Do I Really Have to Cut Out Alcohol?

 

Written by: Hailey Wegner, SLU Dietetic Intern

When the word “dietitian” slips into conversation with any friend or passerby – I often know what is going to come next... a question regarding nutritional intake that this person wants to know about.

Friends: “What’s with this keto diet... Anyway?”

Stranger at the grocery store: “So...should I be eating more super foods?”

But when I am among young adults... there is one question that almost always comes up.

Everyone: “Do I really have to cut out alcohol?”

This question especially comes up when the young adult wishes to see physique changes. This is especially, especially true when the young adult is a competitive athlete... and especially, especially, especially true when the young adult is a competitive collegiate athlete.

_______________________

There is no question that drinking alcohol is written into the culture of almost every college attendee. First year students of traditional college often drink irresponsibly, and believe drinking to be integral to the college experience with over 40% of college students endorse heavy episodic or “binge” drinking (generally defined as 5 + drinks in one sitting for men and 4 + drinks in one sitting for women)^{(1, 2)}.

This is not untrue for athletes. While some may believe that the collegiate athlete is at a lower risk of engaging in binge drinking due to scheduling constraints or the physical demand of peak performance; studies show that students involved in sports have a higher tendency to drink/get drunk/binge on alcohol more often than those students with no involvement in sports⁽³⁾.

So what DO I tell athletes when the question of: “so what about alcohol...” comes up?

_______________________

Me: “I’m glad you asked... because it indicates that you care about your body performing the BEST that it can...”

Depending on the circumstances that apply to the athlete in front of me... I can choose from the LARGE array of evidence that shows the detrimental effects of alcohol on athletic performance.

Me: “Alcohol consumption disrupts our metabolism of nutrients... so your body and performance will suffer.”

And its true! Research has shown that: Alcohol consumption has been shown to inhibit liver glucose output during exercise; which can cause low blood sugar while exercising, and alcohol will decrease muscle glucose uptake – so tissues cannot get the fuel that they need. It also suppresses the breakdown of fatty acids—and is therefore regarded as a risk factor for weight gain ^{(5) .} Alcohol consumption prevents your body from absorbing important nutrients like thiamin, vitamin B12, folic acid and zinc⁽⁴⁾. (These nutrients help in the formation of new cells, boost your immune system, and aid in the metabolism of proteins and fats).

Me: “Most importantly to athletes, though, is that large amounts of alcohol can shut off muscle repair, growth, and even has been shown to produce muscle wasting.” ⁽⁷⁾

Which is ALSO true. AND... Athletes tend to consume the most alcohol in the 1-2 hours after exercise, which is the timeframe that is the most critical for optimal nutrient uptake. ⁽⁶⁾

Me: “Not surprisingly then... Athletes who drink alcohol at least once per week have an elevated risk of injury as compared to athletes who do not drink”

This is for a variety of reasons... Alcohol is shown to increase fatigue during high-intensity exercise, ⁽⁶⁾ which can lead to poor concentration and sloppy performance. Alcohol increases production of anti-inflammatory molecules; and inflammation is a key part of the muscle repair process, and alcohol consumption induces dehydration and loss of blood flow to active tissue. ⁽⁶⁾

Me: “There are even some detriments that most people wouldn’t think about... such as impaired temperature regulation, depressed immune functioning, low testosterone production, and decreased quality and duration of sleep.” ^{(10, 6)}

I am sure we can all imagine how those could negatively impact performance.

Me: “And I know you think you can hang... but even mild hangover symptoms have direct impact on performance; such as: headache, nausea, hypersensitivity to light or sound, diarrhea, fatigue, dehydration, and body aches” ⁽⁴⁾

Athlete: “Okay... so I will avoid alcohol in-season... but it’ll be fine in off season.. right?

Me: “Well... actually, no. Studies have shown “chronic” detrimental effects of alcohol can accumulate in as little as as 6-weeks.”

Some well-researched chronic detriments include increased whole-body protein breakdown and long-term compromises to the immune system... which makes an athlete more susceptible to career-delaying illnesses  ^{(6, 8)}

Me: “But... Don’t worry! Everything in moderation, including moderation... there is evidence that low doses of alcohol can be safely consumed without an impact on performance”

That’s right! As long as the athlete is of legal drinking age, low-to moderate doses of alcohol have been shown to have no effect on certain subsets of athletic performance. 

Studies show that low doses of alcohol are unlikely to be detrimental to repletion of glycogen, rehydration and muscle injury and have little to no effect on muscle protein balance or muscle growth ⁽¹¹⁾

Notably, low doses of alcohol would be less than 1-2 drinks per day for men, and less than ½-1 drink per day for women; and that “stacking” these drinking events to 1-2 days per week is still considered binge drinking. ⁽¹²⁾ These drinks would be measured using a “1 drink” equivalent of 5 oz of wine, 12 oz of beer, or 1 shot (1.5 oz) of liquor ⁽¹³⁾ .

