Digestion, health and nutrition: Dr. Anil Minocha, a gastroenterologist and nutritionist

Diverticulitis Prevention

Diverticulitis Prevention - Popcorn, Nuts & Corn

Popcorn, nuts, corn cause diverticulitis. Don't eat nuts, popcorn, corn if you have diverticulosis. Any evidence to support this dietary recommendation in diverticulosis? Does avoiding corn, nuts, popcorn help avoid complications of diverticular disease?

Now we have study looking at the role nuts, popcorn play in diverticular disease. Dr Strate and colleagues from Seatle, WA,  investigated if nut, corn, or popcorn consumption is associated with diverticulitis and diverticular bleeding.

They utilized the Health Professionals Study which is a cohort of US men followed up prospectively from 1986 to 2004 for medical and dietary information. Men reporting newly diagnosed diverticulosis or diverticulitis filled supplemental questionnaires.

They found that in men without known diverticular disease, nut, corn, and popcorn consumption did not increase the risk of diverticulosis or diverticular complication like diverticular bleeding. Surprisingly, there was an inverse association between nut and popcorn consumption and the risk of diverticulitis, i.e. the consumption of nuts and popcorns actually protected against diverticulitis. By the way, probiotics may help in diverticular disease.

Do you or someone you know have diverticulosis? Have you been given dietary advice about nuts, popcorn and corn? Will this article alter your attitude towars intake of nuts, corn and popcorn? Please share your thoughts.

Sexual function preservation, prevent ED

Sexual function declines with age causing erectile dysfunction; the big question is how to prevent the decline in sexual prowess and the ED. Answer is simple: have more sex. Use sex or lose sex! We already know that senior citizens are more likely to have sex than the earlier generations.

A recent study in AJM titled “Regular intercourse protects against erectile dysfunction: Tampere Aging Male Urologic Study” followed men (mean age 59.2 years) over a period of five years. The overall incidence of moderate or complete erectile dysfunction was 32 cases per 1000 person-years. The authors found that those who were having regular sex at the start of the study had the least sexual decline.

The risk of erectile dysfunction was inversely related to the frequency of intercourse Men who had sexual intercourse less than once per week at baseline had twice the risk of erectile dysfunction compared with those reporting intercourse once per week (incidence rate ratio 2.2). There was no relationship between morning erections and erectile dysfunction.

Bottomline: Sexual prowess is just like exercise in general which builds strength and endurance. Sex in golden years equals gold medal in sexual prowess, and potentially less need for sex stimulant ED foods/pills like Viagra. Erectile dysfunction is related to complex interplay between physiologic as well as psychosocial and nutritional factors. Modify the factors that you can, i.e. have more sex

Digestion, upper GI health

Preventative life style measures for healthy digestive system or gut

Patients may be advised to follow some life-style modifications as well care using medications including over-the counter medicines.

• Avoidance of NSAIDs as much as possible should not be restricted to prescription formulations only. For example, NSAIDs in the form of BC powder is taken people in the south for pain on the assumption that it is risk free. candy. Health care providers should try using acetaminophen as much as possible for pain instead of NSAIDs. If NSAIDs are needed, use the lowest possible dose and avoid multiple NSAIDs.
• Smoking increases gastric acidity and affects the gastroprotective mechanisms predisposing the patients to ulceration as well as GERD. Smoking cessation in addition to other systemic health benefits like reduction of cancer risk, may reduce dyspeptic symptoms as well as potentially prevent ulcers in some patients.
• Alcohol has direct toxic effects on the gastric mucosa and may lead to gastritis and even gastrointestinal bleeding in some cases. Excessive drinking also increases gastroesophageal reflux. Mixed drinks like bloody Mary, screw driver have components (tomato juice and orange juice etc) that have additional injurious effect on esophageal mucosa. Many after dinner drinks have in addition to alcohol sweetened cream etc leading to slower gastric emptying and more gastroesophageal reflux. Avoiding excess alcohol may help reduce dyspeptic symptoms as well as ulcers in otherwise predisposed individuals.
• Routine life style measures for GERD in addition to the above include avoiding large fatty, spicy meals especially at dinner, not going to bed for atleast 3 hours after supper, weigh reduction if overweight.
• Role of diet is frequently patient specific and may play a role in symptoms in some individuals with dyspepsia. Thus dietary modifications need to be individualized based on patient’s symptom triggers. Patients usually know the foods that trigger their symptoms and they should be asked to avoid them instead of looking for a treatment. Pharmaceutical therapy is not a good substitute for any particular food just because they “like that food” and “cannot give it up”.Patients suffering from recurrent peptic ulcer disease may benefit from eating complex carbohydrates, fresh fruit, vegetables and avoiding red and fried meats.

