Fruit, Fiber, & Leafy Greens… On A Low-FODMAP Diet!

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Fiber For FODMAP-Avoiders

First, let’s quickly cover: what are FODMAPs?

FODMAPs are fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.

In plainer English: they’re carbohydrates that are resistant to digestion.

This is, for most people most of the time, a good thing, for example:

When Is A Fiber Not A Fiber? When It’s A Resistant Starch.

Not for everyone…

However, if you have inflammatory bowel syndrome (IBS), including ulcerative colitis, Crohn’s disease, or similar, then suddenly a lot of common dietary advice gets flipped on its head:

Dietary Intolerances & More

While digestion-resistant carbohydrates making it to the end parts of our digestive tract are good for our bacteria there, in the case of people with IBS or similar, it can be a bit too good for our bacteria there.

Which can mean gas (a natural by-product of bacterial respiration) accumulation, discomfort, water retention (as the pseudo-fiber draws water in and keeps it), and other related symptoms, causing discomfort, and potentially disease such as diarrhea.

Again: for most people this is not so (usually: quite the opposite; resistant starches improve things down there), but for those for whom it’s a thing, it’s a Big Bad Thing™.

Hold the veg? Hold your horses.

A common knee-jerk reaction is “I will avoid fruit and veg, then”.

Superficially, this can work, as many fruit & veg are high in FODMAPs (as are fermented dairy products, by the way).

However, a diet free from fruit and veg is not going to be healthy in any sustainable fashion.

There are, however, options for low-FODMAP fruit & veg, such as:

Fruits: bananas (if not overripe), kiwi, grapefruit, lemons, limes, melons, oranges, passionfruit, strawberries

Vegetables: alfalfa, bell peppers, bok choy, carrots, celery, cucumbers, eggplant, green beans, kale, lettuce, olives, parsnips, potatoes (and sweet potatoes, yams etc), radishes, spinach, squash, tomatoes*, turnips, zucchini

*our stance: botanically it’s a fruit, but culinarily it’s a vegetable.

For more on the science of this, check out:

Strategies for Producing Low FODMAPs Foodstuffs: Challenges and Perspectives ← table 2 is particularly informative when it comes to the above examples, and table 3 will advise about…

Bonus

Grains: oats, quinoa, rice, tapioca

…and wheat if the conditions in table 3 (linked above) are satisfied

(worth mentioning since grains also get a bad press when it comes to IBS, but that’s mostly because of wheat)

See also: Gluten: What’s The Truth?

Enjoy!

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  • Cancer is increasingly survivable – but it shouldn’t depend on your ability to ‘wrangle’ the health system

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    One in three of us will develop cancer at some point in our lives. But survival rates have improved to the point that two-thirds of those diagnosed live more than five years.

    This extraordinary shift over the past few decades introduces new challenges. A large and growing proportion of people diagnosed with cancer are living with it, rather than dying of it.

    In our recently published research we examined the cancer experiences of 81 New Zealanders (23 Māori and 58 non-Māori).

    We found survivorship not only entailed managing the disease, but also “wrangling” a complex health system.

    Surviving disease or surviving the system

    Our research focused on those who had lived longer than expected (four to 32 years since first diagnosis) with a life-limiting or terminal diagnosis of cancer.

    Common to many survivors’ stories was the effort it took to wrangle the system or find others to advocate on their behalf, even to get a formal diagnosis and treatment.

    By wrangling we refer to the practices required to traverse complex and sometimes unwelcoming systems. This is an often unnoticed but very real struggle that comes on top of managing the disease itself.

    The common focus of the healthcare system is on symptoms, side effects of treatment and other biological aspects of cancer. But formal and informal care often falls by the wayside, despite being key to people’s everyday experiences.

    A woman at a doctor's appointment
    Survival is often linked to someone’s social connections and capacity to access funds. Getty Images

    The inequities of cancer survivorship are well known. Analyses show postcodes and socioeconomic status play a strong role in the prevalence of cancer and survival.

    Less well known, but illustrated in our research, is that survival is also linked to people’s capacity to manage the entire healthcare system. That includes accessing a diagnosis or treatment, or identifying and accessing alternative treatments.

