Blame it on the Alcohol?

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Image source: pixabay.com

Jamie Foxx’s song “Blame it” encourages blaming alcohol for all ruined relationships, unsafe situations, and perceived enhancement of other’s attractiveness. Outside of the many issues and poor decisions can that can result from a night of boozing, including a high credit card bill, higher risk for accidents, and even a 2am Taco Bell run…there are more. During Covid-19, some are hitting the wine and beer harder.

Let’s review the basics: alcohol interferes with communication between nerve cells and all other cells in the body. Moderation (the amount considered to not contribute to any major health concerns) for the average woman is defined by the CDC as not more than one drink per day and for the average man as not having more than two.

A study published in the Journal of the Academy of Nutrition and Dietetics asserts, “there has been an increase in the proportion of US adults who drink on any given day and an increase in calories consumed from alcoholic beverages when drinking occurs.”

What effect is this having on us from a weight loss perspective? Or a liver-health one?

Now we appreciate the humor some of you bring to our appointments:

“I think I’m drinking enough water. There’s water in beer, right?”

“I’m not too concerned. It’s called a liver, not a die-er”

“Wine-o? Maybe; I prefer ‘wine-yes'”

With alcoholic beverages being among the top five contributors to total caloric intake among US adults, this is something we need to talk about. But beyond calories, here are more reasons to explore your relationship with alcohol:

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Celiac vs. Gluten Intolerance

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Source: Sapone A, et al. Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Medicine. 2012; 2013

Gluten is the scary gremlin on the health scene. Just because your best friend, neighbor, or favorite celebrity is gluten-free, does that mean you should be too?

What is gluten? It’s a collective term for a group of proteins found in grains such as wheat, rye, barley and derivatives (i.e. spelt, einkorn). Gluten is well-recognized for giving breads a doughy, elastic structure; but beyond breads, it is used as a thickening agent and flavor enhancer.

Quick note: Gliadins and glutenins are the two main components of the gluten fraction of the wheat seed. Some experts maintain that gliadins are catalysts for problems typically attributed to gluten.

Celiac disease

For those with celiac disease (CD), exposure to gluten triggers an autoimmune attack on the intestines. When the villi (finger-like projections) of the intestines become damaged, the body cannot absorb nutrients into the bloodstream, which can lead to malnourishment and serious chronic health conditions.

People generally develop celiac from a combination of genetic disposition for the disease, a stressful event triggering the genes, and a diet with exposure to gluten, wheat, gliadin, barley, etc.

The diagnosis of celiac disease can be challenging since it shares symptoms to other conditions such as Crohn’s, ulcerative colitis, irritable bowel syndrome, diverticulosis, and even lactose intolerance. Blood tests can reveal auto-antibodies to gluten and often an endoscopy follows; this is where a biopsy can reveal intestinal damage, if one hasn’t started a gluten-free diet already. The presence of genetic markers HLA-DQ2 and/or HLA-DQ8 only shows you may develop CD; it is not a confirmed diagnosis for CD as not all of our genes fully express. Because those with celiac are at risk of malnutrition , other auto-immune conditions, cancer, and osteoporosis, proper diagnosis and support is essential.

For those with celiac disease, it is essential to avoid gliadin/gluten for the remainder of life.

Wheat allergy

Wheat is one of the 8 most common food allergens in the United States. The reaction to ingesting wheat can include rashes, hives, swelling of the eyes, face, mouth, a rapid heart-rate and anxiety.

Unlike celiac disease, where there’s an immune reaction to all gluten-containing grains, for those with a wheat allergy there is only a reaction to the proteins in wheat. Wheat allergies can be diagnosed via a skin prick or blood test.

Sometimes wheat allergies are diagnosed in children but can fade in time.

Non-celiac gluten sensitivity

People with non-celiac gluten sensitivity (NCGS) may experience
similar symptoms as those with CD (including gas, bloating, abdominal pain, fatigue, headaches, forgetfulness/foggy thinking), however, antibodies to gluten are not produced nor is there intestinal damage (two hallmarks of CD). There’s not enough evidence to know for sure if eating small amounts of gluten causes damage.

