Food sensitivities: Why you react, and how to identify your trigger foods

Food can be a minefield!

Food provides the building blocks for life, can act as medicine, and is associated with celebrations and our most memorable times, sharing with family and friends.

Yet, food can also be a source of fear and confusion, ill-health, and toxicity in the body. We can spiral into a hole of poor gut health and inflammation, reacting to more and more to foods, still not knowing exactly which foods are triggering us. Some people then end up eating a severely restricted diet and become afraid of food in general.

Common digestive symptoms include bloating, wind and diarrhea. We may not have yet connected the dots between what we eat and seemingly unrelated symptoms such as migraines, joint pain, eczema, fatigue or sinus congestion, and mood disturbances.

Adverse food reactions fall into four causal categories.

  1. Immune system mediated – antibodies and inflammation in response to particular foods
  2. Digestive tract mediated – e.g. enzyme dysfunction such as a lactase deficiency which results in an inability to break down lactose, found in dairy
  3. Gut fermentation mediated – high FODMAP foods may lead to a worsening of symptoms. Read about the Low FODMAP diet here.
  4. Something else in the food e.g. salicylates, oxalates, sulfur, histamine, lectins

This article will explain how immune-system mediated over-reactivity comes about, and how to identify which foods are may be affecting you. My aim is help you understand the reasoning behind the interventions I suggest in my second article (released in the next week or so) on lessening these reactions.

Immune Tolerance

A huge proportion of our immune system lives within the lining of the Gastro-Intestinal (GI) tract. The immune cells that line our GI tract have two critical jobs:

1) Defend us from potentially harmful ‘pathogens’ in our guts (e.g. bacteria or viruses that are a threat)

2) To not react to food that we eat, and the bacteria in our gut. The immune system should actively suppresses a reaction to these.

It turns out that most of the time, the role of the immune system is actually NOT to respond to things. It should only react when there actually is a real threat. This concept of an appropriate response to our food and environment is called Oral Tolerance. Oral intolerance normally develops through a baby’s contact with their parents and breastfeeding. The first 1000 days of life are therefore very important in establishing immunity in general.

If we lose oral tolerance, we can start reacting to foods that we eat, and often we also develop increased intestinal permeability (leaky gut), inflammation, and digestive discomfort. This may progress to the stage where our immune system starts targeting our own tissues and organs (auto-immunity). And so it’s important to work on improving gut health not just to reduce food sensitivities themselves, but also to prevent progression of an auto-immune process.

Leaky Gut and Loss or Oral Tolerance

Increased intestinal permeability, commonly known as leaky gut, can be a contributing factor to loss of oral tolerance, but it isn’t the only mechanism involved in food sensitivities!

Mechanism of Intestinal Permeability

With a leaky gut, larger molecules, such as undigested food particles, toxins and micro-organisms, can enter the bloodstream through gaps, called tight junctions, between the cells that make up the gut lining.

The immune system doesn’t recognise these foreign molecules, raises the alarm that an invader is present, and then makes antibodies specific to these molecules. If those macro-molecules are gluten, your body will make antibodies to gluten. If it’s dairy, your body will make antibodies to dairy. A loss of oral tolerance to that food is developing..

A leaky gut can also be associated with a general loss of tolerance to a range of foods. In which case, you may find yourself reacting to more and more foods.

Then the question is not how do you avoid those foods but how do you calm the over-reactivity of the immune system in your gut, as well as heal leaky gut. The goal here is to reduce the hyper-reactivity to a whole range of foods, rather than focus on tolerance or avoidance of individual foods. We will cover this later in this article.

Dendritic Sampling Cells

Dendritic cells are a type of immune cell that sample the environment inside the gut (the gut lumen), providing an inflammatory signal to the rest of the immune system if they find something which they deem to be a threat. It’s vital therefore that they aren’t over-reactive (like Donald Trump on Twitter!).

So dendritic cells can initiate an inflammatory response to foods in the absence of leaky gut! This is important as it means even fixing a leaky gut, doesn’t necessarily mean the inflammatory response in our gut will develop normal tolerance. It may take extra work to support the Dendritic cells and T-Reg cells in our gut, as well as the spleen and liver!

dendritic cells sample antigens from the gut lumen

One of the ways our dendritic cells are protected from over-activation by the contents of our gut is through a natural layer of mucus that lines our gut. This mucus contains a protective antibody called secretory IgA (SIgA). SIgA also take some of the pressure off dendritic cells by surrounding bacteria, viruses, and problematic proteins.

An overgrowth of yeast, such as Candida in the intestine, aswell as other bacterial and viral overgrowths, psychological and emotional stress, and immune suppressants can all decrease the amount of protective SiGA and this has the potential to allow over-reactivity of our dendritic cells, and an inflammatory response to food.

It’s important that you chew food well, and have adequate stomach acid and digestive enzymes as partially digested food can also over-activate the dendritic cells

Regulatory T-Cells (T-Regs)

Dendritic cells surround foreign proteins and transport them to the lymphatic system. There, they present the protein to T-Reg cells. It is the T-Reg cells that determine whether the immune response should be one of activation or tolerance. If a response is initiated, B cells within the immune system start to create antibodies to that protein.

The good news is that we can support out T-Reg cells through nutrition and lifestyle. I’ll cover this and what else we can do to reduce food sensitivities in my next article in this series.

Testing for Food Sensitivities

The first step you should take when working to lessen food sensitivities is to temporarily remove trigger foods from your diet. We can then work to improve your overall gut health so that you are better able to tolerate foods without an exagerated immune response. But how do you know all the foods that you are reacting to?

One of the best ways to identify food sensitivities is an elimination diet. An elimination diet involves removing all suspect foods, that may be triggering the immune system, for a limited time (at least 3 to 4 weeks). After this period, foods are re-introduced systematically, every two or three days whilst keeping a close eye on your symptoms for a reaction to the food. In that way, we can identify which foods that you are react to.

