Let's Talk About Milk

Nowadays, there is more than just one type of milk to buy at the grocery store. It used to be a choice of fat-free, 1%, 2%, or whole milk, and now there is the addition of non-dairy milks to our shelves. What is the difference and what is the best option for you? Let’s get down to the bottom of it.

Dairy Milk

Dairy milk is naturally rich in calcium, vitamin B-12, potassium, and vitamin D. The calories per glass of milk depends on the type; fat-free, 1%, 2%, or whole with calories ranging from 80, 100, 120, and 150, respectively. All dairy milk will have 0 grams of added sugar and provides 8g of protein per serving. Fat-free or 1% has the lowest amount of saturated fat and can be a good choice for some people. That being said, if you prefer 2% or whole, it is okay to drink occasionally. Recent studies have shown that moderate consumption of whole milk can be beneficial for weight loss. This may be due to the fat in milk promoting a sense of satisfaction and fullness. Organic whole milk also contains a small amount of omega-3 fats which can be beneficial for health.

Soy Milk

Soy milk is the best option out there for those who prefer to drink non-dairy milk. One glass contains anywhere from 6-12 grams of protein, depending on the brand. Soy milk has a similar caloric content to milk, averaging about 100 calories per glass. It also matches dairy milk on certain vitamins and minerals such as calcium, Vitamin D, and potassium. Fortunately, soy milk does not contain any saturated fat, and instead contains the healthier, unsaturated kind. Lastly, when picking a soy milk to purchase, it is important to look for “unsweetened” soy milks because many of them contain added sugars.

Almond Milk

Did you know that most almond milks have no more than 4 to 6 nuts per cup? This is part of the reason why unsweetened almond milk has such a low-calorie count of about 30-50 calories per cup. However, if you choose to pick a sweetened almond milk, you are looking at 1-3 grams of added sugar and 100 calories per cup. Many almond milks contain more calcium than soy and dairy milk, but fall behind when it comes to Vitamin D, potassium, and especially protein. One glass of almond milk provides on average only 1-2 grams of protein. Fortunately, just like soy milk, almond milk does not contain any saturated fat, and instead contains the healthier, unsaturated kind.

Coconut Milk

Why is everyone so obsessed with coconut lately? It may be partly due to the medium-chain fatty acids contained in coconuts that help support metabolism. However, coconut milk also has long chain saturated fatty acids that can raise your cholesterol. Coconut milk has more grams of saturated fat than dairy, soy, and almond milk, averaging about 4.5 grams per cup. Calories range anywhere from 45-80 calories per cup depending on if the milk is unsweetened or sweetened. There is also no protein in coconut milk and low amounts of calcium and vitamin D.

Recommendation

Dairy or soy milk is your best option for providing adequate protein, calcium, vitamin D, and potassium. Unless you have an opposition, allergy, or intolerance to either of these milks, they are the best options out there for you. If you choose to not drink dairy milk, pay attention to your intake of vitamin B12. Dairy milk is the only form of milk that contains this vitamin and it is essential to ensure that it is being adequately replaced in the diet. Almond milk comes in 2^nd place, while coconut milk comes in last. It contains high amounts of saturated fat, no protein, and low amounts of calcium and vitamin D.

Sources

Kirkpatrick, K. (2014). 6 popular milks: a comparison. Retrieved from

https://health.clevelandclinic.org/2014/01/6-popular-milks-a-comparison-infographic/

Moyer., L. & Ettman, L. (2018). What milk? How to navigate the non-dairy aisle. Nutrition Action Health Letter.

My name is Brianna Newell and I am currently a senior at RIT in the Nutrition & Dietetics Program. I will be graduating in May 2018 and will be attending the University at Buffalo to complete my Dietetic Internship and combined Masters of Science in Nutrition. My focus as a future Registered Dietitian is to educate others on a personal and communal level to prevent and treat illnesses and diseases related to health and nutrition. 

