¡Albricias!
Tenemos una nueva normativa sobre la calidad del #pan,
aprobada en el consejo de ministros hace un par de semanas. 👏👏👏👏
¿Y
qué significa esto? Pues que ya no vamos a tener que ser
detectives🕵️♂️ cuando vayamos a comprar pan y que, por irónico que
parezca, cuando en la etiqueta ponga "pan integral", el pan ¡estará
hecho con harina integral 100%!
Hasta ahora, no había un % mínimo
para llamarse integral 🙈, con los que panes con 0% harina integral
podían llamarse integrales.
También van a ampliar el IVA reducido
del "pan común" a panes elaborados con otras harinas distintas a las de
trigo, como los elaborados con harinas integrales, con salvados o bajo
contenido en sal que solían tener un 10% de IVA.
Además los
"panes multicereales" ahora van a tener que tener un 10% mínimo del
cereal en cuestión mencionado en la etiqueta y al menos elaborado con 3
harinas diferentes. Otro cambio es que si compramos por ejemplo, "pan de
#espelta",
ese pan deberá contener al menos un 50% de espelta, se acabaron esos
panes de X, con un 1% de X.
Hay otros cambios de los que ya hablaremos
en nuestro blog próximamente.
Mostrando entradas con la etiqueta Nutrition. Mostrar todas las entradas
Mostrando entradas con la etiqueta Nutrition. Mostrar todas las entradas
jueves, 30 de mayo de 2019
lunes, 8 de abril de 2019
Thin Privilege: An Update
After another lively debate on Facebook regarding this topic I spent most of the other night thinking about it and my reaction to it.
Is this where I suddenly repent and accept my thin privilege? No, it isn't. I still don't like the term, the concept and everything it entails and here is why.
When I read the original article and the comments associated with it it made me angry because deep down I didn't think I was getting any kind of privilege for being thin. Yes as a man, and although I really didn't want to bring race into it, a white man, I fully acknowledge the society we live in has been constructed in my favour. I accept that, and if it will change anything, which I doubt it will, I acknowledge that privilege.
The comments I received mostly seemed to indicate that I was denying that "weight bias" "body diversity" "Sizeism" and so on existed, which was not the case. What I didn't like was first the assumption that people are "naturally thin", and that my life is easy because I am thin, You have no idea about my life just as I don't about yours, any assumption based on appearance is wrong.
This point didn't seem to be accepted and I continued to receive anecdotes about people's lives and how they struggle with discrimination, which, at the risk of sounding like a stuck record I didn't deny existed.
After being directed towards research around weight bias and wages, a couple of points jumped out at me and made me rethink why I am reacting this way.
In an article in the Journal of Applied Psychology (1) it was demonstrated that thinner women get paid more, not surprising, but the opposite was true for men. In fact, larger men get paid more up until the point of obesity. And a quote lifted from an article on Forbes (2) based on the study said. "Skinny men, indeed, are often regarded as nervous, sneaky, afraid, sad, weak, and sick, where men of well-proportioned build are associated with traits such as having lots of friends, being happy, polite, helpful, brave, smart, and neat."
So is this really "Fat Vs Thin"? Or is it just another example of different rules for men and women?
I started thinking through my experiences in work and the times I've had to say "yes I do eat" or "no I am not addicted to heroin", did me being a thin man (as opposed to just thin) have something to do with this?
Or the times I felt I wasn't taken seriously in staff meetings. I had always assumed it was because I was one of the youngest in the room (sadly no longer the case) but maybe it was because I was thin?
While I can still find clothes that fit me in most shops I have noticed that I have had to drop down a size from M to S with no major change in body weight. It appears that provisions are being made to spare men's feelings by simply shifting everything up one size which is not happening for women. So is this really "thin privilege" or just plain old sexism?
Is it possible that as a man "thin privilege" doesn't extend to me? Or at least not as much as it does for women?
Rethinking where I stand on this topic I still reject the term thin privilege because I think it diverts away from the real issue which is what society expects of women. It looks like as a man I can put on a few kilos and not suffer any negative consequences, up to a point, whereas women cannot. And to me that is sexism not thin privilege.
1. J Appl Psychol. 2011 Jan;96(1):95-112. doi: 10.1037/a0020860.
2. https://www.forbes.com/sites/freekvermeulen/2011/03/22/the-price-of-obesity-how-your-salary-depends-on-your-weight/#29a06bbb3d9a
Is this where I suddenly repent and accept my thin privilege? No, it isn't. I still don't like the term, the concept and everything it entails and here is why.
When I read the original article and the comments associated with it it made me angry because deep down I didn't think I was getting any kind of privilege for being thin. Yes as a man, and although I really didn't want to bring race into it, a white man, I fully acknowledge the society we live in has been constructed in my favour. I accept that, and if it will change anything, which I doubt it will, I acknowledge that privilege.
The comments I received mostly seemed to indicate that I was denying that "weight bias" "body diversity" "Sizeism" and so on existed, which was not the case. What I didn't like was first the assumption that people are "naturally thin", and that my life is easy because I am thin, You have no idea about my life just as I don't about yours, any assumption based on appearance is wrong.
This point didn't seem to be accepted and I continued to receive anecdotes about people's lives and how they struggle with discrimination, which, at the risk of sounding like a stuck record I didn't deny existed.
After being directed towards research around weight bias and wages, a couple of points jumped out at me and made me rethink why I am reacting this way.
