Monday, November 28, 2011

The Truth Behind Reflux

A match being lit inside your chest; a burning sensation that seems to go up till it reaches your neck; a taste of hot, sour, bitter and acidic fluid in your mouth. That’s what you call heartburn. It’s one of the most annoying feelings that you can have after a meal. And it makes you regret eating anything at all. It gets worse when you bend over or lie down. And you’re stuck there for two hours waiting for the feeling to just fade! Only medication can relieve the pain.
So where does a heartburn come from and how can you prevent it?

1. Tell me more about heartburn…

Wait! Before learning about heartburn, let’s see how the stomach works…

When food passes down the throat, it goes through a long tube called the esophagus in order to reach the stomach. There is a valve separating the last two; it is called the Lower Esophageal Sphincter (LES). It is like a door that opens to allow food into the stomach and then closes again when the mission is accomplished. At this point, the stomach releases strong acids that break down the food you eat.

Sometimes, for several potential reasons, the LES relaxes when it shouldn’t or becomes weak, allowing stomach acid to reflux or seep upward constantly. So, basically, this door doesn’t close properly and the content of the stomach is then able to travel back to the esophagus. That is when heartburns occur.

This condition happens occasionally to most people. However, when it becomes recurrent and when it interferes with the life of the patient, it is classified as a disease. It is the Gastro-Esophageal Reflux Disease or GERD.

2. Consequences

An occasional reflux doesn’t have serious implication. The only annoying thing about it would be the heartburn; the latter could be relieved with medication.

On the other hand, GERD can cause many damages. In fact, on the long run, the constant contact of acid fluids with the esophagus may ultimately lead to an inflammation (Esophagitis). It can result in painful swallowing and on occasions, ulcers.

More severe cases suffer from esophageal stricture. It is the narrowing of the esophagus in attempt of the body to repair reflux damage. Consequences include difficulty swallowing, food regurgitation and severe weight loss.

A major concern in persons with long-standing and more significant esophageal reflux is the development of Barrett’s esophagus, a condition in which cells lining the esophagus become abnormal and potentially malignant (cancerous).

3.     What foods and behaviors should I avoid?

Luckily, there are foods and behaviors you can avoid in order to reduce the risk of reflux and thus the feeling of heartburn.

-          Avoid large, high fat meals: have 4 or 5 small, low fat meals rather than 3 large ones.
-          Avoid eating at least 3 to 4 hours before bedtime.
-          Avoid smoking.
-          Avoid alcoholic beverages.
-          Avoid caffeine containing foods and beverages.
-          Consume a healthy, nutritionally complete diet with adequate fiber.
-          Avoid acidic foods such as  oranges, berries, grapes, etc. as well as highly spiced foods.
-          Avoid chocolate.

Note that every individual reacts to the foods listed above differently. For example, acidic foods such as oranges, tomatoes or lemon juice can cause reflux to some but not to others. That’s why you should test those foods separately in order to find out whether you can tolerate them or not.

-          Drink liquids before or after meals but not during.
-          Lose weight if overweight or obese.
-          Stay upright and avoid vigorous activity soon after eating: do not lie down after a meal.
-          Avoid tight-fitting clothing especially after a meal: they can cause pressure to the stomach and make it easier for the food to travel back into the esophagus.

As you can see, the consequences of frequent reflux are very serious. Nutritional management of this condition may not be sufficient. That’s why you should consult with your physician if you’re having recurrent heartburn. 


Wednesday, November 23, 2011

1, 2, 3 Salad!

3 ingredients are enough to make this salad an absolute delight:

1. Purslane: Although it is very low in calories, purslane is particularly known for its content in omega 3 fatty acids which decrease the risk for cardiovascular disease. It is also rich in B vitamins such as folate (vitamin B9), vitamin C and vitamin A. Don’t forget that it’s also rich in antioxidants, essential for cancer prevention!

2. Tomato: This beautiful red fruit (oh yes, botanically speaking, it is a fruit) is rich in vitamins A and C. It is a very good source of potassium, an important component of cell and body fluids that helps controlling heart rate and blood pressure. Its red color is due to lycopene, a powerful antioxidant that protects against many cancers including prostate, lung and stomach cancer.

3. Onion: Even though cutting it makes you cry, eating it will make your body smile! Not only is it rich in Vitamin C and some B vitamins; but it also contains Quercetin, an antioxidant that protects against many diseases, including cancer.

