5 No-Fear Food to Eat When IBS Is Taking Over Your Life

From 5 No-Fear Food to Eat When IBS Is Taking Over Your Life

If you’re part of the one in five Americans with irritable bowel syndrome (yes, it’s that common), you’re all too familiar with the fear that can creep up before sitting down to a meal. Every food is a possible grenade that could explode in your stomach. (It’s a gross metaphor, but it’s unfortunately a pretty apt one.)

“First, it’s important to get rid of that fear of eating, because anxiety affects the gut. You have to be able to relax,” says Dr. Vincent Pedre, MD, the author of Happy Gut. The second piece of advice he gives his patients with IBS is to weed out the foods that are the most problematic: gluten, dairy, soy, corn, and legumes. And oh yeah, you’ll want to limit your sugar intake, too.

“It’s best to take the load off your gut completely, and then re-introduce each of these foods slowly, one at a time,” Dr. Pedre says. “That way, you’ll have a blank slate and stronger gut, which can help you really determine what your problem foods are.”

“First, it’s important to get rid of that fear of eating, because anxiety affects the gut. You have to be able to relax.”

While the rewards will likely pay off, avoiding all those possible triggers isn’t easy. It’s totally normal to wonder, Sheesh, what can I eat?

Fortunately, Dr. Pedre flagged some foods that are not only still on the table, but actually help ease IBS symptoms. And his knowledge comes firsthand: After suffering from IBS for years, he found a way to heal himself with food. Ditto for Jeff Burgee, the founder of IBS Formula. “I spent years visiting the best doctors in the country and tried everything,” Burgee says. “When none of them could help me, I started experimenting with different ingredients on my own.”

Curious about what you have in your fridge that can help with IBS? Keep reading.

Fermented foods

This one shouldn’t come as a total shocker—you probably already know fermented foods are packed with probiotics, which are crazy-good for your gut. “One of probiotics’ most important functions is their ability to outnumber and antagonize unwelcome pathogens in the GI tract,” says Dr. Pedre. In other words, they boost more of the good bacteria while fighting off the bad kind, helping bring your gut back to balance. (And FYI, our expert prefers fermented foods over the probiotic fave kombucha. “It can have too much sugar, which feeds yeast in the gut—not good,” he explains.)

There is one time, however, when Dr. Pedre warns against filling up on fermented foods: If you have SIBO, an overgrowth of bad bacteria in the small intestine. “Then, it can actually be uncomfortable for people to eat them,” he says. 

Almond milk

Dairy is not kind to people with IBS, but that doesn’t mean a life without smoothies, lattes, and ice cream. Almond milk is Dr. Pedre’s go-to milk replacement because it’s widely available, affordable, and easy on the gut—but other nut milks are also kind to your body. Just make sure to reach for the unsweetened kind to avoid extra sugar, which could feed the aforementioned pesky yeast-overgrowth problem.

Bone broth

According to Dr. Pedre, there are a couple reasons why bone broth is a great food for people with IBS: One, it’s already in liquid form, so your stomach doesn’t have to go through all the work of breaking it down. Two, it’s an excellent source of collagen. It turns out, collagen can smooth your gut lining from the inside out the same way it does wrinkles in your skin. (Dr. Pedre adds a half-cup of lemon or apple cider vinegar to his recipe to up the gut-healing properties even more.)

Acai

When Burgee, the IBS Formula founder, heard about a scientific study linking the buzzy superfood acai berries to IBS treatments, he decided to give it a shot. “I started taking it and didn’t have any IBS symptoms for a week, which was amazing for me,” he says. It was the first ingredient he experimented with to have a lasting result—years later, it’s still working for him. “They are super high in antioxidants, which have been found to really help with IBS,” he says. 

Aloe vera

Aloe vera is known to (ahem) help move things along, which is great news if constipation is your biggest IBS symptom. But while some studies have found the ingredient helps if you’re backed up but not if you have diarrhea, Burgee believes it works for (some) people on both sides of the IBS spectrum. “It’s almost entirely water and soluble fiber,” he says. (Insider IBS tip: soluble fiber helps bulk up stool.)

Dr. Pedre’s advice for testing anything new you’re nervous to try is to start small. “It’s like going to the pool. You don’t have to just dive in—you can dip your toe in first.” If you try a shot of aloe vera and don’t experience any gassiness or bloating, next time you can try a bit more and see how you feel.

Treating IBS is tricky business: There’s no one-size-fits-all rule when it comes to gut health. But if you give your stomach a rest by weeding out any problem foods while filling up on the five items on this list, you just might be able to spend less break time in the bathroom.

