What is the Anti-Inflammatory Protocol and what is it used for?

Changing how and what we eat, as well as managing stress and getting enough restful sleep has been shown in research studies to reduce pain and symptoms in people with chronic inflammatory diseases such as Rheumatoid Arthritis, Fibromyalgia, Hashimoto’s Hypothyroidism, Celiac disease, etc.. As well, there is increasing evidence that cardiovascular disease, including heart attack and stroke are inflammatory in nature and that lowering risk is best managed through dietary and lifestyle changes. For those with a strong family history of heart disease, the Anti-Inflammatory Protocol dove-tails perfectly with a low-carb high healthy fat diet.


Knowing which foods promote inflammation and why and which foods are evidence-based to have anti-inflammatory properties  and why is essential for those seeking to reduce pain and symptoms associated with a chronic inflammatory condition. Choosing foods that are nutrient densepromote gut healthaddress diet-related disruptions in hormone-regulation and that target immune system regulation are key in the Anti-Inflammatory Protocol.

Nutrient density – Every system in the body, including the immune system requires an array of vitamins, minerals, antioxidants, essential fatty acids, and amino acids to function normally. Micronutrient deficiencies and imbalances are considered key players in the development and progression of autoimmune disease, therefor attention is put on consuming the most nutrient-dense foods available. A nutrient-dense diet provides the ‘building blocks’ that the body needs to heal damaged tissues. The goal is to supply the body with a surplus of micronutrients to correct both deficiencies and imbalances, supporting regulation of the immune system, hormone and neurotransmitter production.

Gut health – It is thought that ‘gut dysbiosis’ (gut microbial imbalance) and ‘leaky gut’ may be key facilitators in the development of autoimmune disease. The foods recommended on the Anti-inflammatory Protocol support the growth of healthy levels and a healthy variety of gut microorganisms. Foods that irritate or damage the lining of the gut are avoided, while foods that help restore gut barrier function and promote healing are encouraged.

Diet-related Disruptions in hormone regulation – What we eat, when we eat, and how much we eat affects a variety of hormones that interact with the immune system. Eating foods with too much sugar or ‘grazing’ throughout the day, rather than eating food at set meals spaced apart deregulate these hormones. As a result, the immune system is typically stimulated. Promoting regulation of these hormones through diet, in turn has a modulating effect on the immune system. As well, dietary hormones that impact the immune system are also profoundly affected by how much sleep we get, how much and what kinds of activity we do, and how well we reduce and manage stress, so looking at diet and lifestyle together, is key.

Immune system regulation – Our intestines are home to millions of bacteria which live in symbiotic relationship with us.  We provide food for them and when in balance, they maintain the integrity of the gut wall, which serves as a protective barrier. When our gut ‘flora’ gets out of balance, having an excess of pathogenic bacteria, this protective barrier becomes compromised, resulting in small ‘holes’ that permit exchange between the inside of our gut and the blood stream.  This is what is called “leaky gut“. Endotoxins produced by the proliferation of “bad” bacteria can get into the blood stream, stimulating the immune system, and resulting in systemic inflammation. What becomes critical is to limit the factors that contribute to excess of the “bad bacteria” and restore a healthy amount and diversity of “good” gut microorganisms, so that the gut once again functions as a protective barrier, and immune system regulation is achieved.

What is the Anti-Inflammatory Protocol?

The Anti-Inflammatory Protocol identifies foods that promote inflammation from those that research indicates have anti-inflammatory properties. It isn’t simply a list of “eat this” and “don’t eat that”, but explains what about a particular food promotes inflammation or inhibits it. It explains the role of key inflammatory -producing compounds such as lectinssaponins and protease inhibitors, and which foods they are found in, and how eating those foods contribute to “leaky gut“. Which grains can one eat?  Which should be avoided? What about beans and lentils? Are there some better than others?

The Anti-Inflammatory Protocol explains which healthy cooking and eating fats won’t contribute to the production of Advanced Glycation End-Products (AGEs) – and how this compound causes oxidative damage to the cells in the body. Knowing this enables people to know whether oils such as grapeseed for example, are a good choice and if not, why – as well as which other oils would be preferable.

