Tag Archives: food science

The FODMAP Diet: An IBS diet based upon peer-reviewed science

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I’m extremely lactose intolerant. What this means, biologically, is that I no longer produce enough lactase to process lactose sugar. Because I can’t process lactose in my small intestine, it moves on intact to my large intestine where bacteria eat the sugar. The byproduct of their digestion, gas, causes bloating, pain, cramping and, well, you know the rest.

What is IBS and what causes it?

Irritable Bowel Syndrome (IBS) is an incredibly common malady, affecting 6-46% of the population, depending upon the study. It’s a diagnosis resulting from the lack of a diagnosis; it’s diarrhea, bloating, stomach pain, and cramping that can’t be explained by celiac disease, lactose intolerance, fructose intolerance, or other understood gut disorders.

IBS is thought to be caused by visceral hypersensitivity, or over-sensitivity to pressure on the intestines. Imagine two people eat broccoli and get a bit gassy: the person with IBS would feel pain and discomfort while the other person might be bloated but otherwise fine.

It’s often implied that IBS is psychological as much as physiological. Anxiety and depression are common in people with IBS. In my experience, the perceived psychological component, the lack of simple treatments, and the lack of life-threatening consequences can lead doctors to be blasé about IBS. They recommend fiber, exercise, and routine, and shrug if that does little. Small wonder that people might feel blue. But gut science is improving, and the FODMAP approach is a new and widely successful strategy for reducing the symptoms of IBS.

What is the FODMAP approach, and what is different about it?

The FODMAP diet is based upon known biochemistry and the hypothesis that visceral hypersensitivity causes IBS. There are many molecules that, like my undigested lactose, tend to be digested in the large intestine and produce gas. The FODMAP diet eliminates a wide range of such molecules.

FODMAP, introduced in 2005 by Monash University, is a peer-reviewed diet based upon a concrete biological hypothesis supported and improved by scientific trials. It is not a weight-loss diet. FODMAP stands for Fermentable Oligo- Di- and Mono- Saccharides And Polyols. Catchy, right? But the concept is simple—FODMAPs are short-chain sugars that we know most people digest poorly (meaning bacteria digest them), and you avoid FODMAPs on the FODMAP diet. (For the biochemists, that means avoiding fructans (oligosaccharide), lactose (disaccharide), fructose (monosaccharide), and all sugar alcohols such sorbitol (polyols).)

Many other diets have questionable scientific bases and are profit driven. The Atkins Diet was published by a cardiologist who never published any peer-reviewed work, but several books. The Paleo Diet was published by an “exercise scientist untrained in paleobiology”. This is not to say that these diets cannot be beneficial in any way. But they have not been tested and refined in the way the FODMAP diet has been, and their fundamental science is hazier. Putting the cart before the horse, they have been developed first for profit, and then researched afterwards, often with mixed results. To be fair, the scientific process is slow and contentious and doesn’t always lend itself well to studies as broad and complex as diet. But FODMAP was developed, tested, and improved using the scientific process. If you’re skeptical of diets, as I am, you can read up and convince yourself that this diet has a reasonable basis and good results.

What’s a FODMAP diet like?

If you are considering a FODMAP diet, you will have to do some research, and be able to prepare food often from scratch. The internet is a phenomenal tool, and there are even some dieticians you can consult online. FODMAP sensitivity is not the same thing as an allergy. You don’t have to absolutely eliminate FODMAP foods, you simply must aim to minimize them for a period of time.

To follow the FODMAP diet, you avoid FODMAP-laden foods for two weeks to two months (different sources vary in their recommendations, and provide rationales). After this time, you re-introduce foods in a controlled manner to identify trigger foods. Most IBS-sufferers are not sensitive to all FODMAPs. Many people report benefits within a few days of starting the diet, and 70% of IBS patients in peer-reviewed studies reported improvements following the diet. I personally had much less bloating within a few days. Following a FODMAP diet revealed that some of my symptoms are due to gastritis, which I’m now treating. I see now that I’ve had gastritis symptoms for a while, but I was unable to separate various gastrointestinal symptoms before this diet. I remain on the full FODMAP diet after three months, but I have eliminated one side issue.

What foods are and aren’t allowed?

Following the most basic level of the FODMAP diet, one avoids all garlic, onion, and gluten-containing foods. It is not a gluten-free diet, but grains containing gluten overlap almost perfectly with grains containing the FODMAP fructan. Beer happily is the major exception; it is FODMAP-free due to the fermentation process.

I consider the FODMAP approach an alternative way of categorizing foods. There is a common perception that vegetables and fruit are healthful, and grains and meat are less healthful. At least from the perspective of IBS, that is not a useful framework. On the FODMAP diet, meats are okay. Roughly half of grains, dairy, vegetables and fruit contain FODMAPs, and these are avoided on the diet. Specifically, greens and squash are okay, but broccoli, leeks, and  brussels sprouts aren’t. Citrus and melon are okay, but peaches, cherries, and figs aren’t. Lactose-free milk and hard cheeses are okay, and ice cream, fresh cheeses, and sour cream aren’t.

