Thursday, August 25, 2016

Probiotics and Irritable Bowel Syndrome

This past April, I presented my research with Dr. Suzanne Neubauer on Treatment of Irritable Bowel Syndrome with Probiotics at the Massachusetts Dietetic Association's Annual Nutrition Convention and Exposition. This research was a part of the Seminar in Clinical Nutrition course that I took in Framingham State University's Coordinated Program in Dietetics. Below is a summary of my findings.

Presenting Treatment of Irritable Bowel Syndrome with Probiotics at MDA's ANCE
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain or discomfort and abnormal bowel habits, with an estimated global prevalence of 11%. It has unclear causes and is diagnosed based on symptoms rather than structural abnormalities. Probiotic supplementation has been proposed to treat IBS, because the fecal microbiota composition of patients with IBS has been found to be significantly different compared to healthy patients. 

A review of 21 primary studies was performed to examine the efficacy of probiotic treatment on IBS symptoms in subjects over 16 years old. Most of the studies reviewed were double-blind, placebo-controlled, randomized controlled trials. While some trials examined multi-strain probiotics, others assessed the influence of individual probiotic strains.

The results suggest abdominal pain, bloating, stool frequency, stool consistency, adequate relief, and quality of life are not adequately addressed with multi-strain probiotics in patients with all types of IBS. Different dosages, compositions of probiotic mixtures, treatment lengths, and subtypes of IBS studied make trials on probiotics hard to compare. The results were also impacted by the placebo effect, which may be a common occurrence in IBS trials, because IBS has unclear etiologies and is diagnosed based on subjective report of symptoms. 

Meanwhile, impacts of single strains of Escherichia, Bifidobacterium, Saccharomyces, and Lactobacillus were limited and varied according to specific strains. Drawing general conclusions from the studies on single-strain probiotics is not straightforward, as outcomes were strain specific, and some results were only observed in one bacterial strain in one trial.

Due to the inadequate number of studies that demonstrate substantial benefits of probiotics, single- and multi-strain probiotic supplements are not recommended for IBS treatment. However, if patients with IBS are interested, taking up to 8 strains of probiotics and up to 9x10^11 CFU per day has been shown to be safe.

I was surprised to discover there was not enough evidence to support supplementing with probiotics to treat IBS. However, following a low-FODMAP diet may help to manage IBS symptoms. In addition, find out what else probiotics may be good for at the Boston Fermentation Festival this Sunday!

Treatment of Irritable Bowel Syndrome with Probiotics Research Sources
1. Begtrup et al. Scand J Gastroenterol. 2013;48(10)1127-1135. 
2. Cha et al. J Clin Gastroenterol. 2012;46(3):220-227. 
3. Ford et al. Am J Gastroenterol. 2014;109(10):1547-1561. 
4. Jafari et al. Arch Iran Med. 2014;17(7):466-470. 
5. Ludidi et al. Neurogastroenterol Motil. 2014;26(5):705-714. 
6. Roberts et al. BMC Gastroenterol. 2013;13:45. 
7. Shavakhi et al. Adv Biomed Res. 2014;3:140. 
8. Simrén M et al. Aliment Pharmacol Ther. 2010;31(2):218-227. 
9. Sisson et al. Aliment Pharmacol Ther. 2014;40(1)51-62. 
10. Søndergaard et al. Scand J Gastroenterol. 2011;46(6):663-672. 
11. Wong et al. Dig Dis Sci. 2015;60(1):186-194.
12. Yoon et al. J Gastroenterol Hepatol. 2014;29(1):52-59. 
13. Kruis et al. Int J Colorectal Dis. 2012;27(4):467-474. 
14. Choi et al. J Clin Gastroenterol. 2011;45(8):679-683. 
15. Dapoigny et al. World J Gastroenterol. 2012;18(17):2067-2075. 
16. Ducrotté et al. World J Gastroenterol. 2012;18(30):4012-4018. 
17. Ligaarden et al. BMC Gastroenterol. 2010;10:16. 
18. Stevenson et al. Nutrition. 2014;30(10):1151-1157. 
19. Guglielmetti et al. Aliment Pharmacol Ther. 2011;33(10): 1123-1132. 
20. Charbonneau et al. Gut Microbes. 2013;4(3):201-211. 
21. Pineton de Chambrun et al. Dig Liver Dis. 2015;47(2):119-124.

