TOP 3 must have VITAMIN SUPPLEMENTS for those with FOOD INTOLERANCE

vitamin supplements

Vitamin Supplements

Accepted medical wisdom is that vitamin supplements are not necessary as long as we eat a varied and balanced diet. However, for those with food intolerance, cutting out food groups can lead to malnutrition. I firmly believe that a diagnosis of food intolerance is a great way to kick start a healthy lifestyle.  So, don’t go gluten free and just replace all the gluten in your diet with unhealthy, processed gluten free foods.  Also, don’t go dairy free without taking into account the impact a loss of calcium can have on your health.  There is a real danger for those with food intolerance that cutting foods out to relieve symptoms can have knock on effects if you don’t take enough care to replace these foods with suitable alternatives.

The following are my three preferred vitamin supplements based on the weight of scientific research that supports their benefits and also the danger that we aren’t already getting enough of these in our diets. Let’s start with omega 3:

Omega 3omega 3

Numerous studies have shown the health benefits of omega 3 oils on inflammatory conditions including reducing systolic blood pressure, improving circulation, reducing blood triglycerides, and there are also some preliminary findings for proof it helps rheumatoid arthritis.1 Evidence of their clinical efficacy is strong in these settings and further studies are being conducted on their use in helping patients with other conditions such as bowel disease, asthma and eczema, although evidence here is not yet as strong.2

The best way to get enough omega 3 oils is to eat two portions of oily fish per week; this includes mackerel, salmon, sardines, anchovies, herring, and tuna (not tinned tuna; tuna steaks). Flaxseeds, chia seeds and walnuts are also a good source of omega 3 (you can buy flaxseeds from the health food store and sprinkle over your food – e.g. morning porridge). Vegetable sources of omega 3s include kale, brussels sprouts, spinach, and cabbage. Organic, grass-fed animals are also a source of omega 3 (grain-fed animals less so) as are eggs from organically fed, free-range hens. Indeed, a joint study by the USDA and researchers at Clemson University in South Carolina, found that fat from organically reared, grass-fed animals contained 193% more omega 3 than grain-fed, non-organic animals.3

Official British Dietetic Association recommendations are for two portions of oily fish per week for women and four portions for men. This is because of pollutants such as mercury and dioxins in fish which at high levels can be toxic (particularly for unborn foetuses, which is why the recommended limits for women are lower). As the benefits of omega 3 can be outweighed by the toxins in fish (again, everything in moderation!), it may actually be more beneficial to take an omega 3 supplement rather than overdose on oily fish.4

There are also two other omega oils to take into consideration: omega 6 and omega 9. Omega 3 and 6 are the oils that the body cannot manufacture on its own – we need to get these from our diet. Omega 9 (e.g. in avocados, olive oil or rapeseed/ canola oil) can be made by the body so is still important, but not as essential as omega 3 and 6.

Historically, when human beings existed on the ‘Palaeolithic diet’ (of grass-fed meat, nuts, seeds, fruits, berries and vegetables) we ate omega 3 and omega 6 oils in a roughly 1:1 ratio. Nowadays, because so many omega 6 vegetable oils are being used in processed foods (such as biscuits, cakes and crisps), the average western diet consists of an omega 3:6 ratio of more like 1:16 rather than 1:1. This is not healthy for us. Indeed, recent studies have shown that chronic, excessive consumption of omega 6 versus omega 3 can lead to a number of inflammatory conditions such as arthritis and cancer.5 We need therefore to reduce our intake of omega 6 oils (like sunflower, safflower or corn oil) and increase our intake of omega 3 oils (found in oily fish). I know this sounds surprising when for years we have been told that plant oils are healthy.

It is important to make sure you buy a good quality supplement (ask your local pharmacist) and also to be careful of the liquid supplements which can easily oxidise (go rancid) when exposed to air. A dose of 500-1000mg per day is recommended.6

Fat in general is a confusing subject, and in recent times our thoughts have also been completely turned around regarding the recommended intake of saturated fat. We had been told for years that animal fat is bad for us as it contains a lot of saturated fat (as does butter, lard, ghee and coconut oil). Studies showing saturated fat linked to heart disease and promoting instead the consumption of vegetable oils have been accepted by the general public for at least 50 years. However, in recent times, large scale studies have disproved this theory of saturated fat making us ‘fat’ and some studies even point to the fact that the opposite is true.7,8

The British Heart Foundation and the British Dietetic Association still do not recommend eating saturated fat for its health benefits but do now universally acknowledge that saturated fat is not the demon we once thought it was.