For those considering the diet, this is my favorite exhaustive list of allowed and disallowed foods.

TL;DR

In short, the FODMAP diet requires research and it’s a pain to follow, but it offers real promise to the numerous people suffering from IBS. If you’re considering the diet yourself, good luck. I hope this provided a better explanation of the topic than the sources I encountered when trying to understand this diet. To others, maybe this will help explain why your friend has such a fiddly diet, and why you should support them.

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Food and Science: Caramelization and the Maillard Reaction

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When we cook food, we want it to be as flavorful as possible. Two types of chemical reactions contribute to browning; both of these reactions create hundreds or thousands of other molecules, which then add aroma and flavor. The higher temperature reaction you may be familiar with: caramelization is the breakdown and reaction of sugars. The Maillard reaction occurs at slightly lower temperatures (still usually above the boiling point of water); this reaction occurs between the amino acids of proteins and sugars.

Both of these reactions are so complex that scientists don’t know everything that occurs during them. We understand the basic nature of each reaction, but any plant or animal food contains literally thousands of different molecules that can all react together. Fortunately, we can still implement the process without a full understanding (and we have been for millennia), and a lot of very nice foods undergo either or both reactions.

The Maillard reaction and caramelization often occur at the same time, and produce similar results visually, so they can be tough to separate. If something contains both proteins and sugars, both reactions can occur with heat. Fortunately, they both taste good. They’re also easy to do at home. If you want to brown your food, get a skillet nice and hot. Make sure you’ve patted the food dry (this allows the surface to get hotter than the boiling point of water, thus allowing the reactions to occur), and sear away.

Food and science: understanding and cheating lactose intolerance

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A person is lactose intolerant when they no longer makes sufficient quantities of the enzyme lactase. Because the enzyme no longer breaks the lactose sugar down, bacteria in the large intestine do instead. The bacteria release a lot of gas when they do this, which irritates the large intestine and causes the symptoms we observe. 

Below is a quick run down to understanding lactose content in foods, and what I’ve done to continue eating awesome dairy food despite my own very inconvenient sensitivity.

What contains lactose?

As a short answer, more than you would think. Obviously ice cream and milk do. Hard cheeses contain very little. I often read that yogurt is well-tolerated by lactose-intolerants due to the bacterial culture, but I do not tolerate yogurt. Sour cream made by traditional methods is low in lactose, but many manufacturers add milk solids.

It gets more complicated. Many foods contain milk powder or whey. Milk powder is 50% lactose by weight, and whey is 10%-70% lactose. Pastries, hot chocolate mixes, pudding mixes, and even Doritos can contain milk powder and whey. Most annoyingly, products do not list the quantity of lactose contained.

Fortunately, several websites tabulate the lactose content of various foods (at least dairy– if you find one for prepared foods, I would love to hear about it). Steve Carper’s Super Guide to Dairy gives a great explanation of the lactose content of a wide variety of dairy products. This link has a decent list.

Circumventing lactose intolerance

Thanks to modern science, we can synthesize the lactase enzyme. The enzyme can be taken as pills and eaten with food, or added to the food as a liquid. I used to take the pills, but as my symptoms progressed, that method became insufficient. The stomach is a mixing chamber, and mixing is imperfect, so enough lactose still got through to cause issues.

After going a year without ice cream or yogurt, I decided to investigate my options. Online, I found the lactase liquid drops, which can be added to any liquid. In 24 hours, these drops reduce the lactose content of a product roughly 70%. I usually add more than the recommended quantity and wait three days to be extra sure. (A side note: I read in the amazon comments that some batches of the enzyme didn’t work; you can test the enzyme’s effectiveness using diabetic glucose test strips. Lactose splits into glucose and galactose, but food doesn’t normally contain glucose; a test strip indicating its presence in a treated food means the enzyme worked. I bought my enzyme in August, and did the test because heat can de-activate enzymes; it was super easy.)

Then I made lactose-free yogurt. I made lactose-free fresh mozzarella cheese (although I wasn’t very good at it). I bought an ice cream maker and made ice cream in any flavor I wanted. I made chocolate mousse. For Thanksgiving, I made ice cream and pumpkin pie with sweetened condense milk and mashed potatoes with sour cream.

Basically, you can add the enzyme to the cream or starting dairy product, let it be for a couple of days, and then cook as you normally would. In milk, the treatment slightly changes the flavor of the milk (it becomes a little cloying, because glucose tastes different than lactose), but in prepared foods I can’t tell the difference. Below are a couple pics of some projects I enjoyed very much. Hopefully this brief run down helps a few of you, or a least gives a picture of our complicated food science lives.

photo1

Green tea ice cream, made with matcha green tea.

photo2

Chocolate mousse.

