May 21st, 2012 | by Pam Stuppy
Printed in Seacoast Online
Bowel habits can vary from person to person and still be considered “normal.” Variations are seen in frequency, consistency of stool, and ease of passage.
We think of constipation, however, when there are longer periods of time between bathroom visits and bowel movements become more difficult or painful. There can be a number of reasons for this and some can be eased by taking a few preventive steps.
Stress, illness, low levels of physical activity, hormonal changes, aging, fluid intake, diet, and some medications can all affect our bowels. Lowering stress levels and getting regular exercise are two positive steps you can take to normalize bowel habits.
Exercise can speed up transit time in the intestinal tract. On the other hand, sitting long periods of time at your desk, in a car or plane can be triggers for constipation.
If your constipation is caused by medication, check with your health-care provider to see if your medication can be changed to one that does not have constipation as a side effect or if the dose can be lowered. Some supplements, like calcium or iron, can also cause constipation. If possible, try getting the nutrient from foods rather than supplements or take the supplement in several smaller doses or with food at a meal.
When it comes to hormones, women may experience changes in bowel status at different times of the month because of menstruation. Pregnant women also frequently report episodes of constipation. In both cases, increasing physical activity, fluid intake, and dietary fiber can be helpful.
Low fluid intake is a common reason for constipation. Many people do not drink enough fluids throughout the day. Adults should try for at least 64 ounces a day, more if the weather is hot, humid, or you are exercising. Some good clues about being adequately hydrated are the frequency of urinating and the color of your urine — paler is better.
One common reason for constipation is the typical American diet. The downfall occurs from a higher intake of processed foods and lesser amounts of foods containing fiber. Fiber creates bulk in the bowel, exercises the muscles there, and triggers the action that pushes the contents along. There are two major types of fiber in the diet, insoluble and soluble, and both can be helpful in slightly different ways.
Insoluble fiber we also call roughage. It is the part of foods that do not digest, so it creates bulk. It tends to be somewhat rougher than soluble fiber, so if someone is already constipated or bowel movements are painful, the diet should contain a lesser amount of this type of fiber and more of the soluble fiber. Examples of where this type of fiber is found include wheat bran, beans (note that beans contain both types of fiber), and the skins/seeds of fruits and vegetables.
Think of soluble fiber as a sponge. When moistened, a sponge is softer. The soluble fiber absorbs water and creates a more gentle mass as it passes through. This type of fiber is often recommended for people with irritable bowel syndrome, a condition that is a frequent cause of constipation or a vacillation between diarrhea and constipation. If your bowel movements have been hard and difficult to pass, focus on consuming more of this type of fiber. Some of the more concentrated sources of soluble fiber are oats and oat products, barley, beans, fruits vegetables, and psyllium.
If your diet does not currently contain much fiber, add it slowly over several days or weeks. If your body is not used to much fiber and you add large amounts all at once, you might experience abdominal pain and bloating. The final goal for adults is about 25-30 grams of fiber a day. For children, figure their age plus 5 gms (for example, a 9 year old would need about 14 gm of fiber a day). Again, do not forget to consume adequate fluids with a higher fiber diet or the higher fiber can trigger constipation.
Increasing fiber in your diet starts at the grocery store. Buy more whole grains, fruit, vegetables, nuts, seeds, and beans. Read food labels and buy products containing more fiber. Check out the local farmers market for some new ideas.
Try new recipes that use these foods. In cooking, ground oats, whole grain flours, ground nuts, fruit, and sometimes pureed or shredded vegetables can easily be added to baked goods. Oatmeal or oatbran is a great way to start the day. Beans can be added to salads, soups, stews, stir fries, grain dishes (like brown rice or quinoa), or eaten as a side dish. Dried fruit, prunes, and prune juice have a natural laxative effect and can be really successful in prompting stubborn bowels.
Because the medications often used to trigger frequent bowel movements, like laxatives, can be damaging if used long term, try increasing physical activity, lowering stress, and increasing fluid and dietary fiber as a first response. These are all positive lifestyle habits and the foods containing fiber also provide a number of nutrients important for overall health.
If constipation causes extreme pain, is persistent, or results in fever, bleeding or vomiting, contact your health-care provider as it may require more serious medical attention. Otherwise, try some of the steps suggested above to reduce the risk of becoming constipated or to address a milder case.
