Despite its importance, choline is seriously overlooked. Data from the National Health and Nutrition Examination Survey suggest only 8 percent of American adults meet the adequate intake for choline; in the 2010 Dietary Guidelines for Americans, it was identified as a shortfall nutrient; and the 2015-2020 Dietary Guidelines for Americans estimate most Americans consume less than the adequate intake level.

Roles in Health

Choline is essential throughout the life cycle and is critical for brain and spinal cord development. Beginning in utero and continuing throughout childhood, choline is crucial for brain development and cognitive learning. Some research shows choline can improve memory by slowing cognitive decline in older adults.

Beyond the brain, choline is part of acetylcholine, a neurotransmitter important in muscle control, memory, mood and nervous system functions. Choline also plays a role in the stabilization of DNA, transportation of fats and (with folate) possibly the prevention of neural tube defects.

Choline’s role as a neurotransmitter signaling muscle cell activity may enhance athletic performance, according to preliminary research.

Some research shows choline may be cardioprotective, yet other studies have found conflicting results. Further research is needed to investigate the link between choline and cardiovascular disease risk.

Current Recommendations

In 1998, the Food and Nutrition Board established adequate and tolerable upper intake levels for choline. Requirements begin at 125 milligrams per day in the first six months of life and advance to 550 milligrams per day for males 14 and older and 425 milligrams per day for females 19 and older. Pregnant and lactating women require 450 milligrams per day and 550 milligrams per day, respectively.

Food Sources

The U.S. Food and Drug Administration recently set the daily value for choline at 550 milligrams per day for adults and children 4 and older based on the updated Reference Daily Intake values. Foods containing 55 to 104.5 milligrams (10 to 19 percent of the DV) of choline per serving can be declared a good source and foods containing 110 milligrams or more of choline per serving (20 percent or more of the DV) are an excellent source.

Supplements are usually necessary for pregnant and lactating women. Choline supplements are available as a single nutrient, with B vitamins and in some multivitamin mineral products in amounts ranging from 10 to 250 milligrams.

Signs of Deficiency

While most Americans fall short of meeting choline requirements, deficiency is rare in healthy, non-pregnant people. A choline deficiency can cause muscle damage and nonalcoholic fatty liver disease from abnormal deposits of fat in the liver.

Toxicity

Exceeding the tolerable upper intake level of 3,500 milligrams per day of choline for adults has been associated with vomiting, increased sweating, low blood pressure and fishy body odor. Further, the FNB warns that individuals with liver or kidney disease, Parkinson’s disease, depression or inherited trimethylaminuria may be at increased risk for severe side effects when exceeding the tolerable upper intake level.

Populations at Risk

Choline’s role in brain and spinal cord development makes its consumption vital for pregnant and lactating women. However, many prenatal supplements contain little choline. In June 2017, the American Medical Association recommended that prenatal vitamins increase the amount of choline from 0 to 55 milligrams to the adequate intake of 450 milligrams daily.

Individuals with genetic alterations also may be at higher risk of deficiency.

Bottom Line

The mounting evidence of choline’s importance makes it essential that registered dietitian nutritionists remain up to date on this critical nutrient. Throughout the life cycle, RDNs can help clients meet choline requirements for good health. Food manufacturers also may take note and start fortifying choline in foods to help consumers meet requirements more easily.

The post Micronutrients: Choline appeared first on HealthStylz.

What does transgender mean?

The term transgender refers to someone’s expression of gender. Gender expression (or gender identity) is unrelated to the physical attributes of a person (i.e. sex). For individuals who are transgender, the sex they were assigned at birth and their gender identity do not match.

Cisgender individuals have the same gender identity as their birth-assigned sex. Furthermore, someone may identify as gender non-binary, meaning they do not associate themselves with any socially identified gender expression. Someone who is transgender, gender non-binary or intersex (born with a combination of male and female sexual anatomy) may further identify as queer, gay, bisexual, lesbian or asexual, to name a few. However, sexual orientation is not related to gender expression.

While research suggests the number of people who identify as transgender has increased, it is difficult to know for sure, as population surveys often do not include gender identity. Greater awareness and cultural understanding by society has led to increased visibility of transgender people. This also impacts how research protocols are developed and established. Studies are continuing on a large scale, including a consortium of five research institutions in Europe and the United States that is exploring whether there is a component in the genome that contributes to one’s gender identity.

Should RDNs use nutrition interventions for a transgender patient as birth-assigned sex or identified/ expressed gender?

Information found in the medical chart may not provide a clinician with the most accurate understanding of someone’s gender.

Situations still exist where an individual’s birth-assigned sex is listed as gender despite the person identifying as transgender. In fact, many medical institutions and insurance companies do not accept transgender expression as an option in the personal identifiers portion of the medical chart.

Maintaining rapport with patients is of the utmost importance when providing nutrition recommendations. Therefore, regardless of information in the medical chart, it is essential to ask patients about their gender expression and use those identifiers when referring to them and their nutrition status.

What are recommended nutrition guidelines for transgender people?

There currently are no specific nutrition guidelines for transgender patients. While evidence is limited on using gender identity for estimating nutrition requirements, research has shown testosterone hormone therapy to change metabolic needs. Health practitioners should use clinical judgment when making nutrition recommendations based on gender identity. Calorie, protein and fluid requirements are not significantly different than they are for cisgender individuals. For those who wish to undergo surgical interventions as part of the transition process, a standard elevation in protein and calorie needs post-surgery are applied for wound healing. Furthermore, many people who identify as transgender may use hormone therapy as part of the transition process. Because the time it takes for hormone therapy to produce results varies from person to person, it is sometimes difficult to tell where an individual is in the process. For those individuals, hormone therapy may cause weight gain and glucose intolerance. As for specific transgender considerations regarding hormone therapy:

Transgender Men (Female to Male): Testosterone hormone therapy (“T”) increases muscle mass, possibly resulting in bone tissue production and an increase in bone mass, at least in the short term. However, long durations of “T” may decrease bone mass and contribute to an increased risk of osteoporosis. Additionally, the effects of “T” may significantly reduce or eliminate the menstrual cycle, which would impact iron needs. It is important to note that once “T” is initiated, it typically is used indefinitely.

Transgender Women (Male to Female): Estrogen may increase risk of thromboembolic disease and progesterone can cause weight gain. In those who have their testicles removed, estrogen replacement can play an important role in preserving bone mass. Compared to cisgender females, whose natural estrogen can decrease over time, consistent estrogen replacement use has been shown to have no negative changes in bone density.

