Wednesday, December 31, 2008

How to Be Better with IBS, take home messages from the American College of Gastroenterology’s latest Review

Irritable bowel syndrome is characterized by diarrhea or constipation, or a mixture, altered bowel habits and frequency of these, bloating and abdominal discomfort. Diagnostic criteria has been around since the following reports - by Manning in 1978, then Kruise in 1984, and Rome 1 1990, Rome 11 1999 and the latest Rome 111 2006.
IBS affects 7-10% of the world’s population, with a prevalence of 7% in North America and is one of the most common reasons for consulting a gastroenterologist or Primary care physician. It has profound affects on daily life for those unfortunate to suffer from this condition.After an extensive review of all the evidence related to various treatments for IBS the American College of Gastroenterology concluded that
Further investigations are unnecessary in young patients with no alarm features except serology of celiac sprue and colonoscopy is only indicated in those over 50, making a diagnosis more straight forward and avoiding unnecessary testing.
• Psyllium fiber, certain antispasmodics and peppermint oil are effective although evidence is poor.
• Wheat bran and corn had no effect
• Chinese herbs may help but there are concerns over purity and safety of these.
• Probiotics (such as live yogurts) may improve symptoms but more data is needed, lactobacilli are not effective and bifidobacteria showed some efficacy.
In regard to diet there is insufficient evidence that food allergy testing or exclusion diets are beneficial although 60% of IBS sufferers believe food exacerbates their symptoms. 8 studies assessed symptomatic response to exclusion diets in 540 IBS subjects, studies reported a positive response in 12.5-67% of patients but absence of control groups makes it unclear whether it was a placebo effect. Also there was no correlation between food that patients identify as a cause of symptoms and allergy testing.
Cognitive behavioral therapy, dynamic psychotherapy and hypnotherapy but not relaxation therapy are more effective than usual care in relieving global symptoms of IBS
So are we any closer to more definitive recommendations? It would appear that in some areas, such as medication usage but overall IBS remains a complex condition and very individualized.
It is best for sufferers to work closely with their physician and consider consulting a dietitian to have a general review of their diet and lifestyle to ensure they are following a balanced diet and active lifestyle for over good health. While evidence for trigger foods is weak, if it is felt that certain foods aggravate symptoms it is fine to limit or omit these foods, as long as the diet is adequate overall.
The dietitian can also work with the sufferer to add in Psyllium fiber to the diet and trial Probiotics, with the use of a food and symptom diary. It is also advantageous to evaluate stress and consider psychological therapies as needed.
One thing is for sure it will continue to be a condition affecting many people across the globe, new treatment options and drugs are in development, hopefully in time we will have a clearer picture of how best to approach Irritable Bowel Syndrome.

Brandt L J et al A Evidence Based Systematic Review on the Management of Irritable Bowel Syndrome. American College of Gastroenterlogy Task Force on IBS. American Journal of Gastroenterology 2009; 104 Supplement (1): 1-40

Tuesday, December 23, 2008

FDA warning for weight loss products

Hi all just wanted to post a link that the FDA has issued a warning on these products, in case you know of anyone taking them for their safety
The tainted weight loss products are:
2 Day Diet
3 Day Diet
3x Slimming Power
5x Imelda Perfect Slimming
7 Day Herbal Slim
7 Diet Day/Night Formula
8 Factor Diet
24 Hours Diet
999 Fitness Essence
Extrim Plus
Fatloss Slimming
Imelda Perfect Slim
Japan Lingzhi
Lida DaiDaihua
Miaozi Slim Capsules
Perfect Slim
Perfect Slim 5x
Phyto Shape
ProSlim Plus
Royal Slimming Formula
Slim 3 in 1
Slim Express 360
Venom Hyperdrive 3.0
Zhen de Shou

Wednesday, December 17, 2008

Its Never too late to Follow your Dreams !