Monday, June 13, 2016

Dietetic Internship Rotations at Needham Public Schools

As a part of the M.S. Coordinated Program in Dietetics at Framingham State University, I completed my food service and school nutrition rotations at Needham Public Schools (NPS) this spring. At NPS, the school cafeteria is considered the nutrition classroom, where students can learn about healthy eating through the nutritious and delicious food options offered.

For my food service rotation, I visited and learned about how each of the school cafeterias in the district operates. At NPS, each school is lucky to have its own kitchen! Projects that I was involved with included updating and training the cafeteria managers on the department's standard operating procedures and designing and running a plate waste study at the three secondary schools. I attended meetings and events, such as monthly manager meetings, the USDA Foods Conference, and The Education Collaborative (TEC) food service director meetings. During staff relief, I helped to manage the cafeteria at High Rock Middle School, which is a HealthierUS School Challenge (HUSSC), Gold Award of Distinction winner. The HUSSC is a voluntary certification, highlighting schools with healthier environments by encouraging nutrition and physical activity.

Buffalo chicken "wings of fire" with a warm biscuit, melon, vegetables, and salad for lunch at Needham High School
In addition to food service, I had the opportunity to teach nutrition lessons in the classroom for students in elementary, middle, and high school. This included an activity on the five food groups with third grade students at Mitchell Elementary School, and a lesson on food marketing with middle school students at Pollard Middle School. I enjoyed teaching to students of various age levels at the different schools.

Teaching the five food groups with MyPlate
Throughout the experience, I worked with a variety of staff in the Nutrition Services department, including the Nutrition Services director, Nutrition Outreach Coordinator, secretaries, cafeteria managers, and food service workers. I also worked with other staff and members of the school community, including teachers, custodial staff, and students.

I learned a lot about school nutrition at Needham Public Schools. I'm looking forward to continuing to learn more about school nutrition by assisting the Food Service Director at Dedham Public Schools!

Sunday, August 23, 2015

Nutrition Experiences at Framingham State University

This past school year I had the opportunity to work as a graduate assistant at The John C. Stalker Institute of Food and Nutrition at Framingham State University. The John Stalker Institute (JSI) provides information, resources, and workshops for Massachusetts school and child nutrition professionals, to address child nutrition and healthy nutrition environments. My work involved publicizing professional development, resources, and information about school nutrition through social media. I also attended JSI workshops and events, such as a Back to Basics: Fresh Vegetables and Fruits Workshop to Go and the 2015 Healthy Kids, Healthy Programs Summit.

Prepared dishes from a Back to Basics: Fresh Vegetables and Fruits Workshop to Go
2015 Healthy Kids, Healthy Programs Summit: Day One - The Learning Connection with Dr. Robert Murray
I enjoyed learning about school nutrition and expanding my skills in online communications through my work at JSI. Read posts that I wrote for the JSI blog and that I contributed to about the Chefs in Schools initiative in Beverly Public Schools on the Chefs Move to Schools blog.

Although I am no longer at JSI, I have an exciting and busy year ahead! This will be my final year of graduate school in the Coordinated Program of Dietetics at Framingham State University. My research for the fall is on a contemporary topic: treating irritable bowel syndrome with probiotics. Supervised practice experiences that I will have include a clinical rotation at Lowell General Hospital, foodservice and school nutrition rotations in the Needham Public Schools, and a community nutrition rotation to be determined. After beginning to study nutrition at Boston University for my bachelor's degree in 2007, I am looking forward to being eligible to take the national exam to become a registered dietitian next year!

Tuesday, May 19, 2015

How to Make Your Own Lip Balm

Making your own lip balm is very simple and rewarding. You only need two ingredients: oil and beeswax. In this post, I will provide directions on how to make your own lip balm, accompanied with photos to illustrate the process.

Homemade Lip Balm Slideshow
Photos are numbered in the same steps as the directions.