Transgender Adolescents: In 2017, the Endocrine Society published a clinical practice guideline for endocrine treatment of adolescents who are gender-dysphoric/ gender-incongruent. There are multiple considerations for this population. Hormone suppressants may cause complications related to bone health. Recommendations include weight bearing exercises and supplementation with calcium and vitamin D may be warranted.

Use clinical judgment when seeing a patient who identifies as transgender. It is completely reasonable to ask the patient if hormone therapy is being administered as part of the transition process. Because not every person who is transgender goes through the physical transition process (the out-of-pocket cost of physical transition is high due to lack of insurance coverage), the only way to know is to speak to the patient directly. Additionally, using nutrition-focused physical examination tools, such as the triceps skinfold measurement, to assess alterations in lean body mass may help determine how to assess protein requirements in someone who may or may not be on “T,” which increases muscle mass and therefore affects protein needs.

Collaborate with the medical team and other ancillary medical services to ensure consistent care is maintained. In a survey of transgender individuals, 50 percent reported having to teach their medical providers about transgender care. The more information an RDN can provide to the multidisciplinary team, the more comfortable the patient will be receiving nutrition and medical care.

How can we approach body acceptance and psychological support for people who are transgender?

Although RDNs are not therapists or licensed mental health counselors, they have a valuable ability to listen. Emotional sensitivity, understanding and acceptance are key not only to establishing rapport, but also to gaining knowledge about where the patient may be regarding body acceptance and other psychological markers.

According to the National Transgender Discrimination Survey, those who are transgender have an increased risk of eating disorders and an increased risk of abusing diet pills to meet social norms. This increased prevalence affects transgender females disproportionately more than males and is related to feeling the need to meet ideal body standards, emotional trauma from the process of accepting gender identity, and stress from social stigma and discrimination. In the same survey, 28 percent of participants reported postponing medical care due to discrimination from their health care providers, while 19 percent reported being refused medical care completely.

RDNs should provide a welcoming and judgment-free atmosphere for patients. The slightest hesitation in confidence during a session can make a patient feel uncomfortable and uneasy about the abilities of the clinician. RDNs with advanced training in nutrition interventions in the treatment of eating disorders find there is little difference between transgender and cisgender individuals when it comes to eating pathology. Because the etiology of the eating disorder can assist in the determination of nutrition recommendations, understanding the overall struggles of the transgender community can be a useful tool in the development of quality dialogue and patient goals.

The post Nutrition Considerations for the Transgender Community appeared first on HealthStylz.

The gut-brain axis is a topic of interest in fields from neurology and gastroenterology to psychology and integrative and functional medicine. While most available evidence on the gut-brain axis comes from animal studies, emerging human research is providing valuable insights into the complex integration of psychology and physiology of the human body.

The gut is a busy place. Not only does it house the influential microbiome, it also includes immune cells, neuropeptides, microbial metabolites and enteroendocrine cells, which secrete hormones. The vagus nerve is a key connection point linking the brain and gut, while nerves along the gut allow for direct communication with contents of the stomach and intestine.

The digestive tract is one of the major entry points for external substances, from food and supplements to drugs and bacteria. These substances all have the potential to impact the gut-brain axis.

Intestinal permeability refers to the physical gaps between intestinal cells, which is thought to be partly regulated by the microbiome. The term “leaky gut” was coined to describe when those gaps are enlarged and external substances and waste products are allowed to pass into the bloodstream. This has been associated with changes in mood, immune function and inflammation. Intestinal permeability may be associated with numerous conditions including inflammatory bowel disease and autoimmune disorders such as Type 1 diabetes and celiac disease.

“RDNs can play an integral role in preventing and repairing intestinal permeability,” says Mary Purdy, MS, RDN, the 2017- 2018 chair of the Academy’s Dietitians in Integrative and Functional Medicine dietetic practice group. According to Purdy, consuming adequate amounts of vitamins A and D, with plentiful dietary fiber, prebiotics and probiotics to keep the gut microbiota healthy, can maintain and improve the integrity of the gut.

It also is becoming clear that the microbiome can influence its host’s appetite and eating behavior. Animal and human research has found a link between specific species of microbes and increased host intake of nutrients that the microbes prefer. “Cravings and feelings of hunger we experience may not be just our own,” says April N. Winslow, MS, RDN, CEDRD, who is working toward her doctorate in food science and human nutrition with an emphasis in nutritional neuropsychology.

The metabolites microbes produce and the neurochemicals they influence impact secretion of satiety-promoting hormones; researchers suspect the microbiome also can influence taste, smell, thoughts, impulsivity and compulsivity about food. Short-chain fatty acids, a major metabolite of gut microbes, and their possible link to obesity and metabolic syndrome are an active area of research. In fact, administering the short-chain fatty acid proprionate to the colon of adults who are overweight led to greater satiety hormone release and reduced calorie intake and weight gain.

Disrupting the gut-brain axis already is used as a treatment for obesity through Roux-en-Y gastric bypass surgery, a restrictive and malabsorptive intervention that in 2015 accounted for an estimated 23 percent of bariatric surgeries. This surgery is unique compared to purely gastric restrictive bariatric surgeries, such as laparoscopic adjustable gastric banding, because part of the stomach is stapled off and attached to the middle part of the small intestine, bypassing the lower portion of the stomach and parts of the small intestine. This may affect not only the absorption of certain micronutrients, but also hunger and satiety hormones.

People who undergo gastric bypass surgery tend not to experience the same increase in the hunger hormone ghrelin as people who achieve non-surgical weight loss through diet and exercise alone. Bariatric experts suspect this is a major contributor to the success of the surgery. In addition, sometimes the vagus nerve is severed during gastric bypass surgery, which could affect hunger hormones and innervation of the gut, therefore impacting appetite.

Nina Crowley, PhD, RDN, LD, metabolic and bariatric surgery program coordinator at the Medical University of South Carolina, says it is imperative to counsel bariatric candidates on the mechanisms at work in various bariatric surgeries, how they differ and how this impacts metabolism. “I like to discuss how the change in gut hormones may be what is required for them to see a metabolic change, and keep a focus on biology, rather than blaming the person for their eating habits or behavior,” Crowley says.

When the body is underfed, such as with bariatric surgery recovery and anorexia nervosa, gut microbiota composition and diversity changes. This has been correlated with depression and anxiety in people with anorexia nervosa and may be related to the fact that 95 percent of the neurotransmitter serotonin, which plays a role in depression, is produced in the gut.