In an article in the Journal of Applied Psychology (1) it was demonstrated that thinner women get paid more, not surprising, but the opposite was true for men. In fact, larger men get paid more up until the point of obesity. And a quote lifted from an article on Forbes (2) based on the study said. "Skinny men, indeed, are often regarded as nervous, sneaky, afraid, sad, weak, and sick, where men of well-proportioned build are associated with traits such as having lots of friends, being happy, polite, helpful, brave, smart, and neat."
So is this really "Fat Vs Thin"? Or is it just another example of different rules for men and women?
I started thinking through my experiences in work and the times I've had to say "yes I do eat" or "no I am not addicted to heroin", did me being a thin man (as opposed to just thin) have something to do with this?
Or the times I felt I wasn't taken seriously in staff meetings. I had always assumed it was because I was one of the youngest in the room (sadly no longer the case) but maybe it was because I was thin?
While I can still find clothes that fit me in most shops I have noticed that I have had to drop down a size from M to S with no major change in body weight. It appears that provisions are being made to spare men's feelings by simply shifting everything up one size which is not happening for women. So is this really "thin privilege" or just plain old sexism?
Is it possible that as a man "thin privilege" doesn't extend to me? Or at least not as much as it does for women?
Rethinking where I stand on this topic I still reject the term thin privilege because I think it diverts away from the real issue which is what society expects of women. It looks like as a man I can put on a few kilos and not suffer any negative consequences, up to a point, whereas women cannot. And to me that is sexism not thin privilege.
1. J Appl Psychol. 2011 Jan;96(1):95-112. doi: 10.1037/a0020860.
2. https://www.forbes.com/sites/freekvermeulen/2011/03/22/the-price-of-obesity-how-your-salary-depends-on-your-weight/#29a06bbb3d9a
viernes, 5 de abril de 2019
No, we don’t need to talk about thin privilege
Update: I have modified slightly my opinion on the term thin privilege which can be read here
This is an opinion piece by Wayne Bradley and does not reflect anybody else's views associated with this blog.
Recently I found myself in a debate with fellow nutritionists and dietitians on the Build Up Dietitians Facebook page regarding the concept of thin privilege. Thin privilege is as follows, we “thin” people live in a world where we don’t experience the stigma and prejudices that overweight people experience. We can find clothes easily, we don’t get stared at when we eat in public and so on.
Ok, so far so good, nobody would argue with that fact. But I have several issues with labelling it “thin privilege”, firstly the word privilege and the tone of the articles I have read regarding this topic indicate that being thin, or “skinny” which gets thrown around lightly but no-one will dare say fat, is something that has been gifted to us, we haven’t earned it and we should thank our lucky stars that we’re in this position.
Most people, especially those in the health & nutrition industry know only too well how hard maintaining/losing weight is and to hint that normal weight people are somehow blessed or “privileged” is quite insulting, but sadly nothing new. Now of course because I said I eat well and do a lot of exercise that also means I think every large person is bone idle and just eats pizzas all day long! No, it doesn’t! It means making ANY assumption about a person’s body shape is wrong.
I feel very proud of myself when I see those scales going down, or when I get up 8am on a Sunday to go riding even though the sun is shining and I’d much rather have a few beers with my wife and friends. To suggest I should somehow feel privileged for that completely undermines the hard work and effort I (or anyone) does to maintain their healthy lifestyle. That doesn’t make me unaware of the battles large people go through, in fact, what I do with my life has nothing to do with what my patients do with theirs, which leads me on to my second issue.
My second issue is also to do with the term “thin privilege”. It is a nonsense term and completely unnecessary. When our patients come to visit us, they will discuss with us the problems they face, not only with their food choices but with self -esteem, health issues and so on. We will listen to them and if we do not share the same problems we will use empathy to understand them and guide our patients through their journey.
We already have the word, it is empathy, we do not need a new Insta-trendy, buzzword. If as a healthcare professional you are unable to empathise with your patients then may I suggest a career change? Politics perhaps.
To repeat a previous point, what I do with my life has no bearing on my patient's lives and has no place in a consultation. They are there to talk about their lives not mine. If the boot was on the other foot and my coach was "acknowledging" their superior athletic ability or shall we say "athletic privilege", I would feel extremely patronised and would probably sever ties with that coach very quickly.
Perhaps I am being too pedantic around terminologies and the use of words. However, I worry that we are going down a particular path where we will not be able to openly discuss weight, obesity and its related health problems. Body size and shape should not be attributed to attractiveness, I will vigorously defend that there is not one "perfect" type of body in terms of what is "hot" or "sexy". We all have our own tastes and that is what makes the human race so amazing! However, obesity is not healthy, it just isn't. Many co-morbidities exist with obesity, we all know it and not discussing them does not make them go away.
Saying "you're fat therefore ugly" is disgusting and should be stamped out immediately. But saying "you are overweight and need to make a change to improve your life" is not the same thing and should be what we are saying, but I fear we are becoming too scared of being labelled as "fat shamers".
To repeat, I acknowledge that larger people have a tough time in regards to the society we live in, but as nutritionists/dietitians we are there to help them and we owe it to them to be honest. What use is saying "yeah I know I'm thin and my life is easier than yours"?
During the debate, the topic of the genetic influence on body weight continued to appear, while it was beside my original point I will address it here.Yes genetics plays a large role in a person's size. The size of that role varies. However, does that mean we all just give up and say "its the genetics"? Because if that is the case then dietetics is dead!! I don't believe that is the case, some of us have been dealt a good hand in genetics, some haven't. That doesn't mean we can't make the best with what we've got. We can still strive to be the best version of ourselves and I strongly believe that externalising ourselves to the genetically thin and fat does us all a huge disservice.
Wayne Bradley BSc (hons) MSc PG cert
This is an opinion piece by Wayne Bradley and does not reflect anybody else's views associated with this blog.
