Tag Archives: Digestion

IgG Food Sensitivity Testing and Reducing Inflammation

Food Antibody testing is one of my favorite tools for helping patients take charge of their own health, especially if there is a chronic inflammatory concern such as eczema, joint pain, digestive upset, or even mental agitation. Virtually all chronic disease has an underlying inflammatory component–that is, any long-term health issue, regardless of what system of the body it effects, is the result of ongoing inflammation.

So what is inflammation?  

It is the natural process the body uses to repair damage to the system and get rid of organisms that make us sick.  When an infectious agent such as a virus or bacteria enter the body, our immune system will recognize that foreign agent and attack it.  White blood cells are our immune cells that mount this attack. Specialized white blood cells will make a “flag”, called an antibody, that recognize certain proteins as foreign.  When they recognize a protein, those antibodies will attach themselves to those proteins (that often are part of a virus or bacteria) and signal the rest of the immune system to eradicate it.  Other white blood cells will engulf the protein, digest it, and then spit out the remains of that protein to be eliminated by the lymph system. This process produces inflammation, which we experience as redness, swelling, heat, and the production of mucus.  

How does this relate to foods?  

Well, in some cases, the body will recognize other proteins that come into the system as foreign.  This can include things like pollen, cat dander, mold spores, or proteins in foods. The body will mount a similar type of attack as described above on these proteins in the body even though they aren’t necessarily pathogens (bugs that will make us sick).  Instead, we call them allergens. If we are continually exposed to these allergens, the body will chronically produce inflammation. While a food may not be the agent that initially triggered the inflammatory response, the body may continue to have an inflammatory response if the food is eaten regularly.  Although foods may not be the only cause of chronic inflammation, they are one factor that can easily be changed without medication that can make a great impact on reducing the inflammatory response.

So what is IgG testing?  

IgG is a type of antibody–the “flags” the body uses to tell the immune system to make inflammation in a specific place.  Our body makes a range of types of antibodies that all do something slightly different. For instance, IgE antibodies are associated with immediate sensitivity reactions–if you know anyone allergic to peanuts or shellfish, for example, you may have seen that type of immediate reaction where the body reacts right away. IgG is a delayed antibody that may take several hours or even a couple of days to react, so it can be quite difficult to pick it out which food is causing the inflammatory response.  For this reason, a delayed food sensitivity can manifest as some of the more ongoing types of reactions, such as joint pain, IBS, eczema, chronic sinus issues, asthma, autoimmune thyroid disease, and even chronic mental agitation. Of course, we can eliminate and reintroduce foods to our diet without any testing, but elimination diets can be laborious and confusing. When we test first, it gives us an idea of the best foods to eliminate first instead of choosing blindly.  Several clinical trials in recent years have found that using IgG testing to guide food elimination can have a positive impact on many chronic issues, including inflammatory bowel disease, eczema, and migraine headaches.

Once I find out which foods I’m reacting to, what do I do?  

This is my favorite part, because it allows us to be scientists with our own bodies.  In a nutshell, the scientific method involves taking a system, changing something within the system, and observing the changes. When we actively change the diet, and pay attention to what happens, we do a little scientific experiment on ourselves that gives us the power to decide how we are going to feel each day based on the decisions we make.  When we do a food elimination, I like for you to eliminate all the potential offending foods that may be causing inflammation in your body. We give your body a few weeks–usually 4 to 6 weeks–to help the system come to a more neutral state. At this point, you note how you feel without all of those foods.

How Do I Reintroduce Foods? 

Once you have eliminated foods for an appropriate amount of time, we will  start to reintroduce foods one at a time. You will find that one of three things happens: 1. You take away a food, feel no different, then add it back, and feel no different.  2. You take a away a food, feel better, then add it back and feel obviously worse. Or 3. Somewhere in the middle–you take away a food, feel better, then you can add it back in a dose-dependent fashion and feel ok. (for example–you can tolerate eggs in baked goods but don’t feel well when you eat scrambled eggs for breakfast). When you reintroduce a food and find it bothers you, I recommend continuing to stay off of that food for at least 6 months.  For some people, a food intolerance will last for life, but for some, if the body becomes healthier and more robust overall they will be able to successfully reintroduce foods.