What The Integrative Dietitian Nutritionist Can Do For You

By Lisa Fischer, MS, RDN, CDN

Greetings my fellow health enthusiasts (or enthusiasts-to-be)! I’m excited to share what I’ve learned over the past few years both personally and professionally. I have been living with gastrointestinal and immune issues for the better part of my life. Beginning at age 10, I experienced bouts of debilitating stomach pain which eventually, at the ripe old age of 11, brought me to a GI specialist who performed both an endoscopy and colonoscopy. After this mildly traumatic event, my parents were told that I had irritable bowel syndrome (IBS) but the doctor had no treatment to offer. Over the next 10 years I would develop Lyme disease (requiring serious antibiotics) and mononucleosis (requiring steroids) which left me depleted and a perfect target for illness. During my long recovery from mono, my dad handed me a nutrition book and unknowingly planted a seed. I began changing my diet and saw that it actually made me feel better, even better than the dozens of bottles of Pepto-Bismol that I downed (my insides might still have a fluorescent-pink glow!). As soon as I learned that I could help others improve their health with food for a living, there was nothing that could have stopped me from becoming a dietitian. I went to a great school and got into one of the top internships in the country, but a year into my first job, I knew something was amiss.

I remember one afternoon meeting with a gentleman in his early-40’s who was recovering from a heart attack. He reviewed his diet with me, which consisted of Spam, Dorito’s, French fries and soda (no joke!), and his family was following suit. What did I do? Because of my packed schedule, I sat with him for 15 minutes and told him the importance of eating less meat and more fruits and vegetables. Who was I kidding? I knew my script was falling on deaf ears and I wasn’t addressing the underlying issues. Something had to change. I began a search for a new way of approaching nutrition. After some encouragement and support from family, friends, and my employer, I began to pursue a path less traveled.

Goal 1: Attend the Food As Medicine conference. Check.

Goal 2: Get my master’s degree in Nutrition and Integrative Health. After 54 flights from New York to Maryland... Check.

Goal 3: Become a Certified Functional Medicine Practitioner. Okay, so I can only do so much at once. This one is in progress, but thanks to steps 1 and 2, I fell back in love with nutrition.

The tides are turning in U.S. healthcare. More people are realizing that the “pill for every ill” approach is too simplistic and is failing us. We spend more money on healthcare than any other developed country and we are among the sickest and most confused about how to foster lasting health.  Groups of forward-thinking practitioners/institutions in integrative and functional medicine are shifting to a more proactive, rather than reactive, style of care. So what do “integrative” and “functional” actually mean?

•          Integrative medicine focuses on the whole person (body, mind and spirit), is informed by evidence, takes into consideration all aspects of lifestyle, makes use of the best conventional and alternative therapies, healthcare professionals, and disciplines to achieve optimal health and healing. "Treatment originates from outside, whereas healing comes from within." – Dr. Andrew Weil

•          Functional medicine addresses the root causes of disease and engages both patient and practitioner in the therapeutic process. It is a science-based, patient-centered systems approach that considers the complex interactions of a person’s history, genetics, environment and lifestyle factors that can lead to illness. “Functional medicine treats the person who has the disease, not the disease that the person has!” –Dr. Mark Hyman

I’m a visual learner, so the above picture may help clear up some of your questions. This is the Functional Medicine Tree. It beautifully illustrates the functional approach. When a plant is diseased, you don’t just clean off the leaves. If you want a plant to grow, you don’t water the branches. To support growth and health of the whole plant, you focus your attention on the soil. In much the same way, rather than treating isolated symptoms or organs, these practitioners focus on the health of the “soil”- sleep, exercise, nutrition, stress levels, relationships, and genetics- the factors that have the greatest impact on disease and disease prevention.  See a larger picture here.

Integrative and functional approaches have their differences, but the most important similarity is that food is medicine. The most potent medicine of all is what, as well as how, you eat. So stay tuned for a series of unique, informative, and entertaining posts that can help you start, or support, your journey to health and well-being.  

This post was written by Lisa Fischer, MS, RDN, CDN. If you are interested in a personal, in-depth integrative nutrition consultation with Lisa, you can contact On Nutrition at (585) 770-1045 to make an appointment.
Visit rochesternutrition.com (About Us) to see Lisa's bio. 

Living with Interstitial Cystitis: How Diet Can Help



Personalized diet changes may help relieve symptoms of IC

 This is a guest post written by Janelle Schleicher.

What is interstitial cystitis?

Interstitial Cystitis (IC), or painful bladder syndrome (PBS) as it has been referred to, is a condition of unknown cause that presents with chronic inflammation of the bladder, possible bleeding, and occasional, but not as common, ulcers on the bladder wall. IC is characterized by recurring pain in the bladder and surrounding pelvic region. It also may result in frequent urination and/or a strong feeling of the need to urinate (1). To put it simply, IC feels like having a urinary tract infection, but is it chronic, meaning it does not go away! IC is a relatively common diagnosis affecting approximately 3-8 million women and 1-4 million men in the United States. It most commonly affects women in their forties, but men and children have also been diagnosed (2).