Whereas lab testing only tests how certain parts of the immune system (such as IgG) respond to foods, an elimination diet paints the picture of how the body as a whole responds to the food. This is important as there may be other causes of a reaction other than just IgG antibody reactions.

Eight common foods that are often temporarily eliminated by someone suspecting food sensitivities are dairy products, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat and soy containing foods.

An elimination diet like this can be empowering but it is also restrictive, mentally challenging and time-consuming. An elimination diet, combined with IgG food reactivity lab-testing, provides the most complete view of food sensitivities. If a strict elimination diet is not possible for a person, then lab-testing alone is still a valuable option.

IgE – Allergic Reactions

In this article, I’m not going to go into detail around allergic IgE mediated, but I am going to focus on IgG food sensitivities. The difference between the two is IgE symptoms develop within a couple of minutes to one or two hours after eating a food and include symptoms such as hives, congestion or swelling of the throat. If you suspect a true allergic reaction to a food, please speak to your GP or contact me for further details on lab testing as I’m not going to focus on true allergies in this article. It is also possible to reduce the severity of IgE reactions, but not typically get rid of them, through nutritional support and Functional Medicine.

IgG Food Reactivity Lab-Testing

IgG antibodies tend to be associated with food sensitivities, and are produced from 3 to 72 hours after a food is eaten. At low levels, IgG antibodies are protective and their production is expected but at higher levels, they are associated with inflammation and typical IBS type symptoms. An IgG-mediated reaction to a food may not be noticed until more than 24 hours after eating a food, and remain in the body for weeks after a reaction is triggered, making identification of food sensitivities difficult without an elimination diet or lab testing.

There are many versions of IgG antibody testing to foods, and this diversity of testing can make choosing the right test confusing and overwhelming. Interpretation also benefits from professional help as the key to real improvement is not to only identify and remove trigger foods from the diet, but also support the gut and immune system so that it’s not so reactive. Our intention should always be to eat as varied and nutrient-rich diet as possible.

The food sensitivity test I recommend is by Dunwoody Labs. It is probably the most clinically relevant as it tests over 90 foods against a single blood sample for the production of IgG antibodies and also something call Compliment (Immune Complex containing C3d (IC-C3d)).  By measuring both IgG and IC-C3d simultaneously, we get a much clearer signal of activation of the immune system, giving much more accurate results than other IgG food tests that only measure IgG.

It is however important to note that some people, that have a severely impaired immune system, may not be capable of launching an immune response to trigger foods. In which case, IgG food sensitivity testing would be essentially useless.

How to Reduce Food Sensitivities

In the second article in this series (which will be coming in the next few weeks), I’ll take a deep dive into what you can do to reduce food sensitivities and improve your oral tolerance.

If you have any questions, I’m always happy to help so please get in touch. To know more about how you can work with me, you can find out more here.


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Stephen Ward (MSc) is trained in assessing the root cause of chronic health issues through Functional Medicine.

He uses nutrition, lifestyle changes, and nutraceuticals (targeted supplements) to help you achieve your goals and improve your health.

What Really Causes Reflux?

What are Reflux and GERD?

Acid reflux is one of the most common digestive disorders in Australia, affecting 10-15% of the population and is increasing in prevalence. The symptoms can range from mild and annoying to severe and include heartburn, chest pain, regurgitation, and nausea. Long-term reflux has also been linked to increased rates of oesphageal cancer. It’s definitely something you want to avoid!

Gastro-esophageal Reflux Disease (GERD) is a more serious form of reflux. As a side note, in Australia, you may find reference to GORD, rather than GERD, due to the different spelling of (o)esophagus, but we will use the GERD abbreviation in this article.

The conventional medical approach to reflux is to treat the symptoms by consuming antacids or taking acid lowering drugs such as PPIs. Unfortunately, not only does this approach fail to adequately address the symptoms, they can make matters worse…

How your Antacid is Making you Sick

Antacids treat the symptoms and discomfort of heart burn without addressing the underlying cause. As soon as you stop taking them, the discomfort returns. There is little money for a pharmaceutical company when they actual cure a disease (no repeat customers!) and some would argue that this leads to the ongoing marketing of short-term solutions and lack of information around the real cause of health issues such as this.

Furthermore, there are consequences of regularly taking antacids and acid stopping drugs:

  • Increased bacterial overgrowth
  • Impaired nutrient absorption
  • Decreased resistance to infection
  • Increased risk of death by chronic disease

When acid blockers and antacids were first introduced to the market, it was recommended that they were used for a maximum of six weeks. Indeed, they can be useful to provide short-term relief but the problem is longer term that can lead to these side effects.

So what can you do?

The good news is reflux and GERD can easily be treated with some simple dietary and lifestyle changes…

A Symptom is Not a Cause: Not Enough Stomach Acid?

But first, I think it’s important to learn a bit more about why acid-reflux develops…

The idea that too much stomach acid causes reflux and GERD is common in the media and the general public. But the scientific literature centers around the theory that GERD is caused by a dysfunction in the spinchter, known as the lower esophageal valve (LES), which separates the stomach from the lower end of the oesophagus.

Normally, the LES only opens when we eat to allow food to pass into our stomach. It doesn’t matter how much acid there is in the stomach; Acid can not rise up through the LES into the oesophagus when it is closed. But if the LES is malfunctioning, either because of a physical defect or because of abdominal pressure (we’ll get on to this), the stomach acid rises back into the sensitive oesophagus and gives the painful symptoms of heart burn.

Acid reflux and the lower esophagal sphincter

Treating gastroesophageal reflux disease with profound acid inhibition will never be ideal because acid secretion is not the primary underlying defect.

http://www.natap.org/2009/HIV/070409_02.htm

What Really Causes Reflux?

