All Things Digestive Health



EXERCISE FOR A HEALTHY GUT

                     

Everyday there is new research published on the importance of exercise.  There are numerous benefits, from the obvious advantages of weight reduction, muscle-fat ratio, cardiac health and metabolism to memory and brain function.  Some of the most exciting studies recently published have shown exercise significantly improves the digestive tract and many disorders involving the gut.

Overall health benefits of exercise include:

  1. Bone Health– Strong bones make strong people. Though many people exercise to improve muscle size and tone, it is just as important for bone density and health. Our bones are not static and exercise increases the osteoblasts to bring calcium and other needed nutrients that strengthen our bones into them. Conversely, inactivity slows that process down and leads to bone fragility. According to the American Academy of Orthopedic Surgeons (AAOS) 50% of all Americans will fracture a bone and need treatment before the age of 65 costing over $10 billion annually in hospital fees and another $1 billion in follow up medical care. (1)
  2. Natural cleansing– Along with exhaling, urinating and bowel movements, sweating is an excellent way of aiding the body to ‘cleanse’ and detoxify itself. The more aerobic the exercise the heavier we breath and the more we sweat, and the detox aspects increase at the same rate.
  3. Stress Reduction– Since exercising (almost any kind) increases the production of endorphins, the ‘feel good’ hormones, it has been found that those who exercise regularly and consistently, even for short periods, have far less depression, anxiety and stress in general. One recent study done at the University of Colorado Boulder in April 2013 and published in the Science Daily even found that whether the exercise is voluntarily done or forced made very little difference in stress reduction. (2)
  4. Good sleep-The National Institutes of Health reports that between 30-40% of adults suffer from insomnia annually. According to a poll done in 2013 by The National Sleep Foundation of 1000 adults between the ages of 23-60, those that exercised regularly not only slept better but also slept longer with less drowsiness during the day. (3)  
  5. Appetite regulation– Very fascinating is that research indicates that appetite can both be stimulated AND suppressed by exercise! In a study by the University of Wyoming it was found that ghrelin, a hormone that increases hunger, is elevated after exercising. However, there are other hormones that are released that tend to allow for a feeling of being satisfied at a faster rate, thus lowering the appetite following exercise. Some feel that the ratio changes if the person is underweight or overweight accordingly. (4)
  6. Improves brain function– What’s good for the body is also good for the brain- including the memory.  Findings from the Canadian Cardiovascular Congress in 2012 found that not only did waistlines and muscle mass improve after 4 weeks of workout but when tested cognitively following their exercise sessions, people’s thinking and memory continually improved. (5)
  7. Better Digestion- Research has shown that minimal to moderate, regular exercise improves digestion in almost all subjects even lowering the risk of colon cancer, diverticular disease and many other issues. In a study done in 2011 by Sahlgrenska University Hospital in Gothenburg, Irritable Bowel Syndrome exercise was shown to improve symptoms in patients across the board. (8)

Exercise and your Gut

Recent research on how exercise effects digestion and the gut has produced some very interesting results.  The gist of the research shows what nutritionists and homeopaths have been saying for quite some time…BALANCE is the key!

The gut has been said to have a “second brain.” What this means is that although the digestive tract does not produce emotional responses or memory, over 100 million neurons regulate digestion without any input from you.  The digestive tract decides when to move food from your stomach to your small intestine, when to release necessary hormones and when to get rid of the waste.

Dr. Gershon found in his research and detailed in his book entiltled “The Second Brain” (6) that the ‘feel good’ hormone seratonin is prolific in the digestive tract and governs the actions required for normal activity as well as protective responses.

“Serotonin in the gut can mobilize inflammation, detect potential invaders, and essentially get the gut to mount a full-fledged defensive reaction,” says Gershon.

There are many reasons the digestive tract can go off track.  Prolonged dietary factors, drugs, mental/emotional disturbances and heredatary factors all can play a role. What can we do to rectify a faulty digestive system?

Exercise is one of the first things shown to have an immediate reaction in a positve way for the gut.

In Julia Edelstein’s article “Your Guide to Digestive Health” (7) she lists “5 Healthy Gut Strategies” and the first one listed is exercise! She states: “1. Commit to exercise. Exercise gets the colon moving, helping you maintain regularity. It’s also useful when dealing with irritable bowel syndrome, or IBS: A recent Swedish study published in the American Journal of Gastroenterology showed that people who exercised three to five times a week for 12 weeks had significant improvement in IBS symptoms; non-exercisers didn’t see the same benefits.”