Symptoms vary from case to case and may include:

- Mild discomfort, pressure, tenderness, or intense pain in the bladder and pelvic area

- Urgent need to urinate

- Frequent need to urinate

- Pain during vaginal intercourse

- Increased pain during menstruation (1)

How is IC diagnosed?

There is no definitive test used to diagnosis IC because IC has an unknown cause and symptoms are similar to a number of other conditions. Therefore, a diagnosis is usually determined through two criteria

1. The presence of pain related to the bladder, usually accompanied by the urgent and frequent need to urinate

2. Ruling out other conditions, such as urinary tract infections, bladder cancer, and endometriosis (1)

How Does Diet Affect IC?

As with the symptoms of IC, foods may affect each individual with IC differently. There are no specific foods or food groups that cause IC, however dietary intake has been shown to affect symptoms. Foods that affect a patient’s symptoms are often referred to as trigger foods, and each trigger food may impact symptoms differently (2).

Important Tip: Citrus and Acidic Foods

Many people suffering from interstitial cystitis find that acidic foods such as oranges and tomato products may worsen symptoms. It is important to note that just because one acidic food may be a trigger food for an individual; this does not mean that all acidic foods will be (4)! So what does that mean? In the elimination diet, discussed in the next section, it is important to introduce each acidic food back separately to identify which specific foods cause symptoms.

The IC Diet

The majority of individuals suffering from IC find that certain foods and beverages affect their symptoms. With input from patients suffering from IC first hand as well as experts in IC research, the IC diet was developed and the IC Food List was compiled (2). The IC diet is a three-column system divided into the following categories:

1. Bladder friendly foods: foods that rarely bother IC patients

2. Try it foods: foods that are generally well tolerated but may bother sensitive IC bladders

3. Caution foods: food that commonly cause bladder discomfort (3)

Click here to access the IC Diet Foods List!

How can you use the IC diet?

The first step is to eliminate all foods from your diet except for bladder friendly foods (3). The idea of eliminating foods may seem scary and overwhelming at first, but it really is the best way to identify trigger foods and the three-column list is a great tool to help you on your journey!

Once your symptoms have improved (this may take a few weeks, just keep at it!), it is time to begin testing for trigger foods by adding back foods from the “Try it” list (3).

The rules for testing foods:

1. Test one food at a time

2. Try a small portion of the food the first time (such as half of a piece of fruit)

3. If the small portion does not trigger symptoms, try a larger portion the next time

4. If symptoms are still not triggered, multiple portions of the food can be consumed the third day

5. If symptoms still do not increase, the food can be added back in and not considered a trigger food!

6. If symptoms are triggered while testing a food, return to bladder friendly foods until you experience relief (3)

References:

1. (2011, September 27). Interstitial cystitis/painful bladder syndrome. U.s. department of health and human services. Retrieved from http://kidney.niddk.nih.gov/kudiseases/pubs/interstitialcystitis/

2. Beyer, J.A. (2010). Interstitial cystitis: A guide for nutrition educators. Auburn Hills, MI: NutraConsults, LLC.

3. Beyer, Julie. The IC diet food list and elimination diet (2012, August 11). Retrieved from: < http://www.ic-diet.com/IC%20Diet%20and%20Food%20List.html>

4. Friedlander, J. I., Shorter, B. and Moldwin, R. M. (2012), Diet and its role in interstitial cystitis/bladder pain syndrome (IC/BPS) and comorbid conditions. BJU International, 109: 1584–1591. doi: 10.1111/j.1464-410X.2011.10860.x

Janelle Schleicher is a senior Nutrition Management major at Rochester Institute of Technology. She is excited to take her next step towards becoming a Registered Dietitian and will begin her Dietetic Internship at the University of Maryland Medical Center in Baltimore, Maryland in September. Janelle has a love for any form of exercise (especially when it is outdoors!), food, coffee, reading, and her incredibly supportive family. She hopes to gain as much experience as possible in the field of nutrition in the next few years and ultimately open a private practice specializing in disordered eating and/or sports nutrition.

