Gut Nutrition

31/07/2024

University of Otago researchers have shown that food outlets en route to school increase children’s consumption of unhealthy food. Please consider supporting this petition against multinational fast foods outlets opening next to a primary school and community church in Tirau.

No Thanks Burger king and star bucks​.​we're a village not a TruckStop

27/07/2022

Silverbeet is in season!

Silverbeet (also called chard) is a winter vegetable that is very versatile and often available in different coloured stems e.g. white, orange, red. Silverbeet is a good source of variety and vitamins and minerals (e.g. vitamin A, E, K, C) but the cooking method does affect nutrient content.

Many people tell me that they are unsure how to use silverbeet. Below are some ideas to make the most of this nutrient-rich winter vegetable.

- eat raw e.g. finely sliced and diced as a shredded lettuce substitute in wraps
- add sliced silverbeet to tomato-based sauce and then blend to make a smooth tomato sauce e.g. use as a pasta sauce, in nachos or in any dishes that include passata or chopped tomatoes
- separate silverbeet stems from the leaves. Finely slice the stems and then saute until soft. Add finely sliced leaves once the stems are cooked and wilt. Serve with a squeeze of lemon (to improve absorption of iron in the silverbeet) and sprinkle with toasted sesame or pumpkin seeds
- Silverbeet leaves can often be used in place of spinach in many dishes.

Choose bunches of silverbeet with younger/smaller silverbeet stems and leaves as these will be less tough / easier to digest than larger leaves.

20/07/2022

🍞🍚🥔 People often say that they are bored of "beige" foods during a flare.

If you are struggling with what to eat during a flare of Crohn's or colitis, get in touch. There are various dietary approaches that are appropriate during both flares of UC and Crohn's. You do not need to eat only beige foods!

Send me a message via www.gutnutrition.co.nz/contact or DM me.

13/07/2022

Eggs! 🥚🍳🐔

Eggs are a great source of vitamin D (a vitamin that is made when we are exposed to UV light), at this time of the year, anyone living south of Wellington does not get enough UV rays from the sun to make vitamin D.

Vitamin D is a fat-soluble vitamin. The egg yolk contains fat, thus the source of vitamin D is in the yolk of the egg.

An easy warm meal to increase your vitamin D levels is fried eggs on toast, a popular breakfast for chilly winter mornings.

Eggs are a great source of vitamin D during the winter months, and eating two eggs could provide you with 50 - 100% of your daily vitamin D needs! Eating eggs a few times a week is a great way to improve your vitamin D intake.

For more information on vitamin D, check out my blog post on www.gutnutrition.co.nz > Blog Posts > Vitamin D.
https://www.gutnutrition.co.nz/blog/vitamin-d

06/07/2022

How to book! ☎️💻 📞

Gut Nutrition provides specialist dietitian support for people diagnosed with inflammatory bowel disease (IBD); either ulcerative colitis (UC), Crohn’s disease (CD) or IBD unclassified as neither CD or UC. Clinic consultations are at 40 Stewart Street, Christchurch or video consultations are available for clients from around New Zealand.

All in person & online appointments can be booked via my website: www.gutnutrition.co.nz/appointments

If you have any questions or queries or would like further information, contact me via DM or send me a message on the contact page via gutnutrition.co.nz

To find out more about Gut Nutrition's specialist IBD food and nutrition services at www.gutnutrition.co.nz

(link to website in bio)

29/06/2022

Should I avoid dairy? 🥛🧀🐮

This is one of the most common questions I am asked. The answer is not that straightforward though. At the moment, research has not shown that eating dairy products promotes or causes inflammation. There may be times though when eating dairy may aggravate your symptoms. Some examples are:

1. active inflammation may cause short-term lactose intolerance. This would mean that liquid dairy products that are higher in lactose can not be digested effectively. This often results in abdominal pain and diarrhoea soon after eating high lactose dairy products (e.g. milk, yoghurt, icecream, cream). Once in remission again, lactose digestion usually improves as does tolerance of high lactose foods.

2. high fat dairy products in larger amounts than normal. Rich dishes that include a lot of cream or melted cheese often result in symptoms. It is often not the dairy itself but the large portion size of fat that triggers symptoms such as abdominal discomfort, flatulence, bloating, reflux and/or diarrhoea. Eating a small portion may be better toleranced and result in less symptoms.

If you choose to avoid dairy products it is important to replace them with a plant-based alternative that is calcium fortified. Calcium is an important mineral that is needed to maintain and build, in conjunction with vitamin D, strong bones. We need three portions of high calcium foods every day to get enough calcium.

