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Digestive WellnessMarch 2010 how to reevaluate and regain control of your digestive health
CAN BACTERIA BE GOOD FOR YOU?
At the University of Chicago Medical Center, we ask questions like this every day.Questions that have the potential to forever change the way gastrointestinal disorders are treated.
DISCOVER FOR YOURSELF.discover.uchospitals.edu | 888-UCH-0200
digestive wellness
CONTENTS 2 EatingRight
3 TreatingGastrointestinalCancers
4 DigestiveEnzymes
5 GoingOrganic
5 ProbioticsAnd
PreventiveNutrition
6 StartingEarly
6 ShouldIGoGluten-Free
7 DigestiveWellnessAnd
NaturalAlternatives
7 KnowTheFacts
8 PanelOfExperts
DIGESTIvEWEllNESSA special supplement produced by Mediaplanet and distributed by the Chicago Tribune.
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Contributor: Jill Coody Smits
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Digestive issues are more
common than most people
think —approximately one
in 25 people suffers from a food al-
lergy and many more suffer from food
intolerances. Celiac disease affects an
estimated one percent of Americans.
And one in five experience symptoms
of irritable bowel syndrome, which
affects twice as many women as
men. If you have a chronic digestive
condition, a carefully planned diet
can make a difference. With certain
diseases, what you eat may reduce
symptoms. In other cases, diet can be
the primary treatment leading to im-
proved health.
For those who are in need of help,
who is the best expert? A recent sur-
vey by the American Dietetic Associa-
tion and the University of Tennessee
Graduate School of Medicine showed
96 percent of primary care physicians
believe the nation’s healthcare sys-
tem should place more emphasis on
nutrition to treat and manage chronic
disease. However, only 12 percent be-
lieve physicians currently pay enough
attention to nutrition when treating
these diseases.
Whether you are trying to treat dis-
ease, lose weight or just make health-
ier choices, it may be hard to figure
out whom to listen to for advice. Hear-
ing someone is a “nutritionist” often
makes the person sound like they’re
educated and trained in nutrition
science and health issues. But in many
states, titles like “nutritionist” and “diet
counselor” are not regulated, so terms
like these can be used by people who
are not qualified to give accurate nu-
trition advice. While some nutritionists
may have an educational background
in nutrition science, others may have
little if any actual nutrition training or
just mail-order credentials. Even if a
person holds degrees from accredited
institutions, nutrition may not be his
or her specialty.
Who is the qualified nutrition
expert? When you need trusted, accu-
rate, timely and practical advice, seek
the advice of a registered dietitian.
With our education and experience,
RDs have the skills and knowledge
to translate nutrition science into
practical meal planning. A registered
dietitian can help you navigate food
allergies; work with your healthcare
team by helping you change your eat-
ing plan pre- or post-surgery; and help
you find ways to work with health
problems such as IBS .
The next time you hear nutrition
advice on television or see a diet book
that looks like it might help you lose
those last 10 pounds, take a closer
look to make sure the information is
coming from the qualified expert in
food and nutrition science: a regis-
tered dietitian.
Visit the American Dietetic Asso-
ciation at www.eatright.org to locate
a registered dietitian near you.
The American Dietetic Association
is the world’s largest organization of
food and nutrition professionals. ADA
is committed to improving the na-
tion’s health and advancing the pro-
fession of dietetics through research,
education and advocacy.
The content in this special advertis-
ing section was not developed by the
American Dietetic Association. The
American Dietetic Association does
not endorse any of the advertisers ap-
pearing within this special advertising
section or the companies mentioned in
the advertorial sections.
Eating Right: Optimizing Your Digestive Health
At every stage of life, from infancy through our senior years, nutrition is essential to keeping our bodies running at their best. As we age, our nutrient needs change with our bodies. But for those with digestive issues, proper food choices not only help them lead a healthier life, but often a more comfortable life.