Research is examining what happens when fecal samples from people with anorexia nervosa are transplanted into mice born in a germ-free environment, compared to what happens when fecal samples from healthy people are transplanted into germ-free mice. This science serves as a foundation for potential new treatments for anorexia nervosa as well as furthering the understanding of the underlying mechanisms of this complex disease.

There is not enough evidence to explain the role of the gut-brain axis in binge-eating disorder, although some researchers suspect the gut microbiome’s impact on impulsivity and compulsivity may play a role.

While research on the gut microbiome is booming, human research is needed on other parts of the gut-brain axis, especially as it pertains to risk and development of psychological and chronic disease. As more human evidence becomes available, novel intervention strategies involving food and nutrition likely will come to light.

“Registered dietitian nutritionists are the ideal medical professionals to lead research in this area because they have the training and skills to obtain nutritional data from human participants and conduct motivational interviewing,” Winslow says.

The post Exploring the Gut-Brain Axis appeared first on HealthStylz.

Emulsifiers made from plant, animal and synthetic sources commonly are added to processed foods such as mayonnaise, ice cream and baked goods to create a smooth texture, prevent separation and extend shelf life. However, in this era of “clean labels,” consumers question the necessity of additives in food.

Definition

A food emulsifier, also called an emulgent, is a surface-active agent that acts as a border between two immiscible liquids such as oil and water, allowing them to be blended into stable emulsions. Emulsifiers also reduce stickiness, control crystallization and prevent separation.

Functions, Names and Labeling

Emulsifiers create two types of emulsions: either droplets of oil dispersed in water or droplets of water dispersed in oil. Within the emulsion, there is a continuous and dispersed phase. In an oil-in-water emulsion, the continuous phase is the water and the dispersed phase is the oil; conversely, in a water-in-oil emulsion, the oil is the continuous phase.

Emulsions also can be made by applying mechanical force from a blender or homogenizer, which breaks down the dispersed phase into tiny droplets that become suspended in the continuous phase.

Low-fat spreads, ice cream, margarine, salad dressings and many other creamy sauces are kept in stable emulsions with the addition of emulsifiers. These additives also are widely used in other foods such as peanut butter and chocolate.

“Emulsifiers enhance the structure of baked goods by increasing whip-ability of batters, conditioning of dough and helping foods like pasta be more resistant to overcooking,” says food scientist Kantha Shelke, PhD, CFS.

Commonly used emulsifiers in modern food production include mustard, soy and egg lecithin, mono- and diglycerides, polysorbates, carrageenan, guar gum and canola oil.

Lecithin in egg yolks is one of the most powerful and oldest forms of an animal-derived emulsifier used to stabilize oil in water emulsions, for example, in mayonnaise and hollandaise sauce.

Emulsifiers are required by law to be included on a food’s ingredient list.

Oversight

Safety of emulsifiers is carefully regulated and tested by the U.S. Food and Drug Administration. Emulsifiers can be found on the Generally Recognized As Safe, or GRAS, list and are allowed in specific types of food and beverages at precise levels.

However, “FDA processes do not take into consideration individual diets of people who rely heavily on packaged foods,” Shelke says.

Although GRAS substances technically must meet the same safety standards as approved food additives, the GRAS process has evolved into a voluntary notification program and many GRAS additives have not been tested.

Congress defines safe as “reasonable certainty that no harm will result from use” of an additive. Additives are never given permanent approval. The FDA continually reviews the safety of approved additives, based on the best scientific knowledge, to determine if approvals should be modified or withdrawn.

Earlier in 2017, the FDA reviewed and confirmed the safety of carrageenan, an emulsifier whose safety has been questioned.

Safety

Most concerns about food additives target synthetic ingredients that are added to foods.
Published peer-reviewed intervention studies involving emulsifiers are limited to animals. A 2015 mouse study published in Nature found that two common synthetic emulsifiers, carboxymethylcellulose (CMC) or polysorbate 80 (P80), triggered weight gain and low-grade symptoms of inflammation and metabolic syndrome after 12 weeks.

“We suspect some emulsifiers act like detergents, upsetting the friendly bacteria in the microbiota, which triggers low-grade inflammation and causes excess eating,” says co-author Andrew Gewirtz, PhD.

A follow-up study by Gewirtz, a professor of biomedical sciences at Georgia State University, and his colleagues, published in Cancer Research, suggested the changes in gut bacteria from emulsifiers could trigger bowel cancer. A small clinical trial currently is underway to evaluate the role of CMC in humans.

In response to questions about the safety of some emulsifiers, a team of FDA scientists conducted a review of seven emulsifiers commonly used in food, including CMC and P80, to determine whether these ingredients pose any risk to human health. Their findings, published in 2017, confirmed that emulsifiers remained safe at the estimated exposure levels.

Final Thoughts

Food additives, including emulsifiers, play an important role in our food supply. Consumers who are concerned about these ingredients are encouraged to read labels and consume more minimally processed foods.

The post Food Additives: Emulsifiers appeared first on HealthStylz.

In the United States, at least 30 percent of adults and as much as 10 percent of children older than 2 have NAFLD. With obesity as a common comorbidity, the prevalence of NAFLD has doubled in the last two decades and may soon surpass hepatitis C infection as the leading cause for liver transplantation in the U.S.

The Disease Spectrum

NAFLD is a non-specific title describing several variations of the disease with differing levels of severity. In simple NAFLD, there are no symptoms, only steatosis, which is an excess of triglycerides in the liver. As many as 30 percent of people with NAFLD will progress to non-alcoholic steatohepatitis, or NASH, a severe form of fatty liver characterized by inflammation. There often are no symptoms related to NASH, though some sufferers complain of fatigue or discomfort in the upper right abdomen. Many people with NASH go on to develop fibrosis or scarring of the liver. As fibrosis progresses, cirrhosis develops, which can lead to progressive chronic liver failure, liver cancer and death.

Risk Factors and Causes

NAFLD is more common in people who have obesity or Type 2 diabetes. At least half of people with Type 2 diabetes and approximately 90 percent of people with body mass indices of 35 or higher have some form of NAFLD. Insulin resistance is common among these conditions and often is expressed as metabolic syndrome.

NAFLD is widely considered the liver manifestation of metabolic syndrome. Insulin resistance leads to excess free fatty acids in the blood stream and increased fat deposition in the liver. Furthermore, metabolic abnormalities spur the liver to produce and store high amounts of fatty acids. Most people with NAFLD have at least one feature of metabolic syndrome, and about one-third have all five features: elevated blood sugar levels, high blood pressure, low HDL cholesterol levels, elevated triglyceride levels and increased waist circumference.