Olive oil, and avocado oil are high in omega 9 content and are generally recommended as healthy oils to eat cold (as salad dressing for example). However, you do need to be careful when heating these oils as they can oxidise at high temperatures, producing harmful free-radicals. Olive oil oxidises less readily than vegetable oils, but there is now mounting evidence to suggest that using a natural oil such as coconut oil for cooking is more beneficial for health.9 Fats such as coconut oil, lard or tallow are solid at room temperature (as are butter and ghee but these are not dairy-free) so take longer to reach the high temperatures required for oxidation and the production of harmful free-radicals.

Bottom line on fats:

  • Eat lots of omega 3 – ideally two portions of oily fish a week, or else take a supplement
  • Eat less omega 6 – these are vegetable oils like corn or sunflower oil found in processed goods such as cakes, biscuits, crisps. Don’t cook with vegetable oils as not only does this increase your omega 6 intake, but these oils oxidise easily producing free-radicals at high temperatures
  • Use omega 9 rich olive oil as a dressing
  • Don’t be scared of saturated fat anymore, particularly when it comes from natural sources like organic meat or coconut oil. Fat intake in the diet is satiating and prevents you overloading on other food groups such as sugars and carbohydrates.10 Remember, everything in balance!

Probiotics

probiotics

Probiotics have become increasingly popular in the last decade. Companies selling brands such as Yakult and Actimel yoghurt drinks heavily promote the idea that our tummies need ‘good bacteria’ in order to be healthy.

One of the difficulties with these yoghurt drinks (apart from the fact that those with a dairy sensitivity cannot take them) is that they are also loaded with sugar (not healthy!) and only a few brands contain anything like the level of live bacteria required to have a beneficial clinical effect.

However, there is truth in the premise of ‘good bacteria’ and the need to establish a healthy intestinal gut flora. The theory behind the use of probiotics goes back to the hygiene hypothesis and the idea that overuse of antibiotics and more city living versus rural lifestyles means that we now have limited exposure to microorganisms. In order for our immune system to develop properly, we need a certain amount of low level ‘challenge’ from bacteria in our environment. Without this low level challenge to set the bar, the immune system ‘over-reacts’ when it comes into contact with what should be harmless foodstuffs, but which the allergic person’s body now sees as a threat. Just to clarify, the idea is not that hygiene in general is bad: no one doubts that a certain level of hygiene is essential, and certainly sanitation and the advent of vaccines means that there are no longer epidemics in the western world from diseases such as cholera and typhoid. However, killing all our ‘good bacteria’ along with the ‘bad bacteria’ seems to have had repercussions for our immune system and medics think that this is one of the things that has led to the rise in allergies and food sensitivities.11

Probiotics are currently actively used in the treatment of antibiotic associated diarrhoea.12 There are also trials showing positive outcomes for patients with irritable bowel syndrome and lactose intolerance. (It is thought the lactase enzyme produced by the bacteria helps lactose intolerant patients digest milk more easily).13,14

Probiotic supplements can be expensive (£25 for a month’s course) and it is recommended to make sure the product you are buying is live and contains at least 10 billion CFU (colony forming units – this denotes the strength of the product). It is also a good idea to vary which probiotic formula you take as different formulas contain different types of bacteria, and you want a good mix of around five or six different strains. If you take both a high strength and multi-bacterial probiotic daily for around a month you should have colonised your gut sufficiently to then reduce your weekly quantity of probiotic (say to around twice a week, but check your specific circumstances with your healthcare professional). Also, double check that the supplement you get does not contain lactose as a filler or any other milk ingredients.

Lactic acid fermented foods (also known as lacto-fermented-enzyme-enhanced foods) such as sauerkraut, dill pickles, miso paste or tamari sauce naturally contain probiotic bacteria. It is a good idea to add these foods to your diet where you can.