By: JESSIE M. PAVlInAC, MS, RD, CSR, lD, PRESIDEnT, AMERICAn DIETETIC ASSoCIATIon
Jessie M. Pavlinac
a very special thanks to...
the next time you hear nutrition advice on television or see a diet book that looks like it might help you lose those last 10 pounds, take a closer look to make sure the information is coming from the qualified expert in
food and nutrition science: a registered dietitian.
digestive wellness
IT DID FOR MARY CARLENE SHEDD.Imagine being told you have cancer. It’s scary. Terrifying even. Now imagine
your doctor taking the time to teach you all about your disease and
treatment, going so far as to sketch a diagram of your surgery. That is
exactly what Mary found at the University of Chicago Medical Center after
her diagnosis of colon cancer. And not only did she receive the latest
treatments combined with the skill of a team of expert surgeons, but she
found the confi dence and comfort only knowledge can provide. At the
University of Chicago Medical Center, we think educating patients is an
essential part of treating them.
DISCOVER FOR YOURSELF.
discover.uchospitals.edu
888-UCH-0200
CAN A SIMPLE DRAWING MAKE ALL THE DIFFERENCE IN CANCER SURGERY?
And though there is no com-
mon thread running through
all GI cancers, there is a stan-
dard approach to diagnosis that is
critical to prescribing the best course
of treatment.
“First, we must determine where
the cancer comes from—what is the
cell of origin,” says Hedy Kindler, MD,
medical director of gastrointestinal
oncology at the University of Chicago
Medical Center. “That information
determines how the cancer behaves
and helps us understand how it might
respond to treatment. Then we ascer-
tain whether the cancer is localized
and removable with surgery, or if it has
metastasized and traveled to another
site.”
There are some commonalities
among treatment regimens for GI can-
cers, but different cancers will require
different treatments depending on the
cell of origin and the degree of spread.
Treatments may include surgery, radia-
tion, chemotherapy, or novel targeted
therapies. For most GI cancers surgery
is considered the only curative treat-
ment, so it is critical for patients to
select a treatment facility with the right
expertise.
“It is very clear that both short- and
long-term surgical outcomes are
better in institutions where surgeries
are done more often by highly-
experienced surgeons,” says Mitchell
Posner, MD, chief of surgical oncology
at the University of Chicago Medical
Center and president of the Society of
Surgical oncology. “not only is there
less patient mortality, but cancer recur-
rence is less likely.”
Though finding a high quality treat-
ment team is important to surviving
and living with GI cancer, finding
the cancer early is equally critical
because cancer treatments are most
successful in the earliest stages of
disease. As a result, researchers and
oncologists are continually looking
for ways to diagnose earlier and
more accurately.
“If we can better image tumors
and use molecular markers to detect
cancers earlier, we have a better
chance of helping patients,” says
Posner. “We have already made great
strides in the area of colon cancer,
and though we know there is a
sequence of events that occurs in
pancreatic cancer it is still much harder
to detect.”
In fact, survival rates for colorectal
cancer have increased significantly in
the past 10 years alone, and 90 percent
of those diagnosed with stage one
disease can now expect to live five
years or longer. That success is partially
attributable to improved diagnostic
tools that allow disease to be found
earlier, as well as improved treatments.
“Though we have made only incre-
mental progress in treating some dis-
eases, the impressive strides in others
help us understand the multiple ways
cancer evades treatment, and may one
day help us treat all cancers more ef-
fectively.”
of course, the great hope of all
cancer patients is a cure. But Kindler
says that though we may not be
able to cure every cancer, there is
reason to be hopeful. At present, while
some patients can be cured, other
patients can live with their cancer
for many years, in the same way
that patients live with other chronic
diseases such as diabetes and high
blood pressure.
“oncologists are eternal optimists,”
Kindler continues. “We never know
where the next great discovery will
come from, and we cannot predict a
timeline. However, as we continue to
learn more about the underlying biol-
ogy of each cancer, and as we go from
the laboratory to clinical trials of novel
treatments, there is definitely hope for
the future.”