_______________________

All in all, the evidence AGAINST consuming alcohol while participating in athletics is overwhelming. However, much like a human-relationship to food, the human-relationship to alcohol can be seen written into many aspects of collegiate culture. My overarching recommendation for athletes always encompasses these two ideas.

Me: “It is best to avoid any alcohol consumption to ensure top-notch athletic performance. But for athletes who choose to drink, you should become fiercely aware with the AMOUNTS that are shown to cause no affect... drinking to achieve social acceptance should not be a priority over your physical performance in your sport, especially since there IS an amount of alcohol that is considered safe to consume. With this in mind, avoid alcohol 48 hours prior to any athletic event and rehydrate/ consume food BEFORE celebratory drinking to slow alcohol absorption.”

Love,

Your Sports Dietitian

 

References:

1) Crawford, L. A., Novak, K. B., & Jayasekare, R. R. (2019). Volunteerism, Alcohol        Beliefs, and First-Year College Students’ Drinking Behaviors: Implications for       Prevention. The Journal of Primary Prevention, 40(4), 429-448.             doi:10.1007/s10935-019-00558-z

2) D.A. Dawson, B.F. Grant, F.S. Stinson, P.S. Chou, Another look at heavy episodic       drinking and alcohol use disorders among college and noncollege youth,        Journal of Studies on Alcohol, 65 (2004), pp. 477-488

3) Ford JA. Alcohol use among college students: a comparison of athletes and nonathletes. Subst Use Misuse. 2007;42(9):1367–77.

4) Alcohol and Athletic Performance. (n.d.). Retrieved from        https://alcohol.stanford.edu/alcohol-drug-info/staying-safe/alcohol-and-          athletic-performance

5) Suter, P., Schutz, Y. The effect of exercise, alcohol or both combined on health and physical performance. Int J Obes 32, S48–S52 (2008).         https://doi.org/10.1038/ijo.2008.206

6) Barnes MJ. Alcohol: impact on sports performance and recovery in male athletes. Sports Med. 2014 Jul;44(7):909-19. doi: 10.1007/s40279-014-0192-8. PMID:        24748461)

7) Steiner JL, Lang CH. Dysregulation of skeletal muscle protein metabolism by           alcohol. Am J Physiol Endocrinol Metab. 2015 May 1;308(9):E699-712. doi:   10.1152/ajpendo.00006.2015. Epub 2015 Mar 10. PMID: 25759394; PMCID:     PMC4420901.

8) Hong-Brown LQ, Frost RA, Lang CH. Alcohol impairs protein synthesis and degradation in cultured skeletal muscle cells. Alcohol Clin Exp Res.            2001;25(9):1373–82.

9) Cameron C. et al, Sport-related achievement  motivation and alcohol outcomes:     An athlete-specific risk factor among  intercollegiate athletes, Addictive       Behaviors, Volume 38, Issue 12, 2013,  Pages 2930-2936, ISSN 0306-4603,

10) Yoda T, et al,. Effects of alcohol on thermoregulation during mild heat exposure   in humans. Alcohol. 2005 Jul;36(3):195-200. doi:         10.1016/j.alcohol.2005.09.002. PMID: 16377461.

11) Kimball, S. R., & Lang, C. H. (2018). Mechanisms Underlying Muscle Protein          Imbalance Induced by Alcohol. Annual review of nutrition, 38, 197–217.       https://doi.org/10.1146/annurev-nutr-071816-064642)

12) Maraldi, C., et al,. (2009). Moderate Alcohol Intake and Risk of Functional Decline: The Health, Aging, and Body Composition Study. Journal of the           American Geriatrics Society, 57(10), 1767-1775. doi:10.1111/j.1532-   5415.2009.02479.x

13) National Institute on Alcohol Abuse and Alcoholism. (NIH Publication No. 07-      3769).Helping patients who drink too much: a clinician’s guide   (updated) 2007

 

Food Waste & Insecurity in the United States

 Written by: Tene Smith, SLU dietetic intern

            The impact of food waste in the United States is higher than any other nation in the world. One could derive to the conclusion that this would mean the United States would not suffer from food insecurity. However, both crisis, food waste and food insecurity are at an all-time high, affecting more than 50 million food insecure Americans to date (www.today.com) . Yet, many efforts are in active process to bring these numbers down, some with the aid of dietetic professionals. In the food service industry, some ways dietitians can prevent food loss/waste are related to overproduction, underutilization, menu changes, portion control, composting, and purchasing.

How can waste be prevented?