Homemade Lip Balm Recipe

Ingredients:
  • 3 oz. oil
    • Such as almond oil, apricot kernel oil, avocado oil, coconut oil, olive oil, and more. Or, a combination of oils.
  • 1 oz. beeswax
  • Essential oils (optional, adds fragrance and prolongs the shelf-life of the lip balm)
    • Such as cinnamon, lavender, and peppermint
  • Empty lip balm tubes, jars, or containers for the lip balm
    • Contact lens cases are also a perfect size!
Directions:
  1. Fill a pot a few inches high with water on the stove over medium-heat, to make a hot water bath.
  2. Combine the beeswax and oil in a heat-proof measuring cup.
  3. Put the measuring cup in the hot water bath. Occasionally stir the oil and beeswax well with a spoon. Take off the heat immediately once all of the beeswax is melted. (Do not turn the heat up to high, because you do not want the oil to go rancid).
  4. Slowly and carefully pour the oil and beeswax mixture into your lip balm containers. 
    • Optional: If you would like to use essential oils, they should be added at the last step. Because essential oils are volatile, they evaporate easily. After pouring the oil and beeswax mixture into a container, add the essential oil and cap the container immediately. I usually add 1 drop of essential oil per lip balm tube (0.15 oz) or ~5 drops per 0.5 oz lip balm.
  5. Let the lip balm containers sit upright, until they cool down to room temperature.
Finished lip balms
You can also make red tinted lip gloss using the same methods above with 3 oz. alkanet-root infused extra virgin olive oil, 1 tbsp. castor oil, 1 oz. beeswax, and optional essential oil.

Red tinted lip gloss 

A few suggestions on where to purchase ingredients:
Recipe inspired by Earthly Bodies & Heavenly Hair, my Boston School of Herbal Studies courses, and personal experience.

Monday, March 16, 2015

Homemade Body Creams

Have you ever wondered how to make your own body cream? After learning how to make my own, I have never looked back. I often describe making a body cream as similar to but more complex than making mayonnaise, which is an emulsion.

To make body creams, I create an emulsion by combining water and fats, which normally do not mix. The water in homemade body creams makes them very hydrating for the skin: the recipe calls for equal amounts of fats and water, with beeswax aiding in the emulsification process. Below are directions and photos for how to make body creams. The photos in the photo gallery help to illustrate the process, numbered with the same steps as the directions. I recommend looking through the photo gallery and reading through the entire directions ahead of time.

Homemade Body Creams


Homemade Body Cream Recipe

Ingredients:
  • 6 oz. liquid oil
    • Such as almond oil, apricot kernel oil, jojoba oil, olive oil, and more. Or, a combination of liquid oils.
  • 3 oz. solid oil/fat
    • For example, cocoa butter, shea butter, coconut oil, or a combination.
  • 1 oz. beeswax
  • 9 oz. distilled water (room temperature)
    • Distilled water is recommend to prolong the shelf-life of the cream
    • Floral waters are another great option
  • 80 drops essential oil (optional, adds fragrance and prolongs the shelf-life of the cream)
    • Such as lavender, rosemary, tea tree, others, or a combination.
  • Jars for the creams
  • Blender or food processor
Directions:
  1. Combine the liquid oil, solid fat, and beeswax in a 16-oz. glass measuring cup.
  2. Place the measuring cup in a pot partly filled with water, and heat on the stove over medium heat. Occasionally stir with a spoon until the solid fats and beeswax melt.
  3. Remove the cup from the pot and allow the mixture to cool down to room temperature. Occasionally mix the mixture with a spoon to ensure the temperature and consistency is even. The mixture will become thick and creamy.
    • This can take over an hour.
    • This process can be sped up by putting the cup in the refrigerator or a cool water bath. If this is done, occasionally stir the mixture and check the mixture frequently to check that the mixture does not get too solid or too cool.
  4. While waiting, put the 9 oz. of room temperature distilled water in your food processor or blender. 
  5. When the oil mixture has cooled down to room temperature, turn on the blender or food processor. Add a LITTLE of the oil mixture at a time to the distilled water. Continue this process VERY SLOWLY.
    • You are creating an emulsion, encouraging water and oil to combine, although they normally do not mix.
    • If you add the oil mixture too quickly, the emulsion may not form or it may separate.
    • The emulsion process is facilitated when the oil mixture and distilled water are around the same temperature.
    • Alternatively, you could do the reverse process: add the oil mixture to the blender and slowly add the water to it. I have not tried this yet, however.
  6. It may take a bit of time for the fats and water to completely combine. The cream should become thick and white if the emulsion forms. 
    • Do not turn off the blender or food processor until the emulsion completely forms.
  7. Pour the cream into a 32-oz. measuring cup.
  8. Mix in the essential oils to the cream if desired.
  9. Pour the cream into small jars for storage. The cream will become more thick as it sets.
    • These creams are perishable. Adding optional ingredients, such as essential oils or vitamin E, can help to preserve them. Refrigeration can prolong the shelf-life of your creams as well. I typically keep one jar out of the fridge for use, and store the rest in the fridge until I am ready to use them.
  10. Enjoy!
Homemade body creams

