Manage Stress to Better Manage Irritable Bowel Syndrome (IBS)

What is Irritable Bowel Syndrom (IBS) and How Does Stress Impact It? Irritable Bowel Syndrome (IBS) is a common disorder of the gastrointestinal tract that affects an estimated 10-15% of people worldwide. Stress has been identified as a major factor in the onset and exacerbation of IBS symptoms and it is definitely a trigger for the patients I see at my clinic when attending one of our super successful gut health programmes. This month has been awareness month for both IBS and Stress, so I thought I would bring the two together in my final blog for this month. As previously mentioned in my previous blogs IBS and Probiotics Irritable Bowel Syndrome is characterized by abdominal pain, bloating, and changes in bowel habits. How does stress affect digestion? Studies have shown that stress can affect the way our bodies process food and how our digestive system functions, leading to an increase in abdominal pain and other IBS symptoms. Additionally, stress can cause changes in hormone levels which can further exacerbate IBS symptoms. It is important for people with IBS to take steps to reduce stress levels in order to manage their condition more effectively. The relationship between our brains and the digestive system is powerful, so it is not uncommon for changes in our emotional or psychological state to affect the way our gut works and could explain why we often feel ‘butterflies in the stomach’ when feeling anxious or stressed. The communication and feedback between the gut and the brain is known as the gut-brain axis. This network consists of two parts: The sympathetic nervous system, which manages fight-or-flight responses; and the parasympathetic nervous system, which controls repair, rest and digestion. It is believed that the enteric system functions as a third part to control the digestive system. This communication between the brain and the gut is referred to as ‘the gut-brain axis’, which helps connect emotional processes in the brain to the physical operations of our digestive system. Recent research has been able to establish the gut-brain axis, which is the connection between the two systems. Emotions can affect how your gut functions and vice versa. It’s important to note that although many digestive problems are related to mental health, not all of them are caused by Irritable Bowel Syndrome (IBS). Anxiety can manifest in various physical symptoms, such as stomach aches or changes in bowel movements. Gut Bacteria and Stress Did you know that having an imbalance in your gut bacteria is having an impact on your mental health? This is sadly not that well known, but with years of research and practice it is a major area that I have built into our programmes and is an important part of successful treatment. Certain bacteria can affect levels of anxiety or stress through activities in the digestive tract. A healthy balance of the ecosystem is necessary for our mental health and well-being, however when it is not balanced (dysbiosis) organisms like bacteria can lead to negative consequences. A recent large, most comprehensive and best-validated association study to date provides further evidence for an association between gut microbes and blood metabolites (generated by host and by microbes) in patients with Major depressive disorder (MDD). (1) They observed “that the genera Sellimonas, Eggerthella, Hungatella, and Lachnoclostridium were more abundant, while genera Ruminococcaceae…, Coprococcus, Lachnospiraceae…, Eubacterium ventriosum, Subdoligranulum, and family Ruminococcaceae were depleted in the guts of individuals with more symptoms of depression. Of these, genus Eggerthella showed statistical evidence of being involved in the causal pathway.” These microbes are involved in synthesising important neurotransmitters, such as gamma-aminobutyric acid, butyrate, glutamate, and serotonin. It is known that Butyrate can influence depression through several routes — ie, via immune regulation, genomic transcript/translation, and/or affecting energy metabolism. So this is really critical for health to ensure these pathways are optimised. 3 Tips for Identifying & Reducing Sources of Stress in Your Life Stress is a natural part of life and we all deal with it at different times in our day, week or life. It is normal and should not cause us problems. It can however become overwhelming if left unchecked. Identifying and reducing sources of stress in your life is essential for maintaining mental and physical health. There are many levels of stress and many ways to address. Here are 3 simple tips to help you identify and reduce the sources of stress in your life. One way is to take time to reflect on what is causing you stress. This could be anything from work or family pressures to financial concerns or relationship issues. Once you’ve identified the source, think about how you can reduce it. This could