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Diet and Lifestyle

Ulcerative Colitis, Probiotics, and Prebiotics

Ulcerative colitis is a lasting disease that causes inflammation and sores called ulcers in the colon. Experts believe that the cause is a genetic mutation that allows bad bacteria to irritate your intestines. This causes a never-ending reaction. It’s treated with medication or surgery, but there’s no cure. Flare-ups can happen even after treatment. Some people turn to probiotics and prebiotics to help. But do they really work?

Probiotics and UC

Probiotics are live microorganisms that help “good” bacteria to grow in your intestine. They’re found in foods such as yogurt, kefir, sauerkraut, kimchi, miso, and tempeh. They’re also available as a dietary supplement.

How do probiotics help with UC? Probiotics act as a barrier. They line your bowels so bad bacteria don’t reach the intestinal wall. They also change the makeup of your gut biome, adding good bacteria to balance out the bad. This lowers inflammation and helps calm the reaction.

Not all probiotics are equal when it comes to treating UC. Several studies have shown two specific probiotics to be effective:

1. Escherichia coli Nissle (Mutaflor) is a strain of E. coli that is nonpathogenic. That means it won’t make you sickStudies show that it can bring UC patients into remission for at least a year.

2. VSL#3 is a combination of eight different probiotics. Studies show that it has brought UC patients into remission for at least 24 weeks.

How to Take Probiotics

When you take probiotics for UC, there are two key things to know.

  1. You’ll likely need to take them for a while. Your stomach acid kills bacteria, whether good or bad. Experts suggest that you take the probiotics for at least 7 to 10 days to get enough good bacteria. You need millions and millions — possibly billions — to start relieving UC symptoms.

To keep up the benefits, you have to keep taking them. If you stop, the balance of bacteria in your colon will change and a flare-up may occur. Talk to your doctor about a long-term probiotic plan.

  1. Taking them by mouth may not be best. Although it may not seem pleasant, there may be some advantages to taking probiotics rectally. A smaller dose may be possible because the probiotics skip the stomach acid. This lets more of the good bacteria reach the intestines. But for obvious reasons, most people find it easier to just swallow a pill

Prebiotics and UC

Prebiotics are foods that aid the good bacteria in your colon. They come from the fibrous parts of food that you can’t digest. Prebiotic fibers give energy to the cells that line the walls of your gut so they can build protective layers against bad bacteria.

  • Prebiotic foods include fruits, vegetables, and whole-grain foods 
  • Bananas
  • Onions
  • Garlic
  • Leeks
  • Asparagus
  • Artichokes
  • Soybeans
  • Oats

While prebiotics may help people with UC, they’re not for everyone. They may make symptoms worse for people with other conditions. These include irritable bowel syndrome, small intestinal bacterial overgrowth, and FODMAPs intolerance.

Side effects of probiotics or prebiotics are rare. They’re usually safe for most adults. Check with your doctor before you take either one to make sure they’re right for you.

How They Compare to Other UC Treatments

The most common prescription medication for UC is mesalamine. This is a nonsteroidal anti-inflammatory drug (NSAID). Several large studies looked at how well E. coli Nissle worked compared to mesalamine. They found that the treatments were equally effective against UC.

No studies have compared VSL#3 to mesalamine head-to-head, but experts think the probiotic’s effects on UC are similar.

Can Probiotics Treat Other GI Issues?

Studies show that probiotics help with symptoms of inflammatory bowel disease. But more research to form a standard treatment goes on.

Research into whether probiotics may help people with Crohn’s disease is less clear. The studies have been small, and we need more research into what types of probiotics might work. Because of this, doctors aren’t likely to recommend probiotics to people with Crohn’s disease.

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Diet and Lifestyle

Udo’s Choice® Super 8 Microbiotic

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Diet and Lifestyle

Get Your Gut Back On Track!

An estimated 110,000 people consume antibiotics daily in Ireland, between December/March. (Source: Health Protection Surveillance Centre).

We asked Nutritional Therapist Rosanna Davison for her Top Tips to get your gut back on track after an illness.

1. Take time out

Don’t push yourself too quickly.  Remember your body needs time to rebuild its reserves and regain strength.

Take more rest than usual.  If you need to sleep longer, go to bed earlier.

Cut back on non-essential activities; they can wait until you are feeling 100%.

  1. Embrace fibre-rich foods full of protective nutrients

Fresh vegetables and fruits are rich in dietary fibre, vitamins and antioxidants.  Try eating seven to nine portions over the course of each day. Choose different colours so that you nourish your body with a variety of phytonutrients.

Eat a portion of complete protein at each meal, such as poultry, fish, eggs, beans, pulses or tofu.

Consume essential omega-3 fatty acids daily.  Avocados, seeds (flax, chia) and oily fish (mackerel, wild and organic salmon), are naturally rich in anti-inflammatory fats.

  1. Go ‘fermented’

Fermented foods are rich in ‘friendly’ bacteria.  Sauerkraut is simple to make at home or buy kefir or kimchi in your local health store.

  1. Reduce or eliminate sugary foods

Processed foods often contain refined sugars to enhance taste. Excess refined sugar and processed foods may encourage the growth of ‘unfriendly’ bacteria, so aim to buy and eat fresh food.

If you have a sweet tooth, try eating berries (strawberries, blackberries, blueberries, raspberries).  They are rich in antioxidants and naturally low in sugar.

If you need a sweetener, try Stevia which is extracted from plant leaves and doesn’t impact blood sugar levels.

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Diet and Lifestyle

Do vegans need to take supplements?

