Food & Fitness After 50: Foods for a Healthy Gut: Part 2

onion_home_graphicLast week in our interview with Jo Ann Hattner, gut health expert and author of Gut Insight: Probiotics and Prebiotics for Digestive Health and Well-Being, we covered basics about the gut microbiome. This week we get down to the application: prebiotics, probiotics, and fermented foods. And, we’ll dispel some myths about pre-and probiotic foods.

Can you describe the difference between a probiotic and a prebiotic?

A formal definition of probiotics is “live microorganisms that, when administered in adequate amounts confer a health benefit on the host.” What that means for us is that when we take in foods with probiotics, either in foods or drinks or supplements, they should have a health benefit for us.

What does confer a health benefit mean?

It means that a particular strain of live bacteria has been studied and demonstrated to have a positive health outcome. “Demonstrated” is an important word because research is required to show it has a health benefit before it can be considered a probiotic.  For example, stains of bacteria called Bifidobacteria (pronounced biff-ah-doe bacteria),a group of lactic acid bacteria that live in your gut, confer a health benefit by alleviating constipation and reducing the symptoms associated with irritable bowel syndrome, to name a couple of demonstrated benefits.

One other benefit is worth mentioning. Probiotic has an opposite…antibiotic. When we take an antibiotic for an infection, it can have a side effect of disturbing our healthy gut bacteria. Ingesting probiotic foods or supplements when we take antibiotics can help push out the bad bacteria. Bad bacteria don’t like to live in the same space as healthy bacteria.

yogurt bowlPrebiotics and probiotics are easily confused. They both contribute to the population of good bacteria in our gut. Think of prebiotics as foods that feed the good bacteria. In other words, once you have a good population of bacteria, it needs to eat! And, it’s nourishment comes from prebiotics. Another term you might hear is synbiotic. That is a food or combination of foods that contain both pre and probiotics. For example, when you eat yogurt (a probiotic) with fruit (a prebiotic) you are doing something good for your gut bacteria. A recent study demonstrated consuming yogurt and fruit is a good combination for a healthy gut.

How do fermented foods affect the gut microbiome?

Fermented foods were traditionally made by taking a food, for example cabbage, and allowing the naturally occurring microbes on the food to grow. This changes cabbage to sauerkraut, and it was originally done for food preservation. Fermented foods can naturally ferment or be aided by adding probiotics. The big question is how many of these new, trendy fermented foods actually contain probiotics that help your gut microbiome? For a probiotic to survive, it can’t be heat treated or pasteurized and it is hard to tell by looking at a food label if it contains live probiotics. Sauerkraut in a glass jar or pouch found in the refrigerated case is more likely to contain probiotics, than canned sauerkraut which is heat treated when it is canned.

One of my favorite fermented foods, and a good source of live active cultures, some of which are probiotics, is kefir, or fermented cow’s milk. It comes in lots of flavors, but you can try the plain kefir and flavor it with fruit or honey until you get used to the sour taste.

Kombucha, a fermented sweetened tea, is made with bacteria and yeast. It is sour-tasting (some people love it, and some describe it as vinegary-tasting dish water). And while it is popular and seemingly sold everywhere, documentation that is an effective probiotic is lacking.

What are some common pre-and probiotic foods that you recommend?

1008p40-live-active-seal-mYogurt is probably the most commonly consumed probiotic food. With so many choices on the market, look for a yogurt that contains the seal “live and active cultures” to make sure you are getting the right strains of bacteria. I prefer yogurt that doesn’t have a lot of added sugar; I would rather eat plain yogurt or Greek yogurt and add my own fruit or toppings, like granola.

Walnuts-in-Dish_Marble-Surface_hi-resMany fruits and vegetables contain fibers that are prebiotics.  Inulin is a prebiotic fiber found in banana and is one of the first foods we feed infants. Inulin can also be extracted from chicory root fiber and is well documented to be an effective prebiotic. Many foods, including yogurts and energy bars are adding inulin for its prebiotic fiber. Fiber-rich foods, like whole grains, contain prebiotics, as do some nuts, like walnuts.

