Monday, February 23, 2015

What is FODMAPs?

A lot of people are following a gluten-free diet for medical reasons but according to this video from the Jimmy Kimmel show, some don't even know what gluten is. Now, I wonder what would happen if Jimmy Kimmel did a question of the day and asked, "What is FODMAPs?

 I can only imagine a response..."um, food maps. Let's see. Is that a map you follow to find food?"

Well, I guess it is in a way. FODMAPs is a diet you follow in order to identify carbohydrates that may be causing you food intolerance issues.

Why do you need a FODMAPs' food map?

Many of us have gluten-sensitivity symptoms, such as weight gain, bloating, allergies, IBS and fatigue. Often, going gluten-free doesn't do the trick and our symptoms remain. These symptoms may actually be an indication of a much broader problem with carbohydrates, related to changes in gut bacteria and intestinal irritation. 

You may have food intolerances to carbohydrates or FODMAPs. Basically, FODMAPs are carbohydrates that are difficult to digest in some people, causing irritable bowel symptoms.

FODMAPs is an acronym for:

F – Fermentable
O – Oligosaccharides (kinds of sugars) in foods such as cereals, bread, biscuits, cakes, pasta
D – Disaccharides (lactose), for example, dairy foods
M – Monosaccharides (fructose) in fruit juice, honey, peas, jams, snack bars
A – and...
P – Polyols (sugar alcohols) found in fruits with stones and some vegetables, such as onions and leeks. Also found in artificial sweeteners and sugar-free gum

Individuals with FODMAPs’ intolerances may have to remove some or all grains, along with some other carbohydrates, to resolve their issues. Food intolerances can cause a whole host of unpleasant and uncomfortable symptoms. They result from the gut’s inability to digest certain foods normally. 

Many individuals who reduce their intake of FODMAPs find their symptoms improve. This diet eliminates certain foods that require specific enzymes to be digested. In the absence of these enzymes, these foods are poorly absorbed, leading to abdominal pain, gas, bloating, burping and other gastrointestinal symptoms.
You can assess your tolerance for foods high in FODMAPs by eliminating them for 6-8 weeks and then gradually reintroducing them to identify troublesome foods. You reintroduce one food every four days with a two-week break between bothersome foods. The goal is to identify the threshold at which you’re able to consume FODMAP-containing foods.

Here is a list of the compounds found in certain foods that are poorly absorbed and lead to symptoms.

Lactose---found in cow’s, sheep’s and goat’s milk, and their products.

Fructose---a carbohydrate found in fruit, honey, high-fructose corn syrup and agave syrup. Not all fructose-containing foods need to be eliminated on the FODMAPs diet.

Fructans---carbohydrates that are malabsorbed in the absence of an enzyme needed to break them down. Limit wheat, onions and garlic, along with other vegetables high in fructans.

Galactans---carbohydrates that require an enzyme for absorption. Found in beans and lentils.

Polyols---Known as sugar alcohols. Found naturally in some fruits and vegetables and added as sweeteners to sugar-free gums, mints, etc. Limit sugar alcohols, sorbitol, xylitol, mannitol and maltitol.

Refer to this webpage for a list of foods to eliminate on the FODMAPs diet:

 I followed the FODMAPs diet after trying the anti-candida diet, paleo diet and paleo auto-immune protocol in an effort to resolve my IBS problems and related fibromyalgia issues. I found I had to restrict even more carbohydrates than FODMAPs or these other diets allow. However, FODMAPs may work for you or at least, point you in the right direction.

Whatever amount you need to restrict carbohydrates to obtain relief, you can still enjoy a treat now and then. You may see a recipe in a cookbook or on the internet, and say, "Oh, that looks so good but I can't eat all those carbs." The trick is knowing what subs to make.

Recently, I saw a recipe for a single-serve chocolate brownie parfait. It contained almond flour instead of other higher carb flours. Unfortunately, the amount of almond flour was too much for me. It also contained more seed or nut butter and cocoa than I can tolerate. And then, there was a berry drizzle with lots of berries. Again, fruit can be a problem if too much is used. There also was a whipped topping made out of full-fat coconut milk which also contains lots of hard to digest carbs for some. You think I would have given up but I came up with my own version.

