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.

Talking Shit, FODMAP Crap that is

After sitting on the shitter while shitting out a shit, I came up on a ditty as you should

I realised that in fact I have been shitting out bubbly , fruity craps for years and they have become the norm instead of a once a week annoyance. I have in fact a form of irritable bowel syndrom and I can trace this back to of course me getting a dose of food poisoning from a frozen in the middle burger up in Aviemore in 1995. I was ill for months with it and had to go on a simple lemonade diet and semolina for weeks, but in fact I never recovered

It can be said that about the same time I started to put on a lot of weight, but it can also be said that I was partying more and cycling a lot less, while retaining my appetite from that, Howevver it still has to be said that from 1995 to 2000  I put on loads of weight in successive bouts, losing some maybe in 96 and then 97, but after Ireland just getting  a bit big and tittied, I was a bit cgubby for years and then only thin with the stress of moving to norway, which may actually be a fact that the new water and gut bacteria thing here helped me get thin

Research in this area has been poo-pooed a bit, pardon the shitty pun, Many dieticians will point to the solid fact that obese people eat a lot more and a lot more fatty and sugary foods, than ordinary BMI folk, However I am quite active and dont eat all that much more, and have tried dieting and atkins without a lot of success, I have varied from 108 to 122 kg for years now,

I did say fuck it all, so what, eat and bevvy and as long as your heart rate is ok and your waistline doesnt get bigger than 40" fuck it, I am healthy, Only I am not, I have an acid reflux problem which has come back and I have irritable bowel witout the pain, just the bloating and potential water retention and tendency for something worse to develope,

I heard about FODMAPS, fermentable sugar species not that long ago and how they are thought to generate the symptoms of IBS by altering the proportion of the bacteria in the gut to a fraction where disease is the result. If these fermenting bacteria were doing somethign else then? Making more simple sucrose or actually starving the body all the time so that it on the one hand stays hungry while on the other hand it lays down fat in contemplation that starvation may get worse?

I will have to see if my theory is borne out in any of the research, but it has a nagging little ring of truth to it. I find that my appetite is bigger now and I am not as satisfied with my food,.

Or rather I did because now I am nine days or so into a low fodmap diet. I have gone for the near total exclusion of gluten and lactose as two prime culprets, but aslo a pile of other things like pears and apples. I allow myself a couple of rye wheat crackers with lunch most often and the odd white flour based thing if I am on the move or ;rude not to; sitiuation., The first few days I had diarheoa, but that I think is to be expected. Suddenly the bugs used to nice fermentable mono, di and poly saccharides are starved, and kick up a fuss as they maybe die back, while others caused commotion, After a week though I was down to a little hard stools but much more even shitting it has to be said, although I am only a few days into that.

I wonder also if this has affected my energy levels for years too, I have been up and down this last week or two but before that I was often vapourised in the afternoons and mid evenings, only to regain a kind of high later on in the evening to my annoyance. Perhaps all that sugar fermentation lead to a sugar rush, or perhaps I was a little drunk on alcohols produced from the fermentations?

It is recommended cutting drastically down on coffee which I have not yet managed, but my bowels dont seem to be going at 100mph like they used to, Often I would be shitting three times a day at the worst times.

It isnt a drastic diet, and I have allowed a major unhealthy thing in - chocolate. The key carbos are oats, bannanas, rice and potatoes, so you cannot go wrong there. Fruits are limited it has to be said. All meats and fish which is not processed is admissable, and simple sucrose is also ok. It is glucose and fructose you should avoid apparently, they get more easily fermented in their basic form rrather than the disaccharide made up of the two. 'Corn syrup' is very high in fructose and it is used as a sweetener increasingly this side of the atlantic, having been long established in the USA. 

Wheat starch, gluten and lactose are the other big evils and you hear more about this generally with food allergies to them a bounding in the under 30s. I wonder then if the big change in the generations from eating potatoes as the staple, to eating more pasta based dinners and more auxilliary dairy like yoghurts and refreshing drinks are a big cause for the jump in IBS? or was it one of those diseases people didnt bother going to the GP about before, or just it wasnt in the media? My dad had some form of IBS< but that was in part from poor nutrition and a shrapnel injury during WWII.

Historically sucrose, glucos and fructose have been very low constituent parts of mans diet, as can be seen from the evidence of tooth health in ancient remains through to the early 19th C, where after dental caries starts to predominate in autopsies.

I would like to feel more satisfied with my food, have less in between meal hunger attacks, have less bubbling down there are generally reduce my appitite while increasing my exercise levels a bit. This diet now is going to stick for the forseeable,. when you can then reintroduce slowly and to a lower level, some FODMAPS and see which ones in isolation by reintroduction, really kick you off. I am a lot less farty and have regular solid stools for the first time in years, while also going to the loo lest often for those no.2s, I have still attacks of the tireds, but now I felt today that my hunger attacks were much abated. There is probably a pyscho somatic thing there two, which is good, because it will keep me off snacking and help me push trhough to the controlled portion meal times, which is my next challenge in terms of taking this further and losing some weight.

I am trying to do 8 hours exercise a week, although our 57' N spring is doing its worst to get in the way of this. I kicked this all off with what turned out to be the biggest day out in the hills for well over a decade for me, and it went very well, a couple of concentration exhaustions that was all, on a perfect day bar the huge patches of snow we had to wade through. Health is important, and you cannot ignore an long term altererd bowel issue and just carry on regardless. The same with mental health, sleep, aches and pains, that bad back from sitting in the office too many hours, and of course finally kicking smoking or three nights a week down the boozer. It is never too late and it is not that huge an effort for the benetfits, particularly if you involved more exercise. For me that meant upping my 4 to 5 hour a week to 8 hours , not always making that target, but that being there and much higher, so that I get an average maybe of about 5 or 6 in reality over a month.

If you are lucky your GP or dietician will know now about FODMAPs and the exclusion diet, and I have no doubt that this will be first line treatment for IBS because there is no other proven treatment so far, apart form perhaps faecal implants *repopulating the microflora from another, healthy person" or a total antibiotic kill back followed by what would be effectively the same FODMAP approach more or less., with a simple diet building up until you hit a trigger foodstuff. IBS is very disabilitating in its moderate to severe forms,  with people being embarressed to go to work, on the one hand, while on the other hand being in so much pain and discomfort they take their own lives. I have done that dastardly of anti intellectual, stupid society things and self diagnosed myself but of course there is really no risk what so ever, beacuse the low FODMAP diet is really very healthy and probablyy lower calorie in the course of a day. I could say that taking multivitamins is a good idea because you do miss out on a lot of fruit in the first six weeks which are super low FODMAP weeks.

If you have IBS< or are over wieght, or have unusual variable bowel movements, or are too thin, or suffer from sudden tiredness with no other symptoms, then give it a  go, the low FODMAP but also of course, disclaimer disclaimer, visit your doctor for advice,.