Pam Stuppy, MS, RD, CSSD, LD, is a registered, licensed dietitian with nutrition counseling offices in York, Maine, and Portsmouth. She is also the nutritionist for Phillips Exeter Academy. Visit www.pamstuppynutrition.com for nutrition information, some healthy cooking tips and recipe ideas.
May 8th, 2012 | by Pam Stuppy
Printed in Seacoast Online
Everywhere we turn we hear the message that our nation’s kids need to eat better. This is obviously a very complex issue, but there are some steps families can take to improve the overall health of the next generations.
Teaching children the basic principles of eating healthfully can improve their chances of a lifetime of good health. Getting them involved in the planning, purchasing and preparation of nutritious foods gives them the tools they need as they get older. Having them help to grow the food, as in a family garden, is another idea. Remember, too, that children tend to follow the behaviors of their parents, so modeling positive eating habits is important as well.
Studies show that children are more likely to eat the foods they grow, choose at the grocery store, and/or prepare. These activities often expand the variety of foods they enjoy and can mean a wider range of nutrients consumed. It is also a good tactic for children who are picky eaters.
Getting children excited about planning and planting vegetable and herb gardens, along with fruit-producing plants and bushes can enhance their awareness and appreciation of the food production process. It can provide a sense of satisfaction and pride, and give them a chance to practice being responsible. Just imagine how important your 5 year old would feel going out to the garden to pick some vegetables or herbs that he or she helped grow, for the family dinner.
Many parents are concerned about food additives, pesticides and other contaminants in the food supply, especially when it comes to feeding their children. Because they are not processed like many of the foods available today, foods grown in a home garden contain numerous nutrients for growth, development, and health.
Teaching children and teens the basics of meal planning can introduce the ideas promoted by the new “My Plate” image (www.choosemyplate.gov). For example, when they plan a dinner, they should try to make at least half the plate fruit and vegetables, a quarter of the plate a lean protein, and the other quarter of the plate a whole grain. The meals should also contain a source of calcium (like low-fat milk, yogurt, cottage cheese, cheese, or a calcium-fortified item like soy milk).
Even very young children enjoy helping with the grocery shopping. As they get older, get them involved in label reading. It can be a great teaching tool about making healthy choices. You can make it fun by having them play detective. An example might be to have them look at cereal boxes to find the ones higher in fiber. Or you can ask them to find soup or pasta sauce with the lowest sodium. Label-reading and guidance about how to choose healthy foods will be increasingly important as they get older and make choices on their own.
When it comes to cooking, your child’s (or grandchild’s) level of involvement will depend on their age. Allow them to participate as much as possible so they feel like they are a major part of the process and outcome. Initially, allowing them to assist you in the kitchen may take a little more time, but eventually, they may be able to take over some of the activities needed for meal preparation.
Very young children love to stir things together. They feel very important with a whisk or wooden spoon and bowl of pancake batter or muffin mix. They can also pour ingredients from a measuring cup. An easy recipe for a young child (that can be enjoyed immediately or frozen into Popsicles) is a yogurt and fruit smoothie. They can also add frozen vegetables to a pan before it is put on the stove or dump frozen blueberries into muffin batter. A fun activity might be for them to help plan a picnic for friends and/or a favorite doll or teddy bear.
Children who are a little older can help measure ingredients. Those who can read, might enjoy calling out the ingredients as they are needed for a recipe. Recipes that have a picture of the finished product are great for kids and adults alike.
Knives and cooking on the stove should be reserved for older children after special instructions and guidance from an adult. Teens might like to create items like a stir fry, salad, or pasta dish. They can also go online to look for healthy recipes. Older children and teens might enjoy being in charge of planning and preparing one or more meals each week. They could also plan and prepare healthy foods for a party.
Cooking together can be a fun family activity and provides an opportunity for quality family time. Studies suggest that families who eat more meals together at home, tend to consume closer to the recommended intake of nutrients. As children learn basic cooking skills, when they do eat out, they have a better understanding of how foods have been prepared. This is especially helpful when they leave home to live on their own.
Some parents have not had the opportunity to learn basic cooking themselves. In this case, friends or other family members can be a good resource. Healthy cooking classes might be available in some communities. Some grocery stores have dietitians who give grocery store tours and talk about how to choose healthy foods.
Think about all the fun ways you can help the children and teens in your life learn more about the path toward a lifetime of healthy eating.
May 1st, 2012 | by Pam Stuppy
Printed in Seacoast Online
A lot of research supports the idea of including a variety of plant-based foods in our diets for health. Because of this, some people are finding ways to incorporate more plant foods into their more traditional eating patterns, while others have moved towards actual vegetarian eating.