22/06/2022

Chickpea Biscuits! 🍪😋🍯

This recipe uses whole chickpeas to replace most of the flour and some of the fat in the biscuit recipes. Chickpeas are a great source of prebiotic galacto-oligosaccharides, are a good source of folate and contain many other vitamins and minerals in small amounts. Tahini is made from ground sesame seeds. It is high in fat but low in saturated fat and higher in monounsaturated and polyunsaturated fat. Using tahini instead of a high saturated fat (e.g. butter or coconut oil) may help to reduce LDL cholesterol levels. Tahini also contains some fibre and a range of vitamins and minerals in small amounts.

This recipe contains only ingredients allowed in phase 2 of the Crohn's disease exclusion diet. If you are not following the Crohn’s disease exclusion diet, these biscuits are delicious with small chunks of dark chocolate added prior to baking.

Ingredients:
1 can of well rinsed chickpeas
1/2 cup tahini
1/2 cup sugar or honey
1 tsp baking powder
2 Tbsp rice flour
1 Tbsp olive oil
1 tsp cinnamon

Method:
Preheat oven to 170°C. Line a baking tray with baking paper.
Add all ingredients to a food processor or blender.
Blend until well combined and the mixture looks like a biscuit dough.
Roll tablespoonfuls of dough into balls and place on the lined baking tray.
Gently flatten with a fork.
Bake for 12 – 15 mins until lightly golden. Remove from the oven and place on a wire rack to cool.
Store in an airtight container or in the freezer.

15/06/2022

Should I avoid gluten? 🍞🥨🥖

This is one of the most common questions I am asked. The answer is not that straightforward though. Gluten is a protein found in wheat, rye and barley. At the moment, research has not shown that eating gluten containing foods promotes or causes inflammation. There may be times though when eating gluten containing foods may aggravate gut symptoms and not promote good health. Some examples are:

1. Wheat and rye contain large amounts of carbohydrates called fructo-oligosaccharides (fructans) that are not fully digested in the small intestine but are broken down and fermented by the gut microbiota in the large intestines. For some people, this process can result in symptoms such as abdominal pain, bloating, flatulence and diarrhoea/constipation. This does not mean that avoidance of wheat and rye is needed, but reducing the portion size eaten, or the number of times in a day, may be needed. This is commonly done as part of phase 1 and phase 2 of the low FODMAP diet.

2. Many processed foods are made with wheat flour, which contains gluten. Gluten free foods are often highly processed too. Eating a highly processed diet that includes a very limited range of foods is associated with poorer gut health and mental health. Eating a variety of grains, rather than only wheat, helps to improve dietary variety, improve fibre intake, improve micronutrient intake and improve overall well-being.

Take home message:
Aim to eat a variety of grains rather than wheat based foods at every meal e.g. weetbix for breakfast, wheat bread for lunch and pasta or wraps for dinner. Other grains include oats, barley, quinoa, millet, sorghum, buckwheat, rice, corn/maize, rye, spelt and amaranth.

08/06/2022

Have you tried overnight oats yet!?
Preparing overnight oats is not only a delicious breakfast option but also a great way to increase your plant food intake, you can easily get five different plant foods into overnight oats by adding a variety of toppings and soaking oats with other grains.
Overnight oats (bircher style muesli) can be prepared within 5 minutes and left in the fridge overnight in an airtight container/jar to be enjoyed as breakfast or a snack.

Once the oats have been soaked in your choice of milk overnight, add as many toppings as you like. Berries, banana, apple, peach, chia seeds, peanut butter, ground linseed, sunflower seeds and almonds (LSA) and honey are some popular options. My favourite savoury toppings are a drizzle of olive oil, yoghurt, seaweed (nori), tahini, ground linseed, mixed nuts and dried beetroot!

Psyllium husk can also be added to overnight oats to increase your fibre intake. Also, using a high protein milk such as cow's milk, lactose-free cow's milk or soya milk helps to keep you feeling satisfied for longer and these milks are higher in calcium which will help to meet your daily calcium needs. Overnight oats can be made in many variations to suit your preferences/dietary requirements e.g. lactose, dairy, gluten and nut-free.

Overnight oats are an excellent contribution to your , eating 30+ plant foods per week is associated with having a diverse gut microbiome, contributing towards a healthy gut as well as improved mental and physical health.