Treating Gastrointestinal Cancers Gastrointestinal (GI) cancers vary widely depending on which part of the digestive system is affected. From the esophagus to the anus, each disease site has its own unique traits and each cancer its own risk factors, treatment options and particular challenges.
Mitchell Posner, MD and Irving Waxman, MD discuss a patient’s course of treat-ment. Collaboration among physicians provides patients with comprehensive treatment plans.
Eating Right: Optimizing Your Digestive Health
digestive wellness
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You wrote a short booked called Why Diets Don’t Work. In a sentence or two, why do you think that?Most diets fail long term because they require too much effort and often consist of changes in behav-ior that are unrealistic and in many ways, unhealthy. They simply “ask too much of us!” People don’t want to give up their favorite foods forever or live with guilt and shame when they have a home cooked meal. Most diets are a recipe for burning out.
What are some tips you recom-mend to people who don’t need surgery but need to lose weight?Everyone is unique so the key is be-ing honest with yourself, mindful of your relationship with food, and find-ing good practical tools to help you gain more control over your eating habits. one powerful tip I give is to eat before you eat. It sounds strange but a good dose of fiber, some pro-tein and a glass of water 30 minutes before your biggest meals can work wonders for stretching the parts of your stomach that lead to satiety. When dinner time comes, tools like that help you be full and eat less (a mantra of ours).
What other tips do you often give?Drink plenty of water, try to minimize the white stuff (processed sugars, starch), make protein 50 percent to 75 percent of each meal (to leave you feeling full longer and give your body what it actually wants), eat five to six small meals per day (to help avoid binge eating at night), and watch out for sugary drinks, fancy coffees, and saturated fats.
So it is possible to lose weight and eat what you want?yes, absolutely. Moderation is the key. The biggest problems are over-eating and mindless grazing. Eating food that makes you feel good and taking time to enjoy each bite can go a long way.
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“Enzymes play a crucial role
in proper digestion by
breaking down proteins,
fats and carbohydrates into their
simplest component,” says Jason
Barker, nD, a naturopathic physician
and spokesperson for Enzymedica.
“once this process is complete,
the body is prepared to absorb
and utilize the nutrients that have
been eaten.“
But what happens when the body
fails to produce enzymes in sufficient
quantities? Many people don’t learn
that lesson until they experience it for
themselves.
“Two of the biggest reasons for
poor digestion are our body’s inability
to produce enough enzymes and the
lack of digestive enzymes in the foods
we eat,” says Jason Barker. “lactose
intolerance is one easily-recognized
example of an enzyme deficiency.”
lactose intolerance occurs when
the body fails to produce enough
lactase, the enzyme that breaks down
the lactose in dairy products. Affecting
up to 50 million Americans, symptoms
of this condition include bloating,
abdominal pain and diarrhea. It can
be combated by gradually introduc-
ing dairy into the diet, or by taking a
lactase supplement.
And while the patient and their phy-
sician should determine the course of
treatment, some experts advocate for
a conservative initial approach.
“In most cases I advocate for taking
a conventional route first—examine
behaviors, consider stress level and
look at the diet to see if you can get
what you need from the food you eat,”
says Jennifer Ventrelle, MS, RD, lDn,
CPT, a nutrition consultant with Rush
nutrition and Wellness Center at Rush
University Medical Center.
Dr. Barker recommends a combina-
tion approach.
“By eating (raw) foods with en-
zymes intact and supplementing
with enzymes when eating cooked or
processed foods, we can increase our
body’s enzyme efficiency.”
Digestive EnzymesMost people learn in fifth grade science class that enzymes are involved in digestion, but many people don’t understand the critical role they play.
two of the biggest reasons for poor digestion are our body’s inability to produce enough
enzymes and the lack of digestive enzymes in the foods we eat.
digestive wellness
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After all, if you can reduce your
risk for allergies and heart
disease by consuming bee
pollen and fish oil, maybe health in-
surance will be less critical down
the road.