    Survivorship is strongly related to material resources, social connections, and understandings of how the health system works and what is available. For instance, one participant who was contemplating travelling overseas to get surgery not available in New Zealand said:

    We don’t trust the public system. So thankfully we had private health insurance […] But if we went overseas, health insurance only paid out to $30,000 and I think the surgery was going to be a couple of hundred thousand. I remember Dad saying and crying and just being like, I’ll sell my business […] we’ll all put in money. It was really amazing.

    Assets of survivorship

    In New Zealand, the government agency Pharmac determines which medications are subsidised. Yet many participants were advised by oncologists or others to “find ways” of taking costly, unsubsidised medicines.

    This often meant finding tens of thousands of dollars with no guarantees. Some had the means, but for others it meant drawing on family savings, retirement funds or extending mortgages. This disproportionately favours those with access to assets and influences who survives.

    But access to economic capital is only one advantage. People also have cultural resources – often described as cultural capital.

    In one case, a participant realised a drug company was likely to apply to have a medicine approved. They asked their private oncologist to lobby on their behalf to obtain the drug through a compassionate access scheme, without having to pay for it.

    Others gained community support through fundraising from clubs they belonged to. But some worried about where they would find the money, or did not want to burden their community.

    I had my doctor friend and some others that wanted to do some public fundraising. But at the time I said, “Look, most of the people that will be contributing are people from my community who are poor already, so I’m not going to do that option”.

    Accessing alternative therapies, almost exclusively self-funded, was another layer of inequity. Some felt forced to negotiate the black market to access substances such as marijuana to treat their cancer or alleviate the side effects of orthodox cancer treatment.

    Cultural capital is not a replacement for access to assets, however. Māori survivorship was greatly assisted by accessing cultural resources, but often limited by lack of material assets.

    Persistence pays

    The last thing we need when faced with the possibility of cancer is to have to push for formal diagnosis and care. Yet this was a common experience.

    One participant was told nothing could be found to explain their abdominal pain – only to find later they had pancreatic cancer. Another was told their concerns about breathing problems were a result of anxiety related to a prior mental health history, only to learn later their earlier breast cancer had spread to their lungs.

    Persistence is another layer of wrangling and it often causes distress.

    Once a diagnosis was given, for many people the public health system kicked in and delivered appropriate treatment. However, experiences were patchy and variable across New Zealand.

    Issues included proximity to hospitals, varying degrees of specialisation available, and the requirement of extensive periods away from home and whānau. This reflects an ongoing unevenness and lack of fairness in the current system.

    When facing a terminal or life-limiting diagnosis, the capacity to wrangle the system makes a difference. We shouldn’t have to wrangle, but facing this reality is an important first step.

    We must ensure it doesn’t become a continuing form of inequity, whereby people with access to material resources and social and cultural connections can survive longer.

    Kevin Dew, Professor of Sociology, Te Herenga Waka — Victoria University of Wellington; Alex Broom, Professor of Sociology & Director, Sydney Centre for Healthy Societies, University of Sydney; Chris Cunningham, Professor of Maori & Public Health, Massey University; Elizabeth Dennett, Associate Professor in Surgery, University of Otago; Kerry Chamberlain, Professor of Social and Health Psychology, Massey University, and Richard Egan, Associate Professor in Health Promotion, University of Otago

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Aspirin, CVD Risk, & Potential Counter-Risks

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    Aspirin Pros & Cons

    In Tuesday’s newsletter, we asked your health-related opinion of aspirin, and got the above-depicted, below-described set of responses:

    • About 42% said “Most people can benefit from low-dose daily use to lower CVD risk”
    • About 31% said “It’s safe for occasional use as a mild analgesic, but that’s all”
    • About 28% said “We should avoid aspirin; it can cause liver and/or kidney damage”

    So, what does the science say?

    Most people can benefit from low-dose daily aspirin use to lower the risk of cardiovascular disease: True or False?

    True or False depending on what we mean by “benefit from”. You see, it works by inhibiting platelet function, which means it simultaneously:

    • decreases the risk of atherothrombosis
    • increases the risk of bleeding, especially in the gastrointestinal tract

    When it comes to balancing these things and deciding whether the benefit merits the risk, you might be asking yourself: “which am I most likely to die from?” and the answer is: neither

    While aspirin is associated with a significant improvement in cardiovascular disease outcomes in total, it is not significantly associated with reductions in cardiovascular disease mortality or all-cause mortality.