The most important thing to remember is to include probiotic foods every few days (every day is ideal) to replenish your healthy gut bacteria. Include prebiotics at every meal; fresh fruit smoothies, veggies and salads, and whole grains all contain fibers which are good for your gut.

What do you think is the biggest misconception about the gut microbiome?

The biggest misconception is that we have a profile of what the gut microbiome should be; we know there are healthy bacteria, but how many bacteria and how much diversity do we need?  As we get older the number of good bacteria decrease. Without good bacteria, we are more susceptible to illness.

We are still in the infancy of understanding the gut microbiome and the relationship to human health, but by eating pre- and probiotic foods every day, we can get on the right path to a healthy gut.

Where can people find more information on prebiotics, probiotics, and fermented foods?

There is helpful information on the International Scientific Association of Probiotics and Prebiotics (ISAPP) website.

On my website, Gut Insight, there are resources such as frequently asked questions and a shopping list of probiotic and prebiotic foods.

For those looking for a cookbook, check out The Well-Fed Microbiome Cookbook.

Learn more on a healthy gut, eating well, moving well, and being well, Food & Fitness After 50.

 

Food & Fitness After 50: Do you have pre-diabetes? Now what?

prediabetes-FNLWhen my friend and colleague,  Jill Weisenberger, published a new book on prediabetes, I couldn’t wait to interview her and ask her to answer questions that adults 50+ have when told they have high blood sugar levels and prediabetes.

Jill is an internationally recognized nutrition and diabetes expert. She is the author of the four books including the best-selling Diabetes Weight Loss, Week by Week and the new Prediabetes: A Complete Guide. Jill has a private practice in Newport News, VA. She is a freelance writer and a consultant and spokesperson to the food industry, as well as a panelist for the US News & World Report Best Diet Rankings. You can follow her on Twitter and Facebook.

How important is it for adults over 50 to get their blood sugar checked? What is the best way to get it checked….doctor, health fair, etc?

With each birthday, we have an increased risk of developing prediabetes and type 2 diabetes. Typically, healthcare providers screen for diabetes and prediabetes around age 45. Your provider may screen you earlier if you’re overweight, have fatty liver disease or heart disease risk factors such as high blood pressure or abnormal cholesterol levels.

It’s a simple blood test. If it comes back abnormal, your provider will take a second measurement to verify the first one. If you are screened at a health fair, be certain to understand the results and follow up with your healthcare provider.

Test Prediabetes Diabetes
Fasting Plasma Glucose 100 – 125 mg/dl > 126 mg/dl
2-hour OGTT (oral glucose tolerance test) 140 – 199 mg/dl > 200 mg/dl
Random plasma glucose in an individual with symptoms of diabetes such as excessive thirst and urination Not done to diagnose prediabetes > 200 mg/dl
A1C 5.7 – 6.4 % > 6.5%

Some people think that if they don’t have any symptoms, they don’t need to see a doctor or get blood work…what would you say to that?

You’re breaking my heart! Sadly, there are 70 million adults in the US who have prediabetes and don’t know it. And that’s precisely because there are no symptoms. If you randomly count out 9 adults who you spend time with, three of them are likely to have prediabetes. That’s how common the problem is. Only about 10% of people with the disorder know that they have it.

What is prediabetes and can diabetes be halted if you have prediabetes?                                                                                            

If your blood sugar level is higher than normal but lower than diabetes, you have prediabetes. This is how we define and diagnose prediabetes. But, prediabetes (like type 2 diabetes) is much bigger than a blood sugar problem.

The two things going on with prediabetes are insulin resistance and the loss of some of our insulin-producing ability. It’s a nasty double whammy. The body is stubborn and resists the action of insulin. Because of this, the pancreas pumps out extra insulin. Early on in the course of the disorder, that extra insulin is enough to tamp down blood sugar levels to the normal level. No one has any idea that there’s a problem. But over time, the body can’t produce enough insulin to make up for the body’s resistance. That’s when blood sugar levels first increase. That’s prediabetes. As time goes on, if the insulin resistance continues, there’s likely to be further loss of insulin-producing ability. Then blood sugar levels rise more, and we have type 2 diabetes.