While exercising, your heart rate and rate of breathing are increased so that the muscles that support the digestive tract get toned just like the other muscles in your body which aid in improving the mechanical action of your gut and stimulate the ability of the intestinal muscles to contract properly.

Besides being having good muscle tone and physically fit, exercise helps prevent and treat problems (including those in your gut) and may lead to a longer, healthier life so get out there and start your exercise program today even if it’s just a nice walk.  Start slow and build up from there and it will not be long before you start seeing results both in your digestion and your overall well being!

 

Paula Tipton-Healy L.M, CiHom

www.DiverticulitisInfo.com

 

 

  1. http://www.sciencedaily.com/releases/2013/04/130425160212.htm
  2. https://www.acefitness.org/acefit/expert-insight-article/29/3157/new-study-promotes-sleep-benefits-of-exercise/
  3. http://www.ncbi.nlm.nih.gov/pubmed/22619704
  4. http://www.ncbi.nlm.nih.gov/pubmed/22619704
  5. http://www.cumc.columbia.edu/psjournal/archive/archives/jour_v19no2/second.html
  6. http://www.foxnews.com/health/2012/11/28/your-guide-to-digestive-health/
  7. http://www.sciencedaily.com/releases/2011/01/110125092231.htm

What Are Prebiotics and Why Do We Need Them?

 

For the last couple of years, everyone has been talking about our lack of and need for probiotics for numerous reasons. Finally though, the research is in on the importance of PREBIOTICS!  What are they? Do we need them?  And, if so, how does one get them?

What are prebiotics?

Prebiotics (inulin) are food ingredients that are not digested but rather stay in your bowel and feed and promote the growth of the beneficial gut bacteria, which are crucial to our digestive health and overall well being.  Prebiotics have been shown to contribute to gut health in several ways:

1)   Prebiotics feed the probiotics (good bacteria) ingested.

2)   They help repair damage to the lining of the gut.

3)   They increase calcium and magnesium absorption.

4)   Provide a healthy soluble fiber to the bowel.

5)   Improve a host’s immune system.

6)   Help with balancing colon pH( lowering colon cancer risk)

7)   Aid in remission for Crohn’s disease and Ulcerative Colitis

8)   Allow the probiotics to ‘colonize’ in the gut.

Prebiotics are found in many of our everyday foods such as bananas (only 1% by weight),  onions, garlic, jicama and jerusalem artichokes (in their raw forms). By and far though, the most concentrated and easily utilized is the inulin source found in chicory root (over 64% by weight).  It is interesting to note that research has found that breast milk, as the first food, sets up our digestive tracts to produce this symbiotic relationship. The  downward trend in breastfeeding may also be a contributing factor in so many digestive problems and disease in the western world today.

Why have I not heard more about them?

Two reasons…The first reason is that only in recent years have our diets become so compromised, causing dysfunction in the entire digestive system. This is due to the over abundance of processed foods, sugar consumption, increased use of trans-fats and the overzealous prescribing of antibiotics.  Before this occurred in our diets there was no need to know about prebiotics as they were just naturally found in the common combinations of foods we normally ate which contained both prebiotic and probiotic activity.

The 2nd reason we haven’t heard more about prebiotics is that because of the above, research related to bacterias role in gut issues is new and only in 1995 did a researcher named Marcel Roberfroid single them out and understand their necessary function in our digestive tracts.  He has since done many subsequent studies showing diminished prebiotic and probiotic activity and availability of our modern-day diet intake and consequences.

How do I get prebiotics?

Eating foods that contain prebiotics is the first place to start but you need to consider the source. For instance, to eat enough bananas to get a minimal amount of prebiotics, you you would need to eat a pound and a half! That would be a lot of calories and too much fruit sugar!  Many fermented and cultured foods are good as they contain both prebiotic and probiotics. If you are supplementing with probiotics you certainly should be adding in the prebiotics so that the probiotics grow and colonize in the gut! Inulin from chicory is the best addition found, when taken with probiotics.

What Should I Eat?

Diverticulitistinfo.com finds that you should stick to some simple, commonsense rules when developing a healthy gut/bowel:

  1. No Fast/Processed Food
  2. No Processed Sugar
  3. No white flour (and many have found limiting their wheat intake helpful)
  4. Do eat full fat, raw dairy
  5. Do eat fermented and cultured foods

It is helpful to stick to these rules as well as changing your whole diet to be healthier.  Eat fresh, organic vegetables and fruits, nuts and whole grains with raw dairy as well as fermented and cultured foods.