    In other words: speaking in statistical generalizations of course, it may improve your recovery from minor cardiac events but is unlikely to help against fatal ones

    The current prevailing professional (amongst cardiologists) consensus is that it may be recommended for secondary prevention of ASCVD (i.e. if you have a history of CVD), but not for primary prevention (i.e. if you have no history of CVD). Note: this means personal history, not family history.

    In the words of the Journal of the American College of Cardiology:

    ❝Low-dose aspirin (75-100 mg orally daily) might be considered for the primary prevention of ASCVD among select adults 40 to 70 years of age who are at higher ASCVD risk but not at increased bleeding risk (S4.6-1–S4.6-8).

    Low-dose aspirin (75-100 mg orally daily) should not be administered on a routine basis for the primary prevention of ASCVD among adults >70 years of age (S4.6-9).

    Low-dose aspirin (75-100 mg orally daily) should not be administered for the primary prevention of ASCVD among adults of any age who are at increased risk of bleeding (S4.6-10).❞

    ~ Dr. Donna Arnett et al. (those section references are where you can find this information in the document)

    Read in full: Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology

    Or if you’d prefer a more pop-science presentation:

    Many older adults still use aspirin for CVD prevention, contrary to clinical guidance

    Aspirin can cause liver and/or kidney damage: True or False?

    True, but that doesn’t mean we must necessarily abstain, so much as exercise caution.

    Aspirin is (at recommended doses) not usually hepatotoxic (toxic to the liver), but there is a strong association between aspirin use in children and the development of Reye’s syndrome, a disease involving encephalopathy and a fatty liver. For this reason, most places have an official recommendation that aspirin not be used by children (cut-off age varies from place to place, for example 12 in the US and 16 in the UK, but the key idea is: it’s potentially dangerous for those who are not fully grown).

    Aspirin is well-established as nephrotoxic (toxic to the kidneys), however, the toxicity is sufficiently low that this is not expected to be a problem to otherwise healthy adults taking it at no more than the recommended dose.

    For numbers, symptoms, and treatment, see this very clear and helpful resource:

    An evidence based flowchart to guide the management of acute salicylate (aspirin) overdose

    Take care!

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  • Want to sleep longer? Adding mini-bursts of exercise to your evening routine can help – new study

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Exercising before bed has long been discouraged as the body doesn’t have time to wind down before the lights go out.

    But new research has found breaking up a quiet, sedentary evening of watching television with short bursts of resistance exercise can lead to longer periods of sleep.

    Adults spend almost one third of the 24-hour day sleeping. But the quality and length of sleep can affect long-term health. Sleeping too little or waking often in the night is associated with an increased risk of heart disease and diabetes.

    Physical activity during the day can help improve sleep. However, current recommendations discourage intense exercise before going to bed as it can increase a person’s heart rate and core temperature, which can ultimately disrupt sleep.

    Nighttime habits

    For many, the longest period of uninterrupted sitting happens at home in the evening. People also usually consume their largest meal during this time (or snack throughout the evening).

    Insulin (the hormone that helps to remove sugar from the blood stream) tends to be at a lower level in the evening than in the morning.

    Together these factors promote elevated blood sugar levels, which over the long term can be bad for a person’s health.

    Our previous research found interrupting evening sitting every 30 minutes with three minutes of resistance exercise reduces the amount of sugar in the bloodstream after eating a meal.

    But because sleep guidelines currently discourage exercising in the hours before going to sleep, we wanted to know if frequently performing these short bursts of light activity in the evening would affect sleep.

    Activity breaks for better sleep

    In our latest research, we asked 30 adults to complete two sessions based in a laboratory.

    During one session the adults sat continuously for a four-hour period while watching streaming services. During the other session, they interrupted sitting by performing three minutes of body-weight resistance exercises (squats, calf raises and hip extensions) every 30 minutes.

    After these sessions, participants went home to their normal life routines. Their sleep that evening was measured using a wrist monitor.

    Our research found the quality of sleep (measured by how many times they woke in the night and the length of these awakenings) was the same after the two sessions. But the night after the participants did the exercise “activity breaks” they slept for almost 30 minutes longer.

    Identifying the biological reasons for the extended sleep in our study requires further research.

    But regardless of the reason, if activity breaks can extend sleep duration, then getting up and moving at regular intervals in the evening is likely to have clear health benefits.

