Outside of white potatoes, nuts might be some of the most hotly-disputed foods in the Paleo world. Depending on who...
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Summer is the season for rolls and the time to eat them is now. No, not the puffy, gluten-filled rolls…...
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These burgers are packed with umami flavor from roasted mushrooms and coconut aminos.
Yield: 4 burgers
Ingredients
Directions
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You have searched the store shelves high and low in the hopes of discovering a fruit jam worthy of the...
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Dramatic stories about massive weight loss are inspiring to read, and a lot of people who start Paleo have very...
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Rice-free sushi? You bet! Paleo sushi bowls are constructed from the base up, using a bed of cauliflower rice rather...
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We all know what steak tastes like – it’s great, isn’t it? -, but have you ever had Chimichurri sauce...
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Sometimes life is so hectic, that when an easy recipe comes your way, you take it with no questions asked...
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Summer is the season for outdoor grilling parties and creamy Paleo ice cream. Making your own grain-free and dairy-free desserts...
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These wild salmon burgers are pure salmon, with no breadcrumbs or egg. A fresh and spicy tomato relish is the perfect condiment to serve alongside the burgers.
Serves: 4 | Prep Time: 10 minutes | Cook Time: 10 minutes
Ingredients
Directions
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If you have been on the lookout for a nitrate-free breakfast sausage, that is also free from gluten, sugar or...
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Simple, yet elegant and perhaps even fresh from the garden, these maple roasted carrots are a versatile dish. Just as...
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If you are absolutely in love with chili peppers and Sriracha makes your mouth water at the very thought of...
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Even Paleo eaters can learn a thing or two from the low-fat craze. In this case, it’s a lesson about...
The post How to Evaluate “Paleo Cookies,” “Paleo Bacon,” and other Paleo-Labeled Foods in the Grocery Store: Learning from the Low-Fat Craze appeared first on Paleo Leap | Paleo diet Recipes & Tips.
Searching for a nourishing mushroom dish that is quick to prepare, and tastes amazing too? Baked portobello mushrooms with a...
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When life gives you lemons, make a marinade – or a lemonade to drink while you wait for your chicken...
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Appetizingly scrumptious and delectable to munch, one after the other… Pineapple is sweet, the meat is savory, and since everyone...
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For an elegant weekend brunch or your go-to weekday evening roast you will need a side dish that fits Paleo...
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Supercharge your day by consuming iron, rather than lifting it. And let your grandma’s liver-and-onions recipe gently slip your mind,...
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In the past you would have soaked/bathed/marinated your chicken in buttermilk with mouth-watering results, but if you are dairy-free for...
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Deviled eggs are classic little things that can be spiced up in a medley of ways. In the end, you...
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Marinating in marinades is what you do when you want tender meat without the wait of slow cooking. It is...
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The Science of an Energizing Breakfast There’s a lot of confusion about exactly what makes for a “good” breakfast, but...
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Paleo vegetables that are as filling as they are nutritious? Cauliflower is but one of them, in fact you can...
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Looking for a dinner recipe that is dressed to impress? Then you are going to have to learn to spatchcock...
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These incredibly delectable and succulent grilled fruit skewers will please the pickiest of eaters, and making them is super simple,...
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The low-FODMAP diet is very popular among people with gastrointestinal illnesses, especially Irritable Bowel Syndrome (IBS)—an extremely common condition in today’s society. If you tell your gastroenterologist or dietitian that you suffer from IBS, chances are they’ll recommend a diet that’s low in fermentable oligo-, di-, and mono-saccharides and polyols (FODMAPs).
One of the primary reasons for this diet’s popularity, both among patients and clinicians, is that a solid body of clinical research supports its efficacy. Few diets have been subjected to as much scientific scrutiny as the low-FODMAP diet. Several clinical trials have examined its therapeutic potential, since it was specifically developed for the management and treatment of gastrointestinal illness. These studies’ results indicate that the low-FODMAP diet effectively reduces gastrointestinal symptoms such as diarrhea and bloating in patients with IBS, and may be useful in the treatment of organic gastrointestinal disorders such as Inflammatory Bowel Disease (IBD).5,7,8,15
Many people assume, after reading the results of these studies, that patients with gastrointestinal illnesses such as IBS should follow a low-FODMAP diet for an extended period, or even indefinitely. In today’s article, I’ll explain why this assumption can be problematic.
It’s a huge mistake to base our understanding of nutrition and health solely on the results of clinical trials, meta-analyses, and other similar studies. These types of studies are undoubtedly informative; however, they only offer us part of the picture. Before we dig into the depths of PubMed, we must ensure that we are equipped with the knowledge and tools we need to make sense of the wealth of information therein. Most importantly, we need to understand the biological mechanisms underpinning the condition we’re researching.
The foods that we eat contain a broad range of nutrients, which are each digested in a specific manner and location within our GI tracts. Fats, proteins, simple sugars, and starches are primarily digested in the upper portion (the mouth, stomach, and small intestine), whereas oligosaccharides and non-starch polysaccharides are primarily digested in the large bowel (the colon). However, there are some exceptions to this rule. For example, in lactose-intolerant individuals, lactose may pass undigested through the small bowel and undergo microbial fermentation in the colon. Moreover, some nutrients may be exposed to digestive enzymes in both the lower and upper parts of the gastrointestinal tract. However, in general, the aforementioned principle holds true, and it figures critically in the therapeutic value and optimal application of a low-FODMAP approach.
