Archive for June, 2015

Cheesy Spaghetti Squash Casserole (Gluten-Free)

Thursday, June 25th, 2015

Our Cheesy Spaghetti Squash Casserole is classic comfort food without making you feeling uncomfortable later. Spaghetti squash has a surprisingly similar texture to hash browns but with much more to offer nutritionally. Combined with sautéed onions, creamy yogurt, and raw goat cheddar, this satisfying dish will be a welcome addition to your family dinner. Adapted from Detoxinista. Serves 4-6.

IMG_0696

Ingredients

1 medium spaghetti squash

1-2 tablespoons MELT® Organic

½ large or 1 small yellow onion, chopped

1-2 cloves garlic, pressed

1 cup plain goat milk yogurt

3 oz raw goat cheddar, shredded and divided into 3 equal piles

1 teaspoon sea salt or to taste

Black pepper, to taste

Directions

  • Preheat the oven to 375 degrees.
  • Cut the spaghetti in half, lengthwise, and scoop out the seeds. Place the spaghetti halves face down on a baking sheet and cook for 60 minutes, or until a fork can easily pierce the outer shell.
  • Remove the squash from the oven and turn the halves face up so they can cool.
  • Lightly sauté the onion in MELT over low-medium heat until it is tender. Add the pressed garlic and stir so it loses its raw smell, but does not burn.
  • Transfer the onion and garlic to a large sized mixing bowl and combine with the yogurt, 2 oz of the cheddar, salt and pepper.
  • When the spaghetti squash is cool, use a fork across the width of the squash to scrape out the “noodles” and add to the mixture. Mix well.
  • Transfer the mixture to a 2.5 quart casserole dish and smooth the top with a spatula. Sprinkle the remaining cheddar cheese over the top and return to the oven to bake for 30 to 35 minutes at 400 degrees, or until a light golden brown crust has formed on the top. Serve immediately.

 

Glazed Double Chocolate Donuts (Gluten-Free)

Wednesday, June 17th, 2015

These Glazed Double Chocolate Donuts are a delightful, rich treat and a welcome change from highly processed donuts made from HFCS, refined wheat, and rancid oils, especially if you are like me and can’t remember the last time you ate a donut. Best of all, these grain- and gluten-free donuts are made with coconut flour, and are baked instead of deep fried. This recipe is adapted from the Detoxinista and makes 6 standard donuts.

Healthy Donut

Ingredients:

For the Chocolate Donuts:

¼ cup coconut flour
¼ cup cocoa powder
1/8 teaspoon sea salt
½ teaspoon baking soda
3 eggs
¼ cup Chocolate MELT®, softened
1/3 cup pure maple syrup
1 tablespoon vanilla extract

For the Chocolate Glaze:

½ cup dark chocolate chips
1 tablespoon Chocolate MELT

Directions:

  • Preheat the oven to 350F and grease a standard donut pan generously with coconut oil.
  • In a medium bowl, sift together the coconut flour, cocoa powder, sea salt and baking soda and whisk so the dry ingredients are well mixed.
  • Add in the eggs, Chocolate MELT, maple syrup, and vanilla and whisk again until a uniform batter is created.
  • Transfer the batter to a plastic storage bag, and snip off one corner of the bag with scissors, to create a “piping bag.” Pipe the batter evenly into the six donut wells.
  • Bake the donuts at 350F for 18-20 minutes, until the dough has risen and is firm to the touch.
  • Allow the donuts to cool for 15 minutes, then gently remove from the pan to cool completely on a wire rack. (If you grease the pan well enough, they should slide right out.)
  • To glaze the donuts, prepare the chocolate glaze by melting together the Chocolate MELT and dark chocolate chips. The mixture will be in liquid-form when warm, but will solidify as it cools. It is easiest to glaze the donuts by dunking them into the melted chocolate mixture while it’s still warm.
  • To quicken the hardening of the glaze, place the glazed donuts in the fridge for 15-20 minutes. Feel free to give the donuts a second glazing, if desired.

Gluten-Free? Or Low-FODMAP diet?

Thursday, June 11th, 2015

Have you heard about the low-FODMAP diet, but have no idea what it is? This week’s blog attempts to shed some light on clarifying what FODMAPs are and why they are important for anyone with a history of digestive disorders (referred herein as IBS).

Reducing or eliminating food intolerances for managing IBS symptoms has been gaining momentum in health-conscious circles for decades. While dietary modifications are not a cure for IBS, they can improve symptoms and quality of life. In particular, the low-FODMAP diet has been shown to improve symptoms in at least 74% of patients with IBS. Non-celiac gluten intolerance has been reported (1), but further research is needed to identify the underlying mechanism. The relative ease of implementing the low-FODMAP diet combined with considerable evidence supporting its effectiveness suggests the low-FODMAP diet should be the first dietary approach in people diagnosed with IBS.