Products should be purchased that would provide the least waste in production and service. Smaller plates and containers also contribute to the lack of food waste through portion control. The portion sizes would help determine how much product needs to be purchased. Therefore, this assists in preventing spoilage and excessive food cost. Also, purchase only what is needed. Avoid impulse, bulk, and sale purchases of fresh items if not planned for consumption, canning, or freezing prior to expiration.  If there are leftover or excessive amount of product available, repurpose it into new menu options such as a soup, casserole, or stew. Scraps can also be used in stocks and/or composting.

                Support of dietetic professionals can assist in implementing ways to prevent food waste and insecurity in the United States. Although these practices will make a great impact in reducing the crisis, it will take individual interest and acts of the American people to put an end to food waste and food insecurity.

Resources available for those experiencing Food Insecurity:

WIC https://health.mo.gov/living/families/wic/families/howdoiapplyforwic/

SNAP https://mydss.mo.gov/food-assistance/food-stamp-program

Saint Louis University Billiken Bounty Food Pantry:  (SLU Students Only)

https://www.slu.edu/student-development/dean-of-students/billiken-bounty.php

Check out this infographic below:

 

 

 

 

 

 

 

 

 

References

Murray, R. (2020). More people are going hungry than ever before. Inside the efforts to help. Today: Food. Retrieved from https://www.today.com/food/50-million-people-may-experience-hunger-year-these-organizations-are-t203672

https://www.slu.edu/student-development/dean-of-students/billiken-bounty.php

“Imperfect Foods” Review

 Written by: Sarah Trost, SLU Dietetic Intern

What is “Imperfect Foods”?

“Imperfect is a food delivery service that was founded to fight food waste by finding a home for the imperfect of “ugly” fruits and vegetables that farms couldn’t sell to grocery stores”. This original concept has grown over time. The company realized that not only was eliminating food waste important, it is equally as important to ensure that the entire food system is improving for everyone.

This company is constantly working on plans to better the environment. Their current plans are aimed at becoming a net-zero carbon company by 2030. They are doing this by focusing on 3 projects:

1. Intentional sourcing: By 2022, Imperfect Foods will increase their regional sourcing by 15% to reduce the number of trucks moving and delivering food. I noticed this in my order specifically. They asked for my zip code and I was given a specific grocery delivery day, Wednesday, based off of where I lived.
2. Reducing waste to landfill: In addition to rescuing one billion pounds of food by 2030, Imperfect Foods will also create their first facility certified zero-waste-to-landfill operation by 2022. This was also something that was reflected in my order. There was no additional packaging in the box that was delivered to me. The box itself, along with insulation was all recyclable or reusable. There were very clear instructions laid out what to do with the extra materials in the box
3. Using energy responsibly: By 2026, Imperfect Foods is hoping to convert all of their fulfillment centers to 100% renewable power. Beyond the fulfillment centers, they also have a goal of having a fully electric vehicle fleet by 2027.

Ordering Process

The ordering process was very user friendly and individualized. Before placing an order, I took a short quiz for them to find out more about me. They asked how many eaters I had in my household, what size box I would like to receive, my food preferences, and what subscriptions I would like to sign up for. Their typical grocery plan includes a produce, plant, dairy, snack, meat & fish, and grains pack. This grocery plan comes with approximate prices for each pack, and it is easy to unsubscribe from any of them. For example, I could have easily removed the meat & fish pack from my plan if I was a vegan/vegetarian or if I just didn’t need any meat during that week. 

Like I mentioned before, my location specific delivery day was Wednesday. I also had a specific time frame during which I could grocery shop, which was Friday to Monday morning. Imperfect Foods curates a box for you that you can then customize if you decide that you don’t want an item or want something that isn’t on that list.

The payment for the groceries does not come out of your account until your box has been shipped. With the adjustments I ended up making to my box, my total for my entire order was around 70 dollars. For the week that I ordered, groceries over 68 dollars were offered free shipping. I did enjoy that perk. They also had a low cost box option for people that may need help paying for their box. There is a short application process, but, if accepted, the low cost box will be given with a 20% discount.

My Order

My curated order with some small adjustments that I made cost a total of 70.88 for 24 items, approximately $2.95 per item. Below is a picture of all of the groceries together.

Review

Overall, I was fairly pleased with my order. I enjoyed the process and found myself getting very excited about receiving groceries that I don’t normally pick up in stores. I also enjoyed the fact that I was supporting a company that is doing so much for causes that I care about.

As far as pros go for the order, there were many. I liked the variety with the groceries and I enjoyed getting to choose some of my own items as well. They typically deliver food that is in season, so a lot of the fresh fruits and vegetables were perfectly ripe. I loved the fact that I didn’t have to actually go to the grocery store; saving that trip also saved me from collecting more plastic bags as well. Receiving items that I don’t typically shop for got me excited to cook and eat meals and changed things up from the typical 5 or 6 meals that I always make.