The knowledge you gain from eliminating and reintroducing foods helps develop what I view as the most powerful tool you have to maintain your health:  self awareness. The more aware we are, the more powerfully we can act. When we understand how our actions influence our overall state of health, we gain the ability to work as our own doctors.

Thank you for letting me be a part of your health journey!

 

Zar S1, Mincher L, Benson MJ, Kumar D. Food-specific IgG4 antibody-guided exclusion diet improves symptoms and rectal compliance in irritable bowel syndrome.Scand J Gastroenterol. 2005 Jul;40(7):800-7.

Aydinlar EI1, Dikmen PY, Tiftikci A, et al.  IgG-based elimination diet in migraine plus irritable bowel syndrome. Headache. 2013 Mar;53(3):514-25.

Alpay K1, Ertas M, Orhan EK, et al. Diet restriction in migraine, based on IgG against foods: a clinical double-blind, randomised, cross-over trial. Cephalalgia. 2010 Jul;30(7):829-37.

Mitchell N1, Hewitt CE, Jayakody S, et al.  Randomised controlled trial of food elimination diet based on IgG antibodies for the prevention of migraine like headaches. Nutr J. 2011 Aug 11

Liu Y1, Yan H2, Shao F3,et al. Correlation between childhood eczema and specific IgG antibody level. J Biol Regul Homeost Agents. 2018 Mar-Apr;32(2):341-344.

 

Congee Takes Away the Chill of Winter

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In my first year of medical school, I had a delightful roommate who was of Vietnamese descent, born in China, and raised in her family’s restaurant in San Jose, California.  Lucky for me, she was a wealth of food knowledge and was happy to share.  From her, I learned about sticky rice steamed in banana leaf, hot pot, geoduck, how to efficiently dispatch a live crab in the kitchen sink, and the magic of congee.

During the winter, the body craves warming foods that provide optimal, easy to assimilate nutrition.  In Chinese medicine, there is a concept called “digestive fire”, which roughly equates to your body’s ability to break down food and absorb it properly.  The bigger the fire, the better you can digest.  I like the metaphor of fire because it seems to parallel how our bodies generally are able to digest:  in the summer when the weather is warm, we can break down much more complex foods and do better with raw fruits and vegetables.  In the winter, we lack that external heat source and so we must apply heat to our foods to assist our digestive fire. Congee is the ultimate digestive assistant.

So what is congee?  Well, more than a specific recipe, congee is more of a concept.  The basic rule of making congee is you take a pulse (most often rice, but millet, wheat, barley, sorghum, mung beans, or other grains or legumes can be used), add a high proportion of water, and cook it for a long time over low heat.  Congee is a traditional food all over Asia, India, and even Portugal, and has historically been viewed as a medicinal food in all of these cultures.  Depending on taste preference, regional specialty, and the specific medicinal quality desired, other foods, herbs, and spices are added.  It can be served for any meal, and depending on your preference can be served sweet or savory.  Many Indian congees are served with milk and jaggery (palm sugar) but many Asian congees contain meats, pickled vegetables, ginger, eggs or crispy fried onions. (for more information, Wikipedia gives a great description of traditional congees across the world).

In my practice, I often recommend making congee as a winter food to bolster nutrition.  However, it is an especially good food for people who are recovering from extended illness or have significant digestive problems.  For patients who seem to “get sick no matter what I eat”, congee is a great place to start.  In people who are needing the simplest, easiest nutrition possible, white rice congee is appropriate. If your digestion is rather intact, brown rice should be fine.

In his book Healing with Whole Foods Paul Pitchford talks about many foods that can be added to congee to boost its healing properties.  A few of the most useful options I’ve found are: Using chicken or mutton broth instead of water is recommended for wasting illnesses and injuries, and duck or fish broth are supposed to relieve swelling. Ginger is warming to the organs and improves digestive function.  Fennel and black pepper also assist in reducing gas and improve digestion. Brown rice is good for nursing mothers and general nutrition, while sweet rice is more specific for recovering from digestive illnesses.

Chicken and Ginger Congee
Use bone-in chicken for this recipe.  The skin, bones, and connective tissue are rich in hyaluronic acid, chondroitin, and other building blocks of a healthy digestive tract and properly functioning immune system.