What If I am Not Getting Enough Prebiotics?

If you aren’t getting enough prebiotics in your diet and especially if you are having digestive problems, you may need to take a supplement to get your digestion back in balance. Food supplements with raw chicory root (Healthy Bowel Support) as an ingredient are especially beneficial.

Chicory root gives support for the digestive system by providing the needed prebiotics and by increasing the flow of bile. Bile breaks down fats whilst helping to digest your food. Chicory also helps with blood composition and aids with blood sugar levels. Chicory has also been found to have a beneficial effect in fighting salmonella and other diarrhea type disorders.

People with digestive troubles often live their lives in constant fear of eating because it will cause them pain to digest their food. Besides the dietary suggestions offered above the other two easy things you can do to help improve your digestion is:

  1.     1.  Eat slowly and chew your food thoroughly
  1.     2.  Eat smaller meals often rather than three big meals

 

 

Paula Tipton-Healy L.M, CiHom

www.DiverticulitisInfo.com

 

 

  1. Roberfroid MB (2007). “Prebiotics: The Concept Revisited”. J Nutr. 137 (3 Suppl 2): 830S–7S. PMID 17311983
  2. Coxam V (Nov 2007). “Current data with inulin-type fructans and calcium, targeting bone health in adults”. J Nutr. 137 (11 Suppl): 2527S–2533S. PMID 17951497.
  3. Scholz-Ahrens KE, Schrezenmeir J (Nov 2007). “Inulin and oligofructose and mineral metabolism: the evidence from animal trials”. J Nutr. 137 (11 Suppl): 2513S–2523S. PMID 17951495
  4. El Oufir L, Flourié B, Bruley des Varannes S, Barry JL, Cloarec D, Bornet F, Galmiche JP (Jun 1996). “Relations between transit time, fermentation products, and hydrogen consuming flora in healthy humans”. Gut. 38 (6): 870–877. doi:10.1136/gut.38.6.870. PMC 1383195. PMID 8984026.
  5. Moshfegh AJ, Friday JE, Goldman JP, Ahuja JK (Jul 1999). “Presence of inulin and oligofructose in the diets of Americans”. Journal of Nutrition 129 (7 Suppl): 1407S–1411S. PMID 10395608
  6. Hughes R, Rowland IR (Jan 2001). “Stimulation of apoptosis by two prebiotic chicory fructans in the rat colon”. Carcinogenesis 22 (1): 43–47. Doi:10.1093/carcin/22.1.43. PMID 11159739.
  7. Peppelenbosch MP, Ferreira CV (2009). “Immunology of pre- and probiotic supplementation”. Br J Nutr. 101 (1): 2–4. Doi:10.1017/S0007114508020746. PMID 18577301

The Fabulous Ginger Root

 

Ginger is known to many cooks as a pungent spice which can add a unique bit of zesty flavor to many dishes, but did you know that ginger also makes a great gastrointestinal supplement?  Ginger’s popularity in cooking is due partly to its flavor, but also to its usefulness since it quells indigestion.

 

In traditional medicine, ginger has long been considered one of the most effective substances out there for reducing gas in the intestine and soothing and relaxing the intestines.  Since ginger root is native to Asia, you will generally find ginger included in Asian cuisine.  Ginger became popular in Europe thousands of years in the past when the Romans imported it.  In ancient times, ginger was very expensive, but nowadays it is very cheap.  Ginger’s efficacy has been proven in many studies, and it is used regularly for gastrointestinal relief not only for patients with IBS, diverticulitis, and other digestive ailments, but also those suffering from motion sickness or nausea during pregnancy.

 

Gastrointestinal benefits aren’t the only ones which you can get from taking ginger regularly.  Ginger’s soothing effect on the intestine is due in part to the anti-inflammatory gingerols it contains.  These same compounds can help to reduce pain in patients with arthritis, and may even improve mobility.  Ginger has also been demonstrated in several studies to impede the growth of ovarian and colorectal cancer cells.  It’s been shown to boost the immune system and help to protect the body from infection by common bacteria such as E. coli and staph.

 

There are several different ways you can take ginger.  You can eat it fresh, by the slice, or you can integrate it into your cooking.  You may also choose to brew a ginger tea, or you can purchase ginger extract in the form of a powder or tablet.  When you purchase fresh ginger, you’ll find it as a root in the produce section of your local grocery store.  The root should feel firm to the touch and should not show any mold growth.  Try to buy organic ginger so that you get the very best product.