involve making lifestyle changes. Such as exercising more or taking up a hobby, or seeking professional help if needed. Second, get into the habit of practising mindful living by being aware of how your thoughts and actions affect your emotions and overall well-being. Taking regular breaks throughout the day to relax and refocus will help keep stress levels low. Third, set realistic goals for yourself that are achievable within a reasonable timeframe. Setting unrealistic expectations will only add more pressure and increase feelings of helplessness. Dietary Changes & Supplements that Can Help with Stress & IBS Symptoms Making changes to your diet can not only help reduce stress levels but also lessen the severity of IBS symptoms. Eating a nutrient-rich diet, and limiting processed fat and sugars is important as well as avoiding specific trigger foods. These can help reduce stress levels and improve digestion. Our 6 week elimination programme combines these all for excellent results. Additionally, certain supplements such as probiotics, omega-3 fatty acids, magnesium, vitamin B12 and zinc may be beneficial for those suffering from stress or IBS. By making key dietary changes and taking the right supplements specifically for you, you can experience improved overall health and well-being. We do a deep dive assessment for each patient that attends our practice. This allows 121 Dietitian programmes to be designed specifically for you, ensuring physical and mental health are addressed. Stress Management
5 Reasons to Eat your Green Vegetables!
“Eat your Greens” How many people are fed up hearing this in their lives!! Green vegetables are notoriously disliked by all age groups and this makes me sad, but I completely understand why. The data I gather from advising thousands of people gives me expert insight. And as you probably guessed, the largest percentage of dislikes stems from being forced to eat these as a child. Definitely, bland, boring over-cooked bitter vegetables do not appeal and should not be on the menu at any age! Green vegetables and especially green leafy vegetables are full of important health-improving benefits which we need to be serving daily – cooked nice. 5 Health Benefits of eating Green vegetables Green vegetables assist in feeding your good gut microbiome – essential for multiple benefits, especially if you have dysbiosis, irritable bowel syndrome, autoimmune conditions and much more. Green vegetables can assist your blood sugar levels – the nutrients are involved in numerous actions with the help of fibre, Vitamin C, magnesium, Vitamin K. If you are Diabetic, pre-diabetic or have metabolic syndrome it’s time for a rethink. Bones – Green vegetables are excellent providers of non-dairy calcium and vitamin K, boron, manganese all essential for strong and flexible bones. Check out my YouTube video on Osteoporosis Green vegetables can assist in weight loss – we know from studies that obesity is linked to diabetes, heart disease, high blood pressure and cancer. Eating good quality nutrients from your food is the key to long-term weight loss success and keeping healthy. Green vegetables provide a plethora of nutrients with fibre, phytochemicals, vitamins and minerals while providing very low amounts of energy. You can learn more by watching my weight loss for life series. Green vegetables for wrinkles. Vitamin E is an antioxidant we know protects skin cells from free radical damage from the environment and the sun. Folate is a vital nutrient for DNA repair and new cell growth. Green leafy vegetables are rich in these and beta-carotene which is a super antioxidant known to renew and repair the skin. Is it OK to eat fruit instead of vegetables? Fruits are amazing for multiple nutrients but should not take the place of vegetables. They should be consumed in moderation. Fruits contain natural sugars that if eaten to excess may derail your nutrient balance. What should I eat if I don’t like greens? Thankfully it is easy to re-establish or start to like eating greens! As a Dietitian I teach people how to be able to add 3-4 of these each day into their diets. It takes a little time and some great recipes but improving the gut bacteria allows for the brain and gut to work together and this is where the magic happens! What green vegetables are good for weight loss? All green and colourful vegetables are important for weight loss. Some green choices can include Spinach, Kale, Rocket/Arugula, Lettuce, Bok Choi, Pak Choy, Broccoli, Sprout, Asparagus, green peppers, Cucumber, cabbage, and watercress. What green vegetables can I eat every day? All! The more the merrier as long as you are getting sufficient good quality proteins, fats and carbohydrates. Should you eat green vegetables every day? Absolutely. If you take a blood thinner warfarin it is really important not to stop eating these if they are part of your normal diet. We know warfarin works best when