Swiss Chard, Black Beans, and Wheat Berries

I recently had fun working with Talk About Healthy making my first cooking video. It has been a learning experience. Most of all, I'm thrilled to present healthy and tasty recipes to my readers with a pinch of nutrition information to help you make the best food choices for you and your family. This video for Swiss chard, black beans, and wheat berries presents a very simple and nutritious recipe. The combination of ingredients provides a powerhouse of nutrients for health. Protein, iron, vitamin C, magnesium, lycopene, lutein, and fiber are only a few nutrients you'll get when you eat a serving. This recipe provides these nutrients (and more) in a tasty package. Give it a try and let me know what you think. You can add other seasonings to suite your taste preferences. My son always adds a nice dose of Sriracha! Happy and healthy eating! 

Swiss Chard, Black Beans, and Wheat Berries




2 T. olive oil

2 cloves garlic, minced

2 small bunches or 1 large bunch Swiss chard, leaves and stems chopped

1 14-oz can black beans, rinsed and drained

2 large tomatoes, chopped into large pieces

1 ½ cup cooked wheat berries

1 bunch green onions, chopped

salt and pepper to taste



Cook wheat berries:

add ½ cup dry wheat berries to 1 ½ cup water. Bring to a boil under medium-high heat, reduce heat to low, cover and simmer about 15 minutes until all the water is absorbed. Set aside.



Heat olive oil under medium-high heat, add garlic and cook 1-2 minutes until fragrant, but not brown. Add Swiss chard in 2 batches. When the first batch cooks down, add the second batch. Cook approximately 3 minutes. Add tomatoes and cook another 3 minutes. Add black beans and wheat berries and cook until warm, approximately 5 minutes. Season with salt and pepper. Stir in green onions. Serve and enjoy.



Makes 6 one cup servings

Exercise: A Healthy Addiction?

Exercise should be part of a healthy lifestyle, but it should not take over your life. 

This is a guest blog post.

Is there such a thing as too much exercise? You will often hear concerns regarding Americans’ sedentary lifestyles and the need for people to “get moving” in the media. While this is most definitely a present concern, there are also individuals on the opposite spectrum that need to tone their exercise behaviors down. I work as an instructor at a gym and have experienced compulsive exercise behaviors first hand. Some people habitually visit the gym three to four hours a day and become extremely troubled if something gets in the way of completing their rigorous workout routine.



Terms such as “obligatory (or compulsive) exercising”, “negative addiction”, and “exercise dependence” are all used in literature and all encompass obsessive exercise behaviors (1-4). Compulsive exercise can be defined as “an intense drive to be active, often in a rigid, routine-like fashion that is predominantly performed to manage weight and shape, as well as alleviating negative emotions.” (1). Up to 10% of high-performance runners have an addiction to exercise (3). Compulsive exercise is often discussed within the family of eating disorders (i.e. Bulimia Nervosa and Anorexia Nervosa), as they often occur simultaneously (1,2). Exercise, along with purging or restricted eating, is often used as another method for weight control.


Predictors of compulsive exercise:

One study investigated the risk factors for compulsive exercise. The three strongest predictors were:

1) A drive for thinness
2) Perfectionism
3) Obsessive-compulsiveness (1)

It is by no surprise that perfectionism and a drive for thinness were on the top three predictors of compulsive exercise, as society today endorses both of these behaviors.

According to Diane A. Klein, MD, of Columbia University’s College of Physicians and Surgeons, “So for people driven to achieve, to be perfectionists, and to be in optimal health, it’s kind of understandable that they become excessive.” (3) The demands from society to have a perfectly sculpted physique are simply unattainable and harmful.


How much is too much?

How do you know that exercise is becoming a problem? Symptoms of exercise dependence may include the following withdrawal symptoms in the absence of exercise: disturbed psychological functioning (i.e. severe distress, guilt, anxiety) and an interference with personal relationships. In addition, some individuals continue to run despite serious injury (2,4).

Acknowledging that there is in fact a problem is the first step to treat exercise addiction. Getting to the route of the obsession - whether it is a low sense of self-esteem or previous family history of addiction - is key. In very serious cases, psychotherapy may be a treatment (3).


Exercise for your health

In moderation, exercise is a wonderful thing. Benefits of exercise include a lower risk for chronic diseases, prevention of weight gain, better cognitive function, reduced depression, and the list goes on. It is currently recommended that Americans get at least 2 hours and 30 minutes of moderate level activities per week, and at least 2 days of strength training. How will you get your exercise this week?