Recently I found myself in a debate with fellow nutritionists and dietitians on the Build Up Dietitians Facebook page regarding the concept of thin privilege. Thin privilege is as follows, we “thin” people live in a world where we don’t experience the stigma and prejudices that overweight people experience. We can find clothes easily, we don’t get stared at when we eat in public and so on.
Ok, so far so good, nobody would argue with that fact. But I have several issues with labelling it “thin privilege”, firstly the word privilege and the tone of the articles I have read regarding this topic indicate that being thin, or “skinny” which gets thrown around lightly but no-one will dare say fat, is something that has been gifted to us, we haven’t earned it and we should thank our lucky stars that we’re in this position.
Most people, especially those in the health & nutrition industry know only too well how hard maintaining/losing weight is and to hint that normal weight people are somehow blessed or “privileged” is quite insulting, but sadly nothing new. Now of course because I said I eat well and do a lot of exercise that also means I think every large person is bone idle and just eats pizzas all day long! No, it doesn’t! It means making ANY assumption about a person’s body shape is wrong.
I feel very proud of myself when I see those scales going down, or when I get up 8am on a Sunday to go riding even though the sun is shining and I’d much rather have a few beers with my wife and friends. To suggest I should somehow feel privileged for that completely undermines the hard work and effort I (or anyone) does to maintain their healthy lifestyle. That doesn’t make me unaware of the battles large people go through, in fact, what I do with my life has nothing to do with what my patients do with theirs, which leads me on to my second issue.
My second issue is also to do with the term “thin privilege”. It is a nonsense term and completely unnecessary. When our patients come to visit us, they will discuss with us the problems they face, not only with their food choices but with self -esteem, health issues and so on. We will listen to them and if we do not share the same problems we will use empathy to understand them and guide our patients through their journey.
We already have the word, it is empathy, we do not need a new Insta-trendy, buzzword. If as a healthcare professional you are unable to empathise with your patients then may I suggest a career change? Politics perhaps.
To repeat a previous point, what I do with my life has no bearing on my patient's lives and has no place in a consultation. They are there to talk about their lives not mine. If the boot was on the other foot and my coach was "acknowledging" their superior athletic ability or shall we say "athletic privilege", I would feel extremely patronised and would probably sever ties with that coach very quickly.
Perhaps I am being too pedantic around terminologies and the use of words. However, I worry that we are going down a particular path where we will not be able to openly discuss weight, obesity and its related health problems. Body size and shape should not be attributed to attractiveness, I will vigorously defend that there is not one "perfect" type of body in terms of what is "hot" or "sexy". We all have our own tastes and that is what makes the human race so amazing! However, obesity is not healthy, it just isn't. Many co-morbidities exist with obesity, we all know it and not discussing them does not make them go away.
Saying "you're fat therefore ugly" is disgusting and should be stamped out immediately. But saying "you are overweight and need to make a change to improve your life" is not the same thing and should be what we are saying, but I fear we are becoming too scared of being labelled as "fat shamers".
To repeat, I acknowledge that larger people have a tough time in regards to the society we live in, but as nutritionists/dietitians we are there to help them and we owe it to them to be honest. What use is saying "yeah I know I'm thin and my life is easier than yours"?
During the debate, the topic of the genetic influence on body weight continued to appear, while it was beside my original point I will address it here.Yes genetics plays a large role in a person's size. The size of that role varies. However, does that mean we all just give up and say "its the genetics"? Because if that is the case then dietetics is dead!! I don't believe that is the case, some of us have been dealt a good hand in genetics, some haven't. That doesn't mean we can't make the best with what we've got. We can still strive to be the best version of ourselves and I strongly believe that externalising ourselves to the genetically thin and fat does us all a huge disservice.
Wayne Bradley BSc (hons) MSc PG cert
Etiquetas:
Colesterol,
Corazón sano,
cycling,
Deporte,
diabetes,
diet,
Dieta,
Dietética Hospitalaria,
Dietista Hospitalari@,
health,
nutrición,
Nutrition,
Obesidad,
Salud pública
viernes, 26 de octubre de 2018
Por qué no debes estresarte con la compra
Hoy os traemos un artículo muy interesante que hemos leído aquí. Está escrito por la dietista registrada Rebecca Scritchfield. El link al artículo original lo tenéis justo encima, os dejo aquí un resumen extenso en español.
--
Todos hemos experimentado alguna vez el ser cuestionados o avergonzados por nuestras elecciones en comida "No te vas a comer eso, ¿verdad?" o "Creo que comer de esta manera es lo correcto", como hubiera una forma incorrecta de comer. Como dietista registrada, me encanta ayudar a las personas a disipar esas presiones sociales poco saludables.
En una conversación reciente, una amiga mía estaba llorando por lo mucho que había subido el precio de su carro de la compra: "Sé que es 'mejor' comer alimentos orgánicos, ¡pero no puedo continuar gastanto tanto!". He escuchado estas preocupaciones de la boca de amigos, familiares y clientes durante muchos años, ¡y ni siquiera es cierto! Los cultivos orgánicos no son más nutritivos (1), ni siquiera están libres de pesticidas. Lo que importa más para tu salud es que obtengas suficientes (2) frutas y verduras, no de dónde vienen ni cómo se empaquetan. El sufrimiento de mi amiga nace de un dilema social: la moralización de los alimentos.
Cuando la comida adquiere un valor moral, se llena de prejuicios: la comida no solo es mala, la gente que la come también es mala.Los prejuicios asociados a los alimentos pueden crear un temor tan fuerte a lo que comemos que una persona arriesga su salud física y emocional. Se ha demostrado que el estrés crónico que pueden causar estas situaciones (3) está asociado con mala salud, probablemente más que los mismos alimentos que las personas sienten vergüenza de comer.