the level of vitamin K in your body stays the same. So if you typically eat leafy greens, you can continue to eat your usual serving. Is drinking your greens the same as eating them? Blitzing vegetables is a useful way to add in greens just make sure you use the whole vegetable, stalks etc as this is the fibre-rich part. Powdered greens have been big business in recent years. If you have the money to spend on them they may assist you if needing more nutrients. But be mindful they do contain many add-ins that you may find change your gut bacteria. If these probiotics are not right for you or the amount of added fat-soluble vitamins are high, these may be stored in excess in the body if not required – not really what you want. In my professional opinion, sporting or highly active people are the ones who may find these helpful. And finally greens from top to bottom! Green vegetables for eyes Green leafy vegetables can assist with preventing age-related macular degeneration and cataracts. The human body cannot make lutein or zeaxanthin; they must be consumed. Spinach, kale and broccoli are leafy green vegetables rich in both lutein and zeaxanthin and vitamin C. These antioxidants act as a natural sunscreen for your eyes and they protect your eyes from harmful UV rays. Green Vegetables for Constipation Constipation- Green vegetables are essential as part of a healthy dietary intake each day as the expandable fibre absorbs water as it passes through the bowel and triggers a regular bowel motion relieving possible constipation. The softening action of the insoluble fibre decreases pressure inside the intestinal tract and may help diverticular disease/diverticulitis. Check out my YouTube Video on Constipation. So if you are still keen and green and … Need help optimising your foods or are unsure of how to change your eating habits? please contact us. We would love to help you or your family and friends with any nutrition-related queries big or small. In the meantime do please check out our 121Dietitian Shop for specially selected choices created for you. If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Why not visit our YouTube Channel for more on keeping your health optimal. How can a Dietitian help Book a consultation via our Online Portal About Gillian Killiner Check out our tailored dietary programmes Gillian x [instagram-feed]
Intuitive Eating – myth busting
Myth Busting Intuitive Eating One of the biggest misconceptions is about intuitive eating. People fear that if they are not following a strict diet then they can’t lose weight, which is thankfully far from the truth… Intuitive eating = eating perfectly all the time This is not the case. So if this is you, don’t fear, read on and I explain this in more detail. There are so many different factors involved in intuitive eating it is not about eating perfectly 100% of the time, this is just not required. What is intuitive eating? In a nutshell -Intuitive eating is making food choices at each meal and snack that are not from a controlling plan but are focused on natural unprocessed sources that suit: your body composition your background your cooking skills your time limits your wallet your health and much more How is intuitive eating different from a diet? Intuitive eating is thankfully very different from traditional dieting. In traditional dieting, rules and numbers are created based on crude figures like your weight and height which are frequently inaccurate. These numbers are to be met each day strictly. The type, quality of food and lifestyle are not factored in and these are important. For example, you can eat a ton of sugar-free and fat-free foods and drinks to meet low kcals or eat a packet of processed nitrate-full meats to meet your protein. These pro-inflammatory options impact negatively on gut bacteria, hormones, insulin release and appetite signalling and keep you stuck in a vicious circle. Intuitive eating is, fortunately, the opposite where you learn to enjoy food and understand what your body needs micronutrients included. No number crunching is involved. Fortunately, there are no foods off-limits but it requires a different mindset and an understanding of how your diet fuels you long-term and keeps you happy. SO -NO QUICK NASTY FIXES! YAH! Can you eat intuitively and lose weight? Yes, Yes, Yes and most importantly intuitive eating is adaptable for life and all the variety that comes with it. Intuitive eating allows you to go on holiday, go out with friends, enjoy parties and BBQs, with no guilt attached selecting the right foods and moving on. How do people lose weight through intuitive eating? Instead of weighing your food, counting calories, stressing you are not meeting macros, and feeling miserable in the process, you eat according to your day and what makes you feel fueled and happy. That doesn’t mean junk, takeaways, cookies and buns. It is finding the foods that will assist your