Jenny, a 46-year-old secondary compulsive-exerciser (i.e. secondary to an eating disorder), was interviewed about her exercise attitudes and behaviors. Jenny stated, “My life tends to fit around the exercise, not the exercise fits into my life.” (2) Healthy living requires a careful balance of both diet and exercise. Make it a priority to fit exercise into your life for health!



References

1) Goodwin H, Haycraft E, Willis A, Meyer C. Compulsive Exercise: The Role of Personality, Psychological Morbidity, and Disordered Eating. Int J Eat Disord. 2011 Nov; 44(7):655-60.

2) Bamber D, Cockerill I M, Rodgers S, Carroll D. “It’s exercise or nothing”: a qualitative analysis of exercise dependence. Br J Sports Med. 2000;34:423–430.

3) Allen A. Exercise addiction in men: When exercise becomes too much. Retrieved June 21, 2012 from WebMD:

http://men.webmd.com/guide/exercise-addiction

4) Shipway R, Holloway I. Running free: Embracing a healthy lifestyle through distance running. Perspectives in Public Health. 2010 Nov; Vol 130 No 6.

5) U.S. Department of Health & Human Services. Physical Activity Guidelines for Americans. Retrieved June 21, 2012. http://health.gov/paguidelines/adultguide/part2.aspx


About the Author:

Amy Krug is a senior Nutrition and Dietetics major at Messiah College, located right outside of Harrisburg.  She plans to apply for Dietetic internships next spring and to continue on to become a Registered Dietitian. Amy has a passion for people, and desires to empower others to lead a fit and healthy lifestyle.  She enjoys the outdoors, gardening, running, jamming out on the piano, singing, and laughing!

Finding Relief from Irritable Bowel Syndrome: Say Hello to FODMAPs!

A dietary approach to help manage IBS shows great promise 

This is a guest blog post.


Irritable bowel syndrome (IBS) is defined as disorder that consists of abdominal pain, cramps, bloating, changes in bowel movements, and other symptoms (1). Unlike inflammatory bowel diseases, such as Crohn’s disease, IBS does not result from abnormal structure of the bowels (1). The actual causes of IBS remain unclear, however a possible trigger may be an infection of the intestines, called post-infectious IBS (1). One theory is that sufferers of IBS may have a particularly sensitive colon that is reactive to certain foods and stress, and that the immune system may also be involved (2). IBS can occur at any age, but usually begins in the teens or early adulthood, and is twice as common in women as in men (1). It is said that one in six people in the U.S. experience symptoms of IBS, and it is the most common intestinal problem for patients who are referred to a gastroenterologist (1). Because this disorder causes patients to experience discomfort when eating certain foods, it can eventually breed anxiety from constant worry of what effects these foods will have on their symptoms.


Symptoms

The major symptoms of IBS include abdominal pain, bloating, gas, and fullness. Symptoms may last three days a month for at least three months . These symptoms range from mild to severe, depending on the patient (1).

People with IBS may also switch between constipation (difficulty with bowel movements), or diarrhea (loose or watery stool) (2). Some may only have constipation, while others may only experience diarrhea (1). People sometimes find that their symptoms may subside for a few months and then return, while others have worsening symptoms over time (2).


The FODMAPs Diet

While there is no treatment for IBS, patients can learn to maintain their symptoms by following specific dietary guidelines, including those presented in the FODMAPs diet. FODMAP stands for Fermentable, Oglio-, Di-, and Mono-saccharides, and Polyols (3). The theory behind the FODMAPs diet is that consumption of these carbohydrates increases the volume of liquid and gas in the small and large intestines, leading to bloating and abdominal pain (3). Therefore, it is proposed that a diet low in FODMAPs should decrease these symptoms. FODMAPs include lactose, fructose, fructans, galactans, and sugar alcohols, which are found in many common foods, including:



• Animal dairy products, such as cow’s and goat’s milk, cheese, and yogurt.

• Fruits, particularly apples, pears, watermelon, mangoes, dried fruit, and fruit juices (3).

• Legumes, including chickpeas, lentils, black-eyed peas, broccoli, and soy products (4).

• Wheat products, including wheat and rye breads, cereals, and granola bars containing wheat.

• Sugar-free gums, mints, lozenges, and medications (4).

• Ketchup, barbeque sauce, honey, agave nectar, and other condiments and artificial sweeteners (4).

• Sugary drinks, like soda, and alcohol (4).