I want people to understand in simple terms how omega 6 (ω-6) fats compete for binding sites and elongation enzymes with omega 3 (ω-3) fats, as this enables them to determine whether foods such as nuts and seeds should be included in an anti-inflammatory diet. If they understand the role of hormones such as insulin and what causes it’s release, they can determine for themselves whether products like agave syrup or coconut sugar are preferable to table sugar when following an anti-inflammatory protocol. I find that once people understand the theory as to why they should eat less of certain foods (explained in ways that don’t require an educational background in science!) and they also understand which types of foods they should aim to eat more of, they are empowered to make dietary choices that contribute to reducing inflammation, as well as symptoms, along with risk factors for other inflammation-related conditions.

I consider my primary role is as an educator. I don’t want to tell someone they need to eat this food on this day and this other food on the next day.  It is far more rewarding and helpful to them, if I help them know how to make these decisions themselves.

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To our good health,

Joy


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Copyright ©2017 BetterByDesign Nutrition Ltd.  LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without regular monitoring by a Registered Dietitian and with the knowledge of your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing something you have read or heard in our content. 

Lactose Intolerance

INTRODUCTION:

Lactose is the sugar found in milk and milk products. It is also added to some processed and prepared foods such as salad dressings. An enzyme called lactase is needed for your body to break down (digest) lactose.

Primary lactose intolerance occurs when your body does not have enough lactase – which can occur because your body does not make it. Certain ethnic populations have a higher likelihood of having primary lactose intolerance. In North America, adults lactose intolerance has been reported at 90% of Asians, 80% of First Nations, 75% of Blacks, 50% of Hispanics, and 21% of Caucasians 1. As high as 60-80% of Ashkenazi Jews (Jews of Eastern European background) have primary lactose intolerance 2

Secondary lactose intolerance occurs as a result of something else such as in inflammatory bowel disease, such as Crohn’s or Colitis. Celiac disease (antibody mediated gluten intolerance) or those with Celiac disease who have not been strictly following a gluten-free diet may also have secondary lactose intolerance. In these cases, the villi of the intestine (little hair-like projections that increase the surface area of the intestine) which contain the lactase needed to break down the lactose become damaged, resulting in lactose intolerance.  For those with inflammatory bowel disease or Celiac disease, once their disease is better managed,  the villi in their intestines heal, making them able to digest lactose again. Even a bout of stomach flu can result in temporary lactose intolerance.

Congenital Lactose Intolerance – In rare cases, lactose intolerance is cause by a defective gene that is passed from the parents to a child, resulting in the complete absence of lactase in the child. This is referred to as congenital lactose intolerance.

milk-splash

Symptoms

In those without lactose deficiency, the body breaks down the lactose taken in through the diet into smaller parts for digestion and absorption. Without the lactase enzyme, or enough of this enzyme, the lactose passes into your large intestine undigested, and there it is fermented by bacteria which may result in symptoms such as:

  • bloating
  • gas
  • cramping
  • nausea
  • diarrhea
  • weight loss (in children)

The severity of these symptoms depends on the amount of lactose eaten and the amount of lactase enzyme that the body produces. Most people with lactose intolerance can tolerate some lactose in their diet.

How Is Lactose Intolerance Diagnosed?
Lactose Intolerance Test

This blood test measures your body’s reaction to a liquid that contains high lactose levels.

Hydrogen Breath Test

This test measures the amount of hydrogen in your breath after consuming a drink high in lactose. If your body is unable to digest the lactose, the bacteria in your intestine will break it down instead. The process by which bacteria break down sugars like lactose is called fermentation. Fermentation releases hydrogen and other gases. These gases are absorbed and eventually exhaled. If you aren’t fully digesting lactose, the hydrogen breath test will show a higher than normal amount of hydrogen in your breath.

Stool Acidity Test

This test is more often done in infants and children. It measures the amount of lactic acid in a stool sample. Lactic acid accumulates when bacteria in the intestine ferment the undigested lactose.