health both physically and mentally that you will enjoy. Feeding and fueling the correct gut bacteria reduces inflammation and most importantly fixes the stress and guilt around food. What does intuitive eating look like? A popular question and one again that needs to be suited to you as an individual taking into account: Your age, your health status, your sex, your weight, your height, your ethnicity, your cooking skills, your time, your activity, your stress, your sleep, your fluids and possibly more. The bottom line all needs to be factored into this. Simple options include regular meals made from suitable: natural good quality proteins varied and colourful vegetables regular fruits in suitable amounts – not made into smoothies healthy natural fats high fibre carbohydrates Get these in at each meal and you are on the right path. Is intuitive eating healthy? Studies have found that intuitive eating has positive nutritional outcomes compared to restrictive dieting plans. With letting go of strict control there is instantly less stress, better sleep, and an understanding of real hunger and appetite. Since intuitive eating does not come with specific diet plans, intuitive eaters learn to consume a wide variety of foods, are more likely to get the benefits of well-balanced nutrition and most importantly stick with it long term no yo-yo dieting. Is Intuitive eating dangerous? NO intuitive eating is not dangerous but you must trust your ability to eat the best choices when you feel hungry and stop when you have had sufficient. Undereating or overeating in any diet will be dangerous. Intuitive eating benefits There are many benefits: insulin sensitivity, happy mood, weight loss, not feeling you are on a diet, and consuming not only macros but micronutrients too! My intuitive programmes keeps it real as here at 121 Dietitian we prefer the 80-20 rule where you have a little bit of what you like at a time in the day that works for you. This allows you to feel less isolated and keeps you on track for life. A WIN-WIN! Hunger is Affected by What You Eat Definitely, if you get the balance wrong and eat what you like from the wrong choices then hunger will not be addressed. Refined carbs and processed foods with lots of sugar messes up hunger cues so you will remain tempted by the foods that derail you and keeps you feeling miserable. I can’t count the number of times that I have patients call to tell me they no longer crave the rubbish they were addicted to. Honestly it’s the best feeling ever. How do I know if I’m hungry with intuitive eating? Headaches, tiredness, feeling short-tempered, thinking about food, lightheadedness, or feeling sick could all be signs of hunger – these should not be your ques to eat, it is far too late and a concern if these are your triggers to eat. You are more likely to reach for the wrong stuff. Keeping good blood sugar control from slow and low energy-releasing foods is the only way to assist this. Can you count calories and eat intuitively? Yes, you can and many people do. I am not against this option at the beginning if you need this to get it right and you are coming from strict counting. It can be daunting to chuck this all in so best to ease out while intuitive eating takes control! Kcal counting does take time and dedication and is
The facts on fermented foods – what can they do for you…
With a rise in popularity for fermented foods in recent years comes a look at their impact on health. Here, Gillian gets clear on what fermented foods are and if they actually have a positive effect on health. What are fermented foods? Fermented foods and drinks have become very popular over recent years even though they have been consumed worldwide for over 13,000 years! Fermentation is the bacterial (or yeast) conversion of sugar and starch to acids and other by-products, including ethanol. The acidity not only prevents growth of bacteria in food that can spoil food and drink but also creates foods with an interesting sour, tangy flavour. Fermented local products include yogurt, beer and bread. Across the world fermented products include: Sauerkraut (‘sour cabbage’) from Germany, kimchi from Korea, kombucha from China and kefir from the Caucasian mountains. Any benefits from fermented foods? You can’t escape the supposed benefits of fermented foods as they have been touted all over the media. The main area of focus: probiotic content and gut health. A probiotic is defined as live microorganisms that can establish within the gut and provide a benefit to the host. With this interest has come an increased recognition for the importance of looking after our gut microbiota, both for gut and non-gut health outcomes. Finally emerging evidence from studies for fermented foods and health in humans has found to be positive re gut bacteria. Research has uncovered so many variables that could be at play so the outcomes are not always clear-cut. Some other