Do vegans need to take supplements

A varied, wholesome vegan diet provides almost all essential nutrients in sufficient quantities. I hear you shouting ‘Noooo! It provides absolutely everything we need!’ and you may be right, but only if you regularly eat certain fortified foods. The sad truth is that modern food production systems and lifestyles make it more difficult for everyone – vegans or not – to get all they need from diet alone. It doesn’t mean a vegan diet is unnatural or unhealthy, in fact the opposite is true. It means that how we grow, produce and consume food has changed and, with an ever-growing population, the demands on the systems that produce our food are so high that certain nutrients become harder to obtain.

Confusion, confusion

I get a lot of questions about supplements and understand why people are confused. Over the years, I’ve worked on many vegan research projects and as science and population studies reveal ever more data, the guidelines and recommendations change and evolve. Hence, what we were told 10 years ago may no longer be up-to-date and that’s why different opinions arise, depending on where and when we got our information. It’s my job to keep up-to-date, so hopefully I can bring some clarity to the supplement discussion!

So what’s needed? The trio of nutrients to keep a close eye on are vitamin B12, vitamin D and iodine. You may not need to supplement with all these, all year long, but it depends on several factors. Read on…

Vitamin B12

Vitamin B12 naturally comes from bacteria in the soil and both people and animals would traditionally have got it from eating unwashed plants. However, we not only wash vegetables before we eat them (and for good reasons), but food production is now so sanitised that most vegetables are washed in chlorine, or other sterilising solutions, so there’s not a trace of B12 left.

People are not generally aware that most farmed animals are given B12 supplements and this is how the vitamin eventually ends up in their flesh. So, the argument that meat is a natural source of B12 doesn’t really stack up as meat-eaters essentially consume B12 supplements recycled by the animals that were given them!

It is absolutely necessary that we have a reliable source of vitamin B12 for our bodies. We need it to make red blood cells, for a healthy heart and circulation, and it’s essential for the nervous system. It takes years to develop a B12 deficiency, so on one hand, you don’t need to worry about not having taken B12 for a while. On the other hand, you do need to pay attention, as when symptoms develop, it’s usually serious.

Do vegans need to take supplements

To ensure adequate intake, you should have at least 5µg (micrograms) daily from supplements or fortified foods. The B12 used in both foods and supplements is produced commercially by growing bacterial cultures in large vats – and it’s always suitable for vegans.

There are two forms of B12 in supplements – cyanocobalamin (cheap) and methylcobalamin (expensive). Cyanocobalamin is the stable ‘inactive,’ form of B12 and is used in supplements and to fortify foods and drinks. Once ingested, it’s activated by your body so it can be used. Methylcobalamin is the ‘active’ form of vitamin B12 as it does not require any metabolic reactions to be activated. It costs more and is not so stable.

So which one to choose? Unless you’re a heavy smoker, have kidney failure or any other serious condition affecting your metabolism, cyanocobalamin – the cheap form of B12 – is perfectly fine. Intakes up to 2,000µg a day are safe and you can take either a lower dose daily or a higher dose a couple of times a week.

Vitamin D

We need vitamin D for healthy bones, teeth and muscles and it also performs other essential functions in our metabolism. It is produced in the skin when exposed to sunlight and this is the main source of vitamin D for most people. However, if you always use sun-block, cover most of your skin or live in a country, like the UK, where we don’t get enough sunlight over the winter, you need a supplement, whether you’re vegan or not.

The UK Government now recommends that we all take a supplement from October to April and, if you protect your skin ferociously over the sunnier spring and summer months, you should take a supplement all year long. Otherwise, just 20 minutes of sunlight on the face and arms is all that is required by the body to manufacture sufficient vitamin D.

Do vegans need to take supplements

Fortified breakfast cereals, bread, plant milks and vegan margarines can be useful sources if exposure to sunlight is not practicable, but may not be enough. When it comes to supplements, there are two types and your body can use both, but it’s advisable to check the source – vitamin D2 is always vegan, but vitamin D3 can be of animal origin. Many vegan foods are fortified with vitamin D2 and labelled so, but if not specified, especially on cereal products, vitamin D tends to be of animal origin. If you choose to supplement your diet, there’s a range of quality and affordable vegan supplements with vitamin D2. There are also those made from algae or mushrooms that contain D3 and these are recommended if you need a higher dose. When deciding on your dosage, 10µg per day is enough and you shouldn’t go above 25µg.

Iodine

Iodine has been a hot topic lately, especially with plenty of tabloid ‘experts’ warning that vegans are missing out. This mineral is necessary for thyroid function and helps to regulate how energy is produced and used in the body.

The amount of iodine in plants depends upon the iodine content of the soil in/on which they are grown. The closer to the sea, the more iodine and therefore vegans can get enough from plant foods, but there’s no guarantee. Seaweed, which of course grows in seawater, is always a good source and includes nori, laver, dulse and the kelp family (kombu, arame, wakame). But be warned – kelp absorbs far more than other seaweeds and you can get too much iodine from it. So, while seaweed consumption is encouraged, kelp should be used only sparingly.

Do vegans need to take supplements

It’s best to use a kelp supplement so you know exactly how much iodine you’re taking – it’s cheap, reliable and you don’t have to worry about taking too much. The recommended daily intake is 140µg and intakes up to 500µg are considered safe. In many countries, iodised salt is commonly used to ensure iodine intake, but it’s not the norm in the UK.

The dairy industry has been boasting about the iodine content of cow’s milk. What they don’t tell you is that it’s not a natural component of milk, but comes from iodinated cattle feed, supplements, iodophor medication, iodine-containing sterilisers of milking equipment, teat dips and udder washes. Cow’s milk is neither a natural nor the best source of iodine, so we can happily leave all that dairy out of our diet.

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