What are FODMAPs?

FODMAPs are short-chain carbohydrates and related alcohols that are poorly absorbed in the small intestine. The term FODMAP is an acronym, derived from “Fermentable Oligo-, Di-, Mono-saccharides And Polyols” (2). The low FODMAP diet was developed at Monash University in Melbourne by Peter Gibson and Susan Shepherd (3,4).

How was the low-FODMAP diet discovered?

Throughout the 1980s and 1990s, evidence was building for the role of poorly absorbed, short-chain carbohydrates (lactose and fructose) in inducing IBS symptoms, with dietary restriction providing symptomatic relief (5-8). It was clear, however, that these sugars were not the only culprits. Other short-chain carbohydrates were identified as poorly absorbed in the human GI tract, such as fructo-oligosaccharides (fructans), galacto-oligosaccharides (GOS), and sugar polyols, sorbitol and mannitol (artificial sweeteners also found naturally in some foods).

Gibson and Shepherd were the first to publish a description of FODMAPs in 2005 (9) with the first published research trial in 2006 (10). A total of 74% of patients reported symptomatic improvement on the low-FODMAP dietary regimen. The efficacy of the low-FODMAP diet was confirmed and reconfirmed in subsequent trials and studies (11, 12).

Two additional trials (13, 14) identified the mechanisms that explained the gastrointestinal (GI) effects of FODMAPs: poor absorption in the small intestine, increased water content of the output (explaining why some experience diarrhea), and fermentation of the short-chain carbohydrates, which induced bloating, distension, abdominal pain and excessive flatulence. The low-FODMAP diet reduces fermentation and associated gas production, which is likely to reduce symptom severity of IBS patients.

Other potential factors include alterations in the gut microbiota number, composition, function and location. Some patients with IBS have small intestine bacterial overgrowth (SIBO) with fermentation of malabsorbed carbohydrates occurring in the narrow lumen of the small intestine, the location of which may be associated with abdominal pain and discomfort. With more predominant methane-producing bacteria, fermenting malabsorbed carbohydrates would produce methane gas, which is linked to delayed transit and constipation (15-17).

Since these initial studies, the FODMAP approach has been fine-tuned to include GOS, sorbitol and mannitol, in addition to fructose, lactose and fructans. These six carbohydrates make up the low-FODMAP diet as it is today, with published tables of food composition available on fruits and vegetables and breads and cereals (18-20). The table below summarizes the richest FODMAP food sources.

FODMAP foods table60

What does this mean for you?

Not all FODMAPs will trigger symptoms and will depend on whether they are malabsorbed by the individual. Importantly, fructans and GOS are always malabsorbed and fermented by intestinal microflora (21-23) as are the sugar polyols, sorbitol and mannitol (24-27). Other FODMAP carbohydrates will only induce symptoms in the proportion of patients with IBS that malabsorb them.

Breath testing is useful for clarifying which FODMAP foods to avoid on an individual basis by providing a reliable measure of test sugar absorption via measurement of breath hydrogen lev­els (28). A significant rise in breath hydrogen following ingestion of the test sugar (e.g. fructose) demon­strates poor absorption with fermen­tation by intestinal microflora. Negative breath tests demonstrate complete absorption of the sugar and suggest that the patient can consume this sugar without a negative impact on their symptoms.

Commonly offered breath tests for detecting FODMAP intolerances are typically for fructose, lactose and sorbitol (28). Regardless of breath test results, there are three other FODMAP carbohydrates that need to be considered as potential triggers. Fructans and GOS are not breath tested as they are always mal­absorbed. They are always fermented and should be considered as triggers in all IBS patients. Mannitol is rarely offered as a breath test because it is not found widely in the diet and can be inves­tigated as a trigger through simple dietary elimi­nation and rechallenge (28).

The results from breath tests can be used to implement a low-FOD­MAP diet without restricting sugars shown to be well absorbed. This individu­alizes the diet and avoids unnecessary restrictions as well as assisting with the long-term nutritional composition of the diet (28). In addition, FODMAPs have prebiotic effects due to the production of short-chain fatty acids after fermentation. Therefore, everyone is encouraged to try and reintroduce FODMAPs to a level that they can comfortably tolerate (28).

