Sunday, May 21, 2017

Talking Shit...FODMAP diet three weeks on

  More talking shit then.

Let us get the dirty stuff out of the way, shit lovers, haters, proctologists.

For years and years I have had variable loose, runny shit, pelllety shit, fruity smelling shit, irregular shit, three times a day shit, uncomfortable must shit now shit, farty shit, and the odd bit of constipation amongst this. Also I have a decided issue with appetite and losing weight, being about three stones over where I should be or about 20kg.

As in the last blog, I never ever saw the link between a day in 1995 when I bit into a burger to find it stil frozen in the middle and had a bad dose of food posioning as they call it, most likely campylobacterial in basis. After that time I started to put on weight and certainly my appetite altered.  In 1996 I forced myself to do a lot of exercise in the winter and spring while unemployed and working part time. I used to work out at the gym with aerobic 20 mins to half an hour some weight training, followed by a mile swim in the pool and then I would walk home. I crept down in weight a little avoiding beer and maybe having a chinese take away once a fortnight. I was miserable and had an odd kind of hunger. I lost maybe 3 kg in 3 months and started to put it back on.  I Some years later with a relatively high level of activity in 1997/8, i lost very little weight at that time too, and I really eat pretty normally. I did put on some muscle in these three years with weight training, but my trouser size of 34/36 went soon up to 38 by 2000 and has kind of sat there ever since, with the gut being a bit tighter sometimes than others on the waistline.

A couple of years ago, or maybe longer than that actually, I started to notice that my middle aged spread went up and down. I could get quite bloated during exercise or after of course meals, but a while after. I thought back and could remember feeling very flabby during long tours in the mountains. Ah, maybe I was retaining water. Well as Billy Connolly says, " Retaining Pies and Pints of Lager"  more like. I eat well you may say, and I drink well. In fact though, I do quite a lot of exercise too. However I did put this all down to just my roaring appetite, and that a two week shift to cutting way down on extras, beer, wine and upping exercise from 4-5 hours a week to 8 hours.

I did the latter and felt that I was a fair bit healthier for it, but old summer shorts were dug out and were just as tight as the last time I tried them, and also those photos of me in a tight grey t-shirt!  Flabby. But a beer gut and odd, high side wings around a pretty solid guy who exercises a lot. Then I heard a BBC Radio 4 science programme about FODMAPS, and thought well there could be something in this. I have essentially a mild IBS or abnormal bowel behaviour as you read above. I dont have pain, just lots of trips the loo for #2s and discomfort with urgency you could say. So what the hell?

Now I am three weeks into the low FODMAP diet - that is avoiding fermentable oligosaccharides, and some di- and mono-s too. According to some researchers into the Gut Biome, our bacterial populations are severly disrupted from that which is healthy by too much of in particular, fructose and lactose in our diets. There is then an extended list of other saccharides and the sulphurous onion family is to be avoided.

I found a list on a pdf from a reputable source, with recommendations for daily intakes of low and medium FODMAP foods. Basically it sticks around what you might expect. In essence it is a gluten free, very low lactose diet with avoidance of those smelly farty foods like cabbage, onion and garlic. In fact there are some recommended daily 'doses' of the bad or medium bad stuff too. In the table it is not fully clear though on some low fodmap is how little of some things you may be allowed to eat.

It meant not such a huge change in fact, the biggest things being cereals, fruit juices *apart from some tomato- and of course, the biggy here for Norway especially,  bread. Ok you can have gluten free bread and cereals but they are a bit mediocre. One thing which is allowed is a bowl of common or garden oat porridge, which is a saviour, although without the dried fruit I prefer. Oddly sucrose and glucose are ok in the scheme of things, but not in large amounts. Apples and pears are out, bannanas and a small amount of milk chocolate is in. I use lactose reduced milk and the odd expensive lactose free milk, both of which are long life incidentally which is handy.

Three weeks in? Well a week in I noticed the difference, I had four days of very diarrheoa like stool followed by a little constipation and then more ordinary stools there after by in large. I kept on checking my menu in the house. Some more things went out.

Things went well then. I felt less bloated too, and also I started to notice I was more satisfied from food and a little bit less hungry in general. Stools getting by in large bigger and better, a little hard occaisionally. And once a day's worth you may say, more if it was a little constipated and I gave up pushing.

Then in week 3 we have national constitution day in Norway, and I said, what the hell,  patients had talked about ' lettiing loose' once in a while. The day is an onslauight of refined wheat and most of all lactose. Ice creams all round,  at every opportunity and cream cakes, and strawberries and cream, and coffee with cream for once not black.Also we had our traditional beef cakes made with onion and bit of garlic, so it really was a test. Right enough, squits and more trips to the loo for two days.

After three days of being a good boy, and moving to lactose free milk, I was back to better stools and less trips to the loo. My appetite is lower and most of all I feel I can avoid the daddy dreadful eating up what is left because it is less than a portion for anyone tommorrow, or eating up after the kids refuse one more bit. I do get hunger pangs and then there is  no biscuit to take them up, just bananas which in moderatioon of up to three a day, are very low FODMAP friendly apparently and good for fibre and potassium.

I feel now that I can concentrate on actually calorie counting because I am less hungry already and hope that some of my flab was indeed water retention due to a disturbed gut and years of excess fluid excretion. Energy is up and down a bit, especially week 2 was tough but going into week 4 it seems more normalised.

What is stil naughty? Well portions of dinner were a very, very big issue for me, and that is reduced. Also snacking or need a starter is reduced. But because I can eat crisps, potatoes are way ok, then I do, so that has to be cut out. But I feel empowered by a new, natural STOP sign on my appetite.

Now by trade I am actually a molecular biologist, which included a lot of biochemistry and microbiology , so I will have to look more into what fermentation reactions are being avoided and how the bacterial population balance is maybe being achieved, out of interest. For you dear shitty reader with IBS or working out but not losing weight nor appetite, a low FODMAP cant really hurt anyway- consult your doctor of course disclamier discalimer.

When I was a kid, there were very very few folk who were on gluten free diets, while lactose was a minor issue you heard of once in a while. We just arent supposed to drink cows milk really, lactose is not something we can metabolise or readily digest,. Bacteria though can metabolise lactose directly. There have been studies which show that cows milk can actually lead to opiod biproducts which would certainly explain some of my drowsiness in the mornings post breakfast. Between lactose and Casein, cows milk just isnt for us in the amounts we consume it in, and a mixed diet with oily fish and vegetables can supply enough calcium. I still eat cheese which is nearly all low lactose, because those said bacteria consume the sugar in producing cheese after most of the lactose is actually seperated away in the whey from the protein rich curds.

Our western diets are an odd cultrually influenced mix of foodstuffs which reflect mostly our farming heritage and supply chain which provides infact, if you look at the figures historically and relative to family incomes, extremely cheap commodity food, and very affordable small luxuries. IBS is a very major cause of ill health and sick leave in otherwise healthy living people, and as with myself being a little atypical in not having pain and discomfort, but typical stool disruptions, are going under the radar and possibly building up problems for the future.

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