Let's Gut Real - Easy to Digest Nutrition Science – Détails, épisodes et analyse

The number of people who have reached out to me and shared how the podcast has changed their practice, understanding, and life seriously can't be understated. Unfortunately, after three years and so many personal changes, I've decided to put the podcast on a hiatus. I feel so many mixed emotions about this, and given my personality, it's hard to take a step back but I look forward to bringing you more amazing content in the future.

I talk about:

1)    How nutrition science is rarely sensational or extreme. As well as the importance of doing what feels good for your body - without making it dogmatic.

2)    The value in trying to eat as many plant foods as you can each and every day. The importance of choosing a variety of foods that are acceptable to your palate, culture, budget, and lifestyle.

3)    The value of having a member on your health care team that advocates for you, whether that's your dietitian, pharmacist, doctor, or physio. If you're struggling to advocate for yourself and your medical needs, it is important to find an allied health provider that can get the best care possible for you. 

Connect with me on my website at www.andreahardyrd.com, my clinic website at ignitenutrition.ca, on Instagram @andreahardyrd, or Twitter or Facebook here as well!

Pain is a predominant feature in the majority of functional gut disorders. The higher risk of anxiety and depression when coping with any chronic illness, including GI disorders, as well as anxiety and depression impacting symptoms and symptom perception in many GI conditions are all very important aspect of medical care.

This week I interview Dr. Katia Tonkin on the role that cannabis plays in medical care – including in the treatment of anxiety, depression, and pain.

Dr. Tonkin is a medical oncologist who worked at The Cross Cancer Institute in Edmonton Alberta Canada for 20 years and in London, Ontario Canada for 6 years prior to that. She became interested in medical cannabis in 2016 as many patients started asking about cannabis. After researching into it, Dr. Tonkin felt cannabis was likely to help many patients with a wide variety of problems. She started treating patients in April 2017 and wants to contribute to clinical research to further medical knowledge into appropriate uses of medical cannabis, as well as educating health care providers on the proper use of cannabis. She works out of Optimum Wellness Center as well as other clinics as a medical prescriber.

We talk about:

• Tonkin’s background as a clinician and how they became interested in the role cannabis plays in medical care.
• What cannabis is.
• The components of the plant that have therapeutic impacts.
• The role of a medical prescriber.
• How cannabis, that is medically prescribed, differs from cannabis you might find in stores and why ’self medicating’ is not the best strategy to realize the benefits of cannabis
• The conditions we have evidence for using cannabis with (including anxiety, depression and pain)
• How these overlaps with gastrointestinal disorders.
• How to find a medical prescriber.

Connect with Dr. Katia Tonkin at Optimum Wellness Centres in Edmonton, Alberta.

Diet culture has a profound impact on our beliefs about nutrition and health. It can impact our behaviours and may lead to disordered eating which can have far reaching impacts on our bodies ability to digest food and further lead to uncomfortable digestive symptoms.

This week I interview Jessica Begg, RD on how emotional eating and binge eating influences our digestive symptoms.

Jessica Begg is both a Registered Dietitian as well as a Registered Clinical Counsellor. Jessica’s double qualifications make her uniquely suited to helping clients address the psychological issues that underpin their challenges with eating. She has been working in the area of disordered eating and within eating disorders treatment programs since 2006. Jessica works from a trauma-informed, emotion-focused, weight-inclusive and weight-neutral, anti-diet or non-diet approach. Jessica’s approach allows her clients to live their lives to the full by unshackling their beliefs about diet culture.

She is currently living in Vancouver where she practices clinical nutrition counselling.

We talk about:

• How Jessica became involved in working with patients with eating disorders
• The prevalence of digestive symptoms in eating disorders and what symptoms people usually complain of
• Why manipulating the diet, being the knee jerk approach that registered dietitians MIGHT use, may not be appropriate (Especially registered dietitians without eating disorder experience)
• The importance of screening for eating disorder behaviours
• How emotional and binge eating influences digestive symptoms
• Important things to consider/do to reduce emotional and binge eating
• How restrictive diets for digestive disorders might trigger binge eating /emotional eating, and the problems with that

Connect with Jessica on her website at shiftnutrition.com or on Instagram or on her Facebook or on Twitter here as well!