  1. Biesiekierski, J.R., Newnham, E.D., Irving, P.M., Barrett, J.S., Haines, M., Doecke, J.D. et al. (2010) Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial. AmJ Gastroenterol 106: 508–514; quiz 515.
  2. Shepherd, S. (2013) Low FODMAP Recipes. Melbourne, Australia: Penguin. ISBN 9780143567561.
  3. FODMAPS. King’s College, London. Diabetes & Nutritional Sciences. http://www.kcl.ac.uk/lsm/research/divisions/dns/projects/fodmaps/index.aspx
  4. Gibson, P.R., Gibson, P.R., Shepherd, S.J. (2010). Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach. Journal of Gastroenterology and Hepatology 25 (2): 252–258. doi:10.1111/j.1440-1746.2009.06149.x. PMID 20136989.
  5. Goldstein, R., Braverman, D. and Stankiewicz, H. (2000) Carbohydrate malabsorption and the effect of dietary restriction on symptoms of irritable bowel syndrome and functional bowel complaints. Isr Med Assoc J 2: 583–587.
  6. Nelis, G.F., Vermeeren, M.A. and Jansen, W. (1990) Role of fructose-sorbitol malabsorption in the irritable bowel syndrome. Gastroenterology 99: 1016–1020.
  7. Rumessen, J.J. and Gudmand-Hoyer, E. (1988) Functional bowel disease: malabsorption and abdominal distress after ingestion of fructose, sorbitol, and fructose-sorbitol mixtures. Gastroenterology 95: 694–700.
  8. Symons, P., Jones, M.P. and Kellow, J.E. (1992) Symptom provocation in irritable bowel syndrome. Effects of differing doses of fructose-sorbitol. Scand J Gastroenterol 27: 940–944.
  9. Gibson, P.R. and Shepherd, S.J. (2005) Personal view: food for thought – western lifestyle and susceptibility to Crohn’s disease. The FODMAP hypothesis. Aliment Pharmacol Ther 21: 1399–1409.
  10. Shepherd, S.J. and Gibson, P.R. (2006) Fructose malabsorption and symptoms of irritable bowel syndrome: guidelines for effective dietary management. J Am Diet Assoc 106: 1631–1639.
  11. Shepherd, S.J., Parker, S.C., Muir, J.G. and Gibson, P.R. (2008) Randomised, placebo-controlled evidence of dietary triggers for abdominal symptoms in patients with irritable bowel syndrome. Clin Gastroenterol Hepatol 6: 765–771.
  12. Staudacher, H.M., Whelan, K., Irving, P.M. and Lomer, M.C.E. (2011) Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome. J Hum Nutr Diet 24: 487–495.
  13. Barrett, J.S., Gearry, R.B., Muir, J.G., Irving, P.M., Rose, R., Rosella, O. et al. (2010) Dietary poorly absorbed, short-chain carbohydrates increase delivery of water and fermentable substrates to the proximal colon. Aliment Pharmacol Ther 31: 874–882.
  14. Ong, D.K., Mitchell, S.B., Barrett, J.S., Shepherd, S.J., Irving, P.M., Biesiekierski, J.R. et al. (2010) Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome. J Gastroenterol Hepatol 25: 1366–1373.
  15. Chatterjee, S., Park, S., Low, K., Kong, Y. and Pimentel, M. (2007) The degree of breath methane production in IBS correlates with the severity of constipation. Am J Gastroenterol 102: 837–841.
  16. Fiedorek, S.C., Pumphrey, C.L. and Casteel, H.B. (1990) Breath methane production in children with constipation and encopresis. J Pediatr Gastroenterol Nutr 10: 473–477.
  17. Pimentel, M., Lin, H.C., Enayati, P., van den Burg, B., Lee, H.R., Chen, J.H. et al. (2006) Methane, a gas produced by enteric bacteria, slows intestinal transit and augments small intestinal contractile activity. Am J Physiol Gastrointest Liver Physiol 290: G1089–G1095.
  18. Pimentel, M., Mayer, A.G., Park, S., Chow, E.J., Hasan, A. and Kong, Y. (2003) Methane production during lactulose breath test is associated with gastrointestinal disease presentation. Dig Dis Sci 48: 86–92.
  19. Biesiekierski, J.R., Rosella, O., Rose, R., Liels, K., Barrett, J.S., Shepherd, S.J. et al. (2011) Quantification of fructans, galacto-oligosacharides and other short-chain carbohydrates in processed grains and cereals. J Hum Nutr Diet 24: 154–176.
  20. Muir, J., Rose, R., Rosella, O., Liels, K., Barrett, J., Shepherd, S. et al. (2009) Measurement of short chain carbohydrates (FODMAPs) in common Australian vegetables and fruit by high performance liquid chromatography. J Agric Food Chem 57: 554–565.
  21. Muir, J.G., Shepherd, S.J., Rosella, O., Rose, R., Barrett, J.S. and Gibson, P.R. (2007) Fructan and free fructose content of common Australian vegetables and fruit. J Agric Food Chem 55: 6619–6627.
  22. Macfarlane, G., Steed, H. and Macfarlane, S. (2008) Bacterial metabolism and health-related effects of galacto-oligosaccharides and other prebiotics. J Appl Microbiol 104: 305–344.
  23. Rumessen, J.J. and Gudmand-Hoyer, E. (1998) Fructans of chicory: intestinal transport and fermentation of different chain lengths and relation to fructose and sorbitol malabsorption. Am J Clin Nutr 68: 357–364.
  24. Saunders, D.R. and Wiggins, H.S. (1981) Conservation of mannitol, lactulose, and raffinose by the human colon. Am J Physiol 241: G397–G402.
  25. Ong, D.K., Mitchell, S.B., Barrett, J.S., Shepherd, S.J., Irving, P.M., Biesiekierski, J.R. et al. (2010) Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome. J Gastroenterol Hepatol 25: 1366–1373.
  26. Evans, P.R., Piesse, C., Bak, Y.T. and Kellow, J.E. (1998) Fructose-sorbitol malabsorption and symptom provocation in irritable bowel syndrome: relationship to enteric hypersensitivity and dysmotility. Scand J Gastroenterol 33: 1158–1163.
  27. Fernandez-Banares, F., Esteve-Pardo, M., Humbert, P., de Leon, R., Llovet, J.M. and Gassull, M.A. (1991) Role of fructose-sorbitol malabsorption in the irritable bowel syndrome. Gastroenterology 101: 1453–1454.
  28. Barrett, J.S. and Gibson, P.R. (2012) Fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) and nonallergic food intolerance: FODMAPs or food chemicals? Ther Adv Gastroenterol 5(4) 261–268. DOI: 10.1177/ 1756283X11436241