Other problems associated with insulin resistance, prediabetes and type 2 diabetes include blood vessel dysfunction, fatty liver, chronic inflammation, high blood pressure, abnormal cholesterol, heart disease, stroke, and even some types of cancer.

Because the problem is progressive, the best opportunity for a reversal is right this minute. There is some amount of urgency here because of the continued loss of insulin-producing capacity. Every day, your window of opportunity closes slightly. Without lifestyle changes, 37% of people with prediabetes are likely to progress to full blown type 2 diabetes within 4 years and most will have the diagnosis within 10 years.

Many people think every chronic disease is genetic and that there nothing they can do to prevent a disease like type 2 diabetes. What is the reality?

There are both genetic and environmental factors at play. We can’t change our genes, but we can do so much to improve our health and lower our risks of many chronic diseases, including prediabetes and type 2 diabetes. There are conditions that have lifestyle solutions that include diet, physical activity, sleep and more. And this is exactly what I cover in Prediabetes: A Complete Guide.

Many older adults think carbs must be eliminated if their blood sugar is high…can you explain why carbs are needed and what are the “best” carbohydrate foods?

Especially in the prediabetes stage, I really shy away from emphasizing carbohydrates. Instead I put the focus on the quality of the food. Instead of asking yourself if this food is high-carb or low-carb, ask yourself if this is a wholesome, health-boosting food. Other than having lots of carbohydrates, lentils and lollipops don’t have much in common!

Interestingly, there are several carb-containing foods that improve insulin resistance or lower the risk of type 2 diabetes. I always recommend oats, barley, lentils, beans, yogurt, nuts, and fruits, especially berries.

Can you explain why there is really not such thing as a “diabetic diet?” 

As science has progressed, we’ve learned that there are many ways to a healthy plate, a healthy body weight, and blood sugar management. So again, the emphasis should be on food quality. However, once in the diabetes stage, we do have to put some limits on carbohydrate intake. This is when I help my clients become carb aware. I try so hard to keep them from being carb phobic. But regardless, food quality really matters.

How does exercise help lower blood sugar levels?

Soooo many ways, but I’ll keep it brief. First, every single time that you exercise, you boost your body’s insulin sensitivity. Yes, I mean that. Every single time! And it can last from 2 to 48 hours!

Taking a walk after a meal helps lower blood sugar levels from eating. Strength training helps to build muscle and that means that there’s more place for blood sugar to go because muscle is a big storage bucket for blood sugar. All exercise matters, and it all counts. It all reduces insulin resistance.

Reducing sedentary time is also important. The American Diabetes Association recommends breaking up long periods of sitting with three minutes of light activity every half hour. You can walk to the water fountain at work, take your dog outside, do push-ups against the wall. It doesn’t matter, just do something.

I really like the section in your book on preparing for “lifestyle reset,” many people want to dive in head first without any forethought; can you mention why your tips can help someone get on track to a healthier lifestyle?

So many people just want to follow rules and make big changes right away. They think that willpower and discipline will steer them the right way. But no one has enough willpower and discipline to do what they need or want to do all of the time. We need skills, strategies and a plan much more than we need willpower. It smart to learn about setting goals and building motivation. It’s smart to identify the habits that help you and those that hurt you. The time you put into these things will help you in the long run. My experience tells me that simply rushing to change leads to temporary success and more on and off dieting.

Yellow under trees
Author, Jill Weisenberger

I encourage to check out Jill’s website for many great tips on good health and tasty recipes. Here is a link to a delicious easy lemon basil sauce, perfect for fish or seafood.

For more tips on eating well, moving well, and being well in your 50s, 60s, 70s, and beyond, see Food & Fitness After 50.