Bottom line on probiotics:

  • Probiotics are good for your digestive health and clinical evidence of their efficacy is mounting
  • Take a supplement (check it is a high strength, good quality one) and include probiotic containing foods (such as miso soup, sauerkraut, or tamari sauce) in your diet

 

Calcium and Vitamin D

calcium

Those following dairy-free diets must be careful to ensure that levels of calcium intake are adequate. Calcium is important for maintaining strong bones, muscles, and nerves and is required for blood vessels to operate properly so that enzymes can break down our food. Osteoporosis is caused by calcium deficiency, and is so common in the UK now that one in three women and one in six men is likely to suffer an osteoporotic fracture. Calcium absorption is helped by vitamin D, otherwise known as the ‘sunshine’ vitamin as the body produces vitamin D in response to sunlight. One interesting fact is that children with a vitamin D deficiency (this can include those born in the autumn when there is less sunlight), have a higher prevalence of allergies.15

As a rule of thumb adults need 700mg of calcium per day, children under 10 need 500mg per day and adolescents need 1000mg per day.

Foods other than cow’s milk which contain calcium include:

  • Calcium enriched dairy free milks (such as coconut, rice, soya, oat or hemp milk)
  • Calcium enriched soya or coconut yoghurts
  • Sardines
  • Salmon
  • Baked beans
  • Figs
  • Apricots
  • Bread
  • Spinach
  • Hummus
  • Broccoli
  • Almonds
  • Oranges
  • Tofu 16

It is worth paying attention to which brands of products you buy and also taking care to read the labels. There is some controversy about fortified foods not being ‘natural’, and the healthiest approach would certainly be to focus on eating more spinach, almonds and figs than to try and supplement calcium through fortified foods or supplements. Part of the reason for this controversy (apart from the fact that natural, non-processed foods are best) is the bioavailability of calcium in supplements and fortified products (i.e. how well it is absorbed by the body). To maximise absorption of calcium, it is important to take it with a vitamin D supplement as well as taking it with food (this slows transit time through the gut and allows the calcium time to be absorbed). Also, be aware that foods high in iron (e.g. beef, beans or dark leafy greens) can reduce how well calcium is absorbed.

My practical standpoint is that if you are not a big fan of figs and sardines and worry that your calcium levels are low, it is worthwhile thinking about a supplement. Make sure you take a supplement that contains both calcium and vitamin D. A reasonable daily dose is around 500mg-800mg and do bear in mind that it is possible to overdose on calcium supplements. Excessively high calcium levels can lead to impaired kidney function as well as decreased absorption of other minerals such as iron, zinc and magnesium. There have been studies which show that calcium supplementation can lead to cardiovascular problems and an increased risk of heart attacks.17,18

Bottom line on calcium and vitamin D:

  • Try to incorporate calcium containing foods into your diet on a daily basis
  • If you think you are not eating enough calcium as specified above then you may want to consider taking a calcium and vitamin D supplement. Take around 500mg-800mg daily and take it with food to help absorption
  • Remember you can overdose on calcium supplements so be careful

FOOD INTOLERANCE AND VITAMIN SUPPLEMENTS: In Conclusion

Free from diets can be really healthy and finding out you have to avoid certain foods is the best excuse for overhauling your diet you will ever have.  A varied balanced diet high in fresh fruit and vegetables is without a doubt the best way to stay healthy.  Think also about Omega 3, Probiotics and Calcium and Vitamin D to give you that added advantage.

For more advice on healthy free from eating, check out my book:

GO GLUTEN AND DAIRY FREE AND FEEL GREAT! 

You can also follow me on Twitter or Facebook.

Wishing you good health!