On the opposite side, there were a couple of things that would keep me from ordering again. The biggest turn off would probably be the price. I know that the overall cost for the groceries was not outrageous; however, I typically spend a little less than 70 dollars per week at the store and I feel like I usually get the same amount, if not more items. The items that I did receive were awesome, but I don’t think it was enough to make meals for an entire week, which is what I normally do with my groceries. If you are used to shopping at higher priced grocery stores like whole foods or even target, I don’t think that the prices will be a big problem. Another small issue, which could have been user error, was that the website didn’t portray serving sizes very well. There were a couple of things that I ordered that looked a lot bigger online than they were when they arrived. This wasn’t too big of a deal though, and I believe that I would get better at knowing what to order as time goes on.

I do believe that I will order from Imperfect Foods again. I don’t think I am interested in a weekly subscription, but I could see myself ordering a box every couple of months to change things up a bit and support a great company.

 

Sources:

https://www.imperfectfoods.com/

 

Start Gardening ASAP!

 Written by: Will Sanders, SLU Dietetic Intern

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Are you aware of the potential benefits gardening has to offer? Gardening can provide more than just delicious low cost organic produce. Gardening is a unique learning experience unlike any other. Gardening has been an integral part of my life since I was a young child. As a college graduate student and intern I have been utilizing the university’s garden and gardens at local schools to educate children in the local community about nutrition.  

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Growing up

Gardening has been a fundamental part of my life since I was a young child throughout my years in high school. I assisted my mother in building and maintaining our home garden beds during the warm months. When I reminisce on those times, the fresh scent of mint and an abundance of ripe tomatoes always come to mind.

A couple years following planting mint in the ground, the plants multiplied so rapidly that they eventually took up one third of the garden. My mothers’ favorite crop has always been tomatoes. We grew a variety of different tomatoes in the garden, creating and testing new trellises in an attempt to find the best method for growing tomatoes. The plethora of mint and tomatoes available was utilized in the kitchen to make dishes like tabbouleh and capris salads. These two dishes quickly became favorites of mine (and they still are!). During the time spent with my mother in the garden, I learned a lot about how to ensure garden crops flourish and how to maintain and provide a bountiful harvest throughout the growing season. Picking from the garden and utilizing our harvest to make unique, colorful, fresh, and tasty meals allowed me to understand and embody the fruits of our labors, while simultaneously learning basics of nutrition related to the growth of food.  

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Current experience(s)

While attending Saint Louis University, I have lived in dorm rooms and apartments for the past 4-5 years during my college and graduate studies. Although there are opportunities throughout Saint Louis to continue gardening, my gardening and plant nurturing experiences remained limited during these years. My experiences were primarily isolated to working in my mothers garden during time spent at home while visiting family and to a few plants I attempted to keep alive in my living spaces.

During graduate studies, my interest in gardening was reawakened when we began a project that focuses on educating grade and middle school students in the city of Saint Louis about nutrition and gardening. This project teaches kids about gardening and it’s benefits through short and fun nutrition education lesson with activities that my classmates and I designed. Our first lesson this semester covered garden basics, such as what plants need to grow and thrive. During this lesson we planted some seeds for the kids to watch grow throughout our coming lesson plans. At the end of the semester, the kids get the opportunity to try some of the produce they have been learning about and growing throughout the lessons during what we call “The Salad Party”! 

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The Benefits

There are many benefits to gardening beyond the ability to eat what you grow. In fact, gardening can benefit our mental health, reduce stress, teach us about nature, nutrition and ourselves, and assist our wallets/purses. In modern times, there are many distractions in a typical day of life. When we become consumed with distractions around us, we can get stressed and out of touch with the present moment and ourselves. Gardens can provide opportunities to calm our minds and get in touch with our surroundings and selves.

To me, a garden is an escape from the busy world and distractions around me. While in the garden, I am consumed with the sights, sounds, and smells of the nature around me. While in the garden, my focus does not deter to the stress and distractions I experience on a daily basis. While in the garden, I am calm, content, engaged, and happy. Although I will experience some distractions and stress though out the rest of the week, these thoughts are absent in the garden.

As work is put into the garden, the efforts of labor can be visually recognized, even when miniscule. Maintaining a gardening space and assisting in the growth of plants is a satisfying process! If you are like me and the before/after process of things is exciting to you, then you will be amazed to see produce flourishing in what once appeared as a unsustainable garden bed. There is so much to observe and learn regarding the growth of different types of plants. The fruits of garden labor can be physically embodied following the harvesting, meal preparation, and dinning process

            Gardening can also provide a sense of community as well. Since it can be hard work, getting other friends, family, and community members involved is encouraged! Some mature plants can produce a lot of food if properly cared for, so we should share what we can with those around us. Don’t forget that garden can save us money. It is cheaper to buy seeds, grow them, and eat grown produce than it is to buy from grocery store.

