It was my son's birthday this week, so we decided on buying him a little fish tank. Whilst I found myself instantly relaxed watching the fish swimming around in their fresh clean water, it dawned on me that maybe they did not share my new relaxed sense of zen. I noticed that every time I got closer to the tank, one of the fish immediately spilled his gut contents. I am well aware of the brain-gut connection in humans or how our mental health can affect our gut function. It was obvious that the fish were a bit stressed in their new environment with the bright lights, noise and constant stares of strangers which made me wonder … do fish get IBS?
IBS or Irritable bowel syndrome is a common disorder affecting around 5-11% of the population in most countries. The prevalence is more skewed towards women and appears more frequently in the third and fourth decade. The severity varies very between individuals but remains a matter of concern for most adults suffering with this disorder.
Symptoms can vary between bloating, diarrhoea, constipation, wind and cramps. Although it may at times be difficult to pinpoint the exact problem, general clues refer to food ingredients (for example milk), food composition (for example resistant starch), timing of food intake or mental health.
Latest research and strong evidence from Australia points to effective relief of IBS symptoms through the elimination of foods containing Fermented oligo, di and monosaccharides as well as polyols also known as FODMAPS. This diet excludes foods with a high fructose content for example fruits as well as resistant starches such as those from cereals, wholegrains and sweetcorn. Eliminating diets are most safely and effectively conducted by a trained and experienced dietitian who is comfortable in working with FODMAPS. Eliminaton of FODMPAS from the diet may take approximately 6-8 weeks if done properly. For some individuals this diet has had incredibly good results.
Common dietary advice and guidelines for IBS which may be helpful include:
1) Milk / Lactose – Some people remove dairy from their diet completely. Evidence has shown that a small amount of lactose may be tolerated per day. Therefore try to reintroduce slowly as tolerated or try alternatives such as soy, rice, oat, coconut or quinoa milk.
2) Dietary Fiber – For individuals suffering from constipation, an increase of soluble fiber from oats or fruits may help. In some instances increasing water intake may also help, however some individuals find that reducing fiber intake relieves debilitating symptoms. Ensuring a mixture of fiber intake from consuming a varied diet may also help. In addition, the consumption of (ground) linseeds may alleviate the constipation but may take months to take effect.
3) Fatty Foods – Consuming a diet high in fatty foods such as processed or take-away foods, may make matters worse. Ensure that you are following a healthy eating plan and consider alternative preparation methods such as steam, grill or microwave to reduce fat intake
4) Fluid – As mentioned before, increasing fluid intake while increasing fiber may be helpful in relieving symptoms. Aim for 6-8 glasses of fluid per day. This includes, tea and juice
5) Caffeine – Although rich in antioxidants, a high caffeineine intake may affect gut function by increasing transit time. Try to limit your intake to a maximum of 3 cups per day
6) Alcohol – A high intake can affect gut function and there before it is advisable to stick to the recommended limit of 1-2 drinks per day (or less)
7) Probiotics – Whilst the consumption of probiotics, according to literature, has no great effect on reducing the symptoms of IBS, some individuals do respond well to it. It is recommended to take one product for at least two weeks and if there is no relief in symptoms, to try an alternative product with a different strain.
In essence, there is no harm in taking them Due to the intensity of the brain-gut connection, relaxation and exercise is recommended, and naturally smoking is discouraged.
Nutrigenomics has frequently been blamed for not taking individual gut nutrient absorption into consideration, I feel that combining practical evidence-based information such as FODMAPS with Nutrigenomics may be a novel approach.
Looking at IBS from a Nutrigenomics perspective, gene-nutrient interaction that may be related to IBS symptoms include:
Lactose dehydrogenase enzyme (LDH) deficiency leads to lactose intolerance, common in Asians and Africans
Methyltetrahydrofolate reductase enzyme deficiency (MTHFR) which can reduce folic acid absorption and henceby directly affect serotonin production and gut function
Cystathione Beta Synthase (CBS) which may affect vitamin B6 absorption and metabolism. Vitamin B6 is strongly linked with PMS symptoms. In other words, genetic variation within certain metabolic pathways can affect nutrient absorption, metabolism and requirement. By understanding ones genetic make-up, with further studies Nutrigenomics has the potential to cut down on medical visits, employee absence and dare I say … rates of depression? related to IBS ~.
Looking into the near future therefore, Nutrigenomics knowledge may be able to reduce the 6-8 week waiting time for laborious elimination diets to take effect and be able to pinpoint exactly which supplements or foods are required in combination with current evidence-based practices such as FODMAPS to relieve symptoms. It may also prevent the blanket nutrition advice given to the often stigmatised "its probably IBS" individuals who are crying out for some serious help.
In summary, new ways of approaching common disorders and chronic diseases by using foods may be on the horizon. In the mean time, Im going to stop stalking the poor fish and let them settle in!
Mariëtte MBA RD
Disclaimer – The advice in this article is for guidance only, consult a qualified healthcare professional for personal advice.