Many people are certainly inter-
ested in maintaining their digestive
health, and probiotics are fast be-
coming the preventive “it” product
of the day. These healthy bacteria
that enter the body through supple-
ments or probiotic-rich foods are not
new, but there is a steadily growing
consumer interest.
“I have noticed a growing aware-
ness of and interest in probiotics,“
says Jennifer Ventrelle, MS, RD, lDn,
CPT, a nutrition consultant with
Rush nutrition and Wellness Center
at Rush University Medical Center.
“That may be attributed to the fact
that we are learning more about
probiotics and their health benefits,
and also because people are seeing
products as Kefir and yogurt being
advertised with health claims about
containing probiotics.”
A growing body of evidence sup-
ports those health claims, and it ap-
pears that probiotics can be beneficial
in both treating and preventing diges-
tive issues.
“Probiotics can be particularly ben-
eficial for people with conditions such
as Irritable Bowel Syndrome or Crohn’s
Disease that may disrupt their gut
microbial flora by enhancing their im-
mune systems and supporting other
digestive system functions,” says
Ventrelle. “In addition, these bacteria
can help individuals who don’t have
gastrointestinal disorders maintain
the balance of beneficial and harmful
bacteria in the intestine.”
As it is with most nutritional supple-
ments, however, Ventrelle says it is
important to use moderation when
bringing probiotics into your diet.
“If added to the diet too quickly,
probiotics can cause diarrhea. How-
ever, when added slowly, most people
can eat many products and foods
containing probiotics as part of an
overall well-balanced diet without
adverse consequences.”
Probiotics And Preventive Nutrition With health care in a state of flux, it is no surprise that preventive nutrition is one of the fastest growing food trends in America today.
Going Organic: The Why And How
While researchers are still
investigating exactly how
much safer and nutritious
organic food is, advocates say there
are numerous health benefits of eat-
ing organically, including improved
digestion.
“one of the real advantages of
eating organic foods is they do not
contain preservative chemicals and do
contain a richer diversity of microor-
ganisms that help the digestive system
extract nutrients in food,” says Dr.
Charles Benbrook, chief scientist with
The organic Center.
In addition, Benbrook says current
research in support of organic food
strongly suggests that decreased ex-
posure to pesticides in food and water
is beneficial to all people, and infants
and children in particular.
“The evidence is very clear that
pesticides in beverages and foods
contribute to a suite of developmental
problems in kids including allergies,
ADHD, autism, asthma, and predis-
poses them to metabolic syndrome
later in life.”
In addition to being largely
chemical-free, Benbrook says the
benefits of organic food are twofold: 1)
on average, they are 25 percent more
nutrient-dense and 2) they do not
contain the long list of food additives,
preservatives, colors and flavor en-
hancers contained in non-organic food.
So —should you go organic? There
are many factors consumers consider
when making that decision, including
nutrition, environmental concerns and
cost. If you do choose to go organic,
Benbrook says there are a number of
ways to move incrementally into your
new lifestyle.
“When local fruits and vegetables
are in season, visit your local farmer’s
market, area farms or co-op and try
to eat more local organic food that is
picked when it is really ripe and con-
tains by far the most nutrients. In the
winter, look for high-quality frozen or
canned fruits and vegetables that have
been preserved.”
Making the right food choices has a proven affect on digestion, but does choosing organic food make a difference?
digestive wellness
For many, it would be skeptical
at best. And while an explana-
tion that they are consuming
“friendly bacteria” probably won’t
help, early research does show that,
like bushy broccoli and crunchy car-
rots, probiotics can provide important
health benefits to children.
“Probiotics may help children have
fewer colds, need fewer antibiotics and
miss fewer days of school,” says
Dawn Jackson Blatner, RD, lDn,
American Dietetic Asso-
ciation spokesperson
and author of
The Flexitarian
Diet. “In addi-
tion, they may
also help reduce
diarrhea and an-
tibiotic-induced
diarrhea.”