The most common causes of acid-reflux are

  • Food intolerances / triggers
  • Excessive gas production
  • Immune system activation

Most often, these three causes are present together and are connected…

Dietary triggers can include alcohol, dairy, gluten, caffeine, processed foods, fructose, FODMAPs (more on this later). The easiest way to find out if foods are triggering your reflux or GERD is to do an elimination diet where you cut out these potential triggers from your diet.

The Paleo diet is a good option as it removes many of the common inflammatory foods. With a diet like this, you should be seeing some benefit in three weeks or so. If you aren’t seeing the improvement you would like, then that’s telling you that you are not getting to the underlying cause…

Excessive gas may be produced by a bacterial overgrowth in the gut. This gas this causes an increase in intra-abdominal pressure (IAP) which pushes the contents of the stomach, including stomach acid, into the oesophasgus.

But what could be causing the bacterial overgrowth?

One common cause of bacterial overgrowth is low stomach acid. Aaha! Now we we can see a mechanism by which low stomach acid may be contributing to acid-reflux…

At a PH of 3, bacteria in the stomach can only survive for 15 minutes but at a PH of 5, bacteria begin to thrive. And a trial has been conducted which confirmed just this effect. 30 people with GERD were treated with a high dose of Prilosec (40g/day), a PPI that reduces stomach acid, for at least 3 months. 11 of the 30 Prilosec-treated people developed significant bacterial overgrowth, compared with only one of the ten people in the control group.

Now, we know that bacterial overgrowth is also associated with immune system activation as the immune system is activated, including a histamine response, to deal with the threat of a bacterial overgrowth.

The Low-FODMAP diet and probiotics are known to reduce immune system activation and histamine. So if bacterial overgrowth and immune system activation are at the core of reflux for some people, it makes sense that a Low-FODMAP diet and probiotics will be helpful.

Reducing Reflux and GERD in Three Simple Steps

Once food intolerances and physical defects of the LES are ruled out, heart burn and GERD are likely caused by bacterial overgrowth and too little stomach acid. If someone is overweight, working to reduce weight can also be helpful.

So our goal is now to reduce the bacterial overgrowth and increase the acid. This can be done in three steps (and is a similar approach used to regain gut health for reasons other than reflux):

  1. Reduce the bacterial overgrowth and causes of low stomach acid.
  2. Replace the missing stomach acid
  3. Repair the gut mucosal lining, gut immune system and re balance the gut bacteria.

To Reduce the bacterial overgrowth, a low carbohydrate Low-FODMAP diet, together with probiotics is effective. A combination of probiotics, namely Sacchromyces Boulardi, a Lactobacillus / Bifidobacterium blend, and soil based probiotics are likely to be effective for this purpose. You may find the most benefit when combining these three different types. A low-histamine diet can also be trialed.

Replacing stomach acid usually means taking a supplement containing HCL with pepsin or another acid stable protease. Pepsin in the acidic environment of the stomach breaks down protein so that we can absorb it into our bodies. If the stomach is not producing enough HCL, it is likely not producing enough pepsin and so both should be supplemented together.

For sensitive people that feel warmth in their stomach from 1 capsule of HCL, apple cider vinegar before meals is an option. A program to support the gastric lining for 6-8 weeks may be necessary (speak to me about this).

After a period of supplementing HCL, many people find that they are then able to reduce their dose..

Note, HCL should never be taken by anyone is using any type of anti-inflammatory medication (e.g. Ibuprofen or other NSAID) or corticosteroids (e.g. predisone). These medications can damage the gut lining and the supplementary HCL could aggravate this, causing bleeding or an ulcer.

Once we have reduced any bacterial overgrowth and any possible drivers of low stomach acid, and then replaced the low acid, we still need to repair the gut.

Repairing the gut means reducing the increased intestinal permeability (leaky gut) which may be present, supporting the gut immune system and re-balancing the gut bacteria. A re-balanced gut microbiome should support gut barrier function, decrease inflammation and balance the immune system and not produce the excess gas associated with additional pressure and reflux.

We can make use of probiotics and nutra-ceuticals to support the intestinal immune system and provide the building blocks needed for the gut to repair itself. Particular foods such as fermented foods, bone broth and soluble fibres can be helpful. Soluble fibres are prebiotics which act as fuel for the good bacteria in our gut. You can read more about repairing the gut in this article.


If you have any questions, I’m always happy to help so please get in touch. To know more about how you can work with me, you can find out more here.


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FREE 30 INTRODUCTORY CONSULTATIONS NOW AVAILABLE – BOOK HERE

Stephen Ward (MSc) is trained in assessing the root cause of chronic health issues through Functional Medicine.

He uses nutrition, lifestyle changes, and nutraceuticals (targeted supplements) to help you achieve your goals and improve your health.


Low Iron Levels? How our gut affects Iron absorption

Iron deficiency is common, especially among women, vegetarians, and anyone who is hypo-thyroid. It can make you feel, tired, dizzy, moody, and cause head aches as the body doesn’t have enough iron to make haemoglobin, the protein in red blood cells that carries oxygen around the body.

This lack of healthy red blood cells is known as iron-deficiency anemia. Resolving this anemia is a crucial first step of any healing program as it robs cells of the oxygen they need to function.

Iron deficiency may explain persistent symptoms in between 30 to 50% of hypo-thyroid patients despite thyroid hormone therapy. Dr. Ruscio recommends testing for ferritin and getting ferritin levels above 100 in such cases.

Iron balance is critical with too much iron leading to oxidative damage, which may be part of chronic fatigue, liver disease, and brain function.

Iron as a supplement should only be taken following lab testing of iron levels in the body. When supplementing or when focusing on foods containing high levels of iron, some people find their levels remain stubbornly low. What’s going on?

What can you do?

If you suspect your have iron-deficiency anaemia, the first step is to talk to your doctor about testing to get confirmation. Excess iron can cause serious health conditions and low levels of iron are never something you should assume without testing.

Improving your iron absorption, and gut health, should be thought of as an important step to increasing iron absorption. Here are some things that can be done:

Inflammation and the gut?