En lugar de preocuparnos por lo que los demás piensan de nosotros, ¿qué pasaría si seguimos un enfoque diferente, basado en hechos que nos permitieron tomar las decisiones que más nos convengan? Por ejemplo, el tema de los OGM es un tema que a menudo influye en las opiniones de los que nos rodean. Siempre que me preguntan sobre los OGM, lo primero que hago es aclarar qué son exactamente los OGM. A día de hoy todavía existe mucha confusión sobre lo que realmente son e incluso en la literatura científica me he encontrado con innumerables descripciones que se contradicen.
Para simplificar las cosas, aquí está mi definición: los OGM representan un método de producción de semillas que lo hace más eficiente, preciso y seguro para potenciar los rasgos beneficiosos en los cultivos que los humanos han estado modificando durante siglos. Los OGM y los métodos de agricultura sostenible que habilitan los cultivos OGM son muy interesantes. Como madre de dos niñas, me importa mucho la buena nutrición y el bienestar de mi familia y más allá de mi interés profesional, quería verificar los hechos por mí misma. Una vez revisé la información que ofrecen fuentes como la Asociación Médica Americana, la Unión Europea y la Academia Nacional de Ciencia, llegué a la misma conclusión que prácticamente todas las instituciones científicas y médicas: que los cultivos cultivados con OGM son igualmente nutritivos que los convencionales u orgánicos.
Éste es solo un ejemplo de cómo tener acceso a la información puede ser útil para tomar decisiones que se ajusten a las necesidades y preferencias de tu familia. Además, los agricultores que eligen los métodos de cultivo de OGM pueden usar menos pesticidas ¡la agricultura transgénica ha reducido el uso de pesticidas en un 37% a nivel mundial! (4)
Sin embargo, muchas personas aún creen que no pueden comer de manera saludable y sostenible si compran alimentos cultivados con métodos de OGM. Cuando hablo con los clientes acerca de esto, se sorprenden al escuchar que, además de producir cultivos nutritivos, la OGM puede ser beneficiosa para el medio ambiente. Comer de acuerdo con los estándares actuales de pureza en los alimentos puede agotar la cuenta bancaria de cualquier persona.
--
Aunque los cultivos GMO aún no estén extendidos en Europa y los alimentos transgénicos no hayan llegado a nuestros supermercados tal cual (sí que tenemos trazas o pequeños porcentajes de materias primas OGM en alimentos envasados), no dudo que veremos ese día dentro de pocos años. Y eso no debe asustarnos.
1. https://www.youtube.com/watch?v=k9p2jXhYRCk&feature=youtu.be
2. http://www.safefruitsandveggies.com/
3. https://www.apa.org/helpcenter/stress.aspx
4. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0111629
--
Todos hemos experimentado alguna vez el ser cuestionados o avergonzados por nuestras elecciones en comida "No te vas a comer eso, ¿verdad?" o "Creo que comer de esta manera es lo correcto", como hubiera una forma incorrecta de comer. Como dietista registrada, me encanta ayudar a las personas a disipar esas presiones sociales poco saludables.
En una conversación reciente, una amiga mía estaba llorando por lo mucho que había subido el precio de su carro de la compra: "Sé que es 'mejor' comer alimentos orgánicos, ¡pero no puedo continuar gastanto tanto!". He escuchado estas preocupaciones de la boca de amigos, familiares y clientes durante muchos años, ¡y ni siquiera es cierto! Los cultivos orgánicos no son más nutritivos (1), ni siquiera están libres de pesticidas. Lo que importa más para tu salud es que obtengas suficientes (2) frutas y verduras, no de dónde vienen ni cómo se empaquetan. El sufrimiento de mi amiga nace de un dilema social: la moralización de los alimentos.
Cuando la comida adquiere un valor moral, se llena de prejuicios: la comida no solo es mala, la gente que la come también es mala.Los prejuicios asociados a los alimentos pueden crear un temor tan fuerte a lo que comemos que una persona arriesga su salud física y emocional. Se ha demostrado que el estrés crónico que pueden causar estas situaciones (3) está asociado con mala salud, probablemente más que los mismos alimentos que las personas sienten vergüenza de comer.
En lugar de preocuparnos por lo que los demás piensan de nosotros, ¿qué pasaría si seguimos un enfoque diferente, basado en hechos que nos permitieron tomar las decisiones que más nos convengan? Por ejemplo, el tema de los OGM es un tema que a menudo influye en las opiniones de los que nos rodean. Siempre que me preguntan sobre los OGM, lo primero que hago es aclarar qué son exactamente los OGM. A día de hoy todavía existe mucha confusión sobre lo que realmente son e incluso en la literatura científica me he encontrado con innumerables descripciones que se contradicen.
Para simplificar las cosas, aquí está mi definición: los OGM representan un método de producción de semillas que lo hace más eficiente, preciso y seguro para potenciar los rasgos beneficiosos en los cultivos que los humanos han estado modificando durante siglos. Los OGM y los métodos de agricultura sostenible que habilitan los cultivos OGM son muy interesantes. Como madre de dos niñas, me importa mucho la buena nutrición y el bienestar de mi familia y más allá de mi interés profesional, quería verificar los hechos por mí misma. Una vez revisé la información que ofrecen fuentes como la Asociación Médica Americana, la Unión Europea y la Academia Nacional de Ciencia, llegué a la misma conclusión que prácticamente todas las instituciones científicas y médicas: que los cultivos cultivados con OGM son igualmente nutritivos que los convencionales u orgánicos.