Add to those ingredients a lemon oil dressing and you’ve got yourself a delicious, fresh and healthy salad!


Monday, November 21, 2011

Meat is SO last season!

It’s not about losing weight.
It may be just a phase, but to most people, it’s a belief!
It is called The Vegetarian Diet.

What is a vegetarian diet?
The Vegetarian Society defines a vegetarian as: "Someone who lives on a diet of grains, pulses, nuts, seeds, vegetables and fruits with, or without, the use of dairy products and eggs. A vegetarian does not eat any meat, poultry, game, fish, shellfish* or by-products of slaughter."
There are 4 types of vegetarian diets, according to the American Dietetic Association:
1. Strict vegetarian or vegan diet: It’s a diet that excludes ALL animal products including meat, fish, poultry, eggs, cheese, milk and other dairy products.
2. Lacto-vegetarian diet: It excludes meat, fish, poultry and eggs but includes milk and dairy products.
3. Lacto-ovo-vegetarian diet: It excludes only meat, fish and poultry. Eggs, milk and dairy products are allowed.
4. Flexitarian: This is a semi-vegetarian diet that focuses on vegetarian food with occasional meat consumption. It is not recognized by the Vegetarian Society.

Why do people go for a vegetarian diet?
There are many reasons that could push a person to become a vegetarian.
Some people do it out of compassion for all the animals being brutally slaughtered; others because it has a better impact on the environment. A lot of people become vegetarian for health reasons. Research shows that vegetarians are less likely to suffer from obesity, type II diabetes, high blood pressure, coronary heart disease, some cancers, diverticular disease, gallstones, appendicitis and constipation. Other reasons include religion, aversion to meat and economics; it is simply cheaper to be a vegetarian.

Animal products: the good and the bad
All animal products are rich in proteins which is a very important nutrient. The need for protein for an adult is around 1g/kg of body weight. So let’s say you weigh 75kg, you will then need approximately 75g of proteins. Athletes and bodybuilders definitely need more. This nutrient helps building bones, muscle, cartilage, skin and blood. Basically, it is important for growth and maintenance of the body.
They also contain B vitamins that serve a variety of functions in the body. They help the body release energy, play a vital role in the function of the nervous system, aid in the formation of red blood cells and help build tissue.
These products, especially red meat, are a very good source of Iron. The latter is also very well absorbed by the body. Iron helps carry oxygen in the blood. And a deficiency in this mineral can cause anemia. Providing enough iron is critical in women as they lose a lot of blood due to period.
Calcium, Magnesium and zinc are also provided by animal products. The first is used in building bones. The second helps calcium in its function and releases energy from muscles. The third is necessary for biochemical reactions and helps the immune system function properly.
Fish and seafood contain Omega 3 fatty acids. The latter are essential fatty acids that have many health benefits including a reduced cardiac risk.
Well, we’ve listed the good and now it’s time for the bad. Animal products are very rich in saturated fats. These are the bad fats and they are responsible for elevating blood cholesterol levels. They increase the risk of heart disease. Red meat is also known for containing lots of toxins that are harmful for the body and that increase the risk for cancer.

Can vegetarians have all the nutrients they need?
Vegetarian diets can provide all the necessary nutrients for the body. The key is to eat a wide variety of foods and the right amount to meet your caloric needs. There are certain nutrients to be cared for:

Proteins: they can be easily provided by the consumption of beans and other legumes, nuts and soy products such as tofu, tempeh, etc. Vegetarians who consume eggs or dairy products can also get their proteins easier.
Iron: it can be provided through fortified breakfast cereals, spinach, beans and other legumes and some dried fruits. It is important to add a vitamin C source (lemon juice) to beans and spinach in order to enhance the absorption of iron.
Calcium: well, if you’re consuming dairies, this shouldn’t be a problem for you however, if you’re a vegan, then you should probably go for enriched soy milk, fortified breakfast cereals and some dark green leafy vegetables. The absorption of calcium varies in all these products. So, always check with your doctor if you might need a supplement.
Zinc: non animal sources of zinc include fortified breakfast cereals, chickpeas, kidney beans, white beans and pumpkin seeds. Milk is also a good source.
Vitamin B12: Fortified foods such as cereals, soymilk, veggie burgers and nutritional yeast can provide the necessary amount of vitamin B12 needed by the body.  
Omega 3 fatty acids: they are present in flaxseed, flaxseed oil, canola oil, tofu, soybeans and walnuts.
What about pregnant women and kids?
A vegetarian diet is one of the healthiest diets. It can provide all the nutrients the body needs even during pregnancy and growth. Pregnant women should make sure that their diet contains sufficient iron, vitamin B12 and vitamin D. Kids have high needs in protein, calcium, iron, zinc, vitamin B12 and vitamin D. So they should have a very well planned diet if they’re going vegetarian.