Managing Lactose Intolerance

Those with lactose intolerance benefit from reducing the amount of lactose in their diet.

While you expect to find lactose in milk products, it is often added as an ingredient to foods and beverages you might not think have lactose. Be sure to read the ingredient list on product label to find out if the product contains an ingredient that contains lactose – such as:

  • milk
  • milk solids
  • whey
  • lactose
  • curds
  • cheese flavour
  • malted milk
  • non-fat milk solids
  • buttermilk
  • cream
  • non-fat milk powder

chip-dip

Prepared foods may also contain lactose, including:

  • store bought gravy or sauce mixes
  • vegetable or chip dips
  • soups
  • chips or snack crackers (e.g. cheese or ranch flavoured)
  • sugar substitutes made with lactose (e.g. Equal®)
  • artificial whipped toppings
  • powdered meal replacement supplements
  • hot chocolate mixes
  • cream-based liqueurs

Note: Products that contain lactic acid, lactalbumin, lactate and casein do not contain lactose.

Limiting, Rather than Avoiding Lactose

Some people are able to tolerate certain lactose-containing foods while other people with lactose intolerance cannot.

Limit your intake of foods that cause you discomfort.

cheddar
hard cheddar

Once your symptoms have improved significantly, try adding in small amounts (60-125mL or 1/2 cup) of lower lactose foods such as:

  • hard, aged cheese (cheddar, Swiss, Parmesan)
  • yogurt
  • chocolate milk
  • pudding
  • sour cream
  • cottage cheese

If these amounts cause you discomfort, then try eat less.

Greek yogurt
Lactose Free & Lactose Reduced

In Canada, “lactose-free” means that there is no detectable lactose in the food.  “Lactose-reduced” means that at least 25% of the lactose in the product has been removed.

Calcium and Vitamin D

Many foods that contain lactose are also important sources of calcium and vitamin D, so if you avoid lactose-containing foods, be sure to include other sources of these nutrients, such as the following lactose-free or lactose-reduced products, preferably fortified with calcium, such as:

  • lactose-hydrolyzed milk (e.g. Lactaid®, Lacteeze®)
  • soy beverage
  • rice beverage
  • casein or soy-based products in place of cheese
  • yogurts with live bacterial cultures or lactose-reduced yogurts
Calcium & Vitamin D

It is important that if you are lactose intolerant to be sure to get enough Calcium and Vitamin D.

Calcium is a mineral that helps you build and maintain strong bones and teeth, and is also used in other parts of your body – to help your muscles work and is involved in maintaining your heartbeat. Adequate calcium intake throughout your life can help to prevent osteoporosis, a disorder that causes thinning of the bones until they are weak and fracture easily or break. Women are at greater risk of developing osteoporosis than men, particularly after menopause, because estrogen levels which act to maintain bone are reduced.

Lactose-free sources of vitamin D include fish, liver and egg yolks.

Remember…

Being lactose intolerant does not mean you can’t ever have dairy – hard cheese and yogurt are naturally low in lactose and reduced lactose milk can be purchased at most grocery stores. Some people may not have any symptoms at all from regular milk or cream, provided they only have a small amount. If 1/2 cup (125ml) causes you discomfort, then try 1/4 cup.

Finally, remember that Calcium and Vitamin D can be found in other foods besides dairy, such as canned sockeye salmon. Don’t forget that the bones are the best sources, so mash them finely and eat them along with the rest.

best-canned-salmon

 


References

  1. Scrimshaw NS, Murray EB. The acceptability of milk and milk products in populations with a high prevalence of lactose intolerance. Am J Clin Nutr. 1988;48(4 Suppl):1079. Available at: http://www.ncbi.nlm.nih.gov/pubmed?term=3140651. Accessed on March, 6, 2015.
  2. Heyman, MB. Lactose intolerance in infants, children, and adolescents. Pediatrics 2006;118(3):1279-1286. Available at: http://pediatrics.aappublications.org/content/118/3/1279. full Accessed on February 23, 2015.