HIV/AIDS and Aging Awareness Day - Learn more about HIV/AIDS

“HIV/AIDS and Aging Awareness Day is September 18th. Read this to learn more about HIV/AIDS.”

— Dr. Dale

From What Are HIV and AIDS?

About HIV & AIDS

HIV is a virus spread through certain body fluids that attacks the body’s immune system, specifically the CD4 cells, often called T cells. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease. These special cells help the immune system fight off infections. Untreated, HIV reduces the number of CD4 cells (T cells) in the body. This damage to the immune system makes it harder and harder for the body to fight off infections and some other diseases. Opportunistic infections or cancers take advantage of a very weak immune system and signal that the person has AIDS. Learn more about the stages of HIV and how to know whether you’re infected.

What Is HIV?

HIV stands for human immunodeficiency virus. It is the virus that can lead to acquired immunodeficiency syndrome, or AIDS, if not treated. Unlike some other viruses, the human body can’t get rid of HIV completely, even with treatment. So once you get HIV, you have it for life.

HIV attacks the body’s immune system, specifically the CD4 cells (T cells), which help the immune system fight off infections. Untreated, HIV reduces the number of CD4 cells (T cells) in the body, making the person more likely to get other infections or infection-related cancers. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease. These opportunistic infections or cancers take advantage of a very weak immune system and signal that the person has AIDS, the last stage of HIV infection.

No effective cure currently exists, but with proper medical care, HIV can be controlled. The medicine used to treat HIV is called antiretroviral therapy or ART. If taken the right way, every day, this medicine can dramatically prolong the lives of many people infected with HIV, keep them healthy, and greatly lower their chance of infecting others. Before the introduction of ART in the mid-1990s, people with HIV could progress to AIDS in just a few years. Today, someone diagnosed with HIV and treated before the disease is far advanced can live nearly as long as someone who does not have HIV.

What Is AIDS?

AIDS is the most severe phase of HIV infection. People with AIDS have such badly damaged immune systems that they get an increasing number of severe illnesses, called opportunistic infections.

What Are the Stages of HIV Infection?

Without treatment, HIV advances in stages, overwhelming your immune system and getting worse over time. The three stages of HIV infection are: (1) acute HIV infection, (2) clinical latency, and (3) AIDS (acquired immunodeficiency syndrome).

However, there’s good news: by using HIV medicines (called antiretroviral therapy or ART) consistently, you can prevent HIV from progressing to AIDS. ART helps control the virus so that you can live a longer, healthier life and greatly reduces the risk of transmitting HIV to others.

These are the three stages of HIV infection:

Acute HIV Infection Stage

Within 2 to 4 weeks after infection, many, but not all, people develop flu-like symptoms, often described as “the worst flu ever.” Symptoms can include fever, swollen glands, sore throat, rash, muscle and joint aches and pains, and headache. This is called “acute retroviral syndrome” (ARS) or “primary HIV infection,” and it’s the body’s natural response to the HIV infection. People who think that they may have been infected recently and are in the acute stage of HIV infection should seek medical care right away. Starting treatment at this stage can have significant benefits to your health.

During this early period of infection, large amounts of virus are being produced in your body. The virus uses CD4 cells to replicate and destroys them in the process. Because of this, your CD4 cells can fall rapidly. Eventually your immune response will begin to bring the level of virus in your body back down to a level called a viral set point, which is a relatively stable level of virus in your body. At this point, your CD4 count begins to increase, but it may not return to pre-infection levels. It may be particularly beneficial to your health to begin ART during this stage.

During the acute HIV infection stage, you are at very high risk of transmitting HIV to your sexual or needle-sharing partners because the levels of HIV in your blood stream are extremely high. For this reason, it is very important to take steps to reduce your risk of transmission.

Clinical Latency Stage

After the acute stage of HIV infection, the disease moves into a stage called the “clinical latency” stage. “Latency” means a period where a virus is living or developing in a person without producing symptoms. During the clinical latency stage, people who are infected with HIV experience no symptoms, or only mild ones. (This stage is sometimes called “asymptomatic HIV infection” or “chronic HIV infection.”)

During the clinical latency stage, the HIV virus continues to reproduce at very low levels, even if it cannot be detected with standard laboratory tests. If you take ART, you may live with clinical latency for decades and never progress to AIDS because treatment helps keep the virus in check. (Read more about HIV treatment.)

People in this symptom-free stage are still able to transmit HIV to others, The risk of transmission is greatly reduced by HIV transmission. In studies looking at the effects of HIV treatment on transmission, no new HIV infections have been linked to someone with very low or undetectable (suppressed) viral load.