It’s not that easy and it’s not that hard! There are a lot of nutrients to take into consideration, but nowadays, products suitable for vegetarians have become in your reach. If you really want to become a vegetarian and you still have concerns regarding your nutrition, you can consult your dietitian for a well balanced diet. 


Thursday, November 17, 2011

When I say SALAD, you say...

When I say SALAD, you say…

When you say SALAD, I say…


Hell Yeah!

It’s not even real food

A salad can provide you with all the nutrients your body needs if you know just what to mix inside that bowl!
Yes! A salad can provide you with proteins if you add eggs, turkey, cheese, salmon, chicken, steak or ham.
Easy! Just throw in some croutons, toast, corn, boiled potatoes or even a small quantity of rice. Beans and other legumes can also provide carbs and fibers.
Well, the sauce is a source of fat. You can also add some raw nuts, olives or avocado. They are all a source of good fat.
Vitamins and minerals:
Obviously the vegetables can provide you with many vitamins and minerals. Some kinds of fruits can give the most amazing sweet taste to a salad: strawberry, pineapple, apple, etc.
The more colorful your salad is, the more it contains antioxidants that protect you against many diseases including cancer.

Too hard to prepare

Come on! That’s not such a hard thing to do. You can wash all the vegetables as soon as you buy them and keep them in the fridge. The rest is piece of cake. You can also buy a ready-to-eat sauce if it’s such a hassle.
Plus, preparing your food is fun; it will make you lose calories and make the meal more enjoyable. 

Still… Not enough for me!

Fine! If you don’t feel full after eating a big bowl of salad, you can eat something on the side. Just always start with the salad because it will fill a lot of space in that stomach of yours and will leave just a little for the fatty stuff!

Don’t you tell me I still haven’t convinced you! Now hop into that kitchen, put on some music, and start mixing and matching your favorite ingredients!*

* Get Salad recipes from our Healthy Delights section


Monday, November 14, 2011

Gastric bypass: A way out!

Been there, done that!

You’ve been on diets most of your life. There’s nothing you haven’t tried: low calorie, high protein, food delivery, detox, etc. We name it, you’ve done it! You’ve been doing that same dance every time: you go on a diet, you lose weight and then you regain it all with a cherry on top.

You’re sick and tired. And it hits you! Surgery is your last resort. It’s the only way for you to lose that weight you’ve been carrying all those years.

So what’s the deal with the gastric bypass? Well, let’s find out all about it together…

First of all, please tell me what’s a gastric bypass?

It is a weight loss procedure involving two major events: cutting the stomach leaving a little pouch that contains smaller amounts of food; bypassing a large part of the intestine which reduces the amount of fat absorbed. There are many ways to perform a gastric bypass but the most common one is called Roux-en-Y.
If an image speaks a thousand words, how about a video?! (Don’t worry, it is just a simulation. You can watch it freely, there’s no blood involved!)

Who’s eligible for this surgery?

Cutting out one’s stomach is neither practical, nor cheap. Thus, not everyone can or even should do it. Every case is studied carefully by a medical team in order to evaluate whether the patient should undergo the surgery or not. In general, patients with a BMI of more than 40 or more than 35 with risk factors (diabetes, hypertension, high cholesterol, etc.) should consider it.

What’s going to be my diet after the surgery?

When you’re allowed to start eating after the surgery, you only get to have liquids. Your meal will consist of foods such as sugar free Jell-O, fat free broth, decaffeinated tea and coffee, anis, etc. for a couple of days. Quantities as little as 30 mL should be consumed every 15 minutes.

The next week, you will be able to add 0 fat milk and yoghurt and sugar free pudding. The frequency of meals decreases to 6 meals per day. 120 mL of liquids are consumed at each meal in a period of 30 minutes.

Then, in the next two weeks, you will consume pureed food at a frequency of 4 to 5 meals a day. Every meal is around 90 to 120g.