Single-serve brownie parfait

Step 1:
1 free-range, organic egg (no carbs)
1 T. lactose-free farmer's cheese (no carbs)
1 tsp. almond butter (small amount of carbs)
Note: I substituted the farmer's cheese and small amount of almond butter for the original larger amount of almond flour and almond butter.)

Mix these together in a small bowl.

Step 2:
Add 1 heaping tablespoon of plain cocoa powder and mix. (Note: you can add up to 2 T. cocoa if this does not create issues for you.)

Step 3:

Add 1 tsp. cinnamon powder, pinch of salt, stevia liquid (2 droppersful) or 1/2 tsp. powdered stevia, 1/8 tsp. pure vanilla powder, 1 T. melted coconut oil, 1/2 tsp. baking soda. Stir to blend.

Step 4:

Preheat oven to 400 degrees. Spritz two small cups or one large one with  olive oil or other oil to prevent sticking. Pour in your mixture. Bake 15 minutes until set or microwave 60-90 seconds. Note: microwaving is a bit more tricky as your brownie may overflow if you don't watch it carefully.

Step 5:

Allow to cool 10 minutes. Remove to a serving dish. Carefully cut the brownie in half crosswise. Layer plain lactose-free yogurt in between layers. Garnish with four small strawberries and a drizzle of chocolate sauce (make your own by mixing cocoa powder with melted coconut oil). 

Friday, February 20, 2015

Digestive enzymes really do work plus "Egg Mcmuffin redo"

Have you ever had trouble remembering which side of your vehicle is where the gas goes in? The lady in the YouTube video above had more than just a little trouble. She tried five times moving her car with the same result each time---being on the wrong side.

I laughed at this poor woman's misery but yes, I have done the same thing (well, maybe not five times but at least once or twice). I also realized I had been equally impaired at figuring out how to get any benefits from using digestive enzymes. I probably changed digestive enzymes as many times as this woman moved her car without any success.

Now, I know location of the gas cap is everything with getting gas and timing is everything with taking digestive enzymes. Here's my tip: don't eat anything until you've taken your digestive enzymes and HCL, if needed. I mean it. Don't eat anything. That means no nibbling while you are cooking or snacking without taking digestive enzymes.

I confess I violated all these rules. I snacked without digestive enzymes, and cooked and nibbled without digestive enzymes. The result was I wasn't digesting my food because like many fibro sufferers my gut does not produce digestive enzymes. Trust me. It makes a world of difference if you take them before even having even one bite of food.
Revamped Egg Mcmuffin

Eating eggs was not in my diet repertoire one year ago. First of all, I had a long history of hearing how eggs raise your cholesterol, especially if you eat the yolks. I thought eating a whole egg was a death sentence so I avoided the yolks and ate only whites. The result was I developed a sensitivity to the whites which I construed as more proof that eggs were bad.

Now, we know that eggs (free range or organic eggs) are a great way to add first-class protein to a meal or snack. We know protein is good for the liver. We know your body and your liver need cholesterol to be healthy. We know if you don't eat any cholesterol-containing foods, your liver will manufacture cholesterol anyhow to keep you alive. If your liver is healthy, it will make the good HDL cholesterol which controls the bad LDL cholesterol.

Recently, the FDA updated its food guidelines to say eggs did not contribute to cholesterol and were okay to eat. Eggs (as long as they are free of hormones and antibiotics) are a nutritional super food. They contain:
  • Choline: An essential vitamin needed for cell building, choline is more concentrated in egg yolks than any other food. Nerve signals, including heartbeat, require choline but deficiency is common.
  • Vitamins galore Eggs (especially the yolks) are rich in vitamins A, D, E and all of the B vitamins, as well as the following minerals: zinc, phosphorous, iron, calcium, iodine, potassium and selenium. Rich in lutein and zeaxanthin, egg yolks protect against cataracts and macular degeneration.
Some individuals are allergic to eggs. Egg allergy is one of the most common food allergies in children, second only to milk allergy. Symptoms of an egg allergy reaction can range from mild, such as hives, to severe, such as anaphylaxis. For these individuals, strict avoidance of egg and egg products is essential.