For children
and adults
alike, probiotic
s u p p l e m e n t s
essentially work
by replacing
bad bacteria with good, creating a
more balanced intestinal environment.
And while probiotics appear to benefit
most people, Blatner says there may be
added benefits for the young.
“Because a child’s immune system is
still in development, probiotics may be
even more helpful in childhood than
in adulthood to help kids better fight
off sickness.”
So—how do you entice the picky
eater into consuming a daily dose of
bacteria? There is a growing number
of products on the grocery shelf, in-
cluding yogurt, probiotic-rich cheeses
(packaging may state “live culture”),
and nondairy foods such as sauer-
kraut and tempeh. one of the most
probiotic-rich foods, however, is kefir. A
cultured and fermented milk product
similar to yogurt, kefir contains 10
healthy bacteria compared with one or
two in yogurt.
Blatner says, “Kefir can be a good
source of probiotics for children be-
cause it tastes good—meaning kids
will actually drink it! In addition to the
probiotics, it contains protein, fiber and
vitamins and minerals children need
such as calcium and Vitamin D.”
Who knows, maybe one day soon
children will start requesting probiotics
for dessert.
There’s a good reason for it—it’s
called Celiac Disease and at
least three million Americans
are affected by it.
A genetic autoimmune disorder
triggered by the consumption of
gluten proteins, Celiac Disease causes
the immune system to attack the
small intestine, inhibiting absorption
of nutrients and potentially causing
osteoporosis, infertility and neurologi-
cal conditions.
According to Dr. Stefano Guandalini,
founder and director of The University
of Chicago Celiac Disease Center,
the disease has long been under
diagnosed.
“Until recently, physicians in this
country thought Celiac Disease was
very rare. In fact, at least one percent of
the population has Celiac, but because
it presents with many different symp-
toms it is often overlooked.”
Though many people with Celiac
Disease report no symptoms, there are
literally hundreds of signs that may ap-
pear during childhood or adulthood,
including: recurring abdominal bloat-
ing, chronic diarrhea or constipation,
fatigue, delayed puberty and failure
to thrive.
Dr. Guandalini says people should
speak with their doctors if there is
family history of the disease, or if they
experience any symptoms. Patients
should adhere to their normal diet
prior to testing but, upon diagnosis, he
says there is really only one treatment:
lifelong adherence to a gluten-free diet.
“A strict gluten-free diet is manda-
tory for those with Celiac Disease
because as little as a crumb of bread
can activate the disease.”
And while other conditions such as
gluten intolerance and wheat allergy
might benefit from a gluten-free diet,
there is no evidence that it is healthier
for the unaffected person. For more in-
formation, visit www.celiacdisease.net.
Starting Early: Probiotics And Kids
Should I Go Gluten-Free: Celiac Disease
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digestive wellness
There’s a reason burp cloths are
a popular baby shower gift—
new parents spend a lot of time
cleaning when babies spit-up! But some
newborns spit up more frequently than
others, experiencing unusual discom-
fort that may be symptomatic of acid
reflux disease.
More than half of all newborns suffer
from infant acid reflux, and Beth
Jackson-Gagne, MS, oTR/l, founder of
Baby Stay Asleep, says it’s important for
parents to observe closely to determine
whether their child may be affected.
“If new parents suspect their baby
suffers from acid reflux, they should
monitor the child’s spit up behavior,
especially after meals or snacks and
during bedtime hours.”
Symptoms for infant acid reflux
include irritable behavior, difficulty
falling or staying asleep, bad breath,
blood in stool, wet burp sounds and
refusing feedings. And while only a
trained professional can make a diag-
nosis, Jackson-Gagne says if reflux is
confirmed, there are numerous ways to
treat the symptoms.
“Positioning is key. During and after
feeding, keep babies as upright as pos-
sible in order to keep food from coming
back up. During sleep, raise the head
of the crib to let gravity help keep the
infant’s food down.”
As long as they are doctor-recom-
mended, Jackson-Gagne says some
infants may find relief with medications
such as antacids or proton pump inhibi-
tors, which reduce stomach acid.
