Cut Down on Your Fruit and Vegetables
What sounds like a nutritional heresy may be the best thing you can do if you have digestion issues
Sometimes I tell a client that they should remove much of the fruit and vegetable content from their diet. Plus all those beans, lentils, nuts and seeds they are convinced are the path to health and longevity. From their expression it is immediately clear that they are in a mild state of confusion and wondering what sort of nutritionist I am. I go on to explain my rationale, and they leave reassured.
About a week or so later, they get in touch to let me know just how much better they feel.For most people, plant foods can provide nutrients, fibre, and variety. I too like to garnish the main event on my plate with a little colour and interest. However, for others, specifically those with chronic gut issues, plant foods provide pain, bloating, discomfort and rather more gas than would be considered acceptable.
Below are four occasions when plant foods might be best avoided.
1. You’ve got an irritable bowel
This common condition affects up to 15% of people in the US, mainly women. Here in the UK, with our similar diets and similar lifestyles, that figure is more or less the same.
Irritable bowel syndrome is a non-specific term. It means you’ve had all the usual tests, and passed with flying colours: you don’t have coeliac disease, cancer, Crohn’s, or any other inflammatory bowel disorder. But you still have symptoms, so you are labelled with IBS and continue on your way, without a medical resolution.
It is at this juncture that you start wondering if your diet has anything to do with your symptoms. Welcome to my world.
There’s a cause for every symptom, and for many people, that cause is an inability to digest certain carbohydrates, collectively known as FODMAPs. FODMAP stands for “fermentable oligosaccharides, disaccharides, monosaccharides and polyols”. Avoiding these carbohydrates can bring the much-needed relief you crave.
Some people are unable to digest these carbohydrates, which are left in the gut for bacteria to feast on. And what an almighty feast it is, and you are the host. Pain and inflammation are the consequences.
There are rather a lot of these FODMAP foods, as you can see from the list below (which is not exhaustive, but covers the most common ones). But before you take fright, and abandon all hope now, be aware that in all likelihood, only some of them will be problematic for you. Your task is to identify those culprits, something you can only do through a process of elimination, trial and error.
You could go cold turkey and eliminate the whole lot for a couple of weeks and then reintroduce them one at a time, one day at a time, all the while keeping a food and symptom diary. Alternatively, if that sounds like an insurmountable challenge, you could just eliminate one group at a time.
Note that you do not have to eliminate all fruits and vegetables: there are plenty of options on the low FODMAP list.
2. You’ve got SIBO
It’s not just IBS sufferers who can benefit from a low FODMAP diet. So too can people with SIBO (small intestinal bacteria overgrowth).
What is SIBO? In a nutshell: bacteria that should be residents of the colon have turned around and marched back up the gut and established colonies in the small intestine, where they don’t belong. They like it there because they love nothing more than fermentable carbohydrates.
These colonies create a range of symptoms in the upper gastrointestinal area that include burping, pain, and bloating. There may also be constipation or diarrhea. See:
3. You’ve got a leaky gut
Some plant foods contain substances that are so damaging to the gut that they cause or aggravate intestinal permeability, or leaky gut.
Leaky gut means that the lining of the small intestine, the epithelium, has been compromised and has become porous. The epithelium has two main functions: to allow the passage of digested nutrients and fluids to cross into the blood, and to stop unwanted intruders from doing the same. It’s an important barrier between your insides and the outside world. Once in the blood, undesirable elements — toxins, undigested food particles — have access to all areas.
One substance that contributes significant damage and aggravation to the epithelium is lectin.
Lectins are found in all plant foods, especially beans (and especially soya beans), lentils, cereal grains (wheat, rye, barley, oats, corn), nuts (especially peanuts, which are legumes), seeds and potatoes. The deadly nightshade family are another source: potatoes, peppers, tomatoes and aubergines. Cereal grains and legumes are probably the most problematic. Lectins are there for a reason: they deter animals from eating the plant and they protect against insect attack. Most are resistant to heat and digestive enzymes, surviving intact as they pass through the body. Unfortunately for us, they can also bind to the digestive tract and interfere with the digestion and absorption of nutrients. They can cause diarrhoea, vomiting, digestive pain and bloating, and disrupt the healthy gut microbiome.
Leaky gut means that the lining of the small intestine, the epithelium, has been compromised and has become porous. The epithelium has two main functions: to allow the passage of digested nutrients and fluids to cross into the blood, and to stop unwanted intruders from doing the same. It’s an important barrier between your insides and the outside world. Once in the blood, undesirable elements — toxins, undigested food particles — have access to all areas.One substance that contributes significant damage and aggravation to the epithelium is lectin
Lectins are found in all plant foods, especially beans (and especially soya beans), lentils, cereal grains (wheat, rye, barley, oats, corn), nuts (especially peanuts, which are legumes), seeds and potatoes. The deadly nightshade family are another source: potatoes, peppers, tomatoes and aubergines. Cereal grains and legumes are probably the most problematic. Lectins are there for a reason: they deter animals from eating the plant and they protect against insect attack. Most are resistant to heat and digestive enzymes, surviving intact as they pass through the body. Unfortunately for us, they can also bind to the digestive tract and interfere with the digestion and absorption of nutrients. They can cause diarrhoea, vomiting, digestive pain and bloating, and disrupt the healthy gut microbiome.
Lectins are the reason why legumes, most notably red kidney beans, are highly toxic if they are not soaked and cooked well, processes that disable the lectins.
As well as damaging the gut lining, leading to intestinal permeability and nutrient deficiency, lectins can also provoke allergic responses, and intolerances.
4. You’ve got a problem with oxalates
You may think of leafy green vegetables as inviolable components of a healthy diet, but they can cause nothing but trouble for some people.
That’s because some — but by no means all — leafy greens are especially high in plant chemicals called oxalates. Like lectins, these are anti-nutrients, because they can bind to minerals in the gut, especially calcium, and inhibit their absorption.
On the plus side, boiling vegetables well is a great way to reduce the oxalate content.
In some cases, the issue goes beyond poor absorption of minerals. Oxalates are associated with the development of kidney stones and for that reason, people prone to this condition are often advised to avoid a diet high in oxalates. Oxalates bind to calcium in the kidneys creating calcium oxalate stones, the most common type.
The body also produces oxalates naturally as a waste product and people with low levels of a gut bacteria called Oxalobacter formignes, which breaks down oxalate and prevents it from binding to minerals, are the ones most likely to experience negative effects, including stones.
But so too are those with digestive disorders. Interestingly, you are more likely to get kidney stones if you already have inflammatory bowel disease.
Are you still throwing mountains of leftover fruits, vegetables and other plant foods into your smoothie-maker, and downing the whole lot in the belief that the more the merrier? If you have digestive problems, you may wish to rethink your strategy and be more selective about which foods you include.
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