    Time to revisit guidelines

    These results add to earlier work suggesting current sleep guidelines, which discourage evening exercise before bed, may need to be reviewed.

    As the activity breaks were performed in a highly controlled laboratory environment, future research should explore how activity breaks performed in real life affect peoples sleep.

    We selected simple, body-weight exercises to use in this study as they don’t require people to interrupt the show they may be watching, and don’t require a large space or equipment.

    If people wanted to incorporate activity breaks in their own evening routines, they could probably get the same benefit from other types of exercise. For example, marching on the spot, walking up and down stairs, or even dancing in the living room.

    The key is to frequently interrupt evening sitting time, with a little bit of whole-body movement at regular intervals.

    In the long run, performing activity breaks may improve health by improving sleep and post-meal blood sugar levels. The most important thing is to get up frequently and move the body, in a way the works best for a person’s individual household.

    Jennifer Gale, PhD candidate, Department of Human Nutrition, University of Otago and Meredith Peddie, Senior Lecturer, Department of Human Nutrition, University of Otago

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Almonds vs Walnuts – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing almonds to walnuts, we picked the almonds.

    Why?

    It wasn’t just our almond bias, but it was close!

    In terms of macros, the main important differences are:

    • Almonds are higher in protein
    • Walnuts are higher in fats (they are healthy fats)

    So far, so even.

    In terms of vitamins, both are rich in many vitamins; mostly the same ones. However, walnuts have more of most of the B vitamins (except for B2 and B3, where almonds win easily), and almonds have more vitamin E by several orders of magnitude.

    So far, so balanced.

    Almonds have slightly more choline.

    Almonds have a better mineral profile, with more of most minerals that they both contain, and especially, a lot more calcium.

    Both nuts have [sometimes slightly different, but] comparable benefits against diabetes, cancer, neurodegeneration, and other diseases.

    In summary

    This one’s close. After balancing out the various “almonds have this but walnuts have that” equal-but-different benefits, we’re going to say almonds take first place by virtue of the better mineral profile, and more choline.

    But: enjoy both!

    Learn more

    You might like this previous article of ours:

    Why You Should Diversify Your Nuts

    Take care!

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  • Longevity for the Lazy – by Dr. Richard Malish

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    There are some people who devote all their resources to longevity, which can become a full-time occupation, not to mention a very expensive endeavor. This book’s for those who want to get the best possible “bang for buck” by doing the things that have the most favorable cost:worth ratio.

    Dr. Malish covers what can be done easily for personal longevity, as well as what technological advances can be enjoyed that those before us didn’t have as options. He also discusses the diseases that are most likely to kill us, and how to avoid those.

    He preaches a proactive approach, but one that is simple and consistent and based in good science, and good statistics. Indeed, while he’s served 20 years as an army doctor and a cardiologist, he now works as a healthcare policy consultant, so he is well-placed to advise.

    The style of the book is halfway between regular pop-science and a textbook; you can either read it cover-to-cover, or skim first though the key points, highlight boxes, summaries, and the like. He also provides a time-phased task list, for those who like things to be laid out like that.

    Bottom line: this is a very good, methodical guide to living longer without making it a full-time occupation.

    Click here to check out Longevity For The Lazy, and enjoy healthy longevity that gives you time free to enjoy it!

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  • More Mediterranean – by American’s Test Kitchen

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Regular 10almonds readers will know that we talk about the Mediterranean diet often, and with good reason; it’s been for quite a while now the “Gold Standard” when it comes to scientific consensus on what constitutes a good diet for healthy longevity.

    However, it’s easy to get stuck in a rut of cooking the same three meals and thinking “I must do something different, but not today, because I have these ingredients and don’t know what to cook” and then when one is grocery-shopping, it’s “I should have researched a new thing to cook, but since I haven’t, I’ll just get the ingredients for what I usually cook, since we need to eat”, and so the cycle continues.

    This book will help break you out of that cycle! With (as the subtitle promises) hundreds of recipes, there’s no shortage of good ideas. The recipes are “plant-forward” rather than plant-based per se (i.e. there are some animal products in them), though for the vegetarians and vegans, it’s nothing that’s any challenge to substitute.

    Bottom line: if you’re looking for “delicious and nutritious”, this book is sure to put a rainbow on your plate and a smile on your face.

    Click here to check out More Mediterranean, and inspire your kitchen!

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