For people who are not on ART, the clinical latency stage lasts an average of 10 years, but some people may progress through this stage faster. As the disease progressions, eventually your viral load will begin to rise and your CD4 count will begin to decline. As this happens, you may begin to have constitutional symptoms of HIV as the virus levels increase in your body before you develop AIDS.

AIDS

This is the stage of HIV infection that occurs when your immune system is badly damaged and you become vulnerable to opportunistic infections. When the number of your CD4 cells falls below 200 cells per cubic millimeter of blood (200 cells/mm3), you are considered to have progressed to AIDS. (In someone with a healthy immune system, CD4 counts are between 500 and 1,600 cells/mm3.) You are also considered to have progressed to AIDS if you develop one or more opportunistic illnesses, regardless of your CD4 count.

Without treatment, people who progress to AIDS typically survive about 3 years. Once you have a dangerous opportunistic illness, life-expectancy without treatment falls to about 1 year. ART can be helpful for people who have AIDS when diagnosed and can be lifesaving. Treatment is likely to benefit people with HIV no matter when it is started, but people who start ART soon after they get HIV experience more benefits from treatment than do people who start treatment after they have developed AIDS.

In the United States, most people with HIV do not develop AIDS because effective ART stops disease progression. People with HIV who are diagnosed early can have a life span that is about the same as someone like them who does not HIV.

People living with HIV may progress through these stages at different rates, depending on a variety of factors, including their genetic makeup, how healthy they were before they were infected, how much virus they were exposed to and its genetic characteristics, how soon after infection they are diagnosed and linked to care and treatment, whether they see their healthcare provider regularly and take their HIV medications as directed, and different health-related choices they make, such as decisions to eat a healthful diet, exercise, and not smoke.

Is There a Cure for HIV?

No effective cure currently exists for HIV. But with proper medical care, HIV can be controlled. Treatment for HIV is called antiretroviral therapy or ART. If taken the right way, every day, ART can dramatically prolong the lives of many people infected with HIV, keep them healthy, and greatly lower their chance of infecting others. Before the introduction of ART in the mid-1990s, people with HIV could progress to AIDS (the last stage of HIV infection) in a few years. Today, someone diagnosed with HIV and treated before the disease is far advanced can live nearly as long as someone who does not have HIV.

Learn about how to protect yourself, and get information tailored to meet your needs from CDC’s HIV Risk Reduction Tool (BETA).

The Case for a Breakfast Feast

“A very informative read on why eating breakfast is so important.”

— Dr. Dale

From The Case for a Breakfast Feast

Many of us grab coffee and a quick bite in the morning and eat more as the day goes on, with a medium-size lunch and the largest meal of the day in the evening. But a growing body of research on weight and health suggests we may be doing it all backward.

A recent review of the dietary patterns of 50,000 adults who are Seventh Day Adventists over seven years provides the latest evidence suggesting that we should front-load our calories early in the day to jump-start our metabolisms and prevent obesity, starting with a robust breakfast and tapering off to a smaller lunch and light supper, or no supper at all.

More research is needed, but a series of experiments in animals and some small trials in humans have pointed in the same direction, suggesting that watching the clock, and not just the calories, may play a more important role in weight control than previously acknowledged.

And doctors’ groups are taking note. This year, the American Heart Association endorsed the principle that the timing of meals may help reduce risk factors for heart disease, like high blood pressure and high cholesterol. The group issued a scientific statement emphasizing that skipping breakfast — which 20 to 30 percent of American adults do regularly — is linked to a higher risk of obesity and impaired glucose metabolism or diabetes, even though there is no proof of a causal relationship. The heart association’s statement also noted that occasional fasting is associated with weight loss, at least in the short term.

“I always tell people not to eat close to bedtime, and to try to eat earlier in the day,” said Marie-Pierre St-Onge, an associate professor of nutritional medicine at Columbia University’s College of Physicians and Surgeons, who led the work group that issued the statement.

Perhaps not surprisingly, the latest study found that those who supplemented three meals a day with snacks tended to gain weight over time, while those who ate only one or two meals a day tended to lose weight, even compared with those who just ate three meals a day.

But the researchers also found that those who ate their largest meal early in the day were more likely to have a lower body mass index than those who ate a large lunch or dinner. Breakfast eaters tended to keep their weight down generally, compared with breakfast skippers. The lowest B.M.I.s were recorded in the fraction of people — about 8 percent of the total sample — who finished lunch by early afternoon and did not eat again until the next morning, fasting for 18 to 19 hours.

The conclusions were limited, since the study was observational and involved members of a religious group who are unusually healthy, do not smoke, tend to abstain from alcohol and eat less meat than the general population (half in the study were vegetarian). But the results suggested that rethinking when and how much we eat, and including an extended fast, may have benefits.