"We like eggs a lot! Yum!"
What you need for a paleo-style Egg Mcmuffin:

2 eggs (free range, organic)
1/4 tsp. baking soda
1 T. almond flour or 1 T. farmer's cheese (if eating modified paleo to include cultured foods) or 1 T. riced cauliflower
1 slice good quality Canadian bacon
Optional: 1 slice good quality cheddar cheese (again, modified paleo)
What to do:

Preheat your oven to 400 degrees. Line a baking sheet with parchment paper. Drizzle a bit of olive oil on the parchment paper and spread it out.

Next, make your "English muffin." Mix 1 egg in a small bowl with baking soda and your choice of almond flour, cauliflower or farmer's cheese. (I used farmer's cheese because I am trying to keep fermentation potential low.)

Drop the mixture by dollops on the parchment paper. You should get about four discs the size of an English muffin. Bake in the oven for about 10 minutes.

In the meantime, prepare your sunnyside up egg and slice of Canadian bacon. You can do this in a skillet or on another baking sheet lined with parchment paper.

Assemble your ":Egg Mcmuffin" by placing one slice of Canadian bacon, the egg and optional cheese on a disc. Cover with another disc. Serve with sauteed veggies on the side.

Thursday, February 12, 2015

Fifty shades of carbohydrates

Low fermentation pancake cookies
Carbohydrates are like people. Both are difficult to understand because they are complicated and complex.
That's why I say there are 50 shades of carbohydrates because there is so much gray area, confusion, misunderstanding and  myths.

There is nothing easy to understand about carbohydrates except that we love them. They can be combined into decadent recipes that feed our pleasure senses. A study showed that most women would choose to go without sex for a month rather than go without chocolate for a month.

We try to put carbohydrates into categories such as high carb vs. low carb or good carb vs. bad carb or low glycemic vs. high glycemic or simple vs. complex. Those categories may work for some people but if you have an autoimmune disease like fibromyalgia, you need to know your carbohydrates like the back of your hand.

An acquaintance of mine recently was told to go on a low carb diet. She thought that meant eating mostly protein and few carbohydrates. She asked me to give her quick tutorial on carbs. Let's see, I think it might take a wee bit longer to explain.


Tasty treat with fibro-friendly carbs
Why won't the popular categories for carbs (e.g. low vs. high glycemic) work for someone with fibromyalgia or other autoimmune disorder? Fibromyalgia sufferers often suffer from digestive disorders with symptoms  including gas, cramping and alternating diarrhea and constipation. These symptoms are described as irritable bowel syndrome (IBS). In fibromyalgia sufferers, these IBS symptoms usually can be linked to bowel infections such as bacterial overgrowths (e.g. candida) and food intolerances of some kind that affects their ability to digest carbohydrates.

SIBO (small intestine bacterial overgrowth) was found in 83 percent of 101 IBS patients in one research study. The causes include motility issues, antibiotic use, reduced stomach acid, immune deficiency and carbohydrate malabsorption (which overgrowth bacteria depend and thrive on).
Overgrowth of bacteria in the intestines (candida or SIBO) results in the production of toxins, enzymes and intestinal gases that disrupt digestion, cause intense physical discomfort and damage the small intestines. Enzymes produced by these invading bacteria result in damage to our own carbohydrate digestive enzymes. It's a "vicious cycle" because once our digestive enzymes are damaged, there are more undigested carbohydrates and more unfriendly bacteria.

 How do you outsmart these invading bacteria? You need to understand more than high carb/low carb. You need to understand the chemistry of carbohydrates. Are you beginning to see why I called this post "Fifty shades of carbohydrates"?

I believe I have found something that actually helps reduce my symptoms. It's called the "fermentation potential" of carbohydrates. The molecular bonds in carbohydrates are quite complex and depending on how complex may cause them to be absorbed or poorly absorbed. Those malabsorbed carbohydrates are what I called food intolerances. They result in fermentation and bacterial overgrowth, and cause the unpleasant symptoms.

What I am calling the "fermentation potential" diet is based on the book, Fast Tract Digestion IBS: Science-based Diet to Treat and Prevent IBS and SIBO without Drugs or Antibiotics by Norman Robillard.