With diets like keto and carnivore gaining traction, I've had many people ask - what impact do plants specifically have on our microbiome and human health? 

Today I interview Dr. Veronique Braesco, Dr. Petra Louis, and Dr. Ian Rowland, researchers that have contributed to the latest scientific update summarizing the impact of plant-based diets on the gut microbiome and published through the Alpro Foundation.

The Alpro Foundation has been a scientific platform for over 25 years dedicated to supporting research and the dissemination of evidence-based knowledge on plant-based nutrition and its impact on health and environment amongst academics, healthcare professionals and key stakeholders in nutrition. The ultimate aim is to help drive the transition to more healthful plant-based diets for human and planetary health.

Underpinning Alpro Foundation’s scientific integrity is an independent Scientific Advisory Board of 8 leading academic experts who provide direction and advice and ensure the scientific credibility of the education tools. Professor Ian Rowland is the chair of this Scientific Advisory Board.

Professor Ian Rowland is editor-in-chief of the European Journal of Nutrition. Until his recent retirement, he was the Hugh Sinclair Professor of Human Nutrition at University of Reading. He holds a BSc and PhD in microbiology from University College London. Prof. Rowland’s main research area is the role of diet (in particular probiotics, prebiotics, phytoestrogens, and phytochemicals) in the prevention of colon, breast and prostate cancer. In his current research, he is investigating the role of fruit and vegetable intake on markers of cancer risk. In 2005 he was awarded an honorary doctorate from the University of Gent in Belgium for his work on nutrition and cancer. Professor Rowland has published over 300 papers.

Petra Louis is a molecular microbiologist with an interest in the human gut microbiome, diet and health. She obtained her Diploma in Biology and PhD in Microbiology from the University of Bonn, Germany, where she conducted research on osmoadaptation in halophilic bacteria.

Véronique Braesco holds a PhD in human nutrition. Her academic carrier in Public Research at INRA, as senior scientist, has been focused on vitamins. She then headed the Nutrition Research Department of the Danone Group. In this position, she managed the design and implementation of scientific strategies, in particular in the field of probiotics. She was later responsible for the Human Nutrition Research Centre in Auvergne, dedicated to studying the role of diet in healthy aging. She is now at the head of VAB-nutrition, a consulting firm specialized in human nutrition that she created in 2007.

We talk about:

• What characteristics are associated with better health by way of the gut microbiome
• Beneficial and deleterious dietary components and their influence on gut microbiome
• Fibre from supplements versus food - is one ‘better’ for the gut microbiome?
• The role of the food matrix, the various chemical compounds found in food like polyphenols, and the role variety of fibres plays in the gut microbiome composition
• Polyphenols - where are they found, and what are potential ways in which they influence our health by way of the gut microbiome 
• What are SCFA’s, what their role is in our health, and what influences the production of SCFAs in the gut
• Microbial metabolites from protein - when do we digest protein, how this occurs, how does it influence health?
• How fibre impacts microbial metabolite production in our bodies
• Dietary recommendations we can ultimately take away from the current evidence

The most recent Scientific update with the Alpro Foundation is about the 'Interaction of Plant-based diets and gut microbiota'

Research around digestive health is constantly changing, and it is one of those areas where we don’t necessarily know all the answers. This week I interview RD Abby Langer on fighting nutrition misinformation and debunking some popular digestive health claims.

Abby Langer has been a Registered Dietitian since 1999. Abby is passionate about all aspects of nutrition, from physiology to teaching to cooking. Her approach to nutrition is permissive and relaxed, and she is a true believer in living your best life without dieting. She has written in depth about debunking fad diets and nutrition myths and focuses on body respect and intuitive-style eating.

When she’s not working, Abby loves running, spinning, discovering new foods, and spending time with her husband and two daughters.

We talk about:

• How Langer became passionate in fighting nutrition misinformation
• Some of the worst gut health offenders
• Current claims and popular myths in the digestive health field
• Tips for dietitians looking to tackle misinformation and what to watch for
• How to be vigilant when so many things look credible
• How to address when other dietitians promote things that aren’t evidence based
• The importance of keeping up to date with scientific research
• Tips to consider when trying to make sense of research findings and which types of evidence are stronger than others

Connect with Langer on her website at abbylangernutrition.com on Instagram @langernutrition or on Twitter or on her Facebook here as well!