But what can parents do to prevent
infant acid reflux in the first place?
Jackson-Gagne says while there are no
surefire remedies, good feeding and
bedtime routines can go a long way.
“An ounce of prevention is worth
a pound of cure. But once a child is
diagnosed, parents must act quickly in
order to avoid potential complications
such as failure to thrive and long-term
food aversions that may lead to refusal
to eat.”
Know The Facts: Infant Acid RefluxEosinophilic Esophagitis (EoE) is on the rise. Possibly related to food or environmental allergies, the most common symptom of EoE is difficulty swallowing food.
Some experts say these prob-
lems, combined with readily
available processed foods, can
negatively affect the digestive system
and, ultimately, our overall well being.
“Many of the foods we consume
are impure, contaminated with heavy
metals and other environmental toxins
which our bodies are not designed to
process,“ says Dr. Isaac Eliaz, MD, MS,
lAc and founder of Econugenics. “The
digestive system is constantly chal
lenged to ensure we are nourished,
protect the body and play a critical role
in supporting the immune system.”
In an effort to combat the ill effects
of environmental issues outside of
their control, some Americans are inte-
grating natural alternatives into their
diets. Dr. Eliaz says if there is one bodily
system where natural alternatives are
the leading treatment choice, it is the
digestive system. In fact, he says people
are turning to a combination of West-
ern and Eastern philosophies to treat a
number of ailments including irritable
bowel syndrome and GERD.
“one category of alternative treat-
ments functions to support normal di-
gestive processes. This type of support
can provide ‘digestive heat’ that trans-
lates into normal, well-synchronized
peristaltic movement that restore and
support the digestive system in a way
that helps normalize the secretion of
digestive enzymes and balances the
healthy bacteria in the gut.”
Dr. Eliaz says the key to using natural
alternatives is to introduce different
herbs, compounds and minerals that
support the digestive system and
promote total well being without over-
stimulating the body.
Digestive Wellness And Natural AlternativesAccording to a 2007 United nations report, more than 81 percent of Americans live in urban areas. And while city life offers numerous health benefits including availability of high-quality foods and access to high-quality medical care, there are also a number of potential disadvantages including lowered physical activity, poor water quality and air pollution.
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digestive wellness
Q: What is an overlooked natural remedy for a
common digestive complaint—constipation?
A: What makes us constipated? lack of fiber? yes,
sometimes. But there’s a complementary reason
that we often miss. Magnesium, also known as
Mother nature’s muscle relaxant, helps encour-
age our body’s natural muscle movement (in-
cluding the digestive tract)—motility—to pro-
mote regular bowel movements. Magnesium is
a mineral, it is not a laxative.
Getting your period, have a headache, prone
to muscle aches, flying or traveling by car or sit-
ting at a desk all day? Any of these situations can
exacerbate constipation by slowing or stopping
motility. Thus, increasing magnesium intake can
address the problem at the core (as can add-
ing daily activity such as chair twists or other
stretches.) Also, magnesium works in opposition
to calcium (which helps our muscles contract).
So if you’re taking a calcium supplement—make
sure it contains absorbable magnesium too.
Foods rich in magnesium include whole grains
(the actual grain, not the flour as much), beans,
and chocolate (portion control and good qual-
ity). For supplementation, I recommend magne-
sium citrate. For more information on recipes,
foods, and supplement recommendations, visit
www.ashleykoffapproved.com or get Recipes for
IBS by Ashley Koff, RD where books are sold.
Panel Of Experts
DAVID T. RUBIn, MD Co-Director, University of Chicago Inflammatory Bowel Disease CenterAssociate Professor of MedicineUniversity of Chicago Medical Center
Q: What are probiotics and why are they
important?
A: The term probiotic literally translates to “for
life,” and that couldn’t be more true. your diges-
tive tract is filled with trillions of bacteria, some
promote health (probiotics), and some can harm
your health. Probiotics are healthy bacteria that
keep the harmful bacteria in check and help you
create and maintain a healthy internal balance.