While the FODMAPs diet might call for avoiding many foods, there are still foods that are allowed. These include:



• Lactose-free milk (including rice milk and almond milk), cottage cheese, ice cream and sorbet; cheddar, Swiss, Parmesan, and mozzarella cheeses (4).

• Fruits such as bananas, berries, honeydew melon, oranges, kiwi, grapefruit, grapes, and passionfruit (4).

• All-natural sweeteners, including sugar and natural maple syrup (4).

• Vegetables, including bell peppers, carrots, butter lettuce, celery, corn, eggplant, bok choy, tomatoes, potatoes, and spinach (4).

• Gluten-free breads and cereals, oats, rice and corn pasta, corn tortillas, rice cakes, and potato and tortilla chips (one should check labels on these products for any sweeteners or additives, such as honey or agave nectar) (3, 4).


These guidelines may vary among IBS patients. Some may be able to tolerate some foods that are prohibited by the FODMAPs diet, while others might be able to consume several without having any major discomfort.


Other dietary recommendations for those with IBS include drinking at least six to eight glasses of water per day, especially if they suffer from diarrhea (2). It is also recommended that patients do not consume large meals, as this can cause cramps and bloating (2). Instead, patients may be advised to eat smaller meals throughout the day, or smaller portions (2). Increasing fiber in the diet can also help by reducing constipation (1).


Other Relief Methods for IBS

Along with dietary changes, other methods to relieve symptoms of IBS include:



Prescribed medications

• Laxatives to relieve any constipation, or medicines to decrease diarrhea, such as diphenoxylate and atropine (Lomotil) or loperamide (Imodium) (2).

• Antispasmodic, which helps control colon muscle spasms and reduce abdominal pain (2).

• Antidepressants



Stress reduction activities

• Meditation

• Regular exercise, such as walking.

• Counseling and support

• Adequate sleep.



Resources:



1. Irritable bowel syndrome: Spastic colon; Irritable colon; Mucous colitis; Spastic colitis (Last reviewed: July 22, 2011). Retrieved May 27, 2012 from PubMed Health: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001292/



2. Irritable bowel syndrome (September 2007). Retrieved May 27, 2012 from National Digestive Diseases Information Clearinghouse (NDDIC): http://digestive.niddk.nih.gov/ddiseases/pubs/ibs/#symptoms



3. Bradley Bolen, Barbara. Foods on the FODMAP Diet: High FODMAP Foods and Low FODMAP Foods (Updated March 16, 2012). Retrieved May 27, 2012 from About.com: http://ibs.about.com/od/ibsfood/a/The-FODMAP-Diet.htm



4. Scarlata, Kate. The FODMAPs Approach- Minimize Consumption of Fermentable Carbs to Manage Functional Gut Disorder Symptoms. Today’s Dietitian. Vol. 12 No. 8 Page 30. May 16, 2012.



About the Author:

Lauren Wisnowski is a senior Wellness Management major at SUNY Oswego and is from Rochester, NY. Having a vested interest in nutrition and wellness, she aspires to become a registered dietitian in the future. She enjoys exercising, especially running, as well as reading, writing, and spending time with her friends and family. Her hobbies also include quoting movie lines and watching Nickelodeon re-runs from the '90s.

Should You Be Concerned About Barrett's Esophagus?

Barrett’s Esophagus is a condition where the lining of the esophagus is damaged by stomach acid and is replaced by tissue similar to that which is found in the stomach. The exact cause of Barrett’s Esophagus is unknown, but it is commonly seen in people with gastroesophageal reflux disease, or GERD. Reflux occurs when the contents of the stomach rises into the esophagus, which may cause heartburn or indigestion. Occasional reflux is common, but for those who experience this sensation more than twice a week, a diagnosis of GERD is made. Within this population, Barrett’s Esophagus affects about 1% of Americans, or about 700,000 adults (1), and it may progress into esophageal adenocarcinoma, a deadly form of cancer of the esophagus. Barrett’s Esophagus does not cause any signs or symptoms, so it is important for individuals suffering from chronic reflux (GERD) to visit their doctor for an endoscopy and biopsy of the esophageal tissue regularly. Although cancer diagnosis is rare, most diagnoses are made late stage when treatment is ineffective. Early detection of precancerous cells (dysplasia) may prevent the development of esophageal cancer (2).