The diet builds on the science behind the Specific Carbohydrate Diet (SCD), FODMAPs, Paleo and GAPS eating plans. Many of the foods, allowed on these diets, are too high in fermentation potential (FP) for individuals like me who have SIBO and/or candida, and lack digestive enzymes and stomach acid.  FP is based on glycemic index, net carbohydrates (total carbs minus fiber), sugar alcohols, dietary fiber and types of sugars.

The book includes FP tables which list foods, serving sizes, glycemic index and FP. You select foods to eat based on a low fermentation potential. The goal is to have a total low FP for the day of beween 20 and 30. A low FP for a single meal would be 0-7.

Yes, getting the FP that low can be challenging. It requires a food scale to weigh carbs to get the correct amount to prevent going too high on total FP. I have been trying to stay between 20-25 total FP to get my symptoms under control. 

Here are some examples of vegetables with low FP:

bok choy, 2.8 ounces, FP 1
zucchini, 2.8 ounces, FP 2
leafy lettuce, 2.8 ounces FP 2
celery, 2.8 ounces, FP 2
spinach, 2.8 ounces, FP 3
cauliflower, 2.8 ounces FP 3
chard, 2.8 ounces, FP 3

Many of the foods I had been relying on (e.g. winter squash, carrots, coconut flakes, coconut flour, coconut butter, kale, avocado) are too high in FP. Along with focusing on FP, I also am working on trying to elevate my stomach acid through the use of HCL-pepsin supplements. I also take digestive enzymes with every meal or snack. I get a lot more success in digesting my meal if I take them supplements as well as following the FP protocol.

You thought carbohydrates were starches, sugars and fibers. They are but so much more. Each one has a distinct coding that requires specific enzymes for digestion. You know like lactase for lactose; amylase for amylose; protease; cellulase; and there lots more. But as a fibro sufferer you have damaged digestive enzymes. That's why when you eat carbohydrates you get the IBS symptoms because you can't digest them.

Okay, that's the "quickbook" of carbohydrates for fibro and IBS sufferers. Basically, you need to eat carbohydrates that have a low fermentation potential. Get the book, Fast Tract Digestion, for yourself as a Valentine's Day.

 In the meantime, try this tasty fibro-friendly, low fermentation treat for Valentine's Day. It's like a pancake or a crepe filled with farmer's cheese and melted homemade chocolate. Serve it with a dollop of your favorite yogurt.

For the pancakes:
1 egg from free-range chickens
1 tablespoon of lactose-free farmer's cheese (substitute ricotta, if tolerated)
1/4 teaspoon baking soda

Mix ingredients in a small bowl. Preheat oven to 400 degrees. Cover a baking sheet with parchment paper spritzed with olive oil. Divide the mixture into four small pancakes. Bake until set, about 10 minutes.

For the filling:
1 tablespoon farmer's cheese
stevia, to taste
optional mix-ins such as sunbutter or other seed or nut butter
small square of chocolate

Blend the filling ingredients in a bowl with a spoon. Set aside.

For the chocolate:
Mix 3 T. melted coconut oil with 2 T. cocoa powder
stevia, to taste
1/4 teaspoon raw vanilla powder or alcohol-free vanilla extract
1 teaspoon cinnamon powder

Pour the melted mixture into a small loaf pan or other small pan. Freeze until firm. Then, break into small pieces. Store in the freezer.

To assemble:

Spread your filling on one pancake. Top with a square of chocolate and another pancake. Return to the oven until the chocolate melts. Serve with a dollop of your favorite yogurt on the side for dipping.

"I like soft stuff better than anything."---Misha
Recipe contributed to:

Sunday, February 1, 2015

When do I get some sleep?

Why can't I sleep like a husky?

My new juicer and assortment of veggies for juicing
Poor sleep is common in fibromyalgia sufferers. In fact, fibromyalgia has been called a sleep disorder. As a fibro sufferer, I haven't experienced the wonder of good sleep in years. But, after my fractured wrist from a bicycling accident, sleep has become as precious and elusive as the ring in the "Lord of the Rings."

I haven't slept well since my accident in late November. This chronic lack of sleep is the result of pain from my wrist as well as a "pain in the butt" husky, named Misha, who has decided he wants to wake everyone up at hours ranging from 2 a.m. to 5 a.m. His middle-of-the-night wake up calls are the last thing someone with fibromyalgia needs.