Plant foods contain fiber, vitamins, and minerals, as well as numerous “phytonutrients.” This term refers to the hundreds of nutrients we are now identifying in plant-based foods that appear to contribute to optimal health. Many are important in protecting our bodies from tissue damage, reducing the risk of heart disease and some cancers, boosting the immune system, and countering some of the negative effects of the aging process. An example would be the many antioxidants found in fruits and vegetables. Plant foods include whole grains, fruit, vegetables, beans, nuts, seeds, and herbs.
Leaning more toward plant-based foods often means the diet is lower in saturated fat and cholesterol. Some, like nuts and seeds, provide heart healthy fats as well. Since some plant-protein foods (like beans) have more volume for the amount of protein they contain, protein intake tends to be closer to the recommended levels, as compared to the higher intakes often seen in more meat-focused diets. When food intake contains fewer plant foods and more animal foods, calories can often be higher and contribute to unwanted weight gain.
The fiber in these foods not only benefits the intestinal tract to keep it exercised and healthy, but also helps us to feel fuller at a meal on fewer calories — a great idea for weight control. Since fiber slows digestion, the fuel from a meal or snack containing fiber often lasts longer. Fiber can also lower the risk of high blood pressure, high cholesterol and elevated blood sugars. Many Americans are not getting enough fiber. Adults should try for a goal of about 25-30 gm a day.
For more traditional eaters, there are many ways to slip more plant foods into each day. It might mean including more vegetables, not only at dinner, but maybe also at lunch and snack times. Try making vegetables at least half of your lunch and dinner plates. Another idea could be adding fruit as a snack or for dessert instead of more processed foods. Herbs can add great flavor and are a good replacement for salt.
Beans can be added to soups, salads, stir fries, or combined with other foods like cooked grains (brown rice, quinoa, bulgur), whole grain pasta with tomato sauce, or in chili. Nuts and seeds make easy, non-perishable snacks. They can also add nutrition and crunch to salads, stir fries, Indian or Asian dishes, cereals, or grain sides dishes (like rice or quinoa).
Moving toward more vegetarian eating, requires a little more thought. It does not just mean dropping all animal-based foods from your diet. Unless well-planned, an entirely plant-based diet can be low in calcium, vitamins B12 and D, protein, iron and zinc. Fortified foods or supplements are often needed to cover vitamin B12 and D needs.
Calcium is less concentrated in plant-based foods, but can be adequate if the stronger plant sources are frequently included. Kale, turnip greens, collards, dandelion greens, bok choy, mustard greens, and broccoli are some examples of vegetables that contain calcium. Almonds and sesame seeds are others. Soy milk and tofu often contain higher levels. Soybeans, navy, and great northern beans rank in the upper end of calcium contents for the bean family. Some cereals may be fortified with calcium.
Protein recommendations for vegetarians vary. There is some thought that because of the fiber in many plant proteins, the recommended intake should be about 10 percent higher than for non-vegetarians. Pregnant or breastfeeding women and some athletes who are vegetarian need to be especially careful to get adequate amounts of protein. Sources of plant proteins include beans, soy products (soy milk, soy cheese, edamame, soy nuts, tofu, tempeh, textured soy protein, etc.), nuts and nut butters, seeds, seitan, and quinoa. For vegetarians who include dairy products and eggs, these are high quality protein sources as well.
Since diets with a high percentage of fruits and vegetables can be lower in calories, it is important that calorie needs for the day are met. This not only assumes that adequate nutrients are being consumed, but also protects dietary protein from being used for energy instead of the other purposes for protein in the body, like muscle building and repair.
When it comes to iron needs, meat, poultry, eggs, and fish are the best absorbed forms. Plant sources (whole or enriched grains, beans, nuts, seeds, raisins, dark leafy green vegetables) are less well absorbed, but uptake can be improved by having a source of vitamin C (citrus juices and fruit, kiwi, melon, berries, broccoli, peppers, etc.) at the same meal.
Vitamin B12 is associated with animal-based foods, but even a small amount in a mostly plant-based diet can provide the recommended level. Zinc also tends to be found in protein foods. Plant-based sources would be beans, nuts, seeds, and whole grains.
The evidence for the health benefits of plant-based foods is undisputable. Massive amounts of research support the recommendation for us to include more of these foods in our diets. Think about how you can start today to add more of these lifesaving foods to your diet.