It’s a familiar situation: you’ve been dashing round all day grabbing food on the go when suddenly, heartburn starts. Ouch.
Heartburn (also called acid reflux) is caused by stomach acid escaping up into the oesophagus (the tube that runs from your throat to your stomach). Normally, a ring of muscle called the Lower Oesophageal Sphincter (LOS) tightens up to keep food and acid safely in the stomach. However, certain factors can affect this ring of muscle, stopping it from closing properly and allowing some acid back up into the tube.
The oesophagus isn’t equipped to deal with this acid and it goes into spasms. Sometimes the spasms and pain are so bad they are mistaken for a heart attack. Other symptoms include a sour taste in the mouth, a sickly burning sensation at the back of the throat, bloating, nausea, and a sudden increase in saliva.
Having an occasional bout of reflux ( eg once every few months) isn’t too concerning as the trigger is usually easy to identify and resolve. Eating a large celebratory meal with a few drinks for example, or indulging in some unusual foods on holiday. But if you’re experiencing reflux more than twice a week, it’s possible you could have GORD – GastroOesophageal Reflux Disease.
What causes heartburn & reflux?
Several factors make heartburn and reflux more likely to occur. Pregnancy, for example, and being overweight. Both these conditions increase pressure on the LOS, making it easier for small amounts of acid to escape back into the oesophagus.
Caffeine, chocolate, mint, peppermint, and alcohol can reduce the tone of the LOS, preventing it from closing properly. That’s all kinds of alcohol by the way. I’ve often been asked if there’s a special type of wine or particular beer that doesn’t relax the LOS, but sorry, the answer is no! Other foods can worsen the irritation caused by reflux: this group includes spicy foods and citrus fruits, which is why curries and orange juice are often a problem.
An important thing to note here is that none of these factors causes excessive amounts of stomach acid to be produced. It’s rare to have too much stomach acid. In fact, most people with reflux and heartburn have too little, and that’s another part of the problem…
Stress & Digestion
Aside from foods, the biggest single trigger for heartburn and reflux is stress.
Stress disrupts your entire digestive process from start to finish. Imagine your digestion is like a factory production line. Each part of the line can only do its job if the part before it is working properly. So, if the very first part of digestion isn’t up to scratch, the stomach will suffer.
The very first part of digestion isn’t chewing or swallowing food, it’s SEEING and SMELLING the food. Even HEARING it being cooked (sizzling pancakes anyone?). This stage is called the Cephalic stage after the Greek word ‘kephos’ meaning head. It’s all about the senses of smell, sight, and sound.
When we use these senses, we trigger nerve impulses that go down the vagus nerve into the digestive system. These impulses tell the stomach to get ready for the arrival of food, to get busy producing gastric juices! If we skip this stage as is the case when eating on the go, food arrives in the stomach with no warning and the stomach struggles to deal with it.
Eating on the go usually goes hand-in-hand with feeling busy and stressed. The problem is, our fight-or-flight stress response runs in direct opposition to our rest-digest-heal response. We cannot do both things at the same time: we cannot digest food comfortably whilst being stressed.
This is what happens;
How to manage heartburn & reflux mindfully and naturally
Now you know what might be causing the problem, let’s look at simple ways to deal with it.
1. Make time for eating
As we’ve just discussed, eating on the go is a big trigger for heartburn and reflux so the most important step is to make time to eat. This can be 10 minutes, so long as that’s 10 minutes with no phone, emails, or TV. Just you and your food.
2. Take 3 slow deep breaths before eating
Deep breathing instantly down regulates the stress response and switches your nervous system into rest-and-digest mode. Look at your food whilst taking these deep slow breaths, enjoy the smell and sight of your meal. Engage these important cephalic senses!
It’s amazing how many people simply hoover up food. Like some kind of alien with a suction tube rather than a human with a mouthful of teeth.
Chewing stimulates even more of those important nerve signals, and also helps us to know when we’re full. If you think you’re over-eating, try chewing more to reignite your satiety signals.
4. Avoid foods that relax the LOS
Alcohol, mint, peppermint, caffeine and chocolate. I know there’s a lot of ‘treat’ foods in there, but think about how much better you will feel.
5. Enjoy a small bowl of bitter salad leaves before your main meal
Bitter foods like rocket, watercress, mustard leaves, dandelion leaves, mizuna, apple cider vinegar and lemon juice stimulate the gastric juices. Use the lemon juice and apple cider vinegar in a simple dressing with olive oil and black pepper for a delicious green salad starter.
*Please do not do this if you already have an active stomach ulcer or gastritis or are taking H2 blockers or PPI medications*
6. Eat larger meals earlier in the day
The speed at which your stomach empties is partly controlled by diurnal rhythms. It empties slightly faster in the morning than in the evening. You’re also more likely to be upright and moving round during the day: lying down after an evening meal makes it easier for acid to flow back up into the oesophagus.