Éste es solo un ejemplo de cómo tener acceso a la información puede ser útil para tomar decisiones que se ajusten a las necesidades y preferencias de tu familia. Además, los agricultores que eligen los métodos de cultivo de OGM pueden usar menos pesticidas ¡la agricultura transgénica ha reducido el uso de pesticidas en un 37% a nivel mundial! (4)
Sin embargo, muchas personas aún creen que no pueden comer de manera saludable y sostenible si compran alimentos cultivados con métodos de OGM. Cuando hablo con los clientes acerca de esto, se sorprenden al escuchar que, además de producir cultivos nutritivos, la OGM puede ser beneficiosa para el medio ambiente. Comer de acuerdo con los estándares actuales de pureza en los alimentos puede agotar la cuenta bancaria de cualquier persona.
--
Aunque los cultivos GMO aún no estén extendidos en Europa y los alimentos transgénicos no hayan llegado a nuestros supermercados tal cual (sí que tenemos trazas o pequeños porcentajes de materias primas OGM en alimentos envasados), no dudo que veremos ese día dentro de pocos años. Y eso no debe asustarnos.
1. https://www.youtube.com/watch?v=k9p2jXhYRCk&feature=youtu.be
2. http://www.safefruitsandveggies.com/
3. https://www.apa.org/helpcenter/stress.aspx
4. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0111629
lunes, 15 de octubre de 2018
Diagnosis of IBS: Breath Tests
One of the many frustrating aspects of irritable bowel
syndrome (IBS) is it can appear quite vague and “un-scientific” when it comes
to getting a diagnosis. In today’s modern world we expect diseases to be
diagnosed rapidly and efficiently, we go to the Drs, they take some blood and a
few days later we have our results. With IBS on the other hand, its lots of
questionnaires, symptom diaries and trial and error.
One area that does appear, on the face of it, to offer
a clear yes/no answer are breath tests. But how useful are breath tests when
it comes to an IBS diagnosis?
What are breath tests?
Breath tests are used to determine whether you absorb
or malabsorb a particular sugar. The tests offered are usually for lactose,
fructose, sorbitol and mannitol. The patient will be given a dose of one the
above sugars and then the amount of hydrogen and/or methane is measured in the
patient’s breath. The understanding is that any of the sugars that are not
absorbed are fermented by intestinal bacteria which produce the gases hydrogen
and methane. The gases are carried in the bloodstream to the lungs where they
are exhaled. A cut off point is established and if the amount of exhaled gas is
above that point then the patient is diagnosed as “intolerant” to that sugar.
For an individual that suspects they may have IBS
these tests appear very attractive because all of the mentioned sugars are
associated with the condition plus the tests promise a quick and clear result.
But…..
Sadly here comes the but. While lactose intolerance is
a recognised condition and the breath test to determine it well established,
the same cannot be said for fructose, sorbitol and mannitol. One issue is the
lack of standardisation of the test, different centres have different cut-off
points so your diagnosis may be different depending on the centre’s cut-off
point not the amount of hydrogen you produced in your test.
Focussing on fructose for a second, we all have a
limited capacity to absorb fructose. That means that at a large enough dose
every single one of us will malabsorb fructose. A study from way back in 1986
found that 8 out 10 healthy subjects malabsrobed a 50g dose of fructose,
whereas only 1 out of the 10 malabsorbed the 15g dose (1). Another study in
2014 found similar results, in a group of 16 healthy (non IBS) participants, a
40g dose of fructose was shown to distend the small bowel with water and cause
IBS type symptoms even though they were not IBS sufferers (2).
This means that depending on what dose they give you
could be wrongly labelled as intolerant to fructose or even given a false IBS
diagnosis. What has been shown is that some people are more sensitive than
others to a single dose of fructose but to label them intolerant is probably an
exaggeration.
In conclusion, while the idea of a quick test and
diagnosis is very attractive, especially in a condition such as IBS where patients
are usually desperate for a straight answer. The lack of standardisation of the
tests and the fact that we all could be diagnosed as fructose “intolerant” at
the right dose means that sadly breath tests are not a reliable way to get an
IBS diagnosis.
References
1. J J Rumessen and E
Gudmand-Høyer, 1986. Absorption capacity of
fructose in healthy adults. Comparison with sucrose and
its constituent monosaccharides.Gut. 27 (10) 1161-1168
2. Murray, K et al. 2014. Differential
effects of FODMAPs (fermentable oligo-, di-, mono-saccharides and polyols) on
small and large intestinal contents in healthy subjects shown by MRI. American
Journal of Gastroenterology. 109 (1) 109-110
lunes, 25 de junio de 2018
Gluten Sensitivity: Does it really exist?
In previous
articles we have explained the difference between coeliac disease, wheat
allergy and a third condition known as Non-Coeliac Gluten Sensitivity (NCGS). To
briefly recap, as the name suggests, NCGS appears to be a condition where
people who are neither coeliac nor allergic to wheat still report symptoms of
bloating, loose stools etc. when consuming gluten containing foods. The mechanisms
behind the condition are unclear, the immune system doesn’t appear to be
involved but some researchers have suggested that NCGS may be a step along the
path towards coeliac disease (1). Whilst we were completing the Monash FODMAP
course another possible explanation was put forward to explain why people who
have no immunological response to gluten still report gastrointestinal issues
when eating gluten containing foods. What was interesting was that the
explanation called into question the very existence of the condition of NCGS.
In recent
years gluten free eating has become very popular and lots of pseudo-conditions
are attributed to gluten. Although NCGS isn’t what we would call a pseudo-condition
it has been proposed that it might be part of IBS and the culprit isn’t gluten after all.