1 cup rice
2-inch piece of fresh ginger root, sliced thinly
1 chicken cut into parts
1 onion or 2 shallots, thinly sliced
6 cups water
1 tsp salt
soy sauce, sesame oil, and cilantro for serving

8-10 hours before eating, place rice, ginger, chicken, onion, and water into a large soup pot on low heat or ideally a slow cooker on low. When you come back 8-10 hours later, you should have a thick porridge.  Remove chicken parts from the porridge.  Remove the skin, then remove the meat from the bones and shred.  Skim the top of the porridge if necessary.  Ladle porridge into bowls and top with shredded chicken.  Garnish with soy sauce, sesame oil, and cilantro to taste.

Health Benefits of Pickles

PIckle Night!

Pickle NIght!

Pickling is one of my family’s favorite yearly traditions.  It has been going on since my family came to Denver in the early 1900’s and I suspect long before they immigrated from Eastern Europe.  I can’t recall a meal growing up where meat was served without a pickle to accompany it.  I know it was much more commonplace in the past: there is a famous story of a family friend who used to hold a contest to see who was making the best pickles in the neighborhood.  He, of course, was the judge, and in the end I don’t know if he ever awarded any prizes, he mostly just ate everyone’s pickles.  The point is, at that time just about everyone on the block was making their family’s brand of homemade pickle.

Today, we still get together with my folks once a year and make enough pickles to supply our own pantries, give as gifts to friends, and serve as a favorite side dish at celebrations with the extended family.  Although this is a bit of a novelty in our contemporary culture, pickles have played an important role in many culinary traditions.  From German sauerkraut to Korean kimchee, pickled foods have added an extra zip to food and have historically been a handy way to bring a bit of summer into the winter months.  What we are also finding today is that pickled foods are also important for health reasons.

The health promoting aspect of pickled foods lies in the pickling process itself.  Today, much of what we find in the store that is labeled a “pickle” is actually preserved in vinegar.  A natural pickle, however, is generally placed in a salt brine and allowed to ferment.  This process is called lactic acid fermentation.  What happens during this process is lactic acid producing bacteria (generally in the lactobacillus family, which included our good friend l. acidophilus) “eat” the sugars in the cucumbers and turn them into energy and lactate.  We know this is happening properly when we go to open the jar (always over the sink!) and it starts bubbling–this is the moment when my dad shouts “It’s working mom! It’s working!”  From a chemistry standpoint, this process increases the acidity of the brine and kills any pathogenic bacteria that may be present.  From a culinary standpoint, this results is a tangy, probiotic-infused vessel of crunchy deliciousness.

In our family, there are several other important ingredients in pickle making, all of which play a role in making a delicious and healthy food.  Fresh dill is what is called a carminative, which means it helps to dispel intestinal gas.  The spices in pickling spice, including allspice, cinnamon, cloves, and black pepper, are also digestive aids.  Garlic is antimicrobial which helps to insure that the “bad” bacteria don’t get a chance to culture.  The result is a product that helps to break down heavy foods, dispel gas, and provide probiotic cultures to insure healthy elimination.

In today’s grocery stores, particularly those geared towards natural foods, there are more and more natural pickle options.  They will provide the benefits listed above and will probably taste pretty darn good.  However, they tend to be rather expensive; I’ve seen as high as $15 per jar, which makes them a bit cost prohibitive.  My recommendation is to pull out that ancient copy of The Joy of Cooking (or do a little internet search) and make your own! Start a new family tradition in your kitchen today!

Food Introduction for Infants


During the springtime we focus on setting the stage for good absorption and low inflammation.  For kids and adults, much of this will include some sort of spring cleaning.  However, for infants, we focus simply on developing a healthy digestive tract and giving optimal nutrition.  Many parents ask me for information about when to start infants on different types of foods. The needs of each infant will vary somewhat; however, the following is a guideline for food introduction and timing.