Probiotics promote efficient digestion and
absorption of nutrients and promote an overall
healthy digestive tract. numerous studies sup-
port the idea that regular consumption of pro-
biotics can help with many intestinal conditions
and can even help lower the risk of colon cancer.
What’s more, the positive effects of probiotics
might not be limited to just the digestive tract.
For instance, research suggests that probiotics
help maintain healthier blood cholesterol and
blood pressure levels, support our immune
system and potentially aid with weight control.
you can add probiotics to your diet with
supplements, or an effective (and enjoyable)
way to get them is from yogurt or from foods
and drinks made with yogurt. Plus you get many
added benefits: yogurt is naturally rich in es-
sential vitamins and nutrients including protein,
calcium, riboflavin, Vitamin B6 and Vitamin B12.
There’s a reason they’re called PRobiotics and
they need to be part of your diet. It’s a small
change you can make that can have big effects
on your health.
lInDSEy DUnCAn, nD, CnGenesis Today
Q: I’m lactose intolerant. Are there any dairy prod-
ucts I can still enjoy?
A: Absolutely —just because you’ve been diag-
nosed with lactose intolerance does not mean
you need to abstain from the entire dairy food
group, nor should you, as it provides the bulk of
your bone-building calcium needs.
Between 30 and 50 million Americans suffer
from lactose intolerance, meaning they don’t
produce enough of an enzyme called lactase,
normally manufactured by cells that line the small
intestine, which breaks down lactose into a more
easily absorbable unit. The result: Discomfort
ranging from mild-to-intense nausea to cramps,
bloating, gas, and diarrhea. An array of lactose-
free products can be found at many mainstream
grocery stores, as well as calcium-fortified orange
juice. There’s also kefir, a tangy, yogurt-like drink
that’s been a staple in Russia for centuries and is
gaining traction as a hot superfood in the US. A
recent Journal of the American Dietetic Associa-
tion study found that kefir can actually improve
lactose digestion; the live and active bacteria
cultures help break down milk’s sugars. Kefir also
helps colonize the intestines, further protecting
them from disease-causing bacteria. In addition,
one cup of kefir supplies 30 percent of your daily
calcium needs, is low in fat and contains a healthy
dose of fiber, too.
lESlIE GolDMAn, MPH Health and medical writerspokesperson for lifeway Kefir
ASHlEy KoFF, RD Ashely Koff Approved
Q: What advances in treatment have become
available for inflammatory bowel disease?
A: Inflammatory bowel disease (IBD) is a chronic
intestinal condition that includes two primary
types, Crohn’s disease and ulcerative colitis. Al-
though the causes of these conditions remain un-
known, scientists here and elsewhere have made
significant discoveries of the genetic associations
and have new information that will someday
lead to individualized therapies. In the meantime,
however, there have been tremendous advances
in available treatments. our new treatment strat-
egies now include successful ways to maintain
remission long-term, improve a patient’s quality
of life, avoid hospitalizations, and prevent surgery.
In 2010, there are multiple versions of the
aminosalicylate therapies to treat ulcerative
colitis, offering different delivery systems and
the convenience of fewer pills taken fewer times
per day. In Crohn’s disease, we have a steroid de-
signed to provide significantly fewer side effects
than traditional steroids. When it is needed, sur-
gery remains an important treatment, and new
laparoscopic approaches have resulted in shorter
recoveries and better outcomes. The greatest ad-
vance in treating IBD has been the development
of biologic therapies, antibodies engineered to
target specific proteins related to inflammation.
We have learned that they work much better
when they are used earlier in the disease course
and are much safer than ineffective therapy and
the ravages of active disease.
A lifetime of disability or steroid treatments is
no longer acceptable in IBD. Patients suffering
from IBD in the current era should ask for and
expect expert advice, access to leading-edge
therapies, and a team approach to management
that helps them to achieve control over the dis-
ease until a cure is found.