interesting areas of research ongoing include: the possibility that fermentation can increase the iron bioavailability from cereals by reducing phytic acid content, which can stop your body absorbing iron. Certain bacteria can also synthesise nutritive compounds, including particular B vitamins all very interesting. Overall Fermented foods can be included as part of a balanced, healthy diet, although it should be recognised that some shop bought have a high salt content such as sauerkraut and kimchi. Fermentation is popular at home and if you do wish to commence this ensure you follow safe food hygiene practices and that you use the correct ingredients, conditions and storage for that particular ferment. Although the evidence for specific health benefits is still emerging, the taste, saving on food waste are all positive! We have loved making water kefir (we used these) the last few years and delighted that it tastes amazing while boosting gut health. Just remember if buying fermented foods in the supermarket that are processed by heat, baked or filtrated (e.g. pasteurised sauerkraut, sourdough) these are inactivate as this processing removes the microbes and will not contain live cultures. If you are unsure of how to change your eating habits, or need help optimising the foods you eat please do contact us. We would love to help you or your family and friends with any nutrition related queries big or small. In the meantime do please check out our 121Dietitian Shop If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Why not visit our YouTube Channel for more on keeping your health optimal. How can a Dietitian help Book a consultation via our Online Portal About Gillian Killiner Check out our tailored dietary programmes Gillian x [instagram-feed] Updated December 2022
Snapshot of ADHD in practice – how nutrition can help

Here, Director and Principal Dietitian, Gillian Killiner discusses why children with attention deficit hyperactivity disorder (ADHD) are at risk of being deficient of multiple nutrients and why the link between hyperactivity and food sensitivity is strong. Overall nutritional status in children with attention deficit hyperactivity disorder (ADHD) shows that this patient population is at risk of multiple nutrients deficiency. Why is this? There are many hypothesis from insufficient chemical balancing to early exposure to antibiotics and gut flora and fauna being disrupted negatively affecting nutrient absorption. One area that has been studied is low trace mineral status. Most notably, minerals that may play a crucial role in the production of dopamine, norepinephrine, and melatonin, which regulates sleep. Nutrient deficiency in ADHD Investigators at the University of British Columbia and the Children’s and Women’s Health Centre in Vancouver, Canada, 2010 showed among 44 children aged 6 to 12 years with ADHD. Nutrient deficiencies were averaging around 40%. The data suggested children with ADHD are nutritionally different from the rest of the population in that they eat less meat, fish, and poultry and have low levels of related micronutrients that are essential cofactors for the body’s manufacture of dopamine norephinephrine, and melatonin. Researchers have also theorised that ADHD children may be deficient in essential fats. Not just because their dietary intake from foods such as seeds and nuts is inadequate (though this is not uncommon). But also because their need is higher, their absorption is poor, or they are unable to convert these fats well into EPA and DHA, and from DHA into prostaglandins. All which are important for brain function. Hyperactivity and food sensitivity Of all the avenues so far explored, the link between hyperactivity and food sensitivity is the most established. Food allergies can be of two types: Type 1 in the classical, severe and immediate allergy most commonly associated with peanuts and shellfish. This allergy involves an antibody called IgE and most people discover if they have this type of allergy early in life since the reaction is so immediate and severe. The second type, Type 2 involves the IgG antibody which works in quite a different way. Symptoms of these allergies can be many and varied and may take many hours to appear. These allergies often go undetected for this reason. A study by Dr Joseph Bellanti of Georgetown University in Washington DC found that hyperactive children are seven times more likely to have food allergies than other children. Creating a dietary programme for ADHD sufferers As a Dietitian for over 25 years, I have treated hundreds of children with health issues including ADHD. I find that there are often not one but multiple issues that need to be addressed when creating a programme of care for optimising health in the ADHD individual. The focus in practice requires the following approach: Assessment: A full dietary and fluid assessment A lifestyle assessment Bloods GI and bowel