Additional risk factors for NAFLD include high cholesterol levels, polycystic ovary syndrome, sleep apnea and underactive thyroid. These conditions share risk factors and complications such as weight gain, inactivity, diabetes and poor diet.

Less common causes of NAFLD include medications, infections, genetic disorders affecting metabolism, malnutrition and rapid weight loss.

NAFLD Progression and Cardiovascular Complications

Progression of patients throughout the spectrum of NAFLD is not well-defined. Continued or worsening insulin resistance likely plays a role in the advancement of liver abnormalities, as do oxidative stress and inflammation. Zachary Henry, MD, assistant professor of gastroenterology and hepatology at the University of Virginia, notes that for most of his patients, as metabolic syndrome worsens, so does NAFLD. To make matters worse, the progression to NASH may cause a vicious cycle of increased insulin resistance and faster progression through the NAFLD spectrum.

Not all patients progress in a typical fashion. “There are subsets of patients that likely have a genetic predisposition to progress regardless of metabolic syndrome,” Henry says.

Heart disease is the top killer among people with NAFLD, especially for those who have progressed to NASH. It is unclear if this is an association related to metabolic disturbances or if liver abnormalities cause heart complications. Research suggests NAFLD may lead to heart disease by contributing to blood vessel dysfunction, systemic inflammation, oxidative stress, and worsening cholesterol and triglyceride levels.

Screening for and Diagnosing NAFLD

Screening starts with a blood test to measure liver enzymes, but diagnosis requires imaging of the liver, typically by ultrasound. Health care providers frequently order imaging tests for patients with elevated liver enzymes in the presence of high-risk conditions such as Type 2 diabetes, metabolic syndrome, obstructive sleep apnea and a BMI of 35 or higher. However, the disorder likely is under-diagnosed because many patients with NAFLD have normal liver enzyme levels. Henry favors imaging everyone at high risk, but because this puts a heavy burden on the health care system, many providers order diagnostic procedures only when liver enzymes are elevated.

A liver biopsy is necessary to learn if a patient has simple steatosis or if the disease has progressed to NASH, fibrosis or cirrhosis. Under a microscope, the sampled liver tissue looks identical whether the patient has fatty liver from alcohol consumption, insulin resistance or some other reason. The diagnosis of NAFLD is made by ruling out excessive alcohol intake.

Treatment of NAFLD

There currently are no FDA-approved medications for treating NAFLD. The treatment trifecta is weight loss, healthful eating and physical activity — the same lifestyle interventions that treat other conditions associated with insulin resistance.

Inspiring difficult lifestyle changes for a condition without symptoms is challenging, but early intervention can prevent progression and even reverse NAFLD, says Kristin Kirkpatrick, MS, RD, LD, manager of Wellness Nutrition Services at Cleveland Clinic and author of Skinny Liver (Da Capo Press 2017). The key, she says, is to learn what motivates each individual and to focus on comorbid conditions such as elevated blood sugar levels.

WEIGHT LOSS. As with other conditions related to insulin resistance, even moderate weight loss improves NAFLD. At the University of Virginia Health System, Mary Lou Perry, MS, RDN, CDE, works with a multidisciplinary team to encourage healthful lifestyle habits and weight loss of 7 percent to 10 percent of starting weight. Perry notes that the degree of improvement is proportional to the amount of weight lost. However, rapid weight loss of more than 3.5 pounds weekly, with its greater flux of fatty acids to the liver, may worsen inflammation in NASH and accelerate disease progression.

HEALTHFUL EATING. Research has not identified an ideal diet or macronutrient distribution for the treatment of NAFLD. Thus, following recommendations of the 2015-2020 Dietary Guidelines for Americans is reasonable. One option gaining traction among health professionals is a Mediterranean-style diet. In a small crossover study, a Mediterranean-style diet produced greater reversal of both insulin resistance and liver fat content compared to a low-fat, high-carbohydrate diet even without a change in weight.

The following food items deserve special attention because they affect the progression of the disease or because patients frequently ask about them:

Alcohol: Moderate alcohol intake is associated with less heart disease and greater insulin sensitivity. However, it is unknown if these benefits extend to patients with NAFLD or if small amounts of alcohol are harmful. The American Liver Foundation and some physicians advise people with NAFLD to completely avoid alcohol. In the absence of clear guidelines, patients with NAFLD should adhere to the American Heart Association’s defined daily limits of one drink for women and two drinks for men.

Coffee: Limited data suggests coffee consumption may reduce the severity of NAFLD through anti-inflammatory and antioxidant properties.

Green tea: With its rich polyphenol content, researchers propose that drinking green tea may improve NAFLD. However, there have been no randomized controlled studies in humans.

Sugar-sweetened beverages: Research suggests drinking sugary beverages is associated with greater risk of NAFLD.

Dietary supplements: There is little evidence for the use of dietary supplements in treating NAFLD. Vitamin E shows some promise, but other studies link vitamin E supplements to increased mortality. Although some people may try unproven therapies such as milk thistle and green tea extract, unsupervised dietary and herbal supplements cause 20 percent of liver toxicity cases.

PHYSICAL ACTIVITY. Both cardiovascular exercise and strength training improve insulin resistance and NAFLD. Without clear exercise guidelines for this condition, it is prudent to work toward federal recommendations of achieving at least 150 minutes of moderate-intensity aerobic activity and two full-body strength training sessions weekly.

The post Non-Alcoholic Fatty Liver Disease appeared first on HealthStylz.

Instead of drawing water and nutrients from soil, hydroponic produce is grown with the roots submerged in nutrient-fortified water. Aeroponics is a related method in which the roots hang in the air and are regularly misted with water and nutrients.

One benefit of hydroponic farming is that it allows large amounts of produce to be grown on a relatively small piece of land and in places where traditional farming would be untenable, such as urban centers, or limited by geography and weather, such as in Alaska.

Hydroponic growers help satisfy demand for local produce in areas that are not well-suited for traditional farming. But even in farm-friendly regions where rain and sun are plentiful, storms, heat waves and unexpected freezes can cause unpredictable and costly crop losses, to which indoor farmers are largely immune.

Hydroponic crops also are less susceptible to weeds, insects and other pests, which means the plants can be produced without herbicides and pesticides.

All this has made hydroponics one of the fastest growing sectors of the agriculture industry, with more traditional growers investing in hydroponics as a supplement to existing operations or switching over entirely.