Low grade inflammation is associated with all chronic disease. It can have a wide variety of causes, such as infections, injury, poor diet or toxins, even stress! But one of the most common areas where inflammation starts is in the gut.

When inflammatory cytokines are high (during infection or injury), the liver releases a regulatory molecule (hepcidin) which blocks the absorption of iron. In other words, inflammation blocks the absorption of iron from the gut.

Therefore, we need to consider inflammation and gut health when bringing our iron levels back into balance. This focus on the underlying systems of the body is a cornerstone of what is know as Functional Medicine. You can read about how to reduce inflammation in our gut here.

Phytates

Phytate is found in foods like whole grains, cereals, soy, nuts and legumes. It binds to minerals such as iron and zinc, preventing their absorption.

While eating some phytates is fine, many of us are eating more than the recommended amount, even those eating a Paleo diet containing a moderate amount of nuts.

But the research has shown eating even a small amount of phytate, at the same time as the source of iron, can decrease iron absorption. This inhibitory effect increases as the quantity of phytates increases. This is what is called a dose dependent effect. This effect can be counteracted by eating a source of Vitamin C at the same time.

Pair iron rich foods with Vitamin C

Iron from animal products, known as heme iron is the most easily absorbed by the body. But all is not lost if you are a vegetarian. Eating a source of Vitamin C along with plant base sources of non-heme iron helps absorption.

Foods high in vitamin C include citrus fruits, dark green leafy vegetables, bell peppers, melons and strawberries. In one study, 100mg of Vitamin C taken with food, increased absorption.

Iron and our Microbiome

Probiotics appear to increase the iron absorbing capability of the gut.

In particularly, a 2019 systematic review of the research found that the probiotic Lactobacillus plantarum 299v significantly increased iron absorption in humans.

Luckily for us, there are several commercially available probiotics containing this strain such as this one (affiliate link).

While we have discovered that some strains of probiotics increase iron absorption, other research is showing that other strains block absorption. And so to have optimal iron absorption from the gut, a balanced ecosystem of bacteria is needed. This means a healthy gut and microbiome!

How good is your first line of defense?

I’m talking about the importance of stomach acid! This article will let you know why you should care and I’ll also give you an easy test you can do at home to give you an idea of your stomach acid levels, so read on…

Stomach acid, otherwise known as hydrochloric acid (HCl), plays a pivotal role in the breakdown of food, a healthy balance of bacteria in our gut, and the prevention of small intestinal bacterial overgrowth (SIBO), and so the prevention and treatment of IBS. As it’s becoming widely accepted that a healthy body depends on a healthy gut, this is important stuff for your health.

Many people with reflux also actually have low stomach acid, rather than too much. You can read more about that here.

When we eat food, digestion begins in the mouth through the process of mastication (chewing to you and me) and the release of enzymes, such as salivary amylase which starts the digestion of carbohydrates. Chewing our food sets the digestive process off to a good start!

Food is further broken down in the stomach by HCl (PH 1.0 to 2.5) and more enzymes. This kills harmful microorganisms and helps create favourable conditions for enzymes such as pepsin which helps to break down protein.

Stomach acid

HCl also makes nutrients such as Vitamin B12, Calcium, Zinc, Iron, and Magnesium available from our food..

If the stomach is too alkaline, the system of the digestive tract does not work well and you end up with up complications further along the tract such as SIBO.

Also, it is often a lack of acid in the stomach, not an excess, that causes reflux as food is not being properly digested and is causing acid to flare up into the esophagus.

But the amount of acid produced is also affected by the amount and type of food you are eating, and also how you are feeling!

Pause for a second, and let that sink in …

If you are stressed and eating on the go, your body is likely to be producing less HCl and your digestion just isn’t going to be great, whatever you are eating. A good tip is to take three, deep mindful breaths whenever you sit down to eat, and to eat away from electronic devices or your office desk.

How to Test for Stomach Acid Levels at Home for Free
Now, I’ll show you the simple test you can do from your home with just bicarbonate of soda and water, to give you an indicator of your HCl levels (remember this is just a guide!).If you are taking NSAIDs, Corticosteroids, or have other concerns, please speak to your GP first.

  1. First thing in the morning drink (in one go) a mixture of 1/4 tsp of bicarbonate of soda mixed in 150ml of room temperature water
  2. Set a timer and measure how long before you belch
  3. Repeat for several mornings to check the results

Ignoring tiny little burps, the test tends to show the earlier you burp, the more stomach acid you have

  • 0-2 Minutes: You have plenty (& possibly, though rarely, too much) HCl
  • 2-3 Minutes: You have about the right amount of HCl
  • 4 Minutes upwards: This may suggest you have low HCl

What Next?
If you suspect you have low HCl, you can encourage its production by mixing a teaspoon of apple cider vinegar, or some lemon in about 200mls of water before you eat.

Eating bitter food or drink may also help digestive secretions and prompt HCl production. Bitters include a bitter tonic such as the traditional Swedish bitters, and foods such as rocket, chicory, dandelion (including tea), radicchio, endive, and artichoke.  HCl + pepsin is also available as a supplement if required.  

And if you unlucky enough to already have an ongoing gut issue such as digestive discomfort, IBS, IBD, bloating, leaky gut, or just want to improve your gut health, drop me a message and I’ll see what I can do to help…


Stephen Ward (MSc) is trained in assessing the root cause of your health issues and together, we can work this out. 

Call 0491611043 or BOOK ONLINE.

Alternatively, send me a message and I’ll get back to you ..

Fed up with digestive discomfort? Four steps to gut health

You don’t just have to put up with digestive discomfort, acid reflux or GERD, bloating, diarrhea, constipation, or food sensitivities. Using a Functional Medicine approach, which looks at the root causes of any health issue, it is possible to find the root causes of a gut complaint. Once you know the root causes driver your condition, you can follow a step by step approach to heal your gut. In this article, I’ll explore what that process might look like.

