Showing posts with label Prebiotics. Show all posts
Showing posts with label Prebiotics. Show all posts

Thursday, 15 January 2015

Why Your Large Intestine is Big News


Hi Fodmappers - How are you doing? I just wondered if you spotted the articles on IBS in the news this last week?

The first was a piece in 'The Independent' which reported on a study into the role of prebiotics (note: not probiotics) in the treatment of anxiety and IBS. And the second was a feature on the low-FODMAP diet in the 'Daily Mail'.

If you've been following this blog a while, you'll know that I have written before about the issue of prebiotics and a low-FODMAP diet, but it's something which continues to interest me as prebiotics, often listed simply as FOS or GOS, are high FODMAP. (FOS is short for Fructo-oligosaccharide and GOS for Galacto-oligosaccharide and they are highly fermentable.)

This particular study compared FOS, GOS (specifically one referred to as B-GOS) and a placebo. The Independent reports that, volunteers in the B-GOS group "paid less attention to negative words, and more attention to positive ones, than those taking placebo." And that they "also had lower levels of the stress hormone cortisol in their saliva after three weeks on the prebiotic than they had at the beginning of the experiment." What's more "The effect of B-GOS on the attention task is similar to results found when healthy volunteers were given anti-anxiety or anti-depressant medication."

Impressive results, eh?

As many people with IBS also suffer with anxiety surely this raises the question of whether we should all be dashing out and stocking up on prebiotics despite the fact that they are high FODMAP.

Well before you do, I suggest you take a glance at the images on my earlier blog. There you'll see that the prebiotics added to the supplements you might find in your health store are FOS not GOS. And as the study discovered, "No effects were found after the administration of FOS."

So what does this mean?

Well it means that there's probably no benefit to be gained from the use of prebiotics - at least at the moment. (That's not to say that there's no benefit to be gained from taking a probiotic). And that the most effective means of managing the symptoms of IBS continues to be the low-FODMAP diet. Nevertheless I think this is going to be an interesting area to keep an eye on. I'll let you know if I spot anything further.

Which brings me to the article in the Daily Mail. This was, as you would expect, less academic and more celebrity focused, but it did include a couple of recipes and information on the Monash phone app, which is a really useful tool to have. I'm not sure it had anything new to tell us but it's always nice to see FODMAP getting a bit of coverage and it gets people talking. Thinking about it now, someone asked me a few questions last week about going low-FODMAP and I wonder if they might have seen this particular article. Having experienced the benefits myself, it's something I'm always happy to talk about, and as you know, I also love discovering new things to eat.

I'll be back soon with another yummy recipe for you. In the meantime please don't be shy about saying hello. I'd love to know how you're getting on with your low-FODMAP diet and the difference it's making to you.

Thursday, 24 July 2014

Prebiotics, FOS and a Low-FODMAP Diet

I was speaking to someone recently who told me her doctor had suggested a low-FODMAP diet and a probiotic - with the emphasis on her taking a probiotic which included a pre-biotic. This struck me as a bit of a contradiction, and hesitant as I was to dismiss her doctor's advice, I explained what I knew about prebiotics. But maybe we need to say a little about probiotics first? (Feel free to skip this bit if it's something you already understand).

Probiotics

Probiotics are supplements you will have come across I'm sure. They are sold in various forms such as capsules, powders, liquids and added to foods such as yogurts and yogurt drinks. They are often described as 'friendly bacteria' and advertised as a remedy for bloating. The aim of taking a probiotic is to rebalance the bacteria of the gut after a course of anti-biotics, for example, or where an excess of 'bad bacteria' has resulted in IBS type symptoms.

There seems to be general (if cautious) acceptance for the benefit of probiotics in helping manage IBS symptoms, such as this from NHS Choices;

"Probiotics may help reduce abdominal bloating and flatulence in some people with IBS, and they may help relieve pain and provide general relief. [...] however, we don't yet know the extent of the benefits, nor the most effective probiotic species and strain." (1)

Prebiotics

Prebiotics (FOS) are often included in probiotic supplements to provide a food source for these good guys, which seems reasonable, but it's possible they also feed the bad bacteria. As I found out, most of the studies into the benefits of prebiotics for gut health have been carried out on healthy people, not people with IBS.  In fact, Kevin Whelan of King's College, London reports that "in Crohn's disease and irritable bowel syndrome there is evidence that some prebiotics in high doses worsen functional symptoms." (2)

Well, as you can see in the photos below, the amount of prebiotics in supplements varies drastically. In fact I was surprised by just how much they vary. The first picture is of a bottle of probiotic capsules containing 100mg of FOS per capsule, whereas the  second picture is of a psyllium husk (fibre) supplement which contains 1620mg per serving. Quite a difference yet you might notice that the probiotic content of each is pretty similar.


FODMAPs

And here's that contradiction - the prebiotic Fructo-Oligosaccharides (FOS) are high FODMAP. Surely if you are reducing your FODMAP intake by limiting your diet to 'safe' foods, it doesn't make sense to add them back via prebiotic supplements, especially at the higher doses? Chances are that you are already getting sufficient prebiotics through everyday (low-FODMAP) foods anyway.

"If you are following a strict low–FODMAP diet, you can obtain prebiotics from non–FODMAP foods such as bananas, kale, chard, brown rice and oatmeal." (3)

Having discovered that I am sensitive to Fructo-oligosaccharides (including wheat, onions, garlic and cashews) I'm inclined to steer clear of probiotics which have added FOS altogether. Of course, if you can tolerate FOS (something you will discover from your low-FODMAP diet) then prebiotics probably aren't going to cause you problems either.

1. http://www.nhs.uk/Conditions/probiotics/Pages/Introduction.aspx#IBS 

2.  http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8952695&fileId=S0029665113001262

3. http://www.totalhealthmagazine.com/articles/digestion/hidden-carbs-that-can-hurt-your-gut.html