Friday, September 5, 2014

School Nutrition and Gardening

Welcome to the new school year! This month I begin my position as a graduate assistant with the John C. Stalker Institute of Food and Nutrition at Framingham State University. The John Stalker Institute (JSI) provides information, resources, and workshops for Massachusetts school and child nutrition professionals, to address child nutrition and healthy nutrition environments. Visit the JSI website to learn more about the institute. My work will relate to social media and online communications, and I am looking forward to learning more about school nutrition.

On the topic of school nutrition, I would like to share an infographic that I made and some information that I gathered on school gardening and nutrition, for my Computers in Nutrition Education course that I took last semester. Enjoy!

School Gardening and Nutrition

There are many good reasons to incorporate gardening into the classroom. School gardens are a great way to get children physically active, and to engage student interest while teaching them about science, nutrition, and numerous other topics. In particular, several studies have demonstrated benefits of school gardening in relation to nutrition. For example:
  • In 3rd-5th grade students who participated in gardening activities in Texas, students had an increased preference for vegetables and an increased preference for fruits and vegetables as a snack.
  • Morris and colleagues found that in 1st grade students involved with a school-gardening program, students better identified food-groups and were more willing to taste vegetables.
  • In a study on 4th grade students in California, the students who were involved in garden-based nutrition education had a greater preference for vegetables, including snow peas and zucchini, compared to a control group and a group that only had classroom-based nutrition education. In a six-month follow up, the garden group still had greater preferences for broccoli, zucchini, and snow peas compared to the other groups.
The development of eating habits begins at an early age, and garden-based learning is one effective way to incorporate nutrition education into the classroom and to promote healthy eating habits. For more benefits of school gardening, please see the infographic below (click on the image to enlarge it if needed).


Sources:

Thursday, July 24, 2014

Mochi Waffles

If you have never had mochi, you are missing out. Mochi is a traditional Japanese sticky rice cake, and it is delicious!

Assorted mochi from Mochi Kitchen


Pictured above is an assortment of freshly made mochi from Mochi Kitchen, based in Somerville, MA. Although I have not made my own mochi from scratch before, I have bought pre-made Grainaissance Mochi from Whole Foods.

Brown rice, Grainaissance Mochi
 Just pre-heat the oven to 450°F, and cut the mochi into 1" - 2" squares.

Mochi to be baked
Bake 8-10 minutes until the mochi puffs up, and they're done! Eat the mochi as is, or with sauces.

Baked mochi
When I first heard about mochi waffles from my friend Sean Kushi, who ate them growing up, I could not believe I had not heard about them before. Waffles made out of mochi? Yes, please! Making mochi waffles, or moffles, is easy and quick; and they are gluten-free and tasty.

Luckily, I was already equipped with a waffle maker.

Black & Decker Waffle Maker
Pre-heat the waffle maker, and coat the surfaces with oil. When the waffle iron is ready, put in the mochi, cut to your preferred size.

Mochi in the waffle maker
Cook the mochi for about 4-5 minutes, depending on your waffle maker.

Mochi waffle
And your mochi waffle is ready! Eat moffles with maple syrup, natto, nut butters, or any toppings of your choosing. Savory or sweet toppings can be used, and check out some other topping ideas towards the end of this article from Serious Eats. Enjoy!