Another potential advantage of hydroponic farming is the degree of control the grower has over the conditions to which plants are exposed and the ability to precisely replicate those which produce better results.

However, not every plant does equally well in hydroponic growing conditions, at least with current technology. Lettuce and other leafy greens, herbs, tomatoes, peppers, cucumbers and strawberries are the most commonly grown hydroponics.

Hydroponic operations, which often use sophisticated water recycling systems, may use up to 90 percent less water than traditional farming, depending on the location. While traditional farms in water-stressed areas rely heavily on irrigation and use far more water than hydroponics, other areas get most of their water from rain.

Some hydroponic growers also rely on electric grow-lights instead of the sun. This allows growers to artificially extend the length of the day and manipulate light wavelengths to increase yield and productivity year-round.

Not having to till and plow fields can reduce the amount of greenhouse gasses associated with crop production. However, the overall carbon footprint of a food depends on additional factors, such as the distance it is transported after harvest, which complicates comparisons of environmental impact between hydroponically and soil-grown crops.

How Do Hydroponics Compare Nutritionally?

Comparing the nutritional content of hydroponic and soil-grown produce is challenging, and research involving direct comparisons is limited. Both traditional and hydroponic farmers can influence the nutritional content of produce by adding nutrients to the soil or growing medium. But the nutritional composition of a fruit or vegetable also depends on the particular cultivar or variety, the degree of ripeness when harvested and the storage period after harvest.

With hydroponics, there is no danger of plants absorbing heavy metals that may be in the soil. On the other hand, growing vegetables in soil may yield benefits that we don’t yet fully understand. Raw produce can be a source of beneficial probiotic soil-based bacteria, for example. Although it’s not yet clear to what extent this can be replicated indoors, commercial hydroponic growers are experimenting with techniques that foster a healthy and diverse microbiome.

What about Flavor?

Although you may think sun and soil are essential for good flavor, the factors that influence flavor — including air temperature, humidity, the amount and color spectrum of light-nutrient availability and moisture — can be precisely controlled and more reliably replicated in a hydroponic environment.

As with nutrient content, the flavor of produce depends on the variety and freshness, as well as growing conditions. “We can breed for flavor, texture and nutrition instead of mold resistance, pest resistance or shelf life,” says Alina Zolotareva, RDN, marketing manager for AeroFarms, an aeroponic grower of salad greens in Newark, N.J. “And because hydroponics can move the farms to the people, it can give people access to fresher produce.”

But the hydroponic produce at a local grocer isn’t necessarily grown locally. Although hydroponics make it possible to grow fruits and vegetables anywhere, the largest hydroponic growers in the U.S., accounting for about half of hydroponic sales, are clustered in Pennsylvania, California, New York, Vermont and Wisconsin.

The Organic Debate

Because hydroponically grown fruits and vegetables can be produced without the use of pesticides or herbicides, many hydroponic growers are pursuing organic certification, which allows produce to be sold at a higher price point. But many traditional organic farmers are crying foul.

“[Hydroponics] is a really efficient model of production,” says Mark Kastel, co-founder of The Cornucopia Institute, a public interest group supporting sustainable and organic agriculture. “If unchecked, hydroponics could squeeze out traditional organic farmers to the extent that consumers wouldn’t really have the option to buy soil-grown organic produce.”

“Allowing hydroponic produce to be certified as organic is completely contrary to the values of the organic movement,” Kastel says. “Improving and maintaining the health and biodiversity of soil is one of the core principles of organic growing. How can you be stewarding the soil if there is no soil?”

Proponents of organic hydroponics argue that hydroponic systems are aligned with the principles of stewardship, conservation and environmental harmony outlined in the Organic Foods Production Act of 1990. They also view new technology, such as hydroponics, as essential to meeting the demand for organics.

In 2010, the National Organic Standards Board, or NOSB, a federal advisory board, petitioned the United States Department of Agriculture to make hydroponically grown vegetables ineligible for organic certification, a recommendation that the USDA has so far declined to adopt.

“The USDA has made it clear that hydroponics will be allowed to be certified organic,” says Nate Lewis, farm policy director for the Organic Trade Association. “At the very least, we’d like to see a rule that requires hydroponically grown vegetables to be labeled as such.”

In April 2017, the NOSB convened and discussed potential recommendations it would provide the USDA for organic certification of hydroponic systems. No decisions were made, and the Crops Subcommittee will be developing a proposal on this topic for a meeting in the fall.

The post The 411 on Hydroponics appeared first on HealthStylz.

According to the American Psychological Association’s 2017 Stress in America survey, 80 percent of Americans experienced at least one physical or emotional symptom of stress within the previous month, such as headache (34 percent), feeling overwhelmed (33 percent), nervousness or anxiety (33 percent) and depression (32 percent).

However, adults also are significantly more likely to recognize the connection between stress and physical and mental health than in previous years — and 36 percent identify stress reduction as a personal priority.

Among myriad anti-anxiety treatments, including behavioral therapy, medication and other therapies, is one of the current darlings in wellness circles: adaptogens.

The use of herbs for maintaining balance in the midst of a variety of stressors has been a healthy lifestyle tenet in Eastern Chinese medicine and Ayurveda for centuries. However, the notion that some herbal plants may help alleviate chronic stress has existed in Western medicine for about 60 years, when midcentury researchers defined adaptogens as nontoxic compounds with many mechanisms of action and pharmacological effects related to adaptability and survival.

The theory is that adaptogenic compounds affect several key mediators of the adaptive stress response both inside and outside cells, thus having a broader spectrum of action than traditional medications that target one symptom or disease.

For instance, adaptogens are characterized as eustressors, or “good stressors,” that induce stress-protective responses. By stimulating the expression and release of mediators of the adaptive stress response, adaptogens may help increase the body’s tolerance to stress.

With chronic stress being linked to adverse health effects such as cognitive, emotional and behavioral dysfunctions, as well as increased inflammation in the body potentially leading to cardiovascular disease, diabetes, cancer, autoimmune syndromes and mental illnesses, alleviating or limiting ongoing stress is vital for overall, long-term health.

This is where adaptogenic plants may play a therapeutic role, as they have been found to normalize chronically increased cortisol and corticosterone — stress hormones that have been linked to anxiety, depression, digestive troubles and other chronic stress issues.

However, the National Institutes of Health National Center for Complementary and Integrative Health emphasizes caution with using herbal remedies due to limited scientific evidence.