Basically, there are four logical steps to regaining gut health: Remove, Repair, Reseed, and Rebalance. It is possible to do this on your own, and Dr. Ruscio offers a good protocol in his book. However, I would suggest working with a Functional Medicine practitioner such as myself, to provide personalised guidance and support which can be invaluable during this process.

1) Remove

In the Remove phase, we identify and then remove triggers of intestinal inflammation and digestive discomfort.

Candida, a bacterial or protozoa overgrowth, SIBO, Helicopter Pylori, and viruses can all drive gut conditions. These are often associated with an overly reactive intestinal immune system which can, in turn, drive inflammation throughout the body through a permeable intestinal barrier (leaky gut).

A stool test that can be done from the comfort of your home can test for these pathogens. I recommend the GI Map test or the GI 360 test in Australia. These tests analyse the DNA of the microbes in your stool and are therefore very precise. They also include markers for leaky gut, digestive enzymes, secretory IGA, gut inflammation, and short-chain fatty acids, making them very complete tests. Small intestinal bacterial overgrowth (SIBO) testing may also be appropriate depending on your symptoms (bloating with 90 mins of eating is a tale-tale sign).

When working with a practitioner, lab testing isn’t always necessary or within budget. In which case, the approach is based can be based on clinical symptoms, history, and treatment response.

If parasites are found or are likely, then there are a number of options including herbal anti-microbials, specific probiotics, and antibiotics. I work with the first two options but you always have the option of talking to your GP about the antibiotic option.

Particular foods can also be a stressor for some people. This can include trigger foods such as gluten, dairy, added sugar, oxalates, or histamine containing foods. When I work with someone, I always start by looking at their diet, identifying potential trigger foods and looking at the impact of high FODMAP foods. Ensuring enough digestive enzymes and stomach acid production is also vital to digesting our food properly. Food sensitivity testing is an option.

I find the Low FODMAP diet helps many people with IBS. The first phase of the diet removes all high FODMAP foods which may be causing your gut symptoms. After three to six weeks, we systematically re-introduce these foods. This allows us to identify your personal trigger foods that can then be avoided whilst maintain as diverse a diet as possible.

2) Repair

When there’s inflammation in the gut, you can also expect there to be increased intestinal permeability, commonly known as Leaky Gut. A leaky gut allows toxins, larger food molecules, unwanted bacteria, and viruses to enter the bloodstream. Lining the gut, we have the mucosal system which protects us from these threats. 

When foreign substances pass through the gut barrier, the immune system launches an inflammatory response to defend us from these invaders. The associated intestinal inflammation has been linked to a diverse range of symptoms such as food sensitivities, fatigue, brain fog, nutrient malabsorption, and has been linked to diseases in remote organs in the body e.g. kidney, lungs, liver. 

Calming the intestinal immune system, and repair the gut lining is therefore an essential step in regaining gut health.

To heal a leaky gut, you also need to consider your lifestyle such as stress levels, making time for yourself, and getting enough sleep. Getting the nutrients you need to support the immune system lining our gut, as well as repairing the gut wall are important. Foods, which contain these nutrients include bone broth, stewed apples, as well as polyphenol-rich foods such as blueberries, blackberries, purple sweet potatoes, purple carrots. The choice of supplements varies from person to person but could include such as Colostrum, L_Glutamine, and Zinc, probiotics such as Sacchromyces Boulardi or Lactobacillus GG. 

3) Reseed

This phase is all about encouraging a diverse range of ‘good’ gut bacteria. This is vital as, without it, your gut issues are likely to return. Time needs to be spent fixing your gut microbiome. It’s a necessity for ongoing gut health!

We can reseed our guts through probiotics, fermented foods, and also soluble fibres known as prebiotics. Our gut bugs love fiber-rich veggies and whole grains such as flaxseed, chia seed, buckwheat, and other non-gluten containing grains.

By this stage, you should be able to handle more prebiotics than you could in stage 1. Healthy high FODMAP foods and resistant starches can be introduced to feed your ‘good’ gut bacteria. Remember high FODMAP foods are often healthy foods and we are working towards being able to tolerate them.

For probiotics, there a number of options including a Lactobacillus / Bifidobacterium blend, Saccharomyces Boulardii, and soil-based probiotics. Different people can find different types of probiotics effective, and I urge you to experiment with a different type if you are not responding to a particular one. For instance, if you are not responding to a Lactobacillus / Bifidobacterium blend after a 4-6 week trial, then try a soil-based probiotic. When trialing a probiotic like this, you are looking for a reduction in your personal symptoms and noticing how it makes you feel. People often find a combination of these probiotic types can be effective.

Saccharomyces Boulardii and Lactobacillus GG have also been found to combat Candida, Blastocystis Hominis and pathogenic bacterial overgrowth.

4) Rebalance

This final stage is focussed on preserving the gains from the previous stages into the future so that your gut stays resilient and tolerates a wide range of foods. Here, we pay particular attention to lifestyle choices such as sleep, exercise, and stress.

Of particular interest is that when we eat, as well as what we eat. Nowadays, we tend to eat all day (16 hours) and fast for just 8 hours overnight. It’s during this fasting period that the gut lining repairs itself and the body clears out unprocessed foods and bacteria from the small intestine. This helps prevent small bacteria overgrowth or SIBO through a process known as the ‘migrating motor complex’.

Spending longer periods without food, say 12 or even 16 hours overnight, and reducing snacking, may help your gut health, improve your overall health and prevent chronic diseases.

Everyone is different

These four steps provide a framework for regaining gut health. But that doesn’t mean that the steps look exactly the same for everyone. A  practitioner can help you identify the root causes of your health issues, identify appropriate lab testing, diet, and supplements, and provides the expertise to filter the scientific research to help you improve your gut health.