A good rule of thumb is to wait until baby seems very interested in what you’re eating—reaches for the spoon or food etc.  Baby spends his or her last months in the womb storing iron to use in the first few months of life because milk is a poor source of iron.  For this reason, many of the first foods listed are higher in iron.  Rice cereal is often recommended as a first food; this is not necessarily a problem but it tends to be somewhat lower in nutrients and can be quite constipating so in this chart  isn’t recommended until 7-8 months.  Remember, at the beginning foods are more something to explore rather than a source of nutrition; let baby experiment and see what he or she likes.

At first, food should of course be pureed—a stick blender is a wonderful tool for this job!  Over time, though, baby may start to prefer food cut in small pieces (and soft!) that he or she can feed herself.  Some babies will quickly tire of the texture of pureed food.  Baby food in jars can be very handy in a pinch, but it is much more economical (and tastes better!) to make your own and freeze it in larger quantities.  When choosing jarred food, keep in mind whether you would want to eat it yourself—if the food is a nice color and tastes like the food (aka carrots should taste like carrots and be orange!) then baby is more likely to enjoy it.

Before 6 months, unless in a very specific situation that would require extra hydration, baby should not require any drinks other than breast milk.  Between 6 and 12 months water should be the only other drink; juices tend to be very high in sugar and unnecessary.

The reason for waiting for specific foods is to ensure that baby’s digestive tract is as well developed as possible to avoid digestive problems or other allergies.  Because of their high allergenicity, it is best to wait to introduce the following foods until 18-24 months, especially if there are known allergies or food allergies in the family:  Whole cow milk, wheat, peanuts, tree nuts.

Food Introduction Schedule

6 Months 7-8 Months 9-10 Months 12 Months
Banana Blackberries Papaya Yogurt (cow milk)
Prunes Carrot Nectarines/stone fruit Goat’s milk
Applesauce Spinach/Chard Mashed potato Barley
Pears Beet Peas Blackstrap molasses
Winter squash Cherries String beans Tofu
Yam/sweet potato Oatmeal Beans Onion/garlic
Blueberries (frozen for teething) Basmati rice Egg(yolk) Sunflower seeds
Avocado Broth Meats (very well cooked and ground) Egg (white)
Split peas Honey

 

 

Decrease Inflammation and Improve Digestion with Sprouts!

When I lived in Alaska, I had a patient who was a Slow Food diva.  Not only did she bake all her breads from scratch, she started from whole grains, then sprouted them, low-temperature oven dried them, and ground them into flour before turning them into delicious treats. Even though we all can’t be this dedicated to our food all the time, there is real value to putting this type of intention into nourishing our family.  Especially during these first weeks of spring, I can’t think of anything more appropriate or seasonal to eat than sprouted foods.  So in honor of all the teeny radish sprouts poking up in my garden, let’s talk about the health benefits of sprouts.

So, why is it worthwhile to eat sprouted foods?  Two of the primary goals for our eating during the spring are to improve digestion and absorption of food and decrease inflammation in the body.  Sprouts and sprouted foods are a wonderful way to work towards all of these goals.  This is both because of how foods are transformed during sprouting as well as the health benefits of the sprouts themselves

To read the rest of this article on Dr Rosen’s Grigel’s blog, click here

Restoring Digestive Health with Cabbage

The sun has returned to Colorado! I spent this morning in my garden with the girls, turning over the sun-warmed dirt and finding a few of last year’s carrots and onions lingering in the soil; perfect for us to share in our lunch.

As we head towards warmer weather, we will soon be getting to enjoy the first delicious foods of spring: greens, asparagus, and peas are all just around the corner. While these foods are delicious and a welcome nutritional boost after the storage foods of winter, it can be a big transition for our digestive tract to bring in all these fresh new foods. Now is the time to tune up our digestion to make sure we are ready to break down and properly absorb the fresh foods of spring.

So how can we utilize the foods of winter to help support our digestion? One of the best options out there is the humble cabbage. Cabbage has long been used as a folk remedy for ulcers as well as generally restoring the lining of the stomach and intestines. A traditional naturopathic remedy for stomach flu and ulcers is to chop up cabbage, cover it with water in the blender, blend it and let it sit for a couple of days before drinking. This may not sound like the yummiest of concoctions, but it works well enough to look into why it is effective.