The basic recipe for overnight oats:
1/2 cup of rolled oats or muesli or mixture of rolled oats, quinoa flakes and chia seeds
½ cup of milk (any milk of your choice)
Toppings of your choice, you don't need lots of each topping. Just a few spoonful’s will add to your 5 plant foods a day.

01/06/2022

Sourdough made from wheat flour is better tolerated by those with IBD than regular wheat flour bread made with commercial yeast. Sourdough is made with a live culture or starter. The culture is initially a mixture of flour and water. The wild yeasts present in flour flourish in the damp environment and ferment and multiply. Over time other microbes from the local environment also join the culture. This culture is what gives sourdough a distinct flavour and texture and is what helps make sourdough bread friendly for a sensitive gut.

Sourdough bread has a long ferment time. The microbes in the culture ferment the flour added to the dough. This fermentation helps to break down some of the carbohydrates, such as fructooligosaccharides (FOS), present in wheat flour. Hence, sourdough bread is lower in FODMAPs than regular wheat bread and is therefore better tolerated.

Not all sourdough bread is equal! I recommend asking the bakery how long the bread is left to ferment prior to cooking. A sourdough bread that has a short ferment time may be less well tolerated than one with a long ferment time. There are many excellent artisan bakers throughout Aoteraroa who make fabulous sourdough bread. This is one of my favourites - Polenta Sourdough from Jerry & George bakery (Christchurch).

For more information on fermented foods, you can read my blog post 'Fermented Foods' 🍞 https://www.gutnutrition.co.nz/blog/fermented

19/05/2022

World IBD day -
I work with people aged 10 to 80+ years who:
- don't know what to eat
- have only a handful of foods that do not upset their gut
- are sick of eating a "white" diet
- want to be able eat more foods
IBD affects people of all ages. IBD can be diagnosed at any age.
Get in touch if you want to find out more about how I can help improve your confidence to eat more foods, enjoy eating more and while improving gut symptoms.

04/05/2022

New research tested whether an anthocyanin-rich supplement affected response to infliximab. Anthocyanin is a type of flavonoid that is thought to act as an anti-inflammatory in the body. Anthocyanin-rich foods are typically red, purple, black or blue e.g. blackcurrants, black beans, purple corn, raspberries, purple cauliflower.

In this pilot randomised controlled study the researchers gave 47 people with Crohn's (n=22) or ulcerative colitis (n=25) starting infliximab either:
1. a daily anthocyanin-rich extract from purple corn or
2. a daily low anthocyanin red fruit tea for 8 weeks
Over the 8 weeks everyone was encouraged to increase the variety of foods in their diet and aim to eat a healthy diet that included seasonal fruit and vegetables.

After 8 weeks, people taking the purple corn extract had lower CRP and lower levels of inflammatory cytokines i.e. had a better response to infliximab. The differences were more pronounced in those with Crohn's disease. A limitation of this research is that it was a small pilot study and the authors plan to conduct a larger study to test their hypotheses. Also, nearly half of the participants smoked which may affect the applicability of the findings to non-smokers.

TAKE MESSAGES: this study supports the philosophy that food and nutrition play an important role in the holistic management of Crohn's and ulcerative colitis.

27/04/2022

Who has tried psyllium husk / ispaghula / well-known brand Metamucil?

Psyllium husk is a dietary fibre supplement that has been used since the 1930s. It is not digested in the small intestine and binds water in the large intestine to promote formation of soft, formed bowel motions. It helps to relieve both constipation and diarrhoea.

To help manage IBD symptoms it is common to avoid fibre. This can result in persistent loose bowel motions even when in remission. My clients find that taking psyllium husk helps to them to pass more formed bowel motions.

Chat with your IBD health provider or message me to find out if a psyllium husk supplement is a hood option for you

20/04/2022

What's cooking in your kitchen?
Want to eat a greater variety of foods but unsure how new foods might affect your symptoms?
I can help improve your confidence to eat more of the "healthy" foods while managing symptoms.
Send me a message or visit my website to find out more

13/04/2022

NEW RESEARCH 🧐

The research study assessed whether different dietary patterns were associated with IBD disease activity and staying in remission.

This large study from the United States included 691 people (248 with Crohn's disease & 443 with ulcerative colitis) and assessed usual dietary intake over the last 3 months. They identified five dietary patterns that included different proportions of high fibre plant foods, animal proteins (e.g. chicken, red meat), manufacturer foods (e.g. bread, breakfast cereals, cakes, biscuits) and types of drinks. The dietary pattern that was associated with less symptoms and being in clinical remission was as follows:
1. more plant foods (vegetables, fruit , legumes, cooked grains)
2. less animal products (especially fatty red and cured meats), sweetened drinks, bakery products, desserts, eggs and commercial breads
3. drinking mostly water
4. average intake of seafood and dairy products

Study reference: https://doi.org/10.1093/ibd/izab335

Next we need studies that teach people how to follow this type of diet and see if it does help people stay in remission.