Prebiotics health benefits

Prebiotics, Probiotics, FOS & GOS - Health Benefits

Prebiotic is a selectively fermented ingredient that allows specific changes, both in the composition and/or activity in the gut bacteria leading to benefits for the host well being and health. Synbiotic is a combination of prebiotic and probiotic.

Bifidobacteria and lactobacilli have been shown to have potent antipathogenic properties for potentially providing health benefits.

A successful prebiotic has the following properties:

1. Is not destroyed or absorbed in the gut on its journey from mouth to the colon.
2. Undergoes bacterial fermentation in the gut.
3. Selectively promotes the number and/or activity of the indigenous beneficial bacteria like bifidobacteria and lactobacilli

While dietary fiber may act as prebiotic, the most promising however are fructo-oligosaccharides (FOS) because of their selective fermentation towards the more healthy gut bacteria.Galacto- oligosaccharides (GOS) are used in infant formula foods. Both FOS and GOS meet the criteria for prebiotics as outlined above. Inulin type fructans have positive prebiotic effects. Other products with possible prebiotic potential include soybean oligosaccharides from soybean whey. Isomalto- oligosaccharides may be regarded as a quasi-prebiotic since it is partially metabolized in human gut.

Possible health benefits of prebiotics include:

1. Improved lactose tolerance
2. Improved resistance to pathogens resulting in decrease in gastrointestinal infections and respiratory infections
3. Decrease in cholesterol
4. Increased bacterial synthesis of vitamins
5. Protection against allergies by reducing gut inflammation
6. Improved absorption of calcium and magnesium

Dose of prebiotic: 5-8 g per day

Products on the market that may be fortified with prebiotics include diary products, health drinks, infant formula, cereal, dried instant as well as canned foods, and pet foods etc.

Do you or someone you know takes probiotics or prebiotics? If yes, in what form do you take and do you think it makes a difference? Please share your thoughts.

Sex intercourse elderly age

Sex is not discussed much as age progresses especially past middle-age. Does that mean older folks are not engaging in sex? Are older folks happy with their sex lives or have they given up on sex.? Baby-boomers, smile and read on!

Beckman and colleagues recently (British Medical Journal 2008) reported on the secular trends in self reported sexual activity and satisfaction in Swedish 70 year olds over a 30 year period

The authors found that from 1971 to 2001, sexual intercourse/activity increased among all groups of the 70 year olds : married men (52% to 68%), married females 38% to 56%), unmarried men (30% to 54%), and unmarried women(0.8% to 12%). Both sexes felt higher sexual satisfaction and more subjects displayed positive attitudes to sexuality.

This study suggests that elderly although perhaps still quiet about sex, are becoming more open-minded about enjoying the pleasures of healthy sexual life including sex outside the domain of marriage.

What do you think about the emerging trends noted above? Do you think that grandma and grandpa should be quiet and just give up on sex in case of physical inabilities of sexual dysfunction or should they talk to their physician about it. Should the health insurance companies pay for prescription drugs like Viagra for erectile dysfunction (ED) irrespective of age or should there be a age related restrictions? Please share your thoughts.