Experiment with having a smaller evening meal, and eat more at breakfast and lunch instead to see if this eases your symptoms.
7. Enjoy an overnight fast
Fasting is the only way for your digestive system to have a rest and do some ‘housekeeping’. Does that sound weird? Well, the billions of bacteria in your gut have a lot of maintenance work to do, keeping your gut lining healthy. The easiest way to give them chance to do this, and for your stomach to have a rest, is to fast overnight for 12 hours. So, if you finish your evening meal at 7.30pm, don’t eat again until 7.30am the following morning. Herbal teas and water are okay, just no food.
Which steps can you take?
Have you found your own natural way of managing heartburn & reflux?
Do share in the comments below or pop over and join the Facebook Group!
There’s little doubt that veganism is blooming. Over 250,000 people participated in Veganuary 2019 – a massive increase from the 3,300 who participated in 2014.
Done properly, a plant-based diet can provide nearly all the nutrients we need to thrive (I say “nearly all” because of the vitamin B12 conundrum – more on that later) and can be deliciously interesting and varied. Done badly, a vegan diet is the same as any other poor diet.
As a nutritionist I come across all kinds of diets. Vegan, juice fasts, raw food, keto, Paleo, Hay (eating proteins at a different time to carbs, not chewing on actual hay…though no doubt someone will one day, and probably make a ton of money from the idea) – and people ask my opinion of them.
When it comes to veganism, I’m happy to agree so long as it’s done properly and involves eating real food. I have several vegan friends and colleagues, including the brilliant nutritionist Elena Holmes, who epitomises the healthy vegan lifestyle.
However, a vegan diet is not;
– The answer to our environmental and food sustainability issues
– The cure for every known health issue
– Easy to follow. This is especially true if you dislike vegetables and pulses. And yes, I have met vegans who don’t like vegetables. Good luck with that.
The environmental impact of animal farming is of significant concern to many who switch to veganism. It’s a complex and knotty issue. Yes, certain crops have a much lower water footprint than farmed animals, but this varies between grass-fed and grain-fed livestock.
There’s also a few surprising figures too… For instance, lets look at the different waterfootprints of chicken, beef, and cocoa beans:
(Figures from https://waterfootprint.org/en/resources/interactive-tools/product-gallery/)
I have yet to hear anyone say they are giving up meat AND chocolate to help the environment!
The boom in veganism has also brought with it an explosion of plastic wrapped ultra-processed foodstuffs like meat-free burgers and fake mince. Heavily reliant on processed soya or fungus grown in fermentation tanks, these plastic shrouded concoctions heavily undermine the environmentally-friendly-veganism argument.
Of course, meat and dairy products aren’t for everyone. There is no one-size-fits-all diet, we each have unique preferences and requirements. But let’s not lose sight of how nutritionally sound ethically reared meat and and dairy can be.
Nutrients from meat & dairy
Earlier this year I was invited to speak to the Future Farmers of Yorkshire about the nutritional properties of meat and dairy as part of a debate covering a range of subjects including the environmental and ethical impacts of farming. There are several key nutrients that can be lacking in a poorly balanced vegan diet, and we started with one of the most common: vitamin B12.
The most bioavailable form of B12 is unique to animal products. It plays an important role in mental wellbeing, heart health, nerve cells, and red blood cell function. A small amount is stored in the body which is why deficiency may not show up for months, even years after switching to a vegan diet.
Top sources include shellfish, lamb, and beef (there’s an interesting list on Nutrition Data: it’s a US site, hence the inclusion of moose meat – not a common source for those of us in the UK!).
Many foods suitable for vegans are fortified with B12; nutritional yeast and breakfast cereals for example. Certain plant foods do naturally contain B12, the most notable being green and purple nori. Studies have shown that eating these forms of nori can improve B12 status, though you would need to eat substantial amounts every day to support levels in the long term! Same goes for shiitake mushrooms. Of all the edible mushrooms, shiitake carries good levels of B12 but you would still need to eat an average of 50g (dried weight) per day to maintain levels.
Spirulina and other edible cyanobacterias (commonly called blue-green algaes) contain pseudovitamin B12 which isn’t bioavailable to us as humans. We can’t absorb it or use it.
Iron – haem and non-haem
Iron deficiency is a particular issue for female vegans due to regular iron loss from periods. Haem iron in animal products is much better absorbed than non-haem iron from plant sources. If you are relying on non-haem iron, be sure to include sources of vitamin C too, as this helps the absorption and usage of plant-sourced iron.
