Gut Feeling

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Along with our weight and what we put into our bodies, North Americans seem to be obsessed with our guts and what's coming out the other end. 

While some people suffer from serious diseases that affect GI tract health such as Crohn's, colitis, celiac or even irritable bowel syndrome (IBS), it seems like virtually everyone else is on some sort of specialized diet or supplement to improve digestion, bowel function and/or a host of what is believed to be associated symptoms.   Gluten-free is the new diet du jour, having replaced past favorites such as low-fat and low-carb.  But is avoiding gluten really going to cure what ails you?  Honestly, I'm willing to bet that in 5 years, most North Americans are no slimmer nor healthier, even if many of us jump on the gluten-free bandwagon.  Therefore, I was very pleased when I saw that the Nutrition Action Healthletter for January/February 2013 was dedicated to GI stuff.

Here's the scoop on poop (and related stuff):

Gluten - There is no evidence that avoiding gluten leads to weight loss.  For those with celiac disease, once  they cut out gluten from their diet, some lose weight, some gain, but the vast majority remain the same weight.  For healthy folks, if weight loss occurs, it's more likely because they have cut out a whole lot of junky foods or decreased their caloric intake.

Individuals with celiac may also get an energy boost when they eliminate gluten, but the energy boost some individuals feel has been attributed to the placebo effect (or perhaps, again, because they have cut out some of the crap from their diet and may be eating more nutritious foods), and tends to wear off after a few months.

Should you cut out gluten?

Not until you see a physician.  If you cut out gluten before going for testing, you may get a false negative for things like celiac and Crohn's.  Moreover, similar intestinal symptoms may be due to cancer.  Get checked out first, then try eating gluten-free, if warranted, to see if it improves your symptoms.

Gas (Farts are a favorite subject of mine...come on, they're funny!) - While beans, vegetables and milk usually get blamed for causing gas, alot of the fibres added to processed foods (like inulin and chicory root extract) contain sugars that cannot be broken down by our digestive enzymes.  So that Fibre 1 granola bar or Skinny Cow ice cream may be the actual culprit.  Sugar alcohols such as sorbitol and maltitol, often found in sugar-free and low-carb processed foods can also cause gas, bloating and diarrhea.

Colon Cleanses - Your colon does not need cleaning.  Our liver and kidneys are designed to detoxify our bodies.  In addition, many of the colon irrigation products on the market are potentially dangerous.  Also, any weight you lose by pooping your butt off is going to be temporary and most likely due to fluid loss (which can lead to severe dehydration!).

Lactose - Many people who believe they are lactose intolerant, actually have irritable bowel syndrome.  Individuals who are lactose intolerant can sometimes eat cheese and yogurt without a problem, while low-fat/fat-free milk causes the greatest distress.

Fibre Supplements - Some are not very effective at promoting regularity.  Look for ones that contain psyllium and/or wheat bran.

Another common gastrointestinal condition is diverticular disease.  This is when you develop little pockets or sacs in the colon that can bleed.  While more than 50% of adults develop diverticulosis by age 60,  less than 30% of those with the condition experience bleeding or symptoms.  A long held belief was that eating things like nuts, seeds and popcorn can lead to diverticulosis, however, a large study that tracked 47,000 men over 18 years found no link between consuming these foods and developing the condition.

What puts people at risk for complications from diverticulosis?
1. Eating too little fibre
2. Obesity
3. Inactivity

So, what's the take-home message?  If you are having bleeding in your stool, or digestive or bowel issues, go get yourself checked out ASAP.  Once any serious condition is ruled out, take a look at your lifestyle.  Before you start spending your money on expensive supplements or gluten-free diets, make sure you are at a healthy weight, if you are sedentary, get active, and make sure you are eating enough fibre (from food rather than supplements).  Women should aim for about 25g of fibre per day while men should aim for 30-35g.

The following chart lists the amount of fibre in various foods:

	Serving size	Total fiber (grams)*
Raspberries	1 cup	8.0
Pear, with skin	1 medium	5.5
Apple, with skin	1 medium	4.4
Banana	1 medium	3.1
Orange	1 medium	3.1
Strawberries (halves)	1 cup	3.0
Figs, dried	2 medium	1.6
Raisins	1 ounce (60 raisins)	1.0

Grains, cereal & pasta	Serving size	Total fiber (grams)*
Spaghetti, whole-wheat, cooked	1 cup	6.3
Barley, pearled, cooked	1 cup	6.0
Bran flakes	3/4 cup	5.3
Oat bran muffin	1 medium	5.2
Oatmeal, instant, cooked	1 cup	4.0
Popcorn, air-popped	3 cups	3.5
Brown rice, cooked	1 cup	3.5
Bread, rye	1 slice	1.9
Bread, whole-wheat or multigrain	1 slice	1.9

Legumes, nuts and seeds	Serving size	Total fiber (grams)*
Split peas, cooked	1 cup	16.3
Lentils, cooked	1 cup	15.6
Black beans, cooked	1 cup	15.0
Lima beans, cooked	1 cup	13.2
Baked beans, vegetarian, canned, cooked	1 cup	10.4
Sunflower seed kernels	1/4 cup	3.9
Almonds	1 ounce (23 nuts)	3.5
Pistachio nuts	1 ounce (49 nuts)	2.9
Pecans	1 ounce (19 halves)	2.7

Vegetables	Serving size	Total fiber (grams)*
Artichoke, cooked	1 medium	10.3
Green peas, cooked	1 cup	8.8
Broccoli, boiled	1 cup	5.1
Turnip greens, boiled	1 cup	5.0
Brussels sprouts, cooked	1 cup	4.1
Sweet corn, cooked	1 cup	4.0
Potato, with skin, baked	1 small	3.0
Tomato paste	1/4 cup	2.7
Carrot, raw	1 medium	1.7

*Fiber content can vary between brands.
Source: USDA National Nutrient Database for Standard Reference, 2012