While my career path veered away from orthodoxy more than a decade ago, I remain a regular reader of the British Medical Journal. One thing I like is its ability to email-alert me to any nutritionally related content. Recently, the BMJ published an editorial on the management of irritable bowel syndrome (IBS), a condition characterised by symptoms such as constipation and/or loose stools, abdominal bloating and wind, but for which no specific cause can be found. As I had not had electronic notice of this review, I imagined the BMJ's automatic alerting service had broken down. All became clear, however, when I discovered the review contained not a single reference to diet.
Even those without any knowledge of the workings of the digestive tract might suspect that symptoms emanating from this organ may have something to do with food. In fact, IBS is quite often triggered by reactions to specific foods. This has not gained widespread acceptance by the medical establishment, which usually advises sufferers to increase fibre intake. However, one study found this was generally ineffective, and exacerbated symptoms in more than half of those with IBS. This is likely to be explained by the fact that those seeking fibre generally find it in bran-filled breads and cereals based on wheat, which nutritionally oriented practitioners find is the most common offender in IBS.
While wheat is a frequent trigger, other foods can be implicated, too. Those with IBS can therefore benefit from identification of problem foods. Several methods of testing exist, such as kinesiology (muscle testing) and dowsing. I believe all such methods have some validity, though those who are more comfortable taking a more 'scientific' approach may have their blood tested for IgG antibodies to specific foods. One study published last year in the journal Gut found that elimination of foods identified by this form of testing was beneficial for IBS sufferers. For details, see www.allergy-testing.com.
No tests are foolproof, however, and there is usually no reason why individuals should not make changes to their diet without testing. I advise trying a diet devoid of wheat (pasta, bread, biscuits, pastries, breakfast cereals) and cows' milk (another common offender) for a week or two. Better tolerated grains include rice and oats (oat-based muesli, porridge, oatcakes), and rice and oat milks are good swaps for dairy milk, too. Next week, I'll focus on what I find to be the other major underlying factor in IBS, namely an imbalance in the microbiological ecosystem within the gut. In the meantime, IBS sufferers might find dietary exclusion does much to reduce unwanted gut reactions.
Dear John
I was interested in your recent recommendation regarding taking linseeds. I take them regularly for their omega-3 content, but read recently that they are a source of cyanide. I could find no data on safety and wonder whether you could comment on this?
Derek Philpott
Linseeds are a potential source of cyanide, though only at low concentration. More than 20 years ago, America's Food and Drug Administration (FDA) declared cyanide levels in linseeds low enough for there to be no health risk. It said they carried no more risk than other foods containing low levels of cyanide, such as lima beans, fava beans, chickpeas, cashews and almonds. Subsequent research published in the American Journal of Clinical Nutrition in 1994 concluded that any cyanide exposure from 60g (six tablespoons) of linseeds a day isn't hazardous. While you do not say how much you consume, it is unlikely to be more than is considered safe. You will get a good dose of omega-3 fats (in the form of alpha-linolenic acid) by consuming about 20g (about 2 tablespoons) of whole linseeds each day.
Nutrition news
Recently, I wrote a column regarding the singular lack of evidence proving that milk drinking is required for healthy bones in children, and highlighted the fact that the Milk Development Council (MDC) has recently been branded one of the United Kingdom's most useless quangos. I read that the MDC has just launched a scheme designed to urge girls to drink more milk. Apparently, the MDC is keen to promote the message that drinking milk helps prevent osteoporosis in later life, and goes even further by claiming that milk actually has beautifying properties for young girls.
The MDC's 'Naturally Beautiful' campaign not only seems to overstate the value of milk in bone health, but might also be considered to be rather misleading regarding its potential effects on beauty. Some research, which was published earlier this year in the Journal of the American Academy of Dermatology, has actually linked milk consumption with a significantly increased risk of acne. The authors of this study hypothesise that this effect may be related to the presence of hormones and/or other biologically active substances in milk.
· If you have any issues you would like Dr Briffa to address in his column, please email him on john.briffa@observer.co.uk. Please note that Dr Briffa cannot enter into any correspondence. You can also visit www.drbriffa.com. Before following any recommendations in this column, you should consult your own medical adviser about any medical problems or special health conditions