In my clinic, my clients report feeling better when they eat a greater variety of plant foods and at the main meal fill more of their plate with vegetables and reduce the portion size of meat to 100-120g. If you would like to support do start eating this type of diet please get in contact (link in bio)

🍍🍉🍑🍊🍈

06/04/2022

Buckwheat Groats 🍽 🌱 What are they?

Buckwheat is a gluten-free pseudocereal. We eat the seeds of the buckwheat plant. Buckwheat originated in China and is now grown through the world including in New Zealand.

Buckwheat comes in many forms including buckwheat flour (the traditional flour used in American pancakes), buckwheat flakes and buckwheat groats (triangular shaped seeds). Buckwheat has a distinctive, earthy, nutty flavour and is packed full nutrition. Buckwheat groats are a good source of protein, vitamins and mineral as well as dietary fibre.

Increase the variety of plant foods you eat by adding soaked buckwheat groats to your breakfast, using a mixture of buckwheat flour and your usual flour or add a handful of rinsed groats to soups and slow cooked meals while they are cooking.

In the picture I have made a bircher style breakfast by soaking buckwheat groats, wholegrain rolled oats with chopped dates, grated apple with water and milk overnight in the fridge. To use soaked groats I recommend:
1. Rinse buckwheat groats with water and then cover with fresh water.
2. Leave to soak for at least 2 hours or overnight.
3. Prior to eating, drain the groats (they will look slimy which is normal) and rinse again with water.
4. Add to breakfast or mix with oat mixture to soak overnight.

30/03/2022

Have you made a courgette chocolate cake this season? 🍰 It is not too late!

Another fab vegetable cake that can also be made lower in FODMAPs (if needed) but higher in fibre by using half wholemeal wheat flour and half gluten-free flour. 🌾

Make it fancy with a lemon cream cheese or chocolate icing.

✯ INGREDIENTS ✯
250g butter, softened to room temperature
1 cup caster sugar
2 eggs
1/2 cup flavourless oil e.g. rice bran oil or light olive oil
2 1/2 cups flour - I used 1 1/4 cups wholemeal wheat flour and 1 1/4 cups of a rice flour/tapioca flour mix.
1/2 cup cocoa
1 tsp baking powder
2 tsp mixed spice
1 1/4 tsp baking soda
1/2 tsp salt
1 3/4 cups grated courgette loosely packed
1/2 cup unsweetened yoghurt

Cream butter and sugar.
Beat in eggs one at a time.
Gradually add oil while beating the mixture.
Sift flour, cocoa, baking powder, mixed spice, baking soda and salt into the mixture.
Fold in with the courgette and yoghurt.
Pour into a well-greased, paper lined round cake tin.
Bake at 160C for 1 to 1 1/4 hours until cooked.
Cool for 5 minutes in tin before turning out.

Enjoy as is or the cake is delicious with a citrus cream cheese icing 😋 🍰

23/03/2022

New research published earlier this month by Gerasimidis et al (https://doi.org/10.3390/nu14051053) assessed the ability of the faecal gut microbiome of adults with IBD in remission and healthy controls to ferment common fibres.

🔬 In a laboratory setting they tested the ability of gut microbiome stool samples to ferment different types of dietary fibre. The fibres tested were maize starch, apple pectin, raftilose (from inulin), wheat bran, alpha cellulose (a common fibre food additive) and a mixture of all the fibre.

The authors found that gut microbiome samples from people with Crohn's or ulcerative colitis had the same ability to ferment the fibres and produced similar amounts of short chain fatty acids compared to healthy control gut microbiome samples. This finding is important because it has been commonly assumed that the gut microbiome of people with IBD did not process/ferment fibre well.

🧪 Further research is needed to explore how the short chain fatty acids produced during fermentation are used by gut lining/microbes in people with IBD. We also do not fully understand yet how long term changes in dietary fibre intake affect the gut microbiome in IBD. In this study short term exposure of the stool gut microbiome samples to the different samples did not result in the same changes in composition that was observed in the healthy control stool samples.

Such an exciting area of research and so much more to learn!

✯ Take home message - Limit the amount of time on a low fibre diet because once in remission your gut microbiome should be able to break down and ferment dietary fibre. ✯