If you have any questions, I’m always happy to help so please get in touch. To know more about how you can work with me, you can find out more here.


Stephen Ward Headshot Image

FREE 30 INTRODUCTORY CONSULTATIONS NOW AVAILABLE – BOOK HERE

Stephen Ward (MSc) is trained in assessing the root cause of chronic health issues through Functional Medicine.

He uses nutrition, lifestyle changes, and nutraceuticals (targeted supplements) to help you achieve your goals and improve your health.

 


 

How to use the Low FODMAP diet to heal your gut

The Low FODMAP diet is now commonly recommended to ease a range of digestive symptoms associated with small intestine bacterial overgrowth (SIBO) and irritable bowel syndrome (IBS). It works by removing foods that commonly cause digestive discomfort from the diet, allowing the gut to heal. Foods are then re-introduced systematically so that trigger foods can be identified. It may be used as part of a gut healing protocol.

FODMAP is an acronym for:

  • Fermentable
  • Oligosaccharides
  • Disaccharides
  • Monosaccharides
  • Polyols

Eek! So what is that in plain English? These are types of sugar that are poorly absorbed by the small intestine and are fermented by bacteria to produce gas. They can cause IBS type symptoms such as gas, bloating, constipation and diarrhea in some people.


Can a low FODMAP diet help you?

Recent research found up to 86 percent of people with IBS saw improvements in their symptoms while on a low FODMAP diet. It has also been found to decrease inflammation, as measured by histamine in the gut, which may reduce neurological symptoms such as brain fog which may be associated with IBS.

A Low FODMAP diet can help you to isolate the types of foods that are causing your symptoms. Once your GP has examined you for other conditions, such as coeliac disease, this diet can help you get back to basics – I commonly recommend this diet as a first step when working with gut issues. It has not only been shown to help many people with IBS, but may also be helpful for other gut conditions such as coeliac disease, Crohn’s and Colitis. It is recommended that you consult with a health care consultant, dietician or Nutritional Therapist, such as myself, before embarking on a low-FODMAP diet.

FODMAPs can feed bacteria in the small intestine, which should only contain a small number of bacteria compared to the colon. This can lead to Small Intestine Bacterial Overgrowth (SIBO). Whereas in someone with a healthy gut, these sugars will pass through the small intestine until they get to the colon where they will act as a food source for beneficial bacteria that live there.

What is the low FODMAP diet?

The low-FODMAP diet helps you identify the foods that are causing your symptoms – this varies from person to person. You start by removing foods that are high in FODMAPs for 2-4 weeks or until symptoms ease.

There are many foods that are restricted but you have to remember why you are doing this – The long-term benefits far outweigh the difficulty of eliminating these foods for this period. Remember, everyone reacts to these foods differently so the Low-FODMAP diet allows you to find out which foods are problematic for you.

As a qualified Nutritional Therapist, I can guide you through this process, help you with tasty and tolerable alternatives to high FODMAP foods, and guide you through the re-introduction phase and help you to identify other causes of your gut issues

The main sources of FODMPs include (there are other high FODMAP foods not on this list):

Oligosaccharides: Wheat products, vegetables such as onions and garlic, all beans and pulses including chickpeas, lentils and soybean, and inulins added to foods such as certain yoghurts, protein bars, and milks.

Disaccharides: The main one is Lactose and many people are Lactose intolerant. Lactose is not the same as dairy: Cream, hard cheeses and butter contain a limited amount of lactose. Most people with malabsorption can handle 4g of Lactose before they encounter issues, and so a thin spread of butter or a dash of milk may be OK, but a Latte may not.

Monosaccharides: These are simple sugars with excess fructose being the main one. Examples of foods containing an excess of fructose include fruit juices, apples, cherries, watermelon, peaches, plums, nectarines, mango

Polyols: Mushrooms, fruits such as apricots, chewing gum, and added sugar alcohols 

How does the low-FODMAP diet work?

Phase 1 – FODMAP Restriction

Phase 1 is a strict restriction of all high FODMAP foods for two to four weeks, or until symptoms settle. The low-FODMAP diet originated out of research by Monash University and they have developed an app which can be used to know the FODMAP content of various foods. It has proven invaluable to many people.

Keeping track of how particular foods affect you is also recommended. That way, you can more clearly see patterns between what you eat and how you feel.

Phase 2 – FODMAP Reintroduction

During this phase, you methodically re-introduce foods that were restricted in Phase 1. Foods are re-introduced one-by-one and in a specific order. The idea is that at the end of this process you will have a better understanding of which foods trigger your symptoms, and you can continue to eat the ones, you do not react to. This process will take several weeks or months, and I suggest you work through this process with a Nutritionist, such as myself, or a dietitian.

Is this the perfect diet?

The Low-FODMAP diet can be a life saver for many people and can transform some people’s quality of life and well being within days…

But like anything, there is a downside. When you do a restrictive diet like this, you run the risk of cutting out many nutrient-rich foods and good sources of fibre –  fibre is fuel for the beneficial bacteria in our colon, and is an important part of a healthy diet.

For this reason, and contrary to the belief of many people, eliminating all high FODMAP foods is not a healthful solution. Identifying the particular FODMAPs that trigger your symptoms allows you to include as many healthy high FODMAP foods in your diet as possible. 

What next?

You can, of course, do the low-FODMAP diet and re-introduction on your own, but many people prefer to work with a Nutritionist such as myself to help them identify what they can eat (that’s tasty too!), what they are reacting to, and to guide them through the re-introduction phase. We even have a coaching app for your phone so that I can support you through this process.  

Also, as the diet doesn’t necessarily help you find the root cause of your IBS, a practitioner can help you with testing for a bacterial or fungal overgrowth that may be causing your issues and work with you on other causes of your health issues.

If you’d like to talk me to about the low-FODMAP diet, or your options for working with IBS or other health conditions, please contact me with any questions or give me a call.