The first reason cabbage is so useful for healing the digestion is its high glutamine content. Glutamine is an amino acid; our body makes glutamine but it becomes an essential amino acid during times of illness or high stress. While most of our body, such as our brain and muscles, use glucose, a sugar, the lining of our digestive tract prefers glutamine as an energy source. So when you eat cabbage, you are giving your stomach and intestines the food it prefers to replace and heal itself. Studies utilizing extracts of cabbage have found them to be protective against and healing to ulcers; it is hypothesized that glutamine is at least part of the reason for this. Glutamine content tends to be higher in raw cabbage, though, so the cabbage juice described above would be preferable to cooked cabbage.

The other medicinal element to our blended cabbage has to do with letting it sit for a couple days before eating. Fermented cabbage tends to develop strains of acidophilus and other bacteria that have been shown to function as probiotics; this means they promote the healthy growth of all the bacteria necessary for healthy functioning of the large intestine. Studies on kimchi, a traditional fermented cabbage product from Asia, have been shown not only to function as a probiotic, but also to inhibit the growth of h. pylori, the bacteria that has been associated with stomach ulcers.

So, as the air begins to warm and we look forward to the fresh new foods to come, utilize the end of our storage veggies to get our digestion ready for the excitement of spring! You don’t necessarily need to drink homemade fermented cabbage juice, but other traditional fermented cabbage dishes such as natural sauerkraut and kimchi could be quite useful. Even shredding cabbage into a slaw will provide a good source of glutamine to heal the lining of your digestion. Enjoy!

Sunchokes, Immunity, and the mysterious Inulin

Sunchokes are a delicious member of the daisy family, which includes many of the superstars of the botanical world: dandelion, burdock, artichoke, arnica, echinacea, chicory, and elecampane to name a few. Something all of these plants have in common is that their roots contain a compound called inulin. Inulin is a polysaccharide that acts as a type of soluble fiber. Fibers do not get broken down by our normal digestive process in the small intestine, so it remains intact as it is either absorbed or sent to the large intestine.

When inulin arrives in the large intestine, it can function in a manner similar to other prebiotics such as fructooligosaccharides. It serves as food to the healthy bacteria living in the digestive tract and thereby can help to grow and develop a healthy balance of flora. The large intestine is our largest immune organ: 70% of the immune tissue of the body resides here. Healthy flora help to protect this immune tissue, boost our natural defenses against infection, and prevent inappropriate inflammation in the digestive tract and throughout the body.

The problem with eating foods high in inulin is directly related to its benefits. When those happy bacteria consume it and grow, they create waste products in the form of gases such as carbon dioxide and methane. This can cause gas, bloating and general discomfort in the belly for some people. Processed foods that contain isolated inulin (which also can be called chicory on a label) do seem to cause problems for many people, so check your labels. That said, many traditional diets have contained high levels of inulin-containing foods and it is well tolerated by many people. Whole foods, such as sunchokes, can cause fewer gassy issues for people so it may be worth the experiment to give your flora a healthy snack!

Bitter Greens to Stimulate Digestion

Happy Chinese New Year week to all! When I lived in Seattle, I had the benefit of being immersed in a city heavily influenced by Asian culture and food. I loved being able to taste the wide variety of fruits, vegetables and other delights available from the other side of the Pacific, including a range of leafy green things. Greens can have a wide variety of flavors; sweet, sour, spicy, and especially bitter. Although in this culture we do not generally have a taste for bitter food, it can be a lovely facet of a meal and does serve an important digestive purpose.
Bok Choi and Tatsoi are two of my favorite leafy greens of all time because of their combination of crispy, juicy, tenderness, and a light bitterness. The fiber and water contained in these greens is of course going to benefit the digestion because it will help to bulk and move the stool. However, there is additional benefit from the bitter component.
Approximately 35% of our digestive process takes place in what we call the “cephalic” or thinking stage. This means, when we think about food or taste food, it affects how the rest of our digestive tract is working. When bitterness touches our tongue, it tells our gall bladder to make bile, our stomach and pancreas to make digestive enzymes, and our intestines to start the peristaltic motion that moves food through the digestive tract. This helps to coordinate the entire digestive process so we are able to absorb and utilize food more readily and move it through more easily. This is why apertifs have traditionally been bitter and why eating bitter greens will help to digest and absorb our food more efficiently.

Enjoy your greens!