Interestingly enough, there is evidence linking gluten intolerance to a number of other health conditions including autism, depression, digestive disorders, even schizophrenia.

The symptoms often improve after removal of gluten from the diet.

Detecting gluten sensitivity is difficult since there is currently no accepted diagnostic test for NCGS. It is important to rule out celiac disease and wheat allergy. An elimination diet should be done under supervision of an expert nutritionist.

If you suspect you have celiac disease, wheat allergy, or gluten sensitivity, it is important to get a proper diagnosis and work with a qualified healthcare professional on an elimination diet and food sensitivity test as well as support for following a gluten-free diet.

gluten testing

The results of an individual’s food sensitivity testing showing gluten, gliadin, and wheat as issues.

#2 Problems Solved! Have the Perfect Poo

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If your bathroom visit has you feeling less-than-stellar, whether from incomplete bowel evacuation or runny rapid transit, you may wonder what’s going on with your gut. We will solve the mysteries of these #2 issues so that you can sit down and take action!

What’s your number?
If you’re looking at the stool chart feeling as through you run the gamut of each type, start to observe toilet clues and investigate reasons that may underlie issues of diarrhea and constipation. Like most changes, this starts with awareness. Track the number associated with the Bristol stool chart type that best matches your bowel movement.

Water makes all the difference. Diarrhea results when the intestine doesn’t have time to reabsorb all the water from the food waste before it exits. On the other hand, if too much water being reabsorbed, constipation occurs and results in hard, dry rabbit-poo-like stools.

When you can’t wait another second….diarrhea. Common causes of diarrhea include:
Food allergies or sensitivities
Lactose intolerance, gluten intolerance/Celiac disease, or malabsorption of fructose
Hyperthyroidism
Emotional stress
Irritable Bowel Syndrome
Gastrointestinal infection

Sh*t happens….hopefully. Constipation involves the passing of hard, dry stools that resemble rabbit or deer excrement. Are you eating sugar, processed carbs, packaged foods? If so, you’re at higher risk for constipation. Or perhaps it’s one of these common issues:
Low fiber intake (or too much fiber and not enough water)
Food allergies (dairy and wheat can also lead to constipation issues for some)
Hypothyroidism & hormonal imbalance
Lack of physical activity
Dehydration
Issues with the nerves or muscles in the intestinal tract

Whoa! That stinks!
If you find that your flatulence clears a room or your BMs are so stinky they cause a plane to turn back, there’s a problem that needs to be addressed. For the deadly gas (silence optional), the problem has its roots in sulfur compounds. One reason why flatulence can flatten the mood: bacteria adds sulfates to trapped air bubbles in the gut, creating smelly farts. Food can lead to foul smells particularly when one is consuming foods high in sulfur (think Brussels sprouts, cabbage, broccoli, garlic, and onion).

Smelly poo can have its origins from food as well. Those who eat a lot of animal protein tend to have stinkier BMs. A weak digestive system will contribute to foods not breaking down well and putrefying in the gut. Poor diet and stress often have key roles to play as can food sensitivities and inflammatory bowel disorders.

Have the Perfect Poo
Though seemingly as mythical as unicorns, some people claim to have the perfect poos. You can too! First, you have to know what you’re aiming for. On the Bristol stool chart, a perfect poo would ideally be a 4, with 3 and 5 being strong contenders. Let your competitive side show as you try some of these tips to improve your digestive wellness.

  • Get more fiber (think fruits, vegetables, legumes, and whole grains)
  • Drink enough water! Some people like to jazz it up with some lemon and/or mint.
  • Address any underlying thyroid issues
  • Consider eliminating gluten and/or dairy from the diet (both are a common cause of diarrhea and constipation) or other foods on your sensitivity results
  • Fermented foods (i.e. kimchi, yogurt, kefir, sauerkraut) may be beneficial as they can support the colonization of healthy bacteria in the gut. Consider a probiotic supplement.
  • Exercise!
  • Incorporate stress management techniques
  • Get enough sleep

It is important to give your body the tools it needs to be healthy. Every piece of food eaten is broken down and nutrients are absorbed. If it passes too quickly in the digestive tract, important nutrients are missed. If it takes too long, damage may occur in the colon (think diverticulitis as an example). Remember that there are plenty of neurotransmitters in your gut and the brain-gut connection is real. Your thoughts, anxiety, depression, stress, and mood impact your gut.  With all of the information and ideas presented, what step will you take to  achieve gastrointestinal balance? 