Now, I am basically what I would call a "basket case" most of the time. I am experiencing emotional outbursts, chronic fatigue, brain fog and depression. Yes, I am difficult to live with. Meditation helps some but what I really need is sleep. Do you hear me, Misha?

Yesterday, I tried to lose, then kill, my cellphone, all of which resulted in a meltdown on my part. This is not me. I am normally calm and reasoned. If any of this sounds like you, you are probably sleep deprived too!

The quality of sleep in fibro sufferers is usually poor. I go to bed fully intending to get 8-9 hours of sleep which is highly recommended for those of us with fibro. Unfortunately, the wrist and other pains, husky and husband snoring reduce the quality of my sleep. The problem is all these interruptions prevent me from experiencing the deeper stages of sleep (stages 3 and 4).

In one study, fibro symptoms were created in healthy volunteers who were constantly awakened during the night for two weeks. Without these deep stages of sleep, many of the repair processes needed for good health don't get taken care of by your body.

Veggies, fruit for juicing
What can we do as fibro sufferers to get better sleep? Before my accident, I was doing pretty well on getting sleep. I purchased a Sleep Number bed which was a big plus. I also took lots of vitamin supplements to boost their levels in my body.

 Poor absorption of vitamins and minerals may be a contributing factor in the poor sleep of fibro sufferers. You see your brain needs certain vitamins and minerals in order to sleep. I have suffered from poor absorption for years due to poor digestion. Tests revealed extremely low Vitamin B, magnesium, Vitamin D and calcium.

Studies have shown that maintaining sufficient levels of Vitamins B3, B5, B6, B9 and B12 particularly help in achieving good sleep. I take a B complex vitamin and a B12 supplement. Prior to my accident, these vitamins, plus eating good food sources of B vitamins, had helped improve my sleep.Good natural sources of B Vitamins include animal products in general but especially clams, beef liver, fatty fish (mackerel, smoked salmon, tuna), crab, fortified cereals, red meat, skim milk, cheese and eggs.

Among other affects, the group of B Vitamins is involved in regulating the body's level of tryptophan, an amino acid important for maintaining healthy sleep.
  • Vitamin B3 (niacin) often promotes sleep in people who have insomnia caused by depression and increases effectiveness of tryptophan. It is reported to help people who fall asleep rapidly but keep waking up during the night.
  • Vitamin B5 (pantothenic acid) is good for relieving stress and anxiety. A deficiency of B5 can cause sleep disturbances and fatigue.
  • Vitamin B9 (folic acid) deficiency has been linked to insomnia.
  • Vitamin B12 (cobalamin) is reported to help insomniacs who have problems falling asleep, as well as promoting normal sleep-awake cycles.

Okay, I drank it up before I remembered to snap a photo.
Poor absorption of vitamins and minerals is a big problem for fibro sufferers. I am now taking a bone builder supplement because my accident revealed I wasn't absorbing enough calcium.

 I also recently started juicing to ensure that I was getting more nutrients. Seventy percent of the nutrient content of fruit and vegetables is found in the juice. Individuals with normal guts probably can pull the nutrients out of whole fruits and vegetables but my sensitive gut isn't getting the job done. That's why I'm helping it out with juicing. I drink about 4 ounces of freshly made juice each day in addition to a healthy diet.
My favorite juice recipe includes a handful of spinach, two stalks of kale, 1 stalk of chard, 1 celery stalk, 3-4 cucumber slices, and sometimes a slice of pineapple and juice of a lemon. Most juicers like to do: greens, fruit, lemon juice, celery or cucumber, ginger. I omit the lemon juice because I have developed a sensitivity to it.

To make your juice taste delicious, always include these three ingredients: ½ inch nub of fresh ginger, juice of ½ lemon, and a piece of fruit, although I prefer one slice of fresh and frozen pineapple. Veggies to choose from include celery, cucumber, carrots, kale, spinach.

Here is my favorite juice blend:

3-4 slices of cucumber
1 handful spinach
2 small stalks of kale
1 slice of fresh pineapple
½ inch nub of fresh ginger
Optional: Juice of ½ lemon

 Someday, I hope to be back to snoozing like Misha.

Recipe contributed: