Irritable Bowel Syndrome or IBS is a problem I often see in clinic and it can be problematic on many different levels. If you've been diagnosed with this condition, you may well have been suffering with it for years and, while a diagnosis can – at first – offer comfort in finally having a recognised problem,that may be short lived because often that’s where all support ends, and you’re left no further forward in actually fixing what the problem is. Or you may have self-diagnosed through searching the internet by using a process of elimination.

The difficulty begins because IBS is essentially a catch-all term, which is used to encompass a huge variety of digestive issues. In my experience, it’s likely to be one of the following five conditions:

1 SIBO (small intestine bacterial overgrowth)
Around 60% of people with IBS will have SIBO. Though you might have heard about good (and bad) bacteria in the gut, really what experts are talking about is the balance of bacteria in the large intestine: the colon.
The small intestine shouldn’t have hardly any bacteria, and each day the body should perform a flush to sweep bacteria from the small intestine and into the large intestine. This flush is called the ‘migrating motor complex’. For a huge variety of reasons (historic food poisoning being the most common, but also low levels of stomach acid or adhesions play a role, among others) the bacteria are not swept away.
The trouble is that these bacteria can ferment the food in your small intestine, causing gas, belching, bloating, pain and a variety of other symptoms, including constipation and/or loose stools, and even anxiety. A breath test can establish which gases are present, and we can devise an action plan based on your results. 

2 Lactose intolerance
This is when your body is not able to tolerate lactose, a type of sugar found naturally in milk and other dairy products. Essentially, bacteria in your intestine feed on these milk sugars, leading to a host of IBS symptoms, like bloating and gas, nausea, constipation or diarrhoea.
It can go hand in hand with other digestive complaints, such as coeliac disease or increased intestinal permeability (‘leaky gut’). Lactose intolerance can be diagnosed via a simple at-home breath test. 

3 Fructose malabsorption
The symptoms are very similar to lactose intolerance. Fructose (which is found in fruit, honey and many processed foods) is a sugar, which, like lactose, is digested in the small intestine.
Some people cannot absorb fructose, and what is not absorbed is fermented by intestinal bacteria, causing bloating, cramping, gas and distension of the stomach. You might also experience brain fog and headaches.
A breath test will confirm the condition. 

4 Dysbiosis
This is an imbalance in the levels of beneficial (good) and pathogenic (bad) bacteria in the large intestine or colon. This is now common due to overuse of antibiotics and alcohol, an increase in high sugar diets, and stress.
Symptoms can vary from a sluggish bowel, constipation or diarrhoea or both, pain, bloating and flatulence, to chronic bad breath, joint pain, fatigue and food sensitivities.
Dysbiosis is also implicated in a variety of health conditions like diabetes, heart disease and obesity. A stool test can help establish whether your gut bacteria are out of balance, along with a host of other markers that might be useful in getting to the root of your digestive problems.
 
5 Yeast overgrowth
Where the gut environment becomes out of balance (due to dysbiosis), yeast can thrive. Diets high in sugar feed the yeast – although if you think you might have a yeast overgrowth, it’s worth noting that long-term yeast problems can mean that the yeast cells are pathogenic or disease causing, and that the yeast has switched its metabolism to also be able to digest protein and fat.
Symptoms of yeast overgrowth include recurring thrush, gas or bloating, fatigue, bad breath, cravings for sweet foods, joint pain and brain fog. 
A stool test can establish the presence of candida or other yeast overgrowth. 
 
Some people struggle with digestive problems for years, but you can often get to the root cause of the issue and make changes to help you feel like yourself again. Do get in touch if you'd like to find out more about how I can help you find your root cause. I offer free 30 minute health assessments - click the link to book.

Blood Orange and Almond Cake

This is a delicious, moist cake, which works perfectly as a dessert or treat for guests. Both gluten and dairy-free, but you would not notice! 