The Straight Poop on Stool

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Everybody poos. Are we getting awkward yet? Fantastic. Yes, we each have our own bathroom habits and the information your unique #2 supplies can help you, and your healthcare practitioner, explore gut issues and even food sensitivities.

What is poo made of? Though some females claim it’s all glitter and unicorn smiles, nope; it’s the pretty much the same as our male counterparts. Stool is about 75% water with the remainder being a combination of fiber, live and dead bacteria, body cells, and mucus. Yay! (Bowel) Moving on…

Often times, our BMs (bowel movements) have established themselves in a certain way for most of our lives and we’ve never stopped to examine them. Have you ever wondered what is “normal” in terms of consistency and frequency? 

Next time, before you ‘flush and dash’, take a look….what is the shape, texture, and color? Does it float or sink?  Each of these factors can give insight into hydration, food sensitivities, digestive issues and more.

Oprah has her microphone, plumbers have plungers, fortune tellers have crystal balls, and dietitians..well we have the Bristol Stool Chart! Behold this amazing tool that can help you categorize your BMs and problem-solve to make them into everything you’ve ever dreamed your digestion could produce.

Disclaimer:  these poos are not real. No poo was harmed in the creation of this blog.

bristol stool chart numbers

Poo Types
1: hard, rabbit-like pellets that are hard to expel
2: a contiguous piece but lumpy and still a bit hard
3: a smoother sausage-like poop with cracks
4: sausage or snake-like, smooth and soft
5: soft pieces, clearly separated
6: mushy stool, ragged edges, not well-defined
7: entirely liquid stool

I think mine was a ‘4’ – is that okay? Gold star for you, perfect pooper! In general, the goal is to stay within types 3-5.

Why is poo brown? When red blood cells break down, there’s a pigment called bilirubin which is made. The bacteria in the intestines transforms the combination of bilirubin, iron (from the red blood cells), and waste into a brown poo.

But what if my poo is red/yellow/green/tarry/mucus-y? Oh gosh, pull up a stool…er, chair…okay, bright red can be from a bleeding ulcer, hemorrhoids, or even eating beets. The first two are worth seeing a doctor about, the third is just a reminder of something you ate within the past few days and isn’t serious. Yellowish-green color can be caused by the green bile that combines with the waste products in the gut but move too quickly through the intestines to turn brown before making the exit. This color, which is typically involved in a malabsorption disorder (i.e. celiac disease), is associated with excess fat in the stool. The green color can also be caused by eating lots of leafy greens, food coloring, or iron supplements. Black tarry stools can indicate that there has been blood which, along its route in your intestines, dried up. This can signal internal bleeding and is worth a trip to the doctor.

Mucus can be clear or vary from white to yellow and looks a bit like jelly. Gawd, can this get any more gross? Yes, because even though mucus is normal to have in your gut to help move things along without much friction, sometimes this can get out-of-hand when there are ulcers or inflammation in the intestines. You may want to let your healthcare provider know if this is an issue for you.

How often should I go? Disturbingly enough, a pediatrician once asked a young dietitian-to-be how often she had a BM; the answer of “once every 3-4 days” was met with a response of “that’s normal, everyone is different.” Only later in her studies did the young one find that having 3-4 days worth of toxins in one’s gut is not normal nor healthy. This is why a dietitian worth her sea salt is going to ask you about not only what goes into your mouth, but what comes out the other end. Because we ❤ you and want you to feel amazing. To answer your question though – ‘normal’ will vary from 3x a week to 3x per day. Generally transit time from eating to expelling runs about 18-72 hours. 

Get a handle on what’s going on inside your guts by paying attention and talking with a healthcare professional about your digestive concerns.

Stay tuned! Our next topic will be problem-solving diarrhea and constipation as well as tips on how to have the perfect poo!