptophan is an essential amino acid which means it can’t be made by the body and therefore has to be sourced from food, making the link between food and mood very relevant for this neurotransmitter.
The Brains Neurotransmitters
These are made from protein and if your diet is deficient in the building blocks then you will not be able to make these and mental and neurological problems may result. Serotonin When balanced you sleep well, enjoy food and think rationally. When out of balance, there can be sleep problems, depression, PMS and hormonal imbalances. Sources in foods: eggs, turkey, bananas, yoghurt, milk, cottage cheese and dates. GABA (gamma-aminobutyric acid) – Natural valium! Controls the brain’s rhythm so you function at a steady rate. When out of balance you can get headaches, palpitations, seizures and heart problems. Sources: flour and potatoes. Dopamine Controls metabolism. Used for, energy excitement, new ideas and motivation. Out of balance can lead to addictive disorders, obesity, severe fatigue and in the long run Parkinsons disease. Sources: in beets, soybeans, almonds eggs, meat and grains. Acetylcholine- A brain lubricant that keeps the internal structures moist so that energy and information can pass easily around the system. When balanced you are creative and feel good about yourself. Out of balance you can get memory loss and language disorders. Sources: eggs, liver and soybeans.
Diet and good mental health
There is common ground in most mental health issues that will aid in the person’s recovery. Below I’ve set out a few ideas on how to change your diet for the better. For more details about food and mood go to www.mind.org.uk and click the mind guide to food and mood for more information. Eat every three hours combining protein with carbohydrate to ensure stable blood sugar levels throughout the day. If possible get some exercise – at least half an hour daily – this is particularly important with depression. Avoid E numbers, colourings, preservatives, msg and sugar substitutes. Keep well hydrated – drink about 1 ½ litres of water daily. Always eat breakfast. Eat enough complex carbohydrates – the body uses them to make serotonin and they keep blood sugars stable. Avoid saturated fat i.e. chips, fried food, too much cheese and red meat. Check yourself for food allergies – there is a strong case for certain foods creating certain moods. If in doubt, get a blood test done or do your own food and mood diary, writing down everything you eat and drink and everything you feel mentally and physically. Eat whole grains: wholemeal bread, brown, rice and brown pasta. Eat a high amount (at least five portions) of fruit and vegetables per day. Eat oily fish (salmon, sardines, mackerel at least three time a week. Eat adequate amounts of protein at every meal, this is important for building neurotransmitters. Keep up with your vitamin and mineral intake – in particular zinc, magnesium, vitamin B and essential fatty acids. These are all important in the production of serotonin. A good multivitamin (with at least 10mg zinc), Omega 3, and a calcium and magnesium supplement would be useful. Get your Vitamin B12, folate and thyroid checked with your GP. Many people with mental health disorders have low levels of B12, B1, B2, B5, B6, magnesium, calcium and zinc. These can all be tested and deficiencies alleviated. Do not self prescribe vitamins and minerals without professional help (particularly if taking medication).
The role of nutrition in mental health isn’t some quack idea. There is overwhelming evidence to the contrary and trials to back up the claims. For those interested, there is a government paper – The Links Between Diet and Behaviour – The influence of nutrition on mental health – a report of an inquiry held by the Associate Parliamentary Food and Health forum in January 2008. Go to www.fhf.org.uk/inquiry to download the document.
If you would like to talk through your mental health issue in confidence and how nutrition may help please call on 01323 737814.
Mental health case history
I don’t usually include case histories in my newsletter but wanted you see an example of how food and mood works in the real world! Tom was 26 yrs old and when I saw him, he was sectioned in a psychiatric hospital north of London. He had been diagnosed with schizophrenia – he heard music, not voices, had self harmed, and been in and out of hospital for six years. His mother was very concerned at his overall health – she felt he had got worse in hospital and he was now sedated much of the day. He had been violent and aggressive towards her so when I visited Tom I had to wear a bleep and have the door open during my visit. I was shocked to see how ill a 26 yr old can look like, when they have not been diagnosed with any physical health problem. He was very pale, very black under the eyes with a face covered in acne, and underweight. Most of his teeth were missing. He looked worn out with a system that was not working for him. It took me three visits to engage with him and to get him to trust me. He was keen to do anything to get better and agreed to some testing. His diet consisted of black coffee, ten cigarettes a day, no water, chips and five Dr Pepper fizzy drinks which seemed to be the only drink on offer. The vending machine in the hallway sold only fizzy drinks and chocolate bars. With the help of his psychiatrist who was skeptical but helpful we found the following: Tom had scurvy. Tom was positive to tissue transglutaminase antibodies ie he had coeliac disease. His B12 levels were extremely low. He had very low levels of zinc. His blood sugar was very low at various points of the day. I’m not sure what the psychiatrist actually thought of the results or me (!) but he was immediately on board to correct what we had found. He did not think vitamin B12 injections or zinc would make a difference. But… they did. Tom followed a gluten free diet, cut out coffee, we balanced his blood sugar as much as we could within the confines of hospital food and he drank water instead of Dr Pepper. He was given Vitamin C, B12 injections and high levels of zinc. And little by little.. he got better to the extent that he is now out of the hospital and working part time. He still smokes and he still has bad days but is now off every medication except a low level anti depressant. There have been no violence or aggressive outbursts, and no bouts of self harming for two years. Tom recently visited India and has become vegetarian and meditates for an hour a day. He feels this has pushed him further on the path to recovery. Clearly, this won’t happen with everyone. Mental issues are complex and multifactorial however in this incidence it was the stepping stone for Tom making a near full recovery.
@katearnoldnutrition
© 2020 Kate Arnold Nutrition
All Rights Reserved