Currently, there are about 70 herbal plants cited in literature with adaptogenic properties, including ginseng, Rhodiola Rosea and maca root. Two of the most popular adaptogens are tulsi and Ashwagandha root.

Also called “holy basil,” tulsi is revered in Ayurvedic medicine as the “elixir of life.” This peppery-tasting herb sometimes is called “hot basil” and is used in stir-fry dishes and spicy soups. Tulsi is used as a treatment for a range of conditions including anxiety, asthma, diarrhea, fever, arthritis, eye diseases and indigestion.

In vitro, animal and human studies reveal tulsi may have therapeutic actions, including adaptogenic, antimicrobial, anti-inflammatory, cardio-protective and immunomodulatory effects. A 2017 review in the journal Evidence-Based Complementary and Alternative Medicine examined 24 studies to assess the clinical efficacy and safety of tulsi and found positive clinical outcomes with no adverse effects. Although these results reinforced the efficacy of tulsi for treating diabetes, metabolic syndrome and psychological stress, further studies are needed to determine its mechanism of action, dosage and dose form, as well as populations that may benefit from it.

The Natural Medicines Comprehensive Database lists holy basil as “possibly safe when used orally, short-term.” The database notes some preliminary research on its effectiveness in reducing anxiety, blood sugar control and decreased symptoms of stress, but more evidence is needed in these areas. There is some evidence that holy basil extract can be used safely for up to six weeks; however, the database advises against use during pregnancy and lactation due to lack of reliable information.

Commonly called “Indian Ginseng” or “Winter Cherry,” the adaptogenic herb Ashwagandha root is named for its odor. This herb emits the smell of horse — which is the literal translation of “Ashwagandha”— and consuming its extracts is said to give people strength and vitality similar to that of a horse.

Known as the “royal herb” in Eastern medicine, Ashwagandha is the most commonly used and studied adaptogen, although human studies are limited and Ashwagandha is not listed in the Natural Medicines Comprehensive Database.

In a 2012 study on the safety and efficacy of Ashwagandha root for reducing stress and anxiety in adults, participants who took 300 milligrams of a high-concentration, full-spectrum extract of Ashwagandha root twice daily for 60 days experienced a significant reduction in stress and cortisol levels. No serious side effects were reported, and researchers concluded Ashwagandha root safely and effectively improved study participants’ resistance toward stress and improved self-assessed quality of life. However, further longterm research using a larger population with varying degrees of physical and psychological stress is needed to determine the effects of Ashwagandha root on stress resistance.

Although the available human research on adaptogens shows potential for alleviating symptoms associated with stress, more studies are needed to determine their efficacy and the range of interactions between adaptogens and stress response pathways in preventing chronic stress and age-related disease — as well as their role in exercise recovery.

As always, a thorough health and nutrition assessment by a physician and registered dietitian nutritionist is necessary, along with supporting evidence, for individualized nutrition recommendations involving botanicals or herbal remedies.

The post Exploring Adaptogenic Herbs appeared first on HealthStylz.

Definition

Color additives, including food dyes and pigments, are substances derived from both synthetic and plant, animal or mineral sources that add color to food. The objective is to enhance natural colors, add color to otherwise colorless foods, compensate for natural color variations and help identify flavors (such as yellow for lemon).

Functions, Names and Labeling

Synthetic color additives were developed to maintain hue and depth of color regardless of pH, temperature or presence of other ingredients. Synthetic colors are classified as “certifiable colors,” as they require U.S. Food and Drug Administration testing and certification each time a new color batch is used. Certifiable color additives are man-made and derived primarily from petroleum.

The nine FDA-approved “certifiable colors” include:

FD&C (FDA approved for Food, Drugs & Cosmetics) Blue No. 1, Blue No. 2, Green No. 3, Red No. 3, Red No. 40, Yellow No. 5 and Yellow No. 6; Orange B (only for use in hot dog and sausage casings) and Citrus Red No. 2 (only for use to color orange peels).

Other color additives derived from sources such as fruits, vegetables, insects and minerals are “exempt” from batch testing and certification, but they still must adhere to safety standards and regulatory requirements. Examples include grape skin extract, saffron, and fruit and vegetable juices. Some people may call these color additives “natural.” However, the term “natural” is not regulated or defined by the FDA, and the FDA objects to the term’s use in products containing added color, whether from certifiable or plant- or mineral-derived colorants.

Certifiable colors must be declared on food labels by the name of the additive, with at least the color and number (such as “Blue 2”). Other color additives may be declared as “Artificial Color,” “Artificial Color Added” or “Color Added,” or by an equally informative term such as “Colored with Fruit Juice” or “Vegetable Juice Color.” Carmine and cochineal extract color additives must be declared on labels because some people are allergic to these substances.

The ability to replace synthetic with plant- or mineral-derived colorant compounds depends on and varies with the pH and temperature of the food or beverage. Certifiable colorants may be preferable when the color needs to be vibrant, stable for long periods of time or when a specific color cannot be achieved with plant- or mineral-derived options.

Oversight

The FDA oversees all color additives, which must be approved for use in food, dietary supplements, drugs and cosmetics, and includes ongoing review of scientific evidence on the safety of their use. In addition, the FDA sets specifications and limitations for types of foods to which each color additive may be added, maximum amounts allowed in foods and how they must be identified on labels.

Color additives are regulated a little differently than other additives. “Because of the potential to deceive consumers about quality or safety of food, color additives require proof of safety during the authorization procedure and cannot be registered as ‘generally recognized as safe,’ exempt from FDA approval,” says Kantha Shelke, PhD, CFS, principal at Corvus Blue, LLC, and adjunct faculty in food safety regulations at Johns Hopkins University.

Safety

Despite additional layers of oversight, some consumers are concerned about the safety of food dyes. The FDA asserts color additives are thoroughly evaluated prior to approval and safe when used in accordance with regulations. However, over the years, many colors — including yellows 1, 2, 3 and 4 — have been banned due to adverse health effects. Color additives that have been found to cause cancer in animals or humans may not be used in FDA-regulated products marketed in the U.S.

Scientists have examined the relationship between food coloring and hyperactive behavior in children with mixed results.

“The FDA has reviewed and will continue to examine the effects of food dyes on children’s behavior,” says Andrew Zajac, PhD, director of the Division of Petition Review in FDA’s Office of Food Additive Safety. “The totality of scientific evidence indicates that most children have no adverse effects when consuming color additives, but some evidence suggests that certain children may be sensitive to them.”

Adverse reactions to color additives are estimated to be quite rare overall, even among people with allergies. Research is limited in this area, and there is no scientific evidence to support a link between exposure to artificial coloring and allergies.