What is Leaky Gut? And 12 signs you have one…

Did you know our digestive system has two purposes?

Of course, it allows us to break down food into smaller and smaller particles to be absorbed into the bloodstream and be used by the body. Naturally, we need those nutrients to live!

But also, it blocks larger particles known as macromolecules from being absorbed into the body. These macromolecules include toxins, pathogens, and undigested foodstuffs. This unseen barrier is vital to our long term health and wellness.

Leaky gut, or increased intestinal permeability as it’s known academically, allows the uncontrolled passage of these macro-molecules into the body from the small intestine.

In the small intestine, the epithelial lining itself is only one cell thick. It functions like a cheesecloth with only small molecules intended to pass through the intestinal barrier. As food winds its way through the small intestine, it is broken down into smaller and smaller components until they are small enough to be absorbed through the cheesecloth.

Holes in a net

However, when there is inflammation in the intestine and increased intestinal permeability, larger macro-molecules, pass through the cheesecloth unchecked. It is as if the cheesecloth has tears in it which let the larger molecules through. This is bad news as the immune system recognises these molecules as undesirables and produces antibodies to these molecules, leading to inflammation, and the potential for a host of health issues.

The state of health or the state of disease is the combination between what we are – meaning what genetically makes us the way we’re engineered – and the environment that’s around us. And the gut is the point of entry in which these two elements meet

Alessio Fasano, MD

The gut lining and mucus layer work together

The good news is the epithelial lining is protected by a layer of mucus, known as the mucosal immune system (MALT). While the epithelial lining restricts access to the body of ‘troublesome’ macro-molecules and secretes antimicrobial substances, the mucus prevents unwanted organisms from sticking to the lining. The lining is where the good ‘good’ bacteria live, limiting the colonisation by unwanted organisms.

In healthy states, the MALT provides protection against pathogens but maintains tolerance against non-threating substances such as food molecules. In other words, the MALT should be smart enough to react to things that may be bad for us, but not react to other things which are harmless. Our microbiome plays a part in training our immune system to react in this way.

Luckily, there are dietary and lifestyle changes, as well as nutrients that can be taken to help repair this protective firewall and increase the diversity of our gut microbiome.

It is now recognized that the interface of the individual’s intestinal immune system with their gut microbiome has a critical effect on metabolism and immunity spanning the function of many organs and diseases including cancer, diabetes, arthritis, obesity, anxiety/depression, and autism.

Dr. J.Bland (Founder and PIONEER IN FUNCTIONAL MEDICINE)

How can I tell if I have leaky gut?

While there is testing that can be done for intestinal permeability, the truth is MOST people with a chronic health issue will have some degree of increased intestinal permeability.

And remember, you don’t have to have gut symptoms to have a leaky gut. Leaky gut can manifest as autoimmune conditions affecting the thyroid (Hashimoto’s) or joints (rheumatoid arthritis), mental illness, depression, skin problems like eczema or psoriasis and more.

12 signs you have leaky gut:

  1. Food sensitivities or intolerances – As food particles may enter the bloodstream through a leaky gut, the immune system of a person with increased intestinal permeability may react to a food (especially gluten and dairy). Leaky gut and allergies have been found to be linked.
  2. Poor Immune System Function: Including susceptibility to viruses and parasites
  3. IBS and bloating Particularly diarrhea-predominant IBS
  4. Candida, Parasites and Small Intestine Bacterial Overgrowth
  5. Inflammatory Bowel Disease
  6. Chronic Fatigue – Inflammatory compounds, called cytokines are associated with increased intestinal permeability and can lead to fatigue
  7. Auto-Immune Diseasesread more here including Hashimoto’s Thyroiditis
  8. Polycystic Ovary Syndrome – PCOS has been associated with increased zonulin, a biomarker of increased intestinal permeability
  9. Nutrient Malabsorption – This may be associated with fatigue
  10. Skin issues – such as psoriasis, acne, rosacea, or eczema
  11. Mood issues, Depression, Anxiety, and Mood Swings
  12. Brain Fog and Memory Issues

Now, the good news is intestinal permeability is completely reversible, and the mucosal firewall can be repaired. This may then improve health conditions outside of the gut so that you feel the difference.

But first, read the next article to find out how intestinal permeability is key to the development of an auto-immune disease. If are looking for the steps you need to heal your gut, you probably need to read this article.


Stephen Ward (MSc) is trained in assessing the root cause of your health issues and together, we can work this out.

Call 0491611043 or BOOK ONLINE.

Alternatively, send me a message and I’ll get back to you ..

Quit sugar: The effect of sugar on our guts

Do you find that when you are stressed or tired, you automatically seek out something sweet?  And then many of us find it difficult to stop eating sweet foods once we have started.

It is as if, we are biologically hard-wired to crave sugar.

In fact we are.

In Paleolithic times, that sweetness was probably hard to find and the calories were valuable, and so our bodies today do not know how plentiful sugar is in today’s society and we still have that craving.

It’s not your fault that you crave sugar, and it’s perfectly normal.

Sugar in Australia

Australia’s sugar intake has been described by experts as ‘alarming’ with the worst habits among children and adolescents. The 2011 Australian Health Survey of more than 8000 participants found 55% of people consumed more added sugars than recommended. The average American is eating somewhere between 130 and 152 pounds, or 58 to 69kg of sugar a year! 152 pounds of sugar equates to 52 teaspoons a day.

If we could see this amount of sugar laid out, I’m convinced we would immediately do something about it. But as it is hidden away in many foods, we simply do not realise how much we are eating.

Sugar and gut health

But is sugar particularly bad when it comes to the gut?

It sure is!

The microorganisms that live in our gut, that is yeasts, bacteria, protozoa, act in a similar way to a metabolic ‘organ’. Sugar changes the gut microbiota in a way that increases intestinal permeability, or ‘leaky gut‘.