Good combinations include;
– Millet grain (iron) in a salad with vit-C foods watercress, parsley, and peppers
– Blackstrap molasses (iron) in hot water with a good squeeze of fresh lemon juice (vit C)
– Pumpkin & sunflower seeds (iron) in a fruit salad with papaya, kiwi, and strawberries (all good sources of vit C)
Many of us, whether vegan or not, are low in vitamin D simply because we don’t get enough regular sunshine here in the UK. Unfortunately for vegans, the optimum dietary sources of vitamin D3 (the most active usable form) are eggs, liver and butter, with plant sources like mushrooms providing a little D2.
It is advisable for everyone to take a supplement during winter months (October to April) and vegans may need to continue all year round. To check your levels, see your GP or try a home test kit from www.vitamindtest.org.uk
Vegetarian and vegan diets tend to have plenty of omega-6, but often struggle with omega-3. Nuts and seeds provide what is known as the ‘parent’ omega 3 fat, Alpha Linoleic Acid (ALA). This needs to go through several conversion steps before it becomes EPA and DHA (eicosapentaenoic acid and docosahexaenoic acid). These are the omega-3 fats we use for brain and heart health, and which are ready formed in fish oils.
These conversion steps rely on co-factor nutrients like magnesium, B-vitamins, zinc, and vitamin C, and a lot of ALA gets lost during the process. There isn’t an easy answer to this dilemma, other than to ensure vegans include walnuts, flaxseed oil, and/or pumpkinseed oil everyday for their rich ALA content, and to enjoy plenty of food sources of the co-factor nutrients too.
What are your thoughts on meat-eating and veganism?
Have you a delicious vegan recipe to share?
Tell us in the comments below, hop on over to the friendly Facebook Group for more conversations and recipe ideas or tag me on Twitter @nutritioninyork
As part of Endometriosis Awareness Month I’ve been sharing nutrition tips (see below) and a Facebook Live that focus on simple steps to support hormone balance.
Endometriosis affects over 1.5 million women and girls in the UK alone, and many women suffer for years before receiving a clear diagnosis.
The condition is caused by cells that normally live in the womb growing in other parts of the body. They can grow on the bowel, the ovaries, even in lungs, eyes and the brain.
Because these cells are womb cells, they respond to the hormonal changes of a woman’s menstrual cycle, growing larger during the second half of the cycle and even bleeding during menstruation.
These changes can cause a wide range of symptoms including painful heavy periods, pain during sex, bowel problems, depression, exhaustion, and infertility.
In the video I explore these tips in more depth and answer some common questions about periods and endometriosis.
If you’d like to know more feel free to comment below or hop over to the Facebook Group at www.facebook.com/groups/nutritioninyork and join in the conversations there!
January 2019 is set to be the most popular Veganuary yet, with over 14,000 people pledging to stick to a vegan diet and lifestyle for the next month.
Whatever your reasons are for cutting out meat, fish, dairy, eggs, honey, and all other animal derived products, the sudden swap to a vegan diet can have a significant impact on your body, especially if you’re used to eating animal produce every day. Digestion and energy levels are frequently affected: let’s explore why…
Digestion: a sudden increase in fibre and indigestible starch from vegan staples like pulses, beans, nuts and seeds can cause bloating and wind. Our gut bacteria are influenced by what we eat, and it can take time for them to adapt to a different way of eating. They thrive on fibre, fermenting it in our gut, which is why one of the side effects of a vegan diet can be uncomfortable wind and bloating!
Bowel movements may also change: some people experience constipation whilst others find stools become loose and more frequent. Again, this is down to the change in fibre intake.
- If you’re suffering with wind and bloating try using a plant-based digestive enzyme formula to support the breakdown of tough plant fibres and starches. Look for one containing alpha-galactosidase, an enzyme proven to reduce gas and bloating.
- Soaking pulses before cooking and using fermented soya products like miso and tempeh can aid digestion.
- Sprouting beans in a seed sprouter can make them easier to digest.
- Soak nuts overnight then allow to dry before eating; this can aid digestability.
- Be mindful of your fluid intake, especially if constipated. Fibre soaks up fluid in the gut, so remember to drink more water throughout the day, and opt for hydrating foods like soups and stews that combine fibre-rich beans and pulses with fluids.
Energy levels: switching from being carnivore to vegan means your body has to adapt to different nutrient sources. This can affect energy levels, particularly if you’re a pre-menopausal woman with regular periods as you are now reliant on plant-based or non-haem iron sources.
The main nutrients to consider are;
Iron: non-haem iron absorption is helped along by vitamin C so aim to combine these nutrients where possible:
Zinc: red meat, poultry, and seafood are packed with easily absorbed zinc, so your body has to adapt to deriving it from plant foods on a vegan diet. Nuts and seeds – especially pumpkin seeds – are good sources, but they also contain phytic acid which can impair zinc absorption. Soaking the nuts and seeds before eating helps to breakdown phytic acid and improve zinc bioavailability.