Giselle Wrigley signature

 References

  1. Delgado-Lista J, Perez-Martinez P, Lopez-Miranda J, Perez-Jimenez F (June 2012). “Long chain omega-3 fatty acids and cardiovascular disease: a systematic review”. The British Journal of Nutrition. 107 Suppl 2: S201–13. http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8586737&fileId=S0007114512001596
  2. Calder, P.C., ‘n-3 Polyunsaturated fatty acids, inflammation and inflammatory diseases.’ Americal Journal of Clinical Nutrition. June 2006; 83 (6): 51505-15195. http://ajcn.nutrition.org/content/83/6/S1505.short
  3. Duckett SK, Neel JP, Fontenot JP, Clapham WM, Effects of winter stocker growth rate and finishing system on: III. Tissue proximate, fatty acid, vitamin and cholesterol content.Journal of Animal Science. May 2009; 87 (9): 2961–70. http://www.journalofanimalscience.org/content/87/9/2961
  4. Davidson P., Meyers G.J., Weiss B., ‘Mercury Exposure and Child Development Outcomes.’ April 2014; 113 (4); 1-23-1029.
  5. Calder, P.C., ‘n-3 Polyunsaturated fatty acids, inflammation and inflammatory diseases.’ Americal Journal of Clinical Nutrition. June 2006; 83 (6): 51505-15195. http://ajcn.nutrition.org/content/83/6/S1505.short
  6. Sachs, F. Dr, ‘Ask the Expert: Omega 3 Fatty Acids.’ Harvard School of Public Health. http://www.hsph.harvard.edu/nutritionsource/omega-3/
  7. Northup, C. Dr, ‘Now saturated fat is good for you?’ Huffington Post. 26th March, 2014. http://www.huffingtonpost.com/christiane-northrup/saturated-fat_b_4914235.html
  8. ‘Saturated Fat Heart Disease ‘Myth’’ BBC News Health. http://www.bbc.co.uk/news/health-24625808
  9. Yeap S.K., Beh B.K., Ali N.M., Yusof H.M., Ho W.Y., Koh S.P., Alitheen N.B., Lang K., ‘Antistress and antioxidant effects of virgin coconut oil in vivo.’ Experimental and Therapeutic Medicine. Jan 2015; 9 (1):39-42. http://www.ncbi.nlm.nih.gov/pubmed/25452773
  10. Mosley M. Dr., ‘Michael Mosley: Should people be eating more fat?’ BBC News Magazine. 15th October, 2014. http://www.bbc.co.uk/news/magazine-29616418
  11. Professor Jonathan Brostoff and Linda Gamlin, The Complete Guide to Food Allergy and Intolerance, (Great Britain: Bloomsbury Publishing, 1998), p 245.
  12. Dietrich C. G., Kottmann T., Alvai M., ‘Commercially available probiotic drinks containing lactobacillus casei reduce antibiotic associated diarrhoea.’ World Journal of Gastroenterology. Nov 2014; 20 (42): 15837-44. http://www.ncbi.nlm.nih.gov/pubmed/25400470
  13. Guandalini S., Cemat E., Moscosco D., ‘ Prebiotics and probiotics in IBS and inflammatory bowel disease in children.’ Beneficial Microbes. Nov 2014; 12:1-9. https://www.ncbi.nlm.nih.gov/pubmed/25391345
  14. Ford A.C., Quigley E.M., Lacy B.E., Lembo A.J., Saito Y.A., Soffer E.E. Spiege B.M. Moayyeti P., Schiller L.R., ‘Efficacy of prebiotics and probiotics and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta analysis. American Journal of Gastroenterology. Oct 2014; 109 (10): 1547-61. https://www.ncbi.nlm.nih.gov/pubmed/25070051
  15. Keet C.A., Malsui E.C., Savage J.H., Neurman-Sunshine D., Skripak J., Peng R.D., Wood, R., ‘Potential mechanism for the association between fall birth and food allergy.’ Allergy. June 2012; 67 (6):775-782. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349789/
  16. Joanna Caines, Debbie Evans and Mary Feeney, (Sept 2009). ‘Calcium: Are you Getting Enough?’ Food Allergy and Intolerance Specialist Group: Part of The British Dietetic Association. (5th Floor, Charles House, 148/0 Great Charles Street, Queensway, Birmingham, B33HT)
  17. Pines A., Langer R.D., ‘The cardiovascular safety aspects of calcium supplementation; where dose the truth lie?’ Climacteric. Oct 2014; 16:1-5. https://www.ncbi.nlm.nih.gov/pubmed/25318377
  18. Kuanrang L., Rudolf K., Jakob L, Sabine R., ‘Association of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk. Heart. Feb 2012; 98:920-925. http://heart.bmj.com/content/98/12/920.short?g=w_heart_current_tab

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