assessment Sleep Plan: No one size fits all when it comes to making changes. Each programme has to be personal and specific to each child based on: Their age Their understanding Their weight If they are growing Their taste – are they fussy/faddy eaters? Their behaviour around food Allergy potential Sleep patterns Mood Resistance to change Supplementation School involvement Their family’s ability to facilitate and provide all of the changes Activity levels Fluid intake Siblings I have excellent success with children as when they are switched on they are keen to please and try. Once you get the correct balance of all the above and focus on the positive things the family can relax and enjoy their lives together again. The programmes created at 121 Dietitian are enjoyable, achievable and fun, which they have to be as they are for life. The results are rewarding. If you wish to book for a dietary ADHD assessment, get in touch today! Unsure of how to change your eating habits, or need help optimising the foods you eat please do contact us. We would love to help you or your family and friends with any nutrition related queries big or small. In the meantime do please check out our 121Dietitian Shop If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Why not visit our YouTube Channel for more on keeping your health optimal. How can a Dietitian help Book a consultation via our Online Portal About Gillian Killiner Check out our tailored dietary programmes Gillian x [instagram-feed]
FODMAP – all you need to know to get results..
Here, Gillian Killiner, Principal Dietitian at 121, discusses the Low Fodmap Programme and in particular, why seeking the help of a qualified and experienced Dietitian is key to implementing it successfully. The Low Fodmap Programme has been around for over 10 years. I heard about it in its infancy and thought: “Wow! This is excellent for gut dysfunction and IBS”. And so in 2010/2011, I packed my bags and returned from Belfast to London on three separate weeks to go back to my training hospital, Guys and St Thomas’s to learn all about it – the first course of its kind outside of Monash University, Australia. The work load was intense but exciting. After qualifying with my certificate in Low FODMAP practice, I took my first guinea pigs patients and we followed the information I had learned from the course. I can’t lie. It was hard work. Now over the 7 years I have been practicing the Low FODMAP programme daily, much has changed in the way I deliver, advise and support because everyone is different. My high success rate of 97% is due to my expertise of using the programme daily. The gut is not just about absorption. It’s microbiota has a complex network of links to emotions, stress, activity, genetics, medical history, medication, lifestyle, food and fluids… We as individuals are not all uniform. We do not all follow the same diet and lifestyle. This is the basis of my increasing frustration and the fiasco I find myself in. People are coming to me more and more in desperation, telling me they have tried the Low FODMAP programme and it hasn’t worked. AhhHHHHH!! Another emotional boundary to cross. I have found that with the programme’s popularity and success has come the internet dippers. They take a bit from one website that they like and mix it with another and believe they have completed the programme. Wrong… The other – and most frustrating way that these people are not succeeding. They are being handed a “sheet” from their Consultant or GP and left to get on with it. Excuse me… WHAT??? A little more respect to the programme please! A sheet or a smorgasbord will not get results but in fact dangerously add to people’s fears around food and restriction is dangerous in the wrong hands. Low FODMAP Dietitian -why use one? A patient came to me recently and had been told by a local health food shop to avoid a major list of foods. She did so and over two years of carefully following the advice she to me gravely ill, malnourished, depressed and still her stomach issues continued. Appalling. If you have a gut health problem that has not resolved with medication, dietary changes, or visiting a health shop to pay and hold two balls in the air and told to eat very little, don’t despair – do get in touch. Gillian Killiner is an expert in all areas of Gut Health. Unsure of how to change your eating habits, or need help optimising the foods you eat please do contact us. We would love to help you or your family and friends with any nutrition related queries big or small. In the meantime do please check out our 121Dietitian Shop which has been expertly created especially for you. If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Why not visit our YouTube Channel for more on keeping your health optimal. How can a Dietitian help Book a consultation via our Online Portal About Gillian Killiner Check out our tailored dietary programmes Gillian x [instagram-feed]