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Start Gardening ASAP!

Gardening is an opportunity to better understand food and ourselves, both of which are easy to become disconnected from in modern times. I encourage you to begin gardening ASAP! I have listed just a few benefits of gardening which I have had experience with. I hope you can relate to and find these benefits and more during your garden future endeavors! If you are in a city or do not think there is a suitable place nearby to maintain a garden, consider searching for local garden beds/spaces for rent, assisting a friend or family member with their garden, and/or indoor growing options. 

A Peek at the Experiences of a Pediatric Intern

 Written by: Julia Shoemaker, Dietetic Intern

“I don’t know how you can work with that age.”

“Kids are crazy, I could never do it.”

“Isn’t it super sad?”

“Kids scare me!”

These are just a few of the responses I have received since beginning my internship as a pediatric dietetic intern here at Saint Louis University. I get loads of positivity from people as well, but the above comments are the responses that encourage me to express and share my passion towards working with the pediatric population.

Throughout this blog post, I want to talk about the rewarding aspects of being a pediatric intern, what kind of experiences we get, and share a few things I have learned this year when working with children from my own opportunities and preceptor guidance.

Are there days where I’ve been weak in the knees due to encountering something extremely sad? Or times where I’ve been sick to my stomach from hearing something I never imagined hearing about a child’s experience? Absolutely! But, it’s the occasional goofy knock knock joke, or that child that lights up when you ask them about their favorite foods, or that growth chart that FINALLY takes a turn for the better after a child has been struggling to grow/gain weight, or the excitement in a parent’s face that finally sees improvements in their extremely ill child that makes every bit of working with this population the most rewarding experience.

As a pediatric intern, we have a very similar experience to the Medical Nutrition Therapy (MNT) track. The main difference between the two tracks is that during the second half of the program, our clinical home is at Cardinal Glennon Children’s hospital or Saint Louis Children’s Hospital. I have spent some time at both of these facilities and they are truly wonderful places to work. You can almost feel the positivity in the air while working with the other health care providers there. It is definite that everyone in the hospital is working provide the best that they can for each patient. Along with this experience with pediatrics, we also get a broad range of experience with the adult population. This helps us to be equipped to work with any age group we want when we graduate. So, if we really do come out of this with the feeling that pediatrics just is not our thing, we have options. 

We also have the opportunity to go to various health fairs hosted for children during the year. These have been quite different this year due to COVID, but I have still had the opportunity to attend a couple events for the kiddos! The health fairs I had the ability to attend were Give Kids A Smile and Tiny Smiles. For these event, kids come and have a dental visit and then they get to come hang out with the dietetic interns to get weighed, measure, and educated about healthy habits. It’s a fun event that allows us to interact with kids in the community and attempt to make a difference very early in the child’s life. This gives us a chance to experience a community type setting, which is quite different than the clinical setting. We also get real life experience using paper growth charts and talking to parents about where their children stand on these charts. It’s great practice working with both kids and parents, which is a valuable skill set that one will need when working with pediatrics.

This is a picture of me at the Tiny Smiles health fair that we did in the fall.

I have truly learned so much throughout the last year of my internship. With little previous experience working in the field of pediatrics, I’ve tried to quickly catch on to various tips and tricks to use with the kids. I’ve learned that it is very important to involve the child in conversations that you are having while in their room. If the child is old enough to be involved and the conversation is appropriate, this is a great way to form a bond and make the child feel comfortable. The hospital is a scary place, especially as a child that may have little understanding about what is going on. I remember being deathly afraid of going to the doctor or having any type of medical appointment as a child, and feel that this has helped me to better empathize with these patients. It seems so unfair what these children are going through and there is not a thing they have done to deserve being in the position they are in. Making them feel better for even a short amount of time is so important to me. Walking into their room with a smile and trying to distract them from the scary hospital situation by talking to them about nutrition is a great way to help them feel better or even joyful for a little bit. 

One of my favorite aspects about working with the pediatric population is that I get to talk to the kids about food. I’m not the one coming in to poke or prod them with needles, draw their blood, or anything of the sort. I am simply there to make sure they are nourished and have a conversation about one of a human being’s favorite things, food! I’ve learned that so many parents will do whatever it takes to help their child get better, and the fact that they are leaning on us to help is so amazing.

Another amazing aspect of working with the pediatric population is the fact that we get to watch these children grow. Through ensuring children are getting the right amount of nutrition, we can physically watch their growth charts move and see that what we are doing for them is truly helping them get better or become healthier. It’s such a good feeling when a parent puts their trust into you as a professional to take care or their child. Though this is not the case with every family, many of them really do look to you for your professional advice because they are willing to do whatever it takes. The fact that these patients and parents often do rely on your advice and act on it really is a breath of fresh air.