Vitamin B12: most plant forms of B12 are not readily used by humans with the exception of purple & green nori, fortified yeast (and other fortified foods), and shiitake mushrooms. You may have enough B12 stores in your system to manage Veganuary, but if veganism is a long-term plan, consider using a B12 supplement or B-Complex containing B12.
Protein: protein is present in varying amounts in foods, which is where the term protein quality comes from. Eggs are an example of high quality or perfect protein as they contain the right ratio of amino acids (the building blocks of protein) to match our human needs. On a vegan diet it is important to combine different protein sources at each meal so that over the course of the day you get all the amino acids you need.
Vegan protein sources include:
– Nuts (whole or as nut butters)
– Pseudo-grains like quinoa and amaranth
– Legumes and pulses
Omega-3 fats: the omega-3 oils found in oily fish are DHA (docosahexanoic acid) and EPA (eicosapentaenoic acid). We can use these straight away with no need for conversion: they help regulate inflammation and support heart health and mental wellbeing.
Plant foods contain ALA (alpha linolenic acid) which is the ‘parent’ of DHA and EPA. It goes through several conversion pathways in the body to become EPA and DHA and we lose some of it along the way. Because of these conversion losses, it’s important for vegans to include ALA sources everyday.
The richest concentrated source of ALA is flaxseed oil; this can be drizzled over cooked vegetables, salads, granola, coconut or soya yoghurt, included in smoothies – the ideas are endless! I know a lady who adds it to her gravy! It can be added to hot foods but don’t cook with it as high temperatures affect the oil structure.
Other sources of ALA include walnuts, pumpkin seeds, pumpkin seed oil, hemp oil, and chia seeds.
Plant-based diets can be as varied and nutritious as meaty-fishy ones, but they do require thoughtful planning, especially at the outset. Browse these recipe blogs for meal inspiration and remember to join the Facebook group and follow me on Twitter where I share a #MeatfreeMonday recipe each week.
Pickles & Honey
Happy Healthy Life
Photo by Toa Heftiba on Unsplash
What springs to mind when you think about self care?
Eating a delicious meal? A relaxing yoga session? Enjoying a massage or spa treatment?
Do you even think about self-care at all?
Finding time to look after ourselves can be hard, especially when other people depend upon our time and attention. Yet we all have at least three opportunities for self-kindness and care every day: breakfast, lunch, and evening meal.
Maybe you’ve fallen into the habit of skipping meals or eating hurriedly between meetings and appointments. Perhaps you don’t even care what you eat, so long as you refuel and can make it through the day.
Such unkind eating habits do more than deplete your body of nutrients and are worth exploring to detect any underlying causes.
Tiredness for example is often a reason for missed meals, but this will of course perpetuate the situation and worsen fatigue. Feeling stressed by an over-filled schedule is another possible reason. Depending on who organises your schedule, dealing with this factor may mean having an honest conversation with your boss, or creating space in your own diary to eat each day.
Skipping meals forces your system to produce more stress hormones to support the levels of glucose in your blood that keep your muscles and brain working. A short burst of stress hormones is easily dealt with, but ongoing stimulation can contribute to some nasty health issues including high blood pressure and gaining fat around your middle.
Eating too quickly can trigger all kinds of digestive problems: from indigestion and bloating, to pain, cramps, and Irritable Bowel Syndrome symptoms.
Learning (or re-learning) to chew food thoroughly can alleviate a lot of digestive discomfort, and even help with maintaining health weight balance.
To start a new simple habit of self-nourishment, kindness and care, try one or more of these 5 steps this week;
- Create time to sit and enjoy breakfast. This can be a small meal: a smoothie perhaps, or poached egg on sourdough toast. Whatever it is, be sure to sit down and take ten minutes to chew thoroughly and enjoy your food.
- Prepare a large pan of soup and freeze in individual portions so you have ready-made lunches for the week ahead.
- Make a mug of your favourite herbal tea, sit somewhere peaceful for twenty minutes and savour the flavour.
- Buy a vegetable you’ve never cooked before and find a new recipe for it.
- Let the rainbow in by including 6 different colour fruits & vegetables each day. Choose 1 from each of these groups: red, orange, yellow, green, blue/purple, and white.
Feeling inspired? Do share your thoughts in the comments below, or over in the Facebook group – we’d love to hear from you!
And you might also like to read;
Depression & Anxiety – What to Eat to Feel Good
Does Food Affect Your Mood? Find out with this FREE Food, Mood and Movement Tracker #1SmallStep
Get Organised with this FREE 7-Day Meal Planner! #1SmallStep
7 Energy Boosting Breakfasts – #1SmallStep