Risk Factors

Individuals with the following characteristics are at higher risk for developing Barrett’s Esophagus:

• Diagnosed with GERD, or experiencing constant reflux

• Heavy alcohol and tobacco use

• Older age

• Being male

• Being Caucasian

• Obesity

• Consuming a poor diet (3, 4).

Research

A study published in the American Journal of Gastroenterology found that diets high in antioxidants such as Vitamin C, E, and beta-carotene are related with a reduced risk for Barrett’s Esophagus. Consuming a diet high in fruits and vegetables, versus the typical Western Diet of processed foods, showed the greatest reduction in risk. It is important to note that similar results were not found in individuals who took supplements. It is theorized that there are other compounds in whole fruits and vegetables with beneficial, anti-cancer properties. Parallel findings were also discovered in a study completed by the National Institute of Health; Individuals consuming low amounts of raw fruits and vegetables were associated with a greater risk of developing cancer associated with Barrett’s Esophagus (5, 6).

Prevention and Recommendations

An effort to minimize acid reflux may reduce the risk of progression to Barrett’s Esophagus. The following is a list of various lifestyle changes that can be made to decrease this likelihood:


Smoking Cessation

• Smoking is strongly associated with cancer of the esophagus and can contribute to the esophageal cancer related to Barrett’s Esophagus.


Drink in Moderation

• Alcohol relaxes the mechanism that prevents stomach contents from entering the esophagus.


Sleeping Habits

• Avoid lying down three hours following meals.

• Sleep with your head elevated to prevent acid from rising into the esophagus.


Weight Loss

• Loosing weight improves GERD symptoms, as well as reduces the risk for both Barrett’s Esophagus and the development of cancer.


Dietary Changes

• Eat a low-fat diet, as high fat meals take longer to digest thereby increasing the risk for acid to rise.

• Consume small, frequent meals.

• Increase daily intake of raw fruits and vegetables, especially those high in antioxidants.

• Reduce caffeine intake to 2 – 3 cups per day. Caffeine, similar to alcohol, relaxes the mechanism in the esophagus that prevents acid to rise.

• Foods such as chocolate, spicy foods, and peppermint have also been show to aggravate reflux and should be avoided as necessary (1, 7, 8).



Resources:
1. Dunbar, K. (2009, April 21). Barrett's Esophagus. Retrieved March 30, 2012, from John Hopkin's Pathology: http://apps.pathology.jhu.edu/blogs/barretts/?p=48

2. Locke, G., & Rich, J. (2008, July 1). Barrett's Esophagus. Retrieved March 30, 2012, from National Institute of Digestive Diseases Information Clearlinghouse: http://digestive.niddk.nih.gov/ddiseases/pubs/barretts/

3. National Cancer Institute. (2011, December 23). Esophageal Cancer Treatment. Retrieved March 30, 2013, from National Cancer Institute at the National Institute of Health: http://www.cancer.gov/cancertopics/pdq/treatment/esophageal/Patient

4. The Cleveland Clinic Foundation. (2009). Barrett's Esophagus. Retrieved March 30, 2012, from Cleveland Clinic: http://my.clevelandclinic.org/disorders/barretts_esophagus/hic_barrett%27s_esophagus.aspx

5. Tufts University. (2008). Antioxidants from Produce May Protect Esophagus. Tufts University. Boston, MA: Tufts University Health and Nutrition Newsletter.

6. Brown, L., Swanson, C., Gridley, G., Swanson, G., Shoenberg, J., Greenberg, R., et al. (1994). Adenocarcinoma of the Esophagus: Role of Obesity and Diet. Journal of the National Cancer Institute , 87 (2), 104-109.

7. Clark, G., Smyrk, T., Mirvish, S., Anselmino, M., Yamashita, Y., Hinder, R., et al. (1993). Effect of Gastroduodenal Juice and Dietary Fat on the Development of Barrett's Esophagus and Esophageal Neoplasia. 1 (3), 252-261.

8. Academy of Nutrition and Dietetics. (2012). Nutrition Therapy for Gastroesophageal Reflux Disease. Nutrition Care Manual . Chicago, IL.

About the Author

Stephanie Wilson is a senior nutrition major at Rochester Institute of Technology.  This May she will graduate from RIT and begin her Dietetic Internship at California Polytechnic in San Luis Obsipo.  Stephanie proudly describes herself as a marathoner, foodie, musician, and blogger at OntheRoadtoRD.com.  She hopes to one day follow in Carol’s footsteps and become a private practice dietitian and share her love of both nutrition and exercise with the public!