This is a picture of a fun kid friendly cooking demo I did during my internship year.

Throughout this year, I have realized that working with children is a great way to build a healthier future for our world. A child that has not yet formed unhealthy habits is much more likely to make the healthy changes that we urge people to make as future dietitians and registered dietitians. I feel that this is another reason I am drawn to working with children. I want to help form healthier generations ahead and I believe that this can be accomplished through nutrition education at a young age. Not only do we have the opportunity to mold healthy habits in children, but we also have an opportunity to teach parents healthier ways of living by talking to them about their child’s health. As dietitians, it is our job to get through to this age group and help them to form these healthy habits early on. We must give them the tools that they need, because no one is equipped in the way we are to do so. Not only should we be pushing the healthy habits, but also educating them on why they are so very important. I hope that throughout my career I see this shift towards healthier lifestyles early in life, and plan to do what I can to make this happen.

With all of this being said, is working with this population sad from time to time? Yes. Are there days where you want to breakdown over a situation with a sick or injured child or after hearing a sad experience? Absolutely. Are kids sometimes a little silly or crazy? Of course. BUT the rewarding feeling you get when you help a child in need really does outweigh the bad days you will have in this job. Most kids truly are so pure and their personalities shine through unapologetically at all times, which is simply amazing and sometimes hard to find in the adult population. Knowing, seeing, or hearing that I have made a difference in a child’s life is worth every single bit of time that I’ve put into schooling/training for this profession. I truly cannot wait to become a registered dietitian and continue to build a healthier world through educating younger generations.

Should You Take a Home Food Sensitivity Test?

 Written by Eris Rolves, SLU Dietetic Intern

I frequently get targeted advertisements all over my Facebook and Instagram accounts for services that provide home food sensitivity tests. Oh, the joys of being an RD to be – your search history from academic research and Googling of medical terms easily spills over into your personal Internet browsing! Like the ad intended, it caught my eye and convinced me to stop scrolling, but not for the reason you may think. I examined the ad with skepticism instead of intrigue.

These home food sensitivity tests are marketed as an easy and cost-effective way to pinpoint what foods you are supposedly intolerant to. For those of us who frequently experience unexplained gastrointestinal distress, this appears to be the answer to our prayers at first glance. No doctors appointments, invasive procedures, or additional suffering? Just fork over a couple hundred dollars to have a company analyze my blood, saliva, or hair sample and return a list of foods that make my belly hurt? Seems like a straightforward, easy solution. However, it also seems too good to be true, and I hate to be the bearer of bad news, but these home food sensitivity tests most definitely are. Allow me to dig into the details of why.

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Defining “Food Sensitivity”

It’s important to keep in mind that “food sensitivity” is not a medical diagnosis. This means that there are no formal criteria for identifying a food sensitivity, so the term isn’t really recognized in medicine. What can be diagnosed, though, are food intolerances and food allergies.

A food intolerance is developed when your digestive system is unable to properly digest or absorb a certain food, causing pain or damage to the GI tract. Gluten and lactose intolerance are two common ailments that fall into this group. Chances are, your adverse reaction to a certain food is related to intolerance, not an allergy.

A food allergy is significantly more severe and stems from the immune system. In a food allergy, your body reacts to a certain food through the digestive system, respiratory system, and the skin. Anaphylaxis can even occur, which is a life-threatening side effect that can include difficulty breathing, dizziness, and/or loss of consciousness. Food allergies are serious and should be diagnosed by a physician, not a home test.

https://www.aaaai.org/conditions-and-treatments/library/allergy-library/food-intolerance

https://www.mayoclinic.org/diseases-conditions/food-allergy/expert-answers/food-allergy/faq-20058538

Why can’t food sensitivity tests diagnose a food intolerance or allergy?

These home tests and diagnostic medical tests are not looking for the same thing. Let’s have a quick science lesson: Your immune system protects you by developing antibodies in response to outside invaders it comes in contact with. The antibodies are custom-made by your body to fight off specific invaders, and there are several types of antibodies, called immunoglobulins (abbreviated Ig). Food allergies are measured and diagnosed by the presence of IgE antibodies. It’s not entirely clear why, but IgE antibodies are made in response to proteins in certain foods that your body deems to be a threat, resulting in an extreme immune response when that food is eaten (cramps/diarrhea, vomiting, hives, swelling, anaphylaxis). Home food sensitivity tests measure the presence of IgG antibodies, which can be made in response to any food and doesn’t necessarily result in that extreme reaction from the immune system. Again, it isn’t clear why IgG antibodies are made in the first place, but most people have IgG antibodies for quite a few foods.