That said, some experts think color additives are completely unnecessary. “It’s better to color food with colorants from food sources or add no color at all than to use synthetic color additives without the benefit of long-term safety studies,” says Virginia Tech food science professor Sean F. O’Keefe, PhD.

Whether in response to mounting evidence or ongoing consumer concern, many companies around the world have begun eliminating food dyes from some or all of their products. The British government now requires warning labels on most foods containing color additives, which has led to the reformulation of many products.

Final Thoughts

There is a growing trend to replace synthetic colors with plant- or mineral-derived compounds. These are assumed to be safer, but without regulation of the term “natural” and without being batch tested or certified, plant- and mineral-derived color additives are not a panacea.

“It is essential that all colorants be tested with the same rigor, something not always done with ingredients such as fruit extracts that bestow a false sense of safety because they are derived from familiar plants and foods,” Shelke says.

Color additives, which confer no health or nutritional benefit, are unlikely to be dangerous for most people. For those wishing to avoid color additives, helpful strategies include reading food labels and eating more foods that are minimally processed.

The post Color Additives appeared first on HealthStylz.

But it wasn’t until the end of World War II when discount merchandising truly took off, fueled largely by consumers seeking bargains in the face of rising prices and demand for goods after wartime shortages. In the 1960s, four major players entered the space and would continue to dominate for decades: Kmart, Woolco, Target and Walmart.

While these discount retailers are viewed more as department stores, food-specific discount operations have emerged and generally fall into two categories: box stores, which sell few perishables and a limited amount of brands and product lines; and warehouse, which sell the manufacturer’s brands at discount wholesale, a moderate amount of product lines but few assortments of goods. Both of these models offer very low prices,few services and a bare-bones atmosphere.

Today, many communities have a mix of grocery store models, from upscale establishments with onsite bars, cafes and restaurants to deeply discounted retailers from all over the world. With all these retailers selling similar foods, more or less, competition is fierce.

According to a 2015 Retail Industry Report by Mazzone & Associates, supercenters, dollar stores and warehouse clubs gained a greater share of the food retailing market as consumers sought out convenience, lower cost and the ability to buy in bulk. In addition, lower-income consumers are forgoing premium goods and stock up on discounted foods instead.

Another way discount retailers win over shoppers is by offering store brands, aka private labels, which help keep cost down. German retailer Lidl found a way to also satisfy consumer demand for healthful, fresh foods, organic produce and all-natural products; its private-label items are free from MSG, trans fat and synthetic colors, and it includes a variety of organic and gluten-free options, such as produce, meat, dairy and packaged goods.

How Supermarkets are Competing

In an attempt to attract new customers, retain existing customers and foster loyalty, many supermarket chains offer discounts and promotions, such as coupons and weekly sales. Some also offer on-site amenities, such as cash machines, movie rentals and coffee shops. However, these tactics may ultimately cause profits to idle or fall.

Generic or off-brand products that were once seen as subpar by some now present an opportunity for retailers to provide value and quality at a lower cost. In 2016, the retailers Costco, Kroger and Trader Joe’s were among the top five vendors of private-label food and beverages in the United States. Customers view these “store brands” as valuable and trusted alternatives to more expensive national brands.

Another attempt to compete is through mergers and acquisitions. Top retail operators buy smaller competitors or merge with larger supermarket chains, which allows the companies to maintain profitability while lowering per-unit costs. On June 16, 2017, Amazon made headlines around the world for its $13.7 billion purchase of Whole Foods Market, an acquisition that caused other grocery chains’ stocks to plunge as much as 17 percent that day.

In the increasingly cutthroat grocery industry, some retailers have saved money and cut costs by keeping employee wages low through salary freezing. Other vendors have implemented self-checkout aisles to reduce their number of employees altogether.

The Future Landscape of Grocery Shopping

Discount retail locations may be smaller than traditional grocery stores, with fewer aisles and a more minimal design, but their competitive edge and consumer appeal are undeniable. Mainstream supermarkets may need to close stores, restructure, cut costs and reallocate dollars to remain viable.

In addition, the world continues to shift to a more technological society, with robust e-commerce and digital grocery stores like AmazonFresh. Online grocery sales are estimated to reach $100 billion by 2025, so innovation is necessary. Supermarkets may introduce mobile apps and advanced point of sale systems, such as self-checkout kiosks, to replace workers and cut wage costs.

Despite the fact that only 40 percent of households shopped at deep-discount retailers in 2016, which is much lower than supermarkets and mass merchandisers, the amount of trips to these retailers rose by 2.8 percent. This indicates there are significant opportunities for discount retailing to continue growing in years to come.

The post Growth of Discount Grocers appeared first on HealthStylz.

Then, TV personality Elisabeth Hasselbeck published The G-free Diet (Center Street 2011), President Bill Clinton promoted his post-heart-surgery gluten-free diet on “The Ellen DeGeneres Show,” Paleo and Wheat Belly (Rodale Books 2014) hit the scene, and a billion-dollar industry was born.

At the time, the scientific community accepted celiac disease as the only adverse reaction to gluten — despite that individuals who tested negative for the autoimmune disease were reporting celiac-like symptoms (“foggy mind,” depression, ADHD-like behavior, abdominal pain, bloating, diarrhea, constipation, headaches, bone or joint pain and chronic fatigue). Eventually new research suggested a spectrum of non-celiac gluten-related disorders that improve when gluten is removed from the diet — now known as non-celiac gluten sensitivity or non-celiac wheat sensitivity.

Today, adults in the U.S. are increasingly self-reporting food allergies without a diagnosis from a doctor. Consumers around the globe are experimenting with elimination diets as a means to identify causal association with symptoms ranging from gut distress to joint pain, lethargy or depression.

Most health practitioners, and registered dietitian nutritionists in particular, do not advocate unnecessary restrictive dieting. Nonetheless, many consumers are finding relief through elimination diets — and the scientific community isn’t sure why.

Confusion over what causes certain responses to foods is a culmination of heated debate among medical researchers, vague terminology with conflicting definitions, gaps in research and, arguably, the inherent discomfort of “the unknown.”

Let’s Start with the Known

A food allergy exists when exposure to a specific food results in an adverse response in the immune system. Because a one-time reaction is not definitive, a criterion for a food allergy is that the immune response be reproducible.

Symptoms range from mild itching and hives to severe anaphylaxis, which can cause difficulty breathing, dizziness, loss of consciousness or death.