The low-FODMAP diet is a contradictory diet. It doesn’t exclude non-starch polysaccharides, although they pass undigested through the upper gut; yet it does exclude fructose and lactose, which many people’s small intestines absorb quite effectively. It is easy to be skeptical of such a carbohydrate-classification system.
That said, in general, the nutrients excluded from the low-FODMAP diet belong to the latter category of the above: carbohydrates that pass through the small intestine largely undigested. The human genome lacks genes that code for the digestive enzymes necessary to break down these carbohydrates; hence, our microbiota do the job for us. Gut microbes love FODMAPs.
FODMAPs are ubiquitous; they appear in a broad range of different plant foods. Hence, they have been a part of the human diet for millions of years. Actually, our ancient ancestors ate many more fermentable carbohydrates than most contemporary humans do.10,13 Some ancient peoples may have consumed as much as 135 grams of inulin-type fructans every day.12 Contemporary African hunter-gatherers, such as the Hadza, are also known to consume a lot of fermentable carbohydrates.14,19
We cannot assume a significant proportion of the human population has suddenly lost the ability to properly digest fermentable carbohydrates. There must be some other mechanism at work here, to cause such rampant dysfunction.
Over the past few decades, it has become increasingly clear that gut dysbiosis—an imbalance in the gut microbiome—is central to the pathophysiology of many health conditions. Virtually all of the gastrointestinal problems that affect Homo sapiens have been linked with gut dysbiosis.12,18 Patients with IBS, the condition most often treated with the low-FODMAP diet, typically harbor an imbalanced gut microbiome.1,4,9,17 Hence, some researchers have suggested that a better name for the cluster of symptoms comprising IBS would be Dysbiotic Bowel Syndrome (DBS).1 Gut dysbiosis is not the sole factor in IBS, but it’s surely a central component.
Therefore, it shouldn’t be surprising that IBS sufferers have trouble digesting fermentable carbohydrates. We depend on the genetic capabilities of the microbes that dwell deep in our gut to digest the great variety of carbohydrates in our plant foods. By ourselves, we’re only capable of digesting starches and some simple sugars. The rest are handled by our bacteria.
A diverse panoply of genes is required to produce the various enzymes necessary to break down all the carbohydrate types that pass into the large intestine. If the microbial community of the lower gut is undersized and/or imbalanced, digestion will obviously be compromised. Some nutrients that pass into the gut may only be partially digested, lacking the microbes capable of processing them; further, certain pathogenic bacteria, allowed to proliferate in the absence of their beneficial counterparts, could harness these nutrients to produce various toxins. This in turn would promote symptoms of food intolerance, such as bloating, loose stools, and flatulence, which are stereotypical of IBS.
Hence, it becomes apparent why studies show symptom improvement in IBS patients who undertake a low-FODMAP diet. Dramatically reducing fermentable carbohydrate consumption eliminates much of the colonic microbes’ food supply. There’s a big problem, though. Cutting out fermentable carbohydrates keeps gastrointestinal symptoms at bay, but does nothing about the underlying foundations of the condition. It may actually aggravate the problem long-term; when starved of food, the beneficial bacterial strains may wither and die, or they may end up digesting the mucus of the intestinal wall.3,20,21
Instead of trying to tame the fire via a low-FODMAP diet, it seems more productive to extinguish it completely, by fixing the microbial community of the gut. This strategy may not be effective in all IBS and IBD cases; genetic/epigenetic factors leave some patients with a severely inflamed gut that precludes development of a healthy, diverse microbiota; however, it should serve well in many cases.
Indeed, recent evidence shows that gut-microbiota manipulation (e.g. fecal microbiota transplantation, probiotics) is an effective treatment for many gut disorders, including IBS and IBD.1,4,11,16,17 The literature remains unclear as to the best approach for repairing a damaged gut microbiome; however, the science is constantly advancing. As long as we adhere to the evolutionary principles of Darwinian medicine, we should be on safe grounds.
The low-FODMAP diet may be useful during the first stages of treatment for certain gut disorders; however, it doesn’t represent an appropriate long-term intervention, unless repairing the gut microbiome and improving fermentable-carbohydrate tolerance have proven very difficult or impossible.
A diet that limits naturally occurring fermentable carbohydrates is evolutionarily novel; as a species, we have evolved to digest such carbohydrates effectively. The fact that many of us now struggle with this process cannot be explained by genetic change, but rather by shifts within the human microbiome.
A modern lifestyle, saturated with antibiotics, processed foods, and other microbial disruptors, has perturbed our bodies’ microbial communities, making us sick and fragile.6 We’re increasingly becoming allergic to pollen and other substances that are a normal part of our environment, and we’re suddenly struggling to digest nutrients that we’ve consumed for ages.
The solution is not merely to erect barriers to exclude the environmental inputs with which our bodies now struggle. Rather, we must restore our bodies to a fully functional state, so that we’re no longer allergic or intolerant to substances that, evolutionarily, weren’t so problematic. Again, this approach may not work universally; yet it should bear fruit in many cases. Removal of the “offenders” should only be a last resort, after exploring all other avenues.
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Breakfast is the most essential meal of the day, it is what gives us the much needed energy to get...
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Paleo cooks keep reinventing the classic burger time and time again, and every time a new recipe emerges, it is...
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Every few months there’s a new study finding that red meat (or saturated fat, cholesterol, animal protein, or some other...
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If eating plenty of greens is good for your health, then these grilled pesto-chicken skewers with fresh basil take the...
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