By measuring the presence of IgG antibodies in your sample, the test is likely to return to you a laundry list of foods you are “sensitive” to – and on top of that, foods that you probably eat regularly. This leads to people following an unnecessarily restrictive diet. Anyone with a diagnosed food allergy or intolerance can attest that having to bend over backwards to avoid their trigger foods is not enjoyable. Why do that if you don’t have to?

A more in-depth explanation of why home food sensitivity tests are not effective can be found here: https://www.jaci-inpractice.org/article/S2213-2198%2817%2930704-3/fulltext#sec2

https://www.istockphoto.com/photo/antibody-immunoglobulin-gm1219978307-357047077

If food sensitivity tests aren’t accurate, why do people feel better after following the results?

If you read the comments on the social media ads for the food sensitivity tests, you’ll scroll through hundreds of comments of people saying that the test was “the only thing that helped them figure out what was wrong with them” and they’ve “never felt better” since cutting out all the foods on their results list. How can this be? One might feel this way for a couple of reasons. First, the placebo effect. Someone who is well aware that they are trying out this new diet that’s supposed to completely alleviate their symptoms may be convinced that it’s working for a while until proven otherwise. Second, that long list of trigger foods the test generated probably did contain a problematic food or two for them, and they are successfully avoiding them along with a dozen others.

There is really no advantage to avoiding foods that do not cause an adverse reaction. Like I mentioned, these tests tend to implicate foods that you eat often, so it would be a major adjustment to remove them from your diet, and a disappointing one at that. Unless your favorite food happens to be the trigger food, a diet without the joy it brings is not recommended, nor is it a healthy one.

Additionally, eliminating too many foods from your diet can result in nutrient deficiencies, ultimately leading to more health problems. That means doctors appointments, procedures, medications to take – all of the results you were trying to avoid in the first place by taking a seemingly harmless home test. These tests market a solution to your suffering, but what you are really buying is more stress, confusion, and complicated mealtimes.

Other factors to consider…

Keep in mind that your headaches, stomach aches, GI symptoms, lethargy, and mental fog may have nothing to do with your diet. Many of these home tests market themselves as answers to general physical ailments like these. But there could be a lot of reasons you feel this way that aren’t food related. Stress from work, school, life, and major events like a global pandemic can cause you to feel less like yourself, especially when that stress is chronic. Additionally, sudden changes in lifestyle like staying at home most of the time and being less physically active can impair digestion. Sudden changes in diet can also have repercussions for your stool patterns, like an increase in fiber or caffeine intake. And, if you are having significant abdominal pain upon eating, it could be indicative of a more serious GI condition like an ulcer, an H. pylori infection, or gallstones.

What should I do instead to get to the bottom of my food issues?

If you think you are having an adverse reaction to food, the best solution is to visit your primary care physician or a registered dietitian. Your physician can refer you to an allergist to determine if you have an allergy based on clinical testing. Registered, licensed dietitians are the only healthcare providers who are able to effectively help you identify intolerances and navigate an elimination diet to narrow down any trigger foods you might have. Their goal is to find what bothers you without unnecessarily cutting out too many foods or even entire food groups.

I know that getting help from a dietitian seems like the long way to a solution and quick answers are much more attractive, especially when you’re in so much discomfort when you eat. Having digestive issues is not fun! But, think of working with an RD as “food therapy”. Working out what foods are bothering you and how to build your diet/lifestyle around that is going to take time. Anyone or anything that says otherwise should be approached with a healthy dose of skepticism. Just like you wouldn’t believe a mental health counselor who says they can cure your depression with one session, or a physical therapist that says they can relieve your pain with one exercise, or a doctor that says they can cure your cancer after just one appointment – don’t believe someone who says they can solve your stomachaches overnight.

http://www.carlehealthfitness.com/wp-content/uploads/2018/07/dietician.jpg

A Taste of the Middle East

 Written by: Iman Rasheed

Let's take a trip to the Middle East, specifically Palestine. This dish is very close to home to not only me, but also my family. Now, this dish is not only a Palestinian dish, it is loved and desired all over the Middle East and has been apart of Arab cuisine for centuries. This beloved dish is called, Shishbarak (شيشبرك‎). It’s a dumpling-like dough, stuffed with flavorful ground beef and boiled in a mouthwatering tangy yogurt sauce. This recipe is perfect to make with your family. Before we get into the Palestinian recipe of this dish, lets talk about the history behind it.

https://www.google.com/search?q=palestinian+shish+barak&rlz=1C5CHFA_enUS813US814&hl=en&sxsrf=ALeKk036teQS92LqTp2yZANeLOec5BcoWQ:1616009273514&source=lnms&tbm=isch&biw=865&bih=718#imgrc=5WR37wP-cj3iSM

Shish Barak originated from the pre-Islamic Persia in the 14^th century. The original Persian version is called Joshpara, which literally means to boil a bit. The name was then changed to gosh e- barreh, which translates to lambs ear because of the shape of the duplings. It is made from wheat dough squares and filled with ground meat and can be served hot or cold. The dish then traveled to the Levant (Palestine, Syria and Lebanon), they then made the recipe into their own, adding pine nuts a little bit of rice and serving it hot. Then renamed it shishbarak. All three countries have their own variation of the recipe.