It can particularly feed Candida (a type of yeast), and ‘bad’ bacteria that cause inflammation, and again, causing leaky gut. This allows larger molecules to come into contact with immune cells, which react with further inflammation. These molecules then pass into the blood, and are transported to the liver via the portal vein.

And so the microbiome and leaky gut have been reported to be involved in the development of chronic liver disease and portal hypertension (high blood pressure).

Leaky gut has also been associated with visceral fat (fat around the tummy), presumably as the body uses the fat cells to store the toxic macro-molecules that have entered into the bloodstream. So it seems, leaky gut can make you fat, and that’s not just from all the calories in all that sugar!

Because there is so much sugar in the typical diet, our blood sugar levels are soaring, and high blood sugar has also been shown to increase intestinal permeability directly, at least in mice. These sugar spikes trigger the centers in our brain associated with reward, pleasure, and seeking out the source of that feeling. Amazingly, these are the same areas of the brain that light up in people that are addicted to cocaine, heroin, and nicotine.

It’s not your fault that you crave sugar!

It’s clear that sugar has addictive properties and we need to put in the effort to de-normalize sugar, so it loses its group on us. We can then choose to eat it in small amounts, as a treat, and under our control 🙂. We may find that our energy is more even, our gut is healing, and we have lowered our type 2 diabetes risk.

Retrain your taste buds

You can retrain your taste buds, by eliminating all added sugar from your diet for four weeks

At the end of four weeks without added sugar, your taste buds will have adjusted, and you may find sweetened foods just too sweet for your new tastes. The tea you drank with two teaspoons of sugar, may now taste weird and kind of disgusting. Congratulations!You have now successfully de-normalized sugar!

Added sugar is any form of sugar or sugar alternative added to, or contained in, your food. This includes the raw sugar in your tea, coconut sugar, rice bran syrup, maple syrup, molasses, or agave syrup on your fruit. While there are some metabolic differences between the forms of sugar, your gut and its microbiome don’t discriminate between the type or source of the sugar, or whether it is refined or unrefined. It is all the same:

Sugar = Sugar = Sugar

At the end of four weeks without added sugar, you can introduce a little maple syrup or raw local honey if you want to…

Artificial sweeteners aren’t recommended either as they wreak havoc on the gut by altering the gut microbiota. Small amounts of stevia are probably the best option, although even that may cause gut irritation in some sensitive people.

What does the science tell us about gluten and leaky gut?

Catchy headlines poke fun at the gluten-free ‘fad’, and many GPs still do not believe non-celiac gluten sensitivity could be affecting their patients. But many people are finding that they feel better when they avoid gluten. So what does the research tell us?

In case you didn’t know, gluten is a family of proteins found in most cereals including wheat, rye, spelt, and barley. It gives dough a glue like consistency which holds it together. Gluten is not only found in obvious foods such as bread, pasta, and beer but also soy sauce, sweats, chips, hot dogs and battered fish!

Celiac Disease

In people with celiac disease, gliadin is a powerful trigger of zonulin release. Zonulin increases intestinal permeability by opening the tight junctions in the epithelial lining, and in people with celiac disease, an auto-immune response follows.  This is a serious condition, and full-blown celiac disease is associated with complete atrophy of the villi which line the small intestine and absorb your nutrients. If you suspect celiac disease, particularly if you have a family history of celiac disease, please speak to your GP about testing.

Non-Celiac Gluten Sensitivity

Whilst increased intestinal permeability in response to dietary gluten is most severe in those with celiac disease, zonulin, a marker for intestinal permeability, is also increased in people with what is called non-celiac gluten sensitivity (NCGS) and also irritable bowel syndrome with diarrhea.

NCGS is a term applied to people who experience symptoms in response to consumed to gluten consumption but do not have celiac disease. They may feel gastro-intestinal discomfort, fatigue or neurological symptoms. These people tend to improve on a gluten-free diet. Unfortunately, these people can be mocked for avoiding wheat and told that it’s all in their head.

But researchers have found that people with NCGS have increased intestinal permeability compared to healthy subjects. This should not be surprising as we know gliadin increases the release of zonulin, which can affect tight junctions. The opening of these tight junctions, our gateways. allows macromolecules to come into contact with our immune system and our bloodstream and explains why the group with NCGS also had a systemic immune activation on eating gluten.

Gluten increases Intestinal Permeability in All Human Tissue

In a 2015 study, researchers found tissue taken from the duodenum of humans became permeable, and there was increased inflammation when exposed to gliadin (i.e. leaky gut). As this study is in tissue taken from people rather than directly in people themselves, we have to be careful extrapolating the results. However, this backs up the experiences of many people .. they feel better when they don’t consume gluten.

In people with gluten sensitivity and NCGS, the damage did not clear after 36 hours, and what is most surprising, is that after five hours the tissue taken from ‘healthy’ people without celiac of NCGS, still had increased permeability.

Now, the epithelial lining of the small intestine is made up of the fastest growing cells in the body, creating a new lining every 3 to 7 days, and the gut lining would heal itself after exposure to gluten. But, if you have toast for breakfast, a sandwich for lunch, and pasta for dinner, it is never getting a chance to heal. Remember, I’m talking about people who aren’t celiac or don’t have NCGS here. If you consume gluten for breakfast, lunch, and dinner, your gut lining never has a chance to repair and you leaky gut will develop.

Researchers refer to this as the loss of oral tolerance. Now, your body can not deal with the toxins you are exposed to, and it may also start reacting to foods you didn’t react to both, as your immune system fights to defend itself. You have pathogenic intestinal permeability or a leaky gut and this can lead to inflammation in the body and autoimmunity.

Although lab tests do exist to look at your sensitivity to gluten, it’s widely accepted that an elimination diet is the best way to test for gluten intolerance. If you have a chronic health condition, it may be a good idea to remove gluten from your diet and see if that is of benefit. If you want to go further with the elimination diet, a Low FODMAP diet may be the next logical step to improve gut health.