Fructans
are chains of varying length of the sugar fructose, they are universally
malabsorbed because we do not have the required enzyme in our body to break the
chains into smaller fructose units. This leads to the fructans passing to the
large intestine where they are fermented by the resident bacteria. This fermentation
and the resulting gas production is usually well tolerated by non-IBS people but
people with IBS tend to be highly sensitive to the fermentation of fructans and
experience painful bloating and bowel distention. Foods that contain fructans
are vegetables such as onion and garlic and of course wheat.
Monash University
state that there is a lack of evidence that has managed to separate the effects
of gluten from fructans so it is unclear which food component they are reacting
to. Therefore, they do not recognise NCGS as a condition in itself and propose
that people who report problems with gluten may in fact be IBS sufferers
reacting to the fructans in wheat (2).
Now, this
all sounds well and good, people can now relax and realise they weren’t
sensitive to gluten after all. However, the problem lies in the practicality of
it all. Finding a food that contains gluten but no fructans is virtually
impossible, the only one we have found so far is sourdough bread or “masa madre”
as it’s known here in Spain. During the fermentation process of sourdough
bread, microorganisms such as Lactobacilli feed on the fructans and reduce
their content in the finished product. The end result is that people who
previously thought they were gluten-sensitive could enjoy sourdough bread,
providing coeliac disease has been correctly excluded.
In conclusion,
it appears that there is a lack of strong evidence to declare that NCGS is a
condition in itself and people who report symptoms may be in fact IBS sufferers
who are particularly sensitive to fructans. Aside from wheat, people who
suspect they may fall into this category also need to keep in mind, onion,
garlic, leeks and chickpeas.
For any
more information on IBS or the Low FODMAP diet please get in touch via info@gabinetederueda.es
References
1. Francavilla MD, et al. 2014, Clinical, Serologic and Histologic Features of Gluten Sensitivity in Children. The Journal of Paediatrics; 164: 463-7
2. https://www.monashfodmap.com/blog/the-truth-behind-non-celiac-gluten/
Etiquetas:
Alergias,
allergy,
Celíacos,
desayuno,
diet,
Dieta,
Dietista Hospitalari@,
FODMAP,
health,
IBS,
Intolerancias Alimentarias,
LCHF,
Low carb,
nutrición,
Nutrition
lunes, 18 de junio de 2018
¿La grasa saturada no obstruye las arterias?
Editorial BJSM, BMJ
La grasa saturada no obstruye las arterias: la enfermedad coronaria es una enfermedad inflamatoria crónica, cuyo riesgo puede reducirse de manera efectiva a partir de intervenciones de estilo de vida saludable.
"A pesar de la creencia popular de médicos y el público en general, el modelo en el que la grasa saturada proveniente de la dieta produce la obstrucción de
las arterias es simplemente incorrecta. Esta revisión sistemática y metanálisis de los estudios observacionales no mostraron asociación entre el consumo de grasas saturadas y mortalidad por cualquier causa, enfermedad coronaria cardíaca (CHD), mortalidad por CHD, accidente cerebrovascular isquémico o diabetes tipo 2 en adultos sanos."
http://bjsm.bmj.com/content/51/15/1111
Siempre es bueno valorar objetivamente la evidencia que sustenta ciertas recomendaciones dietéticas y hay pocos temas tan controvertidos como el de la grasa saturada. Aunque parece escrito en piedra, lo cierto es que los estudios en los que se basan la recomendación de reducir la grasa saturada son mediocres (al igual que los que demuestran lo contrario) y aunque no defiendo ni un lado ni otro, siempre es bueno una sana dosis de escepticismo e investigar intereses comerciales (como los de la American Heart Association, por poner un ejemplo).
La grasa saturada no obstruye las arterias: la enfermedad coronaria es una enfermedad inflamatoria crónica, cuyo riesgo puede reducirse de manera efectiva a partir de intervenciones de estilo de vida saludable.
"A pesar de la creencia popular de médicos y el público en general, el modelo en el que la grasa saturada proveniente de la dieta produce la obstrucción de
las arterias es simplemente incorrecta. Esta revisión sistemática y metanálisis de los estudios observacionales no mostraron asociación entre el consumo de grasas saturadas y mortalidad por cualquier causa, enfermedad coronaria cardíaca (CHD), mortalidad por CHD, accidente cerebrovascular isquémico o diabetes tipo 2 en adultos sanos."
http://bjsm.bmj.com/content/51/15/1111
Siempre es bueno valorar objetivamente la evidencia que sustenta ciertas recomendaciones dietéticas y hay pocos temas tan controvertidos como el de la grasa saturada. Aunque parece escrito en piedra, lo cierto es que los estudios en los que se basan la recomendación de reducir la grasa saturada son mediocres (al igual que los que demuestran lo contrario) y aunque no defiendo ni un lado ni otro, siempre es bueno una sana dosis de escepticismo e investigar intereses comerciales (como los de la American Heart Association, por poner un ejemplo).
Etiquetas:
Corazón sano,
Deporte,
Embarazo,
Menopausia,
Mitos Alimentarios,
Nutrition,
Obesidad,
Prevención diabetes,
Salud pública
miércoles, 20 de septiembre de 2017
An Introduction to Periodised Nutrition
If you regularly read articles about training or subscribe
to any of the millions of training magazines, you will almost certainly be
familiar with the term “periodised training”. Basically, it means instead of
doing the same thing day in day out, you plan your training sessions to ensure
you reach your optimal state of fitness for your given sport at the right time.
As with most ideas regarding training it has been tweaked over the years and
now we have versions such as, inverse periodisation, block periodisation so on
and so on, but the idea remains the same, plan your training.