The other morning I was watching TV while working out on the stationary bike when I came accross a movie The Worlds Fastest Indian starring Anthony Hopkins, it was truely inspirational. It is about Burt Munro a New Zealander who came to Bonneville salt flats to set a record for the fastest motorcycle. He set the World record for under-1000cc, 183.586 mph (295.453 km/h), at Bonneville, 26 August 1967. He was 63 years old at the time with a bad heart riding a 47 year old machine the Indian Scout. He saved for years to make the trip to America often working on his bikes all night. On his first trip he came to America on a cargo ship, in order to pay for his trip he worked as the ships cook !
It just goes to show with dedication and hard work no matter what your age you can achieve your dreams, I am sure President Elect Obama would say the same thing!
So what are you waiting for whether its getting your dream career, improving your health to be able to run up that flight of stairs, making that all important trip with your family just follow your heart if Burt can it his 60's so can you!!
"If you don't follow your dreams, you might as well be a vegetable" Burt Munro.

Monday, December 15, 2008

Merry Christmas

The Traditional British Christmas meal, Turkey, mashed potatoes, brussel sprouts, cranberry sauce, roast potatoes, sausages and gravy. Followed by Christmas pudding. But have you ever wondered how we came to eat these things ?
The turkey was introduced to the UK by William Strickland in Bristol in 1526 when he imported 6 birds from America, the Indians were particularly fond of this bird. King Henry XIII was the first king to have it at christmas. After the meal a long y shaped bone of the turkey will be pulled apart and the person who gets the biggest part can make a wish!
The Pudding has been around since the middle ages, it used to have meat in it, but became more of a desert during victorian times. It was made 5 weeks before christmas after advent sunday and each family member would stir it up and make a wish, called "stir up sunday", often a silver coin would be added and the one who found it got wealth and good luck!
In America the christmas meal is similar but pumpkin pie is a popular desert. Cod fish and baked potatoes are enjoyed in Spain and Portugal, Scandinavian countries like to eat shellfish, pork and caviar. With the Australians enjoying a BBQ due to the heat of their summer and prefering to enjoy the outdoors and the Italians a 7 course feast with salads and pastas.
Whatever you are eating this Christmas, make it a tradition of good food, family time and laughter, a time to be thankful and to remember Christs birth and love for us.

Friday, December 12, 2008

Oprahs Weight Gain

The whole world is a buzz about Oprahs recent weight gain, its been in British newspapers, CNN and debated about on the Nutrition Entrepeneurs listserv I belong to. It just highlights how difficult it is to maintain longterm weight loss, many folks are facing the same struggle and Oprah even with all her resources such as Dr Oz, personal trainer, and chefs is facing the same challenges.
The unfortunate thing is she has to do it in the public eye. I would applaud her for having the courage to discuss the issue and keep trying to improve her health. Maybe she was a little hard on herself and set unrealistic goals of restricting her food intake and excersing so much. I remember seeing one show where she just smelled a desert and didn't taste it to avoid the calories. This highligts the age old rule a little of what you fancy does you good! as we say in England.
Be kind to yourself, enlist a good support network as you work on lasting lifetyle change and if you do re-gain some weight have a number say 10lb to make you reassess what your doing, maybe keep a food diary for a week, or maybe look at your piorities. Make an appointment with your Dr and dietitian for the support to keep your health goals on track. And most importantly never give up on your health is too important, if Oprah can be honest and keep trying so can you.

Thursday, December 11, 2008

First Blog !!

My first Blog ! I thought it would be a great idea to have a place to share wellness tips, my favourite nutrition research and great health information.
I will also offer travel tips and restaurent reviews, I am lucky to be able to travel around the world and love ethic food and hope to inspire others to try new food and experiment.
I have over 8 years experience as a dietitian in the United Kingdom and America, in many clincal areas and different settings such as hospitals, clinics and home health. I am married to a wonderful husband and am delighted to be a new mum to our gorgeous 3 month old daughter.
So thats me, more to follow !!!......


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