Blood oranges are rich in antioxidants, which help reduce the stress of oxidation and lower your risk of chronic health problems like cancer, heart disease, and diabetes.  Due their fantastic pigment, they have 9 x the antioxidant capacity of Navel oranges, as well as 3 x the polyphenol content.

Oh, and they are really tasty!

Ingredients

3 medium blood oranges

6 eggs, separated

150g honey

265g ground almonds

2 tsp baking powder

½ tsp ground cardamon

1 tsp vanilla extract

4-6 tbsp flaked almonds

Pinch salt

Serves 8-10

23cm springform tin, greased and lined

Method

• Wash the oranges and put in a pan. Cover fully with water and bring to the boil, then simmer gently for 2 hours or until very soft. Watch the water level. Drain and leave to cool completely.

• Pre-heat the oven to 160 degrees fan / 180 degrees normal.

• Chop up the oranges, remove any seeds, and put the rest into the blender (skin and all). Blitz to a puree and put to one side.

• In a clean bowl, whisk the egg whites until they form stiff peaks.

• In another bowl, beat the egg yolks with the honey and vanilla essence until fully combined. Stir in the pureed oranges.

• Fold in the ground almonds, ground cardamon, pinch of salt and baking powder.

• Gently fold in a couple of spoonfuls of the egg whites, before then folding in the rest of the egg whites.

• Pour the batter into the prepared tin. Sprinkle with the flaked almonds. Bake for 60 minutes or until a skewer comes out clean. If the cake starts to brown too quickly then cover with foil for the remaining time.

• Allow the cake to cool in the tin for at least 30 minutes as it will be too fragile to remove at this point.

• Leave to cool completely on a wire rack. Serve in slices with whole Greek yoghurt.

INSTANT KIMCHI

This is a popular, spicy condiment that can be used in a variety of way – side dish to a curry, stir-fry or salad, as an element of a sandwich or wrap, or to spice up any dishes that need it.

It’s also a great way to get some of the delicious Hisby cabbage into your diet! Slightly sweeter than your traditional cabbage, it is sometimes known as sweetheart cabbage or pointed cabbage. Cabbage is part of the Brassica family and as such is a superhero in the nutrition world! Rich in vitamins K, C and folate, it also packs a fantastic fibre punch. Cabbage is excellent for gut health – the soluble fibre it contains make a great meal for the microbes in our gut, which in turn keep us healthy. And it is fantastic for hormone health.

Ingredients

1 Hisby or pointed cabbage

1 tbsp sea salt

3 cloves garlic, crushed

1 tbsp grated ginger (fresh or frozen)

2 tbsp chilli sauce (hot not sweet)

2 tbsp fish sauce or veggie fish sauce

1 tsp honey

3 tbsp rice wine vinegar (or white wine vinegar, if you don’t have this) 

2 carrots, grated

1 onion, finely sliced

Makes 1 x 1 litre jar

Method

• Chop the cabbage into 1-inch slices, pop in a bowl and cover with 1 tbsp sea salt. Leave to sit for 1 hour.
• Meanwhile, in a large bowl combine the garlic, ginger, chilli sauce, fish sauce (if using), honey and vinegar into a bowl and whisk to mix thoroughly. Leave to stand for flavours to combine.
• After an hour, transfer the cabbage to a colander and rinse thoroughly to remove the salty layer. Dry in a salad-stirrer or thoroughly with a clean tea-towel.
• Tip the cabbage into the bowl with the sauce you made early and mix thoroughly, so all the leaves are covered in the paste.
• Pop it into the jar. This can be used straight away as a side for a meal, or it will keep in the fridge for maximum a fortnight. The flavour will strengthen as time progresses.
• Enjoy!

Spotlight on Endometriosis

March is Endometriosis Awareness Month. This is a condition that can affect women of any age and studies show that it affects 10-15% of menstruating women.  Endometriosis is where tissue similar to that of the womb lining grows in other places outside of the womb, such as on the ovaries or the fallopian tubes. The main risk factor for endometriosis is heredity, meaning that if your mother or older sister has it, there’s a fair chance that you may get it too. 

While the exact cause is unknown, what is evident is the problems that it causes to those who have it. With endometriosis, the womb-lining-like tissue that grows outside of the womb behaves exactly as you would expect the womb-lining to behave – in sync with the women’s monthly cycle it thickens, sheds and bleeds. But if this tissue is outside of the uterus, it has no way to exit the body as it would within the womb, causing pain that is sometimes incredibly severe. Further complications can include formation of cysts called endometriomas, plus irritation of the surrounding tissue, possible scarring and adhesions.  Fertility problems may also develop.

Symptoms include painful periods, pain during intercourse, pain when going to the loo, excessive bleeding, infertility, plus other symptoms such as fatigue, digestive issues like diarrhoea and constipation, bloating or nausea. While it can be a challenging condition to manage, working with a GP and gynaecologist can help to manage symptoms and provide a programme of care. Plus, research shows that alongside conventional medical help, changes to nutrition and lifestyle may help with the severity of symptoms.

The following nutrition tips may help with the severity of endometriosis symptoms:

Include healthy fats and avoid unhealthy ones

Research shows that foods rich in omega-3 fatty acids, such as oily fish like salmon, mackerel, and sardines, may be protective against increased endometriosis symptoms. Although an exact link was not proven, studies show that women with the highest intake of these fats were 22% less likely to be diagnosed with endometriosis compared with women with the lowest intake. 

And avoid trans-fats, those fats that can be found in deep-fried foods such as chips or crisps, or in shop-bought foods which contain partially hydrogenated fats/oils or shortening. Studies show that women with the highest intake of trans saturated fats were 48% more likely to experience endometriosis symptoms.

Increase intake of high-fibre foods

Food rich in fibre, such as pulses, legumes, and vegetables, may improve intestinal transit time and help to balance gut-friendly bacteria.  Research shows that this may help the body to naturally clear excess oestrogen, which may in turn help with improving symptoms of endometriosis.

Include phytoestrogen-rich foods

Phytoestrogens are chemicals found in certain plant foods such as soy and flaxseed which have been seen to exert a weak oestrogen-like effect on the body. However, by binding to oestrogen receptors in the body, research shows that these phytochemicals may be beneficial to women with endometriosis by encouraging the body’s natural clearance of oestrogen. 

Increase vitamin C-rich foods

Research shows that foods rich in vitamin C may be effective for the prevention and regression of endometriosis possibly by helping to manage the inflammation and growth of excess tissue. Including foods such as peppers, broccoli, Brussels sprouts, and citrus fruits on a regular basis may help with the reduction of chronic pain associated with endometriosis. 

If endometriosis symptoms are impacting your life, why not get in touch with me to discuss how a personalised nutrition plan might help? Book a free 30-minute health review today – just click here to book.

My Super Six Favourite Foods for Healthy Fats

Contrary to popular belief, many of us are not eating enough healthy fats in our diets. We should be aiming to see some fats with each meal that we have. But how can we incorporate them? Here are my super six favourite fats:

1. EXTRA VIRGIN OLIVE OIL 

High in monounsaturated fats and rich in antioxidants, olive oil is the keystone to the Mediterranean diet and is rightly lauded as a hero among fats. Research shows that regular consumption of olive oil may be beneficial in our fight against chronic disease. Drizzle on salads or soups, gently roast vegetables in it, or pour onto veggies for flavour.

2. OILY FISH 

Oily fish, such as mackerel, salmon, herring, fresh tuna, sardines, are chock full of omega 3 fatty acids, which have been seen to help fight inflammation, and may be beneficial for brain, eye and skin health.

3. NUTS 

Packed with nutrients like magnesium and vitamin E, nuts bring plenty of essential fats to the table. They make the perfect snack – eat a handful (preferably raw) with a small piece of fruit or spread a little nut butter on an oatcake (peanut butter is just for starters – try almond for a change).

4. SEEDS

Seeds are the starting point for growing plants, so they are extremely nutritious. They are full of monounsaturated and polyunsaturated fats, as well as antioxidants and fibre. Flax, chia and hemp seeds are a good source of omega 3 fatty acids. Sesame, pumpkin and sunflower seeds are all rich in monounsaturated fats. All add crunch, flavour and interest to a meal – sprinkle on salads, soups or roasted veggies, or eat a handful as a snack.

5. AVOCADOS 

You’ve got to love an avocado! They go with practically anything and are high in both vitamin E and in healthy monounsaturated fats. Slice it, mash it, or stick it in a smoothie.

6. COCONUT OIL 

There’s so much to like – where to start? Coconut oil can act as an anti-fungal (caprylic acid), when used either externally or internally. The ideal replacement for butter in baking and as your oil of choice when frying at higher temperatures. Research shows that it may also help with cholesterol balance and blood pressure.

Cooking with fat

How the fat is used (through cooking and processing) is a big deciding factor whether it is healthy or unhealthy. Essential fatty acids (EFAs) may become less healthy in the presence of light, oxygen and heat. That is because frying with oils like olive oil at high temperature leads to oxidation and the production of free radicals – highly inflammatory for the body and may increase the risk of chronic disease. 

Therefore, pick oils for cooking that are more stable at a high heat, saturated fats such as coconut oil or animal fats. Use olive oil only on a low heat for sauteing.

Use these oils for cooking

Coconut oil, avocado oil, butter or ghee (clarified butter), or goose fat 

Use olive oil on low heats for long, slow cooking that won’t allow it to ‘smoke’.

Use these oils for drizzling or dressings

Extra virgin olive oil, walnut oil, sesame seed oil, flax seed oil, hazelnut oil, almond oil, hempseed oil

Don’t use sunflower oil (although do eat the seeds) or vegetable oil at all.

This is an easy recipe and can be made from store-cupboard items, so this is a great meal to have if you’re needing to go shopping. It also makes a regular appearance in our Friday night ‘fakeaways’ that we’ve been having – pairing this alongside a chickpea or prawn bhuna, plus some spiced quinoa and spinach makes a veritable feast. Plus, this is easy to freeze, so I often make a double batch and put some in the freezer for when I’m short on time at a later date. A winner on many levels!

If you’re new to legumes and pulses, red lentils are a good place to start. They’re quick and easy to cook, and they pack a nutritional punch.  Lentils are a great source of B vitamins, iron, magnesium, potassium and zinc. They're also full of fibre, which supports a healthy tum and provides food for our friendly bacteria. Eating lentils regularly has been seen to improve overall gut function. Plus, they’re delicious, and even the fussiest of eaters seems to get on well with their umami flavour.

Ingredients

1 tbsp ghee or 1 tbsp coconut oil

1 large onion, finely chopped

1 carrot, coarsely grated

3 cloves garlic, crushed

2 tsp cumin seeds

2 tsp black mustard seeds

1 level tbsp turmeric

250g split red lentils

350ml water

1 tin whole coconut milk

1 tin chopped tomatoes

2 tsp freshly grated ginger (or frozen grated ginger)

Seasoning

Chopped coriander to garnish (optional)

Serves 6

Method

• In a large, deep pan heat the ghee or coconut oil and then gently sauté the onions until soft and golden
• Add the grated carrot, crushed garlic and the whole spices. Stir and sauté until fragrant, approximately 5 mins on a gentle heat
• Add the turmeric and stir to cover well, allowing to cook through for 1 min
• Add in the lentils and stir to combine with the onion mix. Follow this with the water, coconut milk, chopped tomatoes and ginger. Stir well to combine. Season to taste
• Bring to simmering point and then leave to cook on a gentle heat, uncovered for 30-40 mins until the lentils are soft and cooked. Note – this has a tendency to catch on the bottom, so stir frequently and add a little more water if required
• When cooked test for seasoning. Serve with brown rice or quinoa, with a garnish of chopped coriander
• Enjoy!