Concussions can have a profound impact on our brains and are not always the result of a direct blow to the head.

This week I interview Erik Bustillo, RD on concussions, what they are, how they impact the brain, how they can happen, nutrition supported recovery and the impact they can have on mental health.

Erik Bustillo, MS, RD, FISSN, CISSN, CSC, CPT practices as a Registered Dietitian, Strength Coach, Fitness Trainer, and Health Coach. He attended Florida International University and earned his B.S. in Dietetics & Nutrition and his M.S. in Applied Exercise Science with a concentration in Sports Nutrition from Concordia University Chicago. Additionally, Erik is the current Co-Vice President and a Fellow of the International Society of Sports Nutrition (ISSN) as well as a Certified Sports Nutritionist (CISSN), a Certified Strength Coach through the National Council on Strength & Fitness (NCSF), and a Certified Personal Trainer through the National Strength & Conditioning Association (NSCA).

Erik has experience in research and working with professional, collegiate & tactical athletes, weekend warriors, avid CrossFitters, and in an outpatient setting helping individuals with weight loss/gain as desired outcomes using motivational interviewing and seeing medical nutrition therapy patients.

We talk about:

• How Erik became interested in sports nutrition 
• What is a concussion and how does it affect our brain? 
• Are there any implications on mental health from concussions?
• What sports are at risk of concussions
• Long term impacts of concussions
• How does nutrition play a role following a concussion? Can it impact return to sport?
• With all the crazy supplements out there focused on enhancing brain health - are there any supplements to take or avoid in concussion recovery?
• Is there any link between gut health and concussion recovery?
• What about Probiotic use for concussion recovery? 

Connect with Erik on Instagram or on Twitter or on his Facebook here as well!

Our diet, the balance of our gut microbiome, and fibre intake can have significant impacts on our digestive health and disease outcomes. This week I interview Dr. Genelle Healey on the use of exclusive enteral nutrition (EEN) treatment for IBD patients.

Dr Genelle Healey undertook her PhD in Nutritional Science at Massey University in New Zealand. Her research looked at what influence habitual dietary fibre intake has on gut microbiota response to a prebiotic (fibre) intervention. Prior to commencing her PhD, Genelle worked as a New Zealand registered Dietitian caring for patients with various diseases including gastrointestinal cancer, inflammatory bowel disease (IBD), renal disease and diabetes.

In 2017, Genelle moved to Vancouver to start a postdoctoral fellowship at University of British Columbia. The focus of her research is to better understand the impact nutrition, particularly fibre, has on the gut microbiome and disease outcomes for patients with IBD. During her postdoctoral fellowship she utilized models of IBD to investigate the therapeutic potential of novel nutritional interventions with the hope that these therapies can one day be used to positively impact the health and wellbeing of patients with IBD. Specifically, she has demonstrated that exclusive enteral nutrition (EEN) enriched with fibre leads to beneficial changes in the gut microbiome, less inflammation and better disease outcomes compared to EEN without fibre.

We talk about:

• How Healey became interested in the field of digestive health
• What IBD is
• How diet plays a role in the management of IBD
• Some prescriptive diets that could put a patient into remission.
• The role of ‘enteral nutrition’ in IBD
• The difference between PEN and EEN
• The mechanism of action in which we believe PEN/EEN can induce remission in IBD patients
• How the gut microbiome is involved
• The formulas used in IBD management and their ingredients, including emulsifiers
• The overall complexity of IBD

Connect with Dr. Healey on her researchgate profile or on Twitter

Were you recently diagnosed with celiac disease? Having celiac disease can mean something different for each patient. There are many different symptoms and yet some people may not experience any symptoms at all.

This week I interview RD Selena Devries about different ways to advocate for yourself if you have been diagnosed with celiac disease and helpful ways to encourage your transition into eating gluten-free.

Selena Devries is a registered dietitian from BC Canada.  She completed her dietetic training at Kelowna General Hospital in 2013 and was, shortly, after diagnosed with celiac disease myself.  Through her diagnosis, she started to volunteer with the Canadian Celiac Association and ended up working on their national board of directors as well as their professional advisory council with other celiac dietitians and gastroenterologists.   She is also trained in the low FODMAP diet for IBS through Monash University.  Her own diagnosis and follow up led her to discover gaps in care for celiac disease which led her to private practice with a focus on the dietary management of celiac disease.   With her online nutrition practice, she helps celiacs fall back in love with food. She helps them resolve persistent symptoms despite a GF diet, help the newly diagnosed get off on their best foot, and help celiacs eat out with confidence.  