When people ask me how much carbs/protein/fat they should
eat I always answer, “it depends on your training”. Initially they think I have
given them a rather vague and unhelpful answer, but once I explain that their
nutrition should match their training and go into detail they understand why I gave
that answer.
This is the concept of periodised nutrition, depending on
the type/duration/intensity of your training regime determines what you should
eat. This is one of my main arguments against the LCHF craze, if during your
training regime you have any periods of high intensity training or races, then
chronically following a low carb diet will not be of much help. Of course, the
opposite is true. If you are not doing any kind of intense or long duration
training then a high carbohydrate diet is not necessary.
A good example would be somebody training for an Ironman, whilst
the event is still several months away and they are wanting to optimise their
fat utilisation capacity, they will most likely be doing sessions of fasted
training or sessions of fairly low intensity. At this point, I would recommend a
diet low in carbs with higher fat. Once they got nearer to race day and the
intensity of training increased, I would increase the amount of carbohydrate in
their diet. And of course, for the event itself, ensuring they take on plenty
of carbohydrate will be vital.
In summary, your diet should provide fuel for your training
and your recovery, the more intense your training is the more you will need
carbohydrate in your diet.
Over the next few months we will be looking in-depth at
different strategies of periodised nutrition, but in the meantime any questions
or comments leave below or contact www.gabinetederueda.es
Etiquetas:
Ciclismo,
cycling,
Deporte,
Dieta,
Entrenamiento,
LCHF,
Low carb,
nutrición,
Nutrition,
Sports,
suplementos,
Supplements,
triatlón
lunes, 18 de septiembre de 2017
Amino Acidos Ramificados: ¿Merecen la pena?
Los aminoácidos
ramificados (también conocidos como BCAAs) son uno de los suplementos más
populares, quizá más que la creatina. Siempre se ha dicho que los BCAAs son
imprescindibles para los aficionados de entrenamiento de fuerza y resistencia,
porque al parecer los BCAAs provocan un estado de anabolismo o impiden un
estado de catabolismo.
Mientras la
creatina tiene décadas de apoyo científico, ¿podemos decir lo mismo sobre los
BCAAs?
En este post
resumimos el artículo de Robert Wolfe de la publicación Journal of the
International Society of Sports Nutrition. Te dejamos el original aquí (en inglés), te recomendamos que leas, aquí abajo tienes los puntos claves.
Antes de que
empecemos a repasar la evidencia, vamos a repasar brevemente qué son los
aminoácidos. Hay en total 20 aminoácidos, 9 son esenciales y 11 no esenciales.
Esencial quiere decir que nuestro cuerpo no los puede construir y tenemos que
obtenerlos través de la dieta. De los 9 aminoácidos esenciales (AAE) 3 de ellos
se llaman los amino ácidos ramificados o “branched chain” (BCAAs) son: leucina,
isoleucina y valina. Las proteínas musculares están en un estado continuo de
rotación, es decir, que siempre hay síntesis de proteínas musculares (SPM) y
descomposición de proteínas musculares (DPM). Hay un estado de anabolismo
cuando hay más síntesis que descomposición, y cuando pasa lo contrario lo
llamamos estado de catabolismo. Se puede alcanzar un estado de anabolismo al
aumentar SPM o al inhibir DPM, pero para la SPM hacen falta todos los aminoácidos.
La evidencia
- En los estudios que demuestran un efecto positivo de la SPM los sujetos son ratas. Los estudios de músculos en ratas tienen casi ninguna relación con los estudios de músculos de los humanos.
- En estos estudios, los BCAAs que les dieron a las ratas fue por la vía intravenosa, no vía oral, un método poco práctico en realidad.
- En los estudios con sujetos humanos, también les dieron los BCAA por la vía intravenosa, pero esta vez hubo una disminución de la SPM.
- En los estudios de humanos hubo también una disminución de descomposición (DPM) pero los sujetos se quedaron en un estado de catabolismo.
Actualmente la
evidencia sugiere que los BCAAs solos (sin otras proteínas, carbohidratos etc.)
reducen la rotación de las proteínas musculares (síntesis y descomposición). El
autor nos advierte que una reducción en la rotación de las proteínas musculares
puede tener un efecto negativo en el esfuerzo del músculo debido a una
reducción en la construcción de nuevas fibras musculares.
La evidencia
actual indica que los BCAA (particularmente leucina) aumentan la señal de SPM,
sin embargo, una señal más potente no significa más SPM si todos los AAE no
están presente. Es como intentar arrancar un coche sin combustible.
Para conseguir la
SPM necesitamos todos los aminoácidos. Después de una comida con proteínas, nuestro
cuerpo puede utilizar los AAE de la comida, pero entre comidas, en el estado
post-absortivo, la única fuente de AAE es a partir de la descomposición de las
proteínas musculares, por eso la proteína del músculo está siempre en un estado
de rotación.
Si tomamos una
dosis de BCAA muy grande sí reducimos DPM, pero eso significa que estamos
reduciendo la cantidad disponible de AAE, por lo que como resultado también
reducimos la SPM.
El lado bueno (más o menos)
Con una señal de
SPM aumentada gracias a los BCAA puede que, en combinación con una comida rica
en proteína, el efecto de la proteína resulte aumentado. Un estudio ha
demostrado que una dosis de 5g de BCAA en combinación con 6.25g de proteína de
suero tenían el mismo efecto en la SPM que 25g de proteína de suero solo.
Aunque esto es
interesante, si pensamos en el precio de los BCAA en comparación con el precio
de proteína de suero o mejor todavía, COMIDA, ¿merecen la pena los BCAA?
