Nutrition & Wellness Q&A by Dr. Tarique Zaman, MD, MPH
Irritable Bowel Syndrome (IBD)
It seems like so many drugs used to treat IBD have significant side effects; are there any other treatment options that don't involve prescriptions?
I read that long term use of steroids to prevent flares can increase my risk of diabetes among other things. What can I do to minimize or stop steroid use completely?
I'm a smoker; I've been told again and again to quit and I've tried before, but now I learned that smoking actually helps with IBD. Should I just continue smoking then?
With risks of immune suppressing medication including risk of bacterial or viral illness, should I avoid taking these medications?
I was frightened to learn that for some people their IBD progresses to the point that they need surgery to remove their colon. What can I do avoid becoming one of those people?
I know that stress can make IBD worse, and the worse my IBD is the more stressed I feel; what can I do to stop this downward spiral?
What You Can Do About IBD:
- Substitute animal protein with plant protein--the more the better: there is increasing evidence that animal protein has both causative and provocative effect on Inflammatory Bowel Disease (IBD)
- Increase green leafy veggies to 3 servings per day to prevent deficiency of vitamin K from IBD medication
- Take care of your emotional health! Connect with other IBD patients to learn what worked for them, find strength in their victories and learn from their mistakes
Benefits of Whole Food Plant-Based Nutrition
Are chronic diseases like diabetes and hypertension reversible?
Yes, in a majority of cases, if diagnosed in time, chronic diseases like type 2 diabetes, hypertension (high blood pressure),and hyperlipidemia (high cholesterol levels) are reversible. And fortunately the steps you take to reverse one, also have a reversing effect on the other chronic diseases that you may suffer from...or better yet, prevent them from coming on in the first place.
These steps are usually painted in one broad stroke as "lifestyle changes." I hope that was not a surprise to you. Unfortunately, in this age of 10-15 minutes face-to-face appointments with your primary doctor or specialist you are only given general advice like "limit carbs," "control your portion size," "stop eating junk food," or "cut out the salt." Unfortunately this kind of advice doesn't cut it, and sets patients up for failure. When it comes to reversing chronic disease a more holistic approach is required--one that includes a diet of delicious nutrient-dense low fat whole plant foods, as well as an active, healthy lifestyle.
Do you suggest the keto diet to treat diabetics?
Great question. No, we don't. Keto can give you quick weight loss and even lower your A1C BUT it's lowering your A1C because you're starving your body of glucose, NOT because you're reducing your insulin resistance (the cause of T2D). And in fact a low-carb high-fat diet has been found in numerous studies published in peer reviewed medical journals to INDUCE insulin resistance. So you can suppress your symptoms with keto, but it's still fueling the progression of your disease.
Aren't I supposed to be following a low-carb diet if I have diabetes?
I do not recommend a low-carb diet to my diabetic patients and I'll tell you why. Limiting carbs avoids triggering your symptoms but actually worsens insulin resistance (see https://bit.ly/2Gr6tOp “a low carbohydrate, high fat diet was associated with a reduced ability of insulin to reduce plasmic glucose; conversely, a low fat, high carbohydrate diet was associated with an improvement in insulin's ability to stimulate glucose disposal.”)
I advise my diabetic patients to really restrict their saturated fat intake to make progress on their blood glucose quickly. Stick to unrefined carbs, but realize that in the beginning your blood glucose levels WILL spike, but over time as you follow this way of eating your body's response to carbs will change as your insulin sensitivity increases. Test often to guard against hypoglycemia as your need for meds decreases, and keep in close communication with your doctor for advice on how to safely phase of meds.
What would you suggest to treat acid reflux?
The most powerful intervention is usually a dietary one. High fat foods relax the oesophageal sphincter (the ring of muscle at the top of the stomach), allowing acid to rise into your oesophagus [see https://www.ncbi.nlm.nih.gov/pubmed/15591498]. Not only does this cause acid reflux and make you miserable, it’s also correlated with a higher incidence of oesophageal cancer (linked specifically to eating red meat) and stomach cancers (linked specifically to eating poultry) [see https://www.ncbi.nlm.nih.gov/pubmed/18537156].
On the other hand, diets high in fiber have been found to be protective against acid reflux [see https://www.ncbi.nlm.nih.gov/pubmed/23477993].
So here are my top tips for getting rid of acid reflux:
1.) Minimize fat intake (strive for just 10% of your calories coming from fat)
2.) Load up on fiber (aim for 30+ grams per day)
3.) Take your time; chew your food well and eat slowly to avoid accidentally overeating
4.) After you’ve eaten give yourself plenty of time to digest your food before lying down
If you follow these faithfully, there’s a good chance you’ll experience significant improvement in a matter of weeks.