After that, you will slowly progress towards solid foods.

It is very important to eat slowly and chew well. Also, avoid overeating as it may lead to throwing up.

Give me the good news first!

Can you imagine eating less than half of what you usually eat and being full?
That’s what the gastric bypass does to you. You will feel an early satiety because the pouch is so small (20-30 mL) it cannot contain large amounts of food. Your calorie intake will decrease significantly. Eventually, you will lose more than 50% of the excess body weight.

In addition to that, losing that much weight can help improve many conditions you may suffer from such as asthma, gastroesophageal reflux disease, high blood pressure, high cholesterol, obstructive sleep apnea and type II diabetes.

Just think that you weigh 50 kilos less! You’re moving around much easier and being able to perform any task you want to. You’re more comfortable inside your body.

Hit me with the bad news!

Just like any surgery, a gastric bypass has its risks. The surgical procedure may produce excessive bleeding, infection, blood clots, lung or breathing problems, leaks in the gastrointestinal system and rarely death.

On the long run, there may be problems like perforations, ulcers, hernias, gallstones, nothing a good doctor can’t handle.

Malnutrition may occur as the intestinal absorption of many vitamins and minerals is reduced. Deficiencies in vitamin B12, calcium and iron may occur. That’s why a supplement is always prescribed.

Another problem you may come across is the Dumping Syndrome. It “occurs when the contents of the stomach empty too quickly into the small intestine. The partially digested food draws excess fluid into the small intestine causing nausea, cramping, diarrhea, sweating, faintness, and palpitations. Dumping usually occurs after the consumption of too much simple or refined sugar.”

What happens in real life?

Theory is amazing! However, in real life, everything’s totally different. Let’s see what M.Z. has to say about her experience.

“I had tried everything, all types of diets ever since I was a little girl. I had reached 115kg and I was only 22. I had a BMI of almost 40. I felt like my weight was preventing me from doing what I wanted in my life and being the person I wanted to be. So I thought to myself, something should be done. I can’t let this thing be an obstacle in my life. So I went to Dr Maher Hussein in AUBMC and after a long inquiry, I did it! And I consider it was my best option. The recovery was a bit painful but then you carry on with your life.

Dr Hussein has a technique where you can allow yourself small quantities of sugar and alcohol without suffering from the dumping syndrome. Besides you can’t throw up if you ate more than you should. However, I can’t tell you I don’t get sleepy when I overeat.

I lost 38 kg in 15 months and I’m still hoping for some more. The thing is: you can’t rely only on the gastric bypass. Dieting and exercising become very important after a certain point. Even though I’m still struggling with that thought, I’m well aware that this is what I need to do to reach my desired weight and shape.

Most important of all, I should always be careful to take my supplements because if I don’t - and believe me at first I didn’t – I lose all the energy and become incapable of performing the necessary tasks during the day.

I recommend this surgery but only to people who really need it because after all, it does change your life!”

Gastric bypass is an amazing surgery. Although it has many risks, it can give outstanding results. However, it is a life changer and in my opinion, one should only leave it as a last resort. 


Thursday, November 10, 2011

I can't get no... Satisfaction!

     What annoys you most about a diet?
I think the answer is unanimous for all dieters out there: it’s the constant hunger! The battle against starvation is often a losing one. And that’s why diets don’t last as long as they should.
Well, now we have a new weapon to use in this matter and it’s called the Satiety Index.

     What’s a satiety index?

It is a system that measures foods’ ability to satisfy hunger.
In a study conducted by the University of Sydney, Australia, 38 different foods were ranked according to their satiety index (SI). White bread was taken as a reference and it was given the score 100. Anything above that meant the food was more satisfying and anything below meant the food was less fulfilling.

     What makes you feel full?

     It has been proven that protein and fiber rich foods as well as complex carbohydrates are very satisfying. So you should always have meat, vegetables and starches in your meal!

The satiety index also depends on:

- Chemical components found in certain foods such as the anti-nutrients contained in beans and lentils that delay their absorption and make you feel full for longer.

- Sheer bulk: some foods like pop corn are voluminous and take so much space in the stomach. So you can eat a large amount and feel satisfied without taking excess calories!

- Taste: the blandness of boiled potatoes is one of the reasons why it gives an early satiety.