Fasting signals to the body to start burning stores of fat for fuel, the researchers said. “It seems our bodies are built to feast and fast,” said Dr. Hana Kahleova, one of the authors of the study, which was done by researchers at Loma Linda University School of Public Health in California and published in The Journal of Nutrition in July. “It needs some regular cycling between having food intake and fasting. This seems to be hard-wired.”

Having the largest meal in the morning appears to have advantages for weight control compared with having a large meal in the evening, she said, since the digestive process and the action of insulin, the pancreatic hormone that the body uses to process the sugars in carbohydrates and store glucose, appear to be at their peak performance early in the day. As a result, “our body can use the nutrients as a source of energy the easiest,” Dr. Kahleova said.

A person eating the identical meal at different times of day might deposit more fat after an evening meal than a morning meal, she said.

That’s because insulin action is more efficient in the morning, experts say. “If you give a healthy individual a big bolus of glucose in the morning, the blood glucose might stay high one or two hours before coming back to normal,” said Dr. Satchidananda Panda, a professor at the Salk Institute for Biological Studies in San Diego. “You take that same normal healthy individual and give them the same bolus of glucose late at night, and now the pancreas is sleeping — literally — and cannot produce enough insulin, and blood glucose will stay high up to three hours.” Doctors once called this “evening diabetes,” he said.

But many people snack all day long, Dr. Panda said. He asked volunteers to use a smartphone app to photograph everything they drank and ate throughout the day and found that even generally healthy people ate and snacked over a period of about 15 hours a day, stopping for an extended amount of time only when they were in bed.

In earlier experiments in mice, Dr. Panda and his colleagues found that when the animals were given unlimited access to a high-fat diet — “the equivalent of humans eating only ice cream, cheese and nachos” — they became obese in nine or 10 weeks, and developed insulin resistance or diabetes and high cholesterol a few weeks later. But when the mice had access to the high-fat diet for only eight hours a day, they did not become obese or diabetic, even though they consumed the same amount of calories as the animals who ate round the clock.

Dr. Daniela Jakubowicz, an Israeli researcher at the Wolfson Medical Center in Tel Aviv, has tested these principles in small clinical trials. For one study, she recruited dozens of obese and overweight women with metabolic problems and put them all on identical 1,400-calorie-a-day diets. The researchers told half the women to consume 700 calories at breakfast, 500 calories at lunch and 200 calories at supper, and instructed the other group to reverse the order. Regardless of when it was eaten, the large meal included foods like tuna, whole wheat bread, a tomato and mozzarella salad, skim milk and a small amount of chocolate.

Women in both groups lost weight after 12 weeks, but those who ate the large meal in the morning lost two and a half times as much as those eating the large dinner. The large-breakfast group also lost more body fat — especially belly fat — and saw more improvement in metabolic factors like fasting glucose levels.

“We observed that the time of the meal is more important than what you eat and how much you eat — it’s more important than anything else in regulating metabolism,” Dr. Jakubowicz said, attributing that to the body’s biological clocks.

Artificial lighting, changing eating patterns, shift work and other variables of modern life can disrupt our internal system of biological clocks, so they are often out of sync, said Courtney M. Peterson, an assistant professor in the department of nutrition sciences at the University of Alabama at Birmingham. While bright light is the dominant timing cue for the body’s master clock in the brain, the peripheral cells and tissues in the body also have biological clocks, and food intake is an important factor for setting their time zones, she said. Ideally, all of the clocks should be in sync and in the same time zone.

“If your timing to light exposure is out of sync with the timing of meals, it’s like your clocks are at different time zones and don’t know how to communicate with each other,” Dr. Peterson said. “It’s like an orchestra whose musicians are playing out of time with each other,” and the result is “cacophony, not music.”

Intermittent fasting may have other advantages as well.

“Twenty years of work on animals shows that compared to those that have constant access to food, those on intermittent fasting diets live longer, their brains function better as they get older and the nerve cells respond to the period of going without food by increasing their ability to cope with stress,” said Mark P. Mattson, chief of the National Institute on Aging’s laboratory of neurosciences. “From an evolutionary perspective, it makes sense that animals in the wild — especially predators — would have to function optimally in a fasted state when they haven’t been able to obtain food.”

Dr. Kahleova says the take-home message is like the old proverb, to eat “breakfast like a king, lunch like a prince and dinner like a pauper.”

That may be a difficult prescription to follow, since family life and social get-togethers so often revolve around sitting down to an expansive meal at the end of the day. Dr. Kahleova suggested making the evening meal smaller as often as possible.

“The message is very straightforward: Make breakfast your largest meal of the day, and eat dinner as your lightest meal of the day,” she said.