We talk about:

• How Selena became interested in celiac disease
• What is celiac disease? 
• The common symptoms of celiac disease and some emerging symptoms (GI and otherwise) 
• The mainstay in celiac treatment
• What you see as major gaps as a dietitian working with celiac and living with celiac when it comes to celiac education
• High risk gluten-free grains
• Tips for eating out while gluten-free
• What to do when symptoms don’t improve
• How to advocate for yourself as a patient with celiac disease
• Health monitoring protocols like annual blood labs
• The overlap with IBS and SIBO or other gastrointestinal issues

Connect with Selena on her website at Healthbean.ca on Instagram @Celiac_dietitian or on her Twitter here as well!

It’s not always easy to identify what may be causing infant colic or infant allergy reactions. Infant food sensitivities are common and can result in projectile vomiting, reflux, mucousy/bloody stool, and more - which can be very distressing to parents and lead to unnecessary dietary restrictions.

This week I interview Dr. Trill Paullin on Infant Food Sensitivities, how they arise and what we can do to help manage them

Dr Trill is a Molecular Biologist and mother to two daughters who had severe infant food sensitivities and reactions to proteins transferred from my diet to her breast milk.  After she processed the painful fact that she could hurt my children through breastfeeding, she started researching how to produce breast milk they could properly digest.  She discovered that many parents experience the same troubling situation. Through this experience, she wanted to create a place for parents to find answers to their questions about infant food sensitivities and empower them to continue their breastfeeding journey.  That was how Free to Feed was born.  Free to Feed is starting this mission by first creating an at-home test strip that will allow mothers to analyze their breast milk for allergens.

We talk about:

• How Trill became interested in the field of infant allergies
• The origin of Trill’s company Free to Feed

• What the differences are between non-Ige mediated allergies (FPIAP and FPIES) and IgE mediated allergies
• How the symptoms between these three diagnoses differ
• How to identify what may be causing infant allergies
• What the treatment options are for mothers trying to cope with infant allergies
• How Trill was able to gather data in this area of research that was largely unrepresented in the literature.
• The research around transferability and reaction timing
• The lack of support for families dealing with non-IgE mediated infant allergies and the importance of validating these experiences
• What Free to Feed offers today to help parents navigate this journey.
• At-home breastmilk test strips as well as infant allergen friendly multivitamins

Connect with Trill on her website at freetofeed.com on Instagram @free.to.free on Twitter or on her Facebook here as well!

Feeling full, nausea and vomiting are all symptoms of gastroparesis, yet other gut conditions can present like this too – so how do we know which it is? This week I interview Dr. Linda Nguyen on gastroparesis and other digestive disorder look-alikes like IBS, functional dyspepsia, cyclic vomiting syndrome and how she works with patients to improve their quality of life. 

Dr. Linda Nguyen is a Clinical Professor of Medicine at Stanford University and Clinic Chief in the Digestive Health Center. Her clinical and research interests include GI motility disorders and disorders of gut brain interaction, with an emphasis on gastroparesis, functional dyspepsia and chronic abdominal pain. Her current research includes identifying biomarkers to better diagnose motility disorders, understanding the role/impact of physiologic testing on clinical care, exploring novel therapies for gastroparesis and expanding the role of neuromodulation in the treatment of GI motility disorders and pain. She is also passionate about quality of life, professional development and physician wellness.

We talk about:

• How Linda came to work in the field of digestive health and her interest in GI motility and gastroparesis
• What gastroparesis is, how it develops, what the symptoms are, and how common it is
• The tests for gastroparesis
• How patients with gastroparesis develop a change in motility or emptying of their stomach
• Treatment options for gastroparesis
• Functional dyspepsia, how it similar or different from gastroparesis, and what the symptoms are
• Cyclic vomiting syndrome, how it similar or different from gastroparesis, and how is it treated / managed
• The use of implanted gastric stimulators for gastroparesis treatment
• The nutrition management of gastroparesis

You can learn from Dr. Nguyen on Twitter @ LindaNguyenMD