Now you know why a croissant in the morning is a very bad choice. Those 600 calories you ingest will leave you hungry a few minutes after you’re done. It’s the same for doughnuts and cakes. And that’s why it’s better to consume cereals for breakfast, all bran if possible, or a whole wheat bread with cheese or eggs!

Dieting doesn’t have to mean starvation. You can eat healthy, filling food and always stay fit! 


Monday, November 7, 2011


Chewing a pencil in class? We’ve all done it!
However, chewing and swallowing? Now that’s a different story!
You say it’s impossible for someone to eat a pencil, a paper, a light bulb, etc.
I say it happens all the time!
… And it is called Pica!


Pica is an eating disorder typically defined as the persistent ingestion of nonnutritive substances, for a period of at least 1 month, at an age when such behavior is developmentally inappropriate. Ok! Let’s make it simpler. When you were 1 or 2 years old, you used to chew on anything. And even though you don’t remember, that was a perfectly normal behavior. However, being 31 and eating the foam inside your couch cushions is not really ok! (pic)
Pica eaters ingest a wide variety of nonnutritive substances. We are talking about dirt, sand, stones, hair, feces, lead, paper, burnt matches, chalk, wood, plaster, light bulbs, and the list goes on…


Pica is very common in children, individuals with developmental disabilities and in pregnant women. It may also occur exclusively during the course of another mental disorder such as schizophrenia.


Why would anyone do such a thing? Well, there could many reasons…

Nutritional deficiencies: Some researchers suggest that nutritional deficiencies in iron, calcium, zinc and other nutrients have been associated with pica. So basically, the theory suggests that pica eaters ingest those nonnutritive substances to provide themselves with those nutrients. However, these findings are not supported by studies. So we’re still facing the dilemma of whether the deficiency came first or whether the ingestion of those foods caused it.

Cultural and familial factors: In some social groups, the ingestion of clay or soil is perfectly normal. Some parents may teach their children to eat those substances. Clay eating and starch eating is seen in some southern, rural, African American communities, primarily among women and children. Starch eating, is frequently started in pregnancy as a treatment for morning sickness.

Stress: Any stress that affects a child’s life may result in pica. What we mean by stress is parent separation, parent neglect, abuse, etc…

Low socioeconomic status: Malnutrition and hunger may result in pica.

Non discriminating oral behavior: As we said before, individuals with developmental disabilities may suffer from pica. This is due to an inability to discriminate between food and nonfood items. Some findings also suggest that there often is an aggressive search for nonfood items.


So what if I ate all those things? Well, the body is not made to either ingest or digest some products. Besides, there are substances that may be harmful and potentially kill the person ingesting them.

Lead Poisoning: Lead can be found in paint, soil, children’s toys, etc. It is a poisonous metal. A long term exposure to it can damage almost every organ in the body. It can ultimately cause death in children and miscarriage in pregnant women.

Hyperkalemia: It is the elevation of potassium in the blood. Due to ingestion of burnt match heads, it can cause the impairment of neuromuscular, gastrointestinal and cardiac organ systems.

Soil-borne parasitic infections such as toxoplasmosis and toxocariasis: It is due to geophagia (soil or clay ingestion) and it can be fatal specifically to people with a weakened immune system such as AIDS patients or pregnant women.

Gastrointestinal tract complications: the ingestion of non-food products can be very damaging to the GI tract. It can cause mechanical bowel problems, constipation, ulcerations, perforations, intestinal obstructions. The last three can be fatal as they can cause internal hemorrhages (bleeding).

Nutritional effects: data suggests that the ingested material displace normal dietary intake or interfere with the absorption of necessary nutritional substances causing deficiencies, especially in iron and zinc.

Dental effects: Pica results in severe tooth abrasion and surface tooth loss.


Effective treatment should involve:

A psychologist that will analyze the function of pica behavior and ask all the right questions. He will attempt a behavioral modification such as discrimination training between edible and non edible items and other.

A social worker to assess the familial situation of the patient, educate regarding the negative effects of pica and remove toxic substances from the environment.

A physician to deal with the treatment of the consequences of the disorder.

A dietitian to address any identified nutritional deficiencies.

A dentist that will fix any damages to the teeth.

There is no specific medical treatment for patients with pica.

Pica can remit spontaneously in young children and pregnant women. However, if left untreated, it can persist for years. So if you suspect any behavior of this sort in a family member, friend or neighbor, please help them get treated!