Most food allergies are IgEmediated, meaning the immune system identifies an allergen as an “invader” and overreacts by producing antibodies called immunoglobulin E. However, some food allergies — such as eosinophilic GI disease and protein-induced enterocolitis — are not IgE-mediated.

A food intolerance refers to malabsorption in the digestive tract and does not involve the immune system. The inability to break down certain foods may be the result of enzyme deficiencies or reactions to naturally occurring chemicals in foods. Unlike food allergies (in which even a microscopic morsel of an allergen can cause an adverse reaction), food intolerances are dose dependent: the more one eats of the offensive food, the worse the symptoms — usually along the lines of nausea, stomach pains, vomiting and diarrhea.

Here is Where it Gets Tricky

There also appear to be adverse food reactions that do not fit current diagnostic criteria for food allergies or food intolerances. Some practitioners refer to these as food sensitivities; however, food sensitivity has no universally accepted definition — and to compound confusion, the term has different meanings, depending on who you ask.

For example, the American Academy of Allergy, Asthma and Immunology uses “food sensitivity” interchangeably with intolerance. According to the Guidelines for the Diagnosis and Management of Food Allergy in the United States, the term “food hypersensitivity” often is used to describe food allergies, while other groups use “food sensitivity” as an umbrella term that includes both allergies and intolerances. And a 2012 study in the Canadian Medical Association Journal defines “food sensitivity” as “a nonspecific term that can include any symptom perceived to be related to food and thus may be subject to a wide range of usage and interpretation.”

These mysterious non-allergic adverse food reactions have many practitioners perplexed.

For example, take sulfite sensitivity, which is more common in people with asthma, especially those taking steroid medications. Reported symptoms include respiratory reactions and asthma, hypotension, GI reactions, dizziness and hives. Currently there are no validated lab tests to diagnose a sulfite sensitivity and the mechanism is yet to be determined. Medical history, symptom diaries and controlled exposure to test for reactions (known as an oral challenge) are used to make the diagnosis.

Other reports of triggers for adverse food reactions run the gamut, including various fruits and vegetables, grains, protein foods and dairy. Often these cases have already gone through allergy testing, excluded GI health conditions and exhausted diagnostic processes by physicians, including general practitioners, endocrinologists, gastroenterologists and allergists.

Debra Indorato, RDN, LDN, CLT, a nutrition and food management consultant in Tampa, Fla., has specialized in food allergies for nearly 30 years. It was early in her career when some of her referrals experienced persistent symptoms, even after testing negative for food allergies, and she began researching food sensitivities and immunology. Her personal working definition for food sensitivity is “a nonallergic inflammatory reaction that can affect any area of the body.” But identifying such a broad, enigmatic occurrence of inconsistent, overlapping symptoms is a challenge.

Food allergy assessment tools — skin pricks or the double-blind, placebo-controlled food challenge — are not applicable for these cases since allergic reactions are immediate and often dramatic, while “food sensitivities” are delayed and hit-or-miss. Carbohydrate intolerances, such as lactose intolerance, can be diagnosed with a hydrogen breath test or fecal test, while blood tests, endoscopies or biopsies may be used to rule out other conditions.

In an attempt to identify specific foods to which individuals are sensitive, medical testing companies have developed various proprietary blood panels. Some measure antibodies in the blood, such as the “IgG test” (which, since IgG is a “memory antibody,” actually only confirms exposure to a food, not a reaction to it). Others are centered on studying white blood cells as an indication of an inflammatory response — including the Alcat test and the enzyme-linked immunosorbent assay, or ELISA.

Recently, the mediator release test, or MRT, has gained favor among some practitioners, including a segment of registered dietitian nutritionists who then implement the Lifestyle Eating and Performance, or LEAP, diet based on the assay results. The MRT measures levels of cytokines, histamine, leukotrienes, prostaglandins and other mediators released from white blood cells after exposure to 150 foods and food chemical profiles. MRT supporters cite evidence indicating correlations between the immune system mediators, ensuing inflammation and risk of chronic disease such as osteoporosis and cardiovascular disease, as well as other conditions including GERD and cognitive decline. But while there is plenty of anecdotal vouching for MRT’s effectiveness in identifying potential sensitivities, there are no peer-reviewed, published studies validating the test.

Laura Matarese, PhD, RDN, LDN, CNSC, professor at the Brody School of Medicine at East Carolina University and co-editor of The Health Professional’s Guide to Gastrointestinal Nutrition (Healthy Nutrition Academy 2013), says that in addition to the lack of research, there also is no consensus or endorsement of food sensitivity panels by any allergy or immunology organizations, noting that most insurance companies will not cover them.

Janice Vickerstaff Joneja, professor at the School of Family and Nutritional Sciences at the University of British Columbia and author of The Health Professional’s Guide to Food Allergies and Intolerances (Healthy Nutrition Academy 2014), also is an MRT skeptic. However, she says the elimination and challenge components of LEAP therapy are useful.

Los Angeles-based consultant Christine Bou Sleiman, MS, RDN, CLT, has been a certified LEAP therapist since 2016 and experienced significant improvements in her own digestive health and inflammatory skin disorder since following the immune-calm LEAP protocol. “The MRT gives us a starting point, rather than taking a stab in the dark,” she says, “especially when many of these referrals are already on some form of elimination diet.” Bou Sleiman adds that she sees profound symptom relief in her clients and often helps increase the variety of foods in their diets.

Still, Emily Fonnesbeck, RD, CD, CLT, says that practitioners need to understand clients’ underlying issues, such as disordered eating, that may be exacerbated by an elimination diet. Before she suggests food sensitivity testing, Fonnesbeck works with new clients to identify potential causes of the symptoms and address primary issues, such as the stress caused by not being able to pinpoint why they don’t feel well.

“Even for clients who feel better on the elimination diet, it is difficult to know exactly why they are seeing benefits,” Fonnesbeck says. After all, the virtue of being more mindful about eating may in itself help ease physical symptoms.

A study in the journal Social Science and Medicine explored the perspectives of British general practitioners when confronted with patients who believe they are experiencing adverse reactions to certain foods. Although working with the patients’ beliefs was seen as important to preserving the doctor-patient relationship, skepticism among the physicians was strong.

However, it was “tempered by an element of self-awareness and an awareness of the limitation of modern medicine,” wrote the authors. “With the transitional nature and constant evolution of medical knowledge, several of the participants entertained the idea that this condition might be recognized and understood in the future.”

The post The Controversial Conundrum of Food Sensitivities appeared first on HealthStylz.