 

Why I cook: food and science series

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I cook a lot. I cook because it’s cheaper, but mostly I cook because I am absurdly lactose-intolerant, with a generally fussy tummy. As a kid, cooking seemed like something girly and irrelevant; food simply appeared. Now I see that eating is something we do every day and it can be either drudgery or exquisite.

This post is the first of a series I will post each Friday. Other posts will talk about specifics: science, recipes, and methods. Today I will talk more about how cooking became something I spend time on, and why cooking matters.

In college, I picked up some kind of food poisoning, probably on dorm food. I started to get sick a lot. I lost weight. I drank bulk-up drinks like body builders do. I became sensitive to milk products; I switched to lactose-free milk, and started drinking whole milk. I couldn’t move after meals, or else I’d get sick. If I ate even a bite too much, I got sick. If I got too hungry, I got sick. My lunches were often half a pizza slice. I bottomed out with a BMI below 18. Doctors seemed disinterested my inability to keep food, but they couldn’t explain the weight loss.

Finally, I started taking probiotics, which seemed to help. Now, seven years after my minimum weight, I’m at my high school weight, with gain more of a concern than loss. I cook most meals for myself, where I have control over my intake. Eating out with others isn’t easy, because I must be picky and inflexible about where and when I eat. I can’t wing it. If I deviate from the rules too much, I will get sick, which directly affects me for up to a day, and destabilizes me for the future. It’s manageable; some people with IBS get sick a dozen times a day, and digestive illnesses like Crohn’s disease can be life threatening.

The gut is understood very poorly, despite its importance. The enteric nervous system, or gut brain, is the site of 90% of serotonin and 50% of dopamine. With my ups and downs, I know well the relationship between gut health and mood. The digestive system is second in neurons only to the brain, and contains more neurons than the spinal cord. It is the engine of our body, and it functions in tandem with more bacteria than there are stars in the galaxy. Yet Americans spend the least time cooking of any country on Earth.

Loads of scientific evidence and my own personal evidence shows that a happy tummy goes a long ways towards a happy person, even in cases less extreme than mine. Good food can be a blissful experience, and in these posts I’ll talk about some methods toward good food. I don’t believe in diets or supplements or shortcuts, just making food that works. Good food can be made in a small kitchen on a limited budget with limited time. The primary ingredient is our own interest and curiosity, which I intend to share here.

Science and Cooking

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I love to cook. As one might gather from this blog, I like to keep my hands busy, and cooking saves money and provides deliciousness. (Many other hobbies have more of a knack for consuming money.) I also happen to be very lactose-intolerant, so cooking for myself also greatly benefits my digestive health.

When I was younger, I was absolutely apathetic to cooking, as I suspect many kids are, feeling that it’s house-wifely and unimportant. Then I got out on my own, and, astonishingly, good food was expensive and I had little currency.  I wanted to improve my cooking, but I really didn’t know the rules. But I knew the next best thing: science. Many recently published books explore the relationship between science and cooking. For those of us that can’t remember the baking soda without knowing its chemical purpose, this is a great thing.

Some recommended books:

  • What Einstein Told his Cook by Robert Wolke. The content is good, especially for those less versed in chemistry. The author wrote a newspaper column about cooking, and this book is mostly the compilation of answers to various questions such as “What is the difference between cane sugar and beet sugar?” It contains several recipes illustrating various points of the book. A major emphasis of the book is clarifying common misunderstandings of food science. As someone who knows a lot of science, I sometimes find the answers too basic, but I definitely learned things reading this book.
  • Molecular Gastronomy: Exploring the Science of Flavor by Herve This. Of the three books I discuss, this is the one I have had the least time to scrutinize. However, I really like what I have read. Wolke’s book covers more conceptual topics, like the differences between various kinds of salts. This’s book covers more specific topics, like why we marinade roasts in red wine rather than white, or how different kinds of truffles are related. This one is probably most strictly for those interested in cooking, with fewer “gee whiz” moments and more “that would be useful” moments.
  • Cooking for Geeks: Real science, great hacks, and good food by Jeff Potter. This one is definitely the most fun of the three! This book is from the publisher O’Reilly, which does a lot of technical textbooks. This book shares its layout with those kinds of book, but its soul is lighter. Its layout is more varied, as textbooks are. Plus, this book has a fun section about hardware like evaporators and sous vide water baths. Sous vide is involves cooking foods in circulating water baths. It is similar to slow-cooking, but the food is kept in a plastic bag and thus not diluted. Foods can safely and extra-deliciously be cooked at much lower temperatures by this method. Low temperatures denature specific proteins, prevent drying, and, when held for a bit, kill bacteria. This book does a great job explaining why and how sous vide works. I just got a sous vide system myself, and this book has given me some confidence about something I knew very little about. Plus it’s very fun to read, and covers tons of other topics in geek-friendly ways.