Food Companies Certifying Themselves as Non-GMO Could Pose Risk to Consumers

Thursday, June 4th, 2015

Recently in the news, the US Department of Agriculture (USDA) was reported as having its own non-GMO seal, which is not the case and is causing some confusion. Instead, a Minnesota-based company known as SunOpta chose to internally develop standards for their own non-GMO seal, which they reviewed with the FDA. The FDA approved; SunOpta then approached the USDA for approval through their program known as “Process Verified,” where the USDA verified that SunOpta is adhering to the rules SunOpta developed internally. In other words, SunOpta is using their seal for non-GMO status, and not a seal developed by the USDA.

It is important to note that the USDA and FDA are not determining whether SunOpta’s standards meet or exceed currently accepted definitions of non-GMO. For example, a third party organization called the Non-GMO Project (NGP) has a certification program verifying the non-GMO status of foods and NGP’s “Non-GMO Verified” seal is shown on many organic products. SunOpta opted not to pursue certification with NGP in favor of developing their own Non-GMO certification. While SunOpta’s non-GMO seal is for commercial purposes and not for consumers, this precedent poses two potential problems.

First, companies with food products sold to consumers could propose that the FDA and USDA approve their own non-GMO seal, leading to potentially multiple non-GMO seals in the marketplace, each with their own internally-defined standards. Without a third party review of those standards, different levels of GMO contamination could be allowed in food products and dilute consumer protection from consuming GMOs. Currently, up to 0.9% of GMOs are allowed by NGP certification standards.

Second, meat and dairy companies – who are currently unable to secure NGP certification – could petition their internally developed non-GMO standards and seals to the FDA and USDA by stating their animals have not been genetically modified. This is a misleading statement because these same companies could still feed their animals GMO feed. Potentially, a milk product found in grocery stores could be labeled non-GMO, yet that company could have fed GMOs to their animals for producing milk.

Always Go Organic

While non-GMO is ALWAYS better than conventional, the bottom line is ALWAYS buy organic where feasible. Organic food products are superior to non-GMO certified food products because organic standards 1) already prohibit the use of GMOs, and 2) prohibit the use of synthetic pesticides, insecticides and fungicides, which are allowed in non-GMO products.

The use of chemicals on crops is meaningful and of real concern. Why?

According to the President’s Cancer Panel, 41% of the U.S. population is expected to contract cancer and 21% of the U.S. population is expected to die of cancer. The Panel stated that it was “particularly concerned to find that the true burden of environmentally induced cancer has been grossly underestimated. With nearly 80,000 chemicals on the market in the United States, many of which are used by millions of Americans in their daily lives and are un- or understudied and largely unregulated, exposure to potential environmental carcinogens is widespread.” One recommendation made by the President’s Cancer Panel is to choose “food grown without pesticides.”

Additionally, the American Academy of Pediatrics reported that pesticides pose a grave danger to children: “… acute poisoning risks (from pesticides) are clear, and the understanding of chronic health implications from both acute and chronic exposure are emerging. Epidemiologic evidence demonstrates associations between early life exposure to pesticides and pediatric cancers, decreased cognitive function, and behavioral problems. Related animal toxicology studies provide supportive biological plausibility for these findings.”

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