Recuerda que más no es necesariamente mejor, si añades más BCAA a tu batido de proteínas no significa aún más
SPM.
Otro punto a recordar, como decimos en nuestro blog de
BCAA e inmunidad, es que los BCAA
compiten por el mismo sitio de absorción y normalmente el aminoácido en mayor
cantidad (casi siempre leucina) es absorbido a costa de los otros dos. Conclusión
No solo hay una falta de evidencia que demuestra un efecto anabólico de los BCAA solos. El autor concluye que sin la presencia de una fuente de AAE (a través la comida o de la DPM), no es posible para los BCAA aumentar la síntesis de las proteínas de musculares. Nuestro consejo es: olvídate de los BCAA y asegúrate de que tu dieta tiene una buena cantidad de proteínas de fuentes animales y vegetales.Si quieres saber más sobre nutrición deportiva visita nuestra web. www.gabinetederueda.es
Etiquetas:
Ciclismo,
cycling,
Deporte,
Dieta,
Entrenamiento,
Iron Man,
LCHF,
Low carb,
Mitos Alimentarios,
nutrición,
Nutrition,
Sports,
suplementos,
Supplements,
triatlón
lunes, 11 de septiembre de 2017
BCAAs: Are they really worth it?
Branched chain amino acids (BCAAs) are in some way the
creatine of the 21st century, what I mean by that is, that they have
become the “go to” supplement for every gym goer. Strength and endurance
enthusiasts alike are sold the idea that BCAAs are an essential component of
their nutrition regime because they supposedly induce an anabolic/avoid a
catabolic state in humans.
Whereas creatine now has decades of convincing research
behind it, can we really say the same about BCAAs?
This post will summarise the recent review by Robert Wolfe
in the Journal of the International Society of Sports Nutrition. I strongly
recommend that you read the full paper (link here) after you have read the main
points below.
First, a quick recap on amino acids. There are 20 amino
acids in total, 9 are essential and 11 are non-essential. The term “essential”
means that the body cannot synthesise these amino acids so we must obtain them
from food. Of the 9 essential amino acids (EEAs) 3 of these are called the
branched chain amino acids (BCAAs) these are, leucine, isoleucine and valine.
Muscle
protein is in a continued state of turnover, meaning proteins are constantly
being broken down and synthesised (built up). The term anabolic state refers to
when muscle protein synthesis (MPS) is greater than muscle protein breakdown
(MPB), in other words, our muscle tissue is being built up as opposed to being
broken down. When muscle protein breakdown is greater than synthesis this is
known as a catabolic state. The anabolic state can be achieved by either
increasing muscle protein synthesis or by reducing muscle protein breakdown. For
MPS to be greater than MPB all 20 amino acids must be present.
We are sold BCAAs under the premise that they stimulate
muscle protein synthesis and so we can avoid the dreaded catabolic state. But
what does the actual evidence say?
The Evidence
- The studies that show an increase in MPS after ingestion BCAAs were conducted on rats. Muscle protein studies on rats have little if any relevance to humans.
- These studies also administered the BCAAs intravenously as opposed to orally
- Studies on humans, (who also administered the BCAAs intravenously), actually showed a decrease in MPS
- The human studies also demonstrated a decrease in muscle protein breakdown but overall net effect was that the subjects remained in a catabolic state.
When all the evidence is considered, it appears that taking
BCAAs alone reduces protein turnover (synthesis and breakdown). The author
points out that this may have a negative effect on muscle strength due to a
reduction in new muscle fibre construction.
Current evidence suggests that BCAAs (in particular leucine)
increase the “signal” for MPS, however an increased signal will not lead to
increased MPS if the other EAAs are not available. Think of it as turning the
key in the ignition, without fuel the engine won’t start.
In order for MPS to occur all amino acids must be available.
After a meal containing sufficient protein, MPS is achievable because the EAAs
will be taken from the ingested food. However, in the post-absorptive state (in
between meals) the only source of EEAs is from the breakdown of muscle protein.
This is why muscle is in a constant state of turn over.
If we take a huge dose of BCAAs we reduce MPB, however, by
reducing MPB we reduce the amount of EEAs available for MPS so in turn, both
MPS and MPB are reduced.
The Good News (kind of)
With an increase in anabolic signalling through BCAAs, it
appears that it can increase the effect of a protein meal. One study
demonstrated that 5g of BCAAs added to 6.25g of whey protein had the same
effect on MPS as 25g of whey protein alone.
While this may seem interesting, when you weigh up the cost
of BCAAs against the cost of whey protein or (shock horror) real food, are they
really worth it? Remember the golden rule, more is not always better, so adding
even more BCAAs to your shake will not have a greater effect on MPS.
Another point to remember is, as we mentioned in our amino
acids and immune system post, the BCAAs
compete for the same site of absorption so when taken in a large dose the amino
acid in the greatest concentration (usually leucine) will be absorbed at the
expense of the others.
Conclusion
Not only is there a lack firm evidence to demonstrate an
anabolic effect of taking BCAAs alone, the author concludes that without a
supply of essential amino acids (either through food or muscle protein
breakdown) it is not possible for BCAAs alone to increase muscle protein synthesis.
Our advice as always is ensure you have a diet rich in high quality protein
before starting to consider supplements.
Etiquetas:
Ciclismo,
Corazón sano,
cycling,
Deporte,
desayuno,
Dieta,
Entrenamiento,
Intolerancias Alimentarias,
LCHF,
Low carb,
Mitos Alimentarios,
nutrición,
Nutrition,
Sports,
Supplements,
triatlón,
Vegetarianos
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