Now, this recipe is time consuming, but the ingredients are fairly simple.  Palestinians are known for their flavorful dishes that only require a few simple ingredients. Palestinians adapted to utilizing only their local harvest, and making the most out of whatever they have on hand. This dish has three parts to it. So, to make it easier I will split up the recipe into the three parts; the beef stuffing, the dough and finally the yogurt sauce.

The beef stuffing:

·       1lb lean ground beef

·       4-5 tablespoons olive oil

·       1 medium onion (finely chopped)

·       1-tablespoon salt

·       1 tablespoon arabic all spice

·       1 tsp black pepper

·       1 tsp cinnamon

·       1 tsp ground cardamom

First, drizzle some olive oil in a pan and turn the heat to medium. Fun fact: Palestine is known for their olive trees and olive oil. Place the beef into the pan and sauté it. Once the beef starts to brown add in the onions, and the spices and stir ensuring everything is mixed well, and the beef is fully cooked. Once fully cooked, remove from heat and allow it to cool while you make the dough.

https://missmuslim.nyc/palestine-in-a-bite-shish-barak/

The dough:

·       2 cups flour

·       1 tablespoon salt

·       3/4 cup of water (give or take)

Add the flour and salt into a bowl, and gradually add in lukewarm water. Kneed the mixture with your hands until it no longer sticks to your hands and holds its shape. If you find yourself with too much water just sprinkle more flour into the mixture. Your goal is for it to look like pizza dough. Now comes the fun part, its time to roll out your dough. First, sprinkle some flour on your counter top and use a rolling pin to roll out the dough until it is as thick as a quarter. Then grab a small cup or a cookie cutter that is about 1 inch in diameter and start cutting your dough into circles. 

Next, you want to grab your small circle dough and stuff it with your meat filling. Place ¼- ½ tsp of beef (depending on the size of your circles) into the center of dough and create a moon shape with it. Then, close the moon by sticking the two ends together to create a dumpling shape. Repeat the process till you finish all your dough and meat.

https://www.cheftariq.com/recipe/shish-barak/

Yogurt Sauce:

·       1 tub of 2lb whole milk yogurt/or if you have it kishik

·       1to 2 cups of water

·       1 tablespoon of corn starch

·       ½ c of uncooked rice

·       1 egg

·       Handful of peeled garlic

·       3-4 tablespoons of olive oil

·       30-40 pieces of Shish-barak

·       1-2 tablespoons of salt

·       A few stems of fresh cilantro

We have finally reached the last step and the easiest step! What you will want to do now is add the yogurt/ kishik (dried, fermented product made from sour milk or yogurt), the salt, the water and the rice (make sure the water covers all the rice) into a pot on medium heat and continue to stir it and then gradually add in your dumplings. Make sure they don’t stick together, give it one good last stir and allow it to cook all together for about 20 minutes. You know your dish is ready when your rice is fully cooked. Transfer the contents of the pot into a large pan for serving. You can top it off with some cooked pine nuts, sautéed onions, and fresh cut parsley/ cilantro! 

VIOLA! There you have it, a traditional Middle Eastern Dish. Sahtain (Sahh- tan), which is an Arabic expression most commonly used when a person is dining. It translates to a wish for double health – for you to enjoy your food before and after eating it. I hope you all try this dish for yourselves, because it is truly so many Middle Easterners favorite dish. To end here are the nutrient facts and a fun TikTok I made with my family about this dish. Enjoy!

Tiktok: https://www.youtube.com/watch?v=bSTLqSmkVng

Nutrient Facts:

https://www.nutritionix.com/i/nutritionix/shish-barak-1-cup/58516e1e3e0322bc63f114e1

Sources:

Taha, Reham. "Palestine In A Bite: Shish-Barak". Missmuslim, 2021,

 Jouzy, Yara. "Shish Barak: Meat Dumplings In Yogurt Sauce". Arab America, 2021, https://www.arabamerica.com/shish-barak-meat-dumplings-yogurt-sauce/#:~:text=Shish%20Barak%20is%20a%20traditional,Uzbek%20and%20several%20other%20countries.

 Joshpara - Wikipedia". En.Wikipedia.Org, 2021, https://en.wikipedia.org/wiki/Joshpara .

 G, Nina. Bespokenutritionconsulting.Com, 2021, https://www.bespokenutritionconsulting.com/post/the-original-shishbarak.