 

Fresh ginger keeps very well; stored in your fridge, it will last up to three weeks.  Stored in your freezer (unpeeled), it will last as long as half a year.  The latter option probably makes more sense unless you take it daily since the ginger can last you a long time.  A little bit goes a long way.  You can make a cup of ginger tea by slicing off a half inch slice, which should be equal to roughly 2/3 of an ounce.

 

Some people have difficulty with the taste of the tea; you can try sweetening it with a bit of honey and adding a little lemon (lemon is also great for digestive issues) to make it more palatable.  Ginger lemonade with a bit of honey is another alternative for hot days when you’d prefer something cooler to drink.  As far as recipes go, ginger goes very nicely on salad; many Asian salad dressings are ginger-based.  You can make this kind of dressing yourself by adding ginger, miso, (or soy sauce), garlic and olive oil.  It’s simple, easy, delicious and good for you (note however that soy sauce disturbs digestion for some people).

 

Ginger is included in one of our favorite supplements for Irritable Bowel Syndrome, IBS Support Botanicals.  IBS Support Botanicals is blended with ginger root, oregano, chamomile flower, marshmallow root, fennel, acacia, and queen of the meadow.  These herbs combine to make ginger even more effective than it would be if you took it as an individual supplement.

Probiotics for Digestive Disorders

The bacteria inside our digestive tracts aren’t all bad—many of them are essential to healthy digestion.  These helpful bacteria can sometimes be wiped out by illness and sometimes need to be replenished.  While they will eventually build up again over time by themselves, you can give the process a boost by taking a probiotic.  Probiotics can be taken in a number of different forms, all of which can help you with diverticulitis and many other digestive ailments.

 

One of the most common forms of probiotics is a supplement that comes in a tablet form.  These are easy to take and deliver a healthy dose of helpful bacteria to your digestive system.  Look for something that contains Bifidobacterium Bifidum and the Bifidobacterium Longum and which you can take daily.  These bacteria are particularly important to the part of the digestive tract that is impacted by diverticulitis but when buying probiotics in capsule form there are 2 things that can boost the beneficial bacteria for your gut and to help turn around digestive disorders. The first is to look for multiple strains of good bacteria and the second is to look for prebiotics included in the formula. Prebiotics help your system recover and regenerate and allow the probiotics to florish and grow. A good source of one is Healthy Bowel Support (http://www.diverticulitisinfo.com/shop/index.php?l=product_detail&p=7).

 

There are a couple of other ways you can get probiotics as well.  You may take them in a liquid form—liquid forms of yogurt are popular in some parts of the world and are starting to take hold around the globe.  You can also simply eat yogurt.  Yogurt contains these bacteria naturally, and is one of the least expensive ways you can replenish the helpful organisms in your system.  When shopping for yogurt, make sure you check the container to see which types of bacteria are contained inside, and make sure it says, “LIVE cultures.”  Also check how much sugar is included in the yogurt.  If the yogurt has sugar added, you may want to avoid it and take tablets instead—sugar does not help your digestive system out; in fact it does the opposite.  Stick with yogurt which has no sugar added and add a little stevia if you’d like to sweeten it to your taste.

 

Natural Sources of Dietary Fiber

High Fiber Sources

If you have or think you may have diverticulitis or any other digestive affliction, one thing which may help you to alleviate or prevent your symptoms and keep things moving smoothly is to eat more fiber.  The average American gets about 15 grams of fiber daily. 25- 35 grams is the recommended minimum though some say we should get closer to 85 grams daily. What we do know is that in developed countries the majority of people do not get enough fiber in their daily diets, so we need to look for ways to increase our intake.  You can do this by taking a fiber supplement in tablet, powder or liquid form (a great choice is Healthy Bowel Support with 1000 mgs of Apple fiber) but it is best to pursue natural sources of dietary fiber that are food-based.  Just by adding a few more fiber-rich foods to your diet, you could notice a reduction in negative symptoms and improve over-all health including weight loss, regulating bowels, preventing diverticulitis and balancing blood-sugars.  What are some natural sources of fiber to consider?

 

  • Fruits.  These are some of the best fiber sources you’ll find.  Apples and pears have a lot of fiber, but only if you don’t cut off the skin.  Raspberries, figs, raisins, bananas, strawberries, and oranges are also good sources as are most fruits in their raw, natural form.
  • Vegetables. Raw and lightly steamed veggies including artichokes, broccoli, and all kinds of leafy greens are all great choices for fiber.  It’s best not to boil your veggies, but if you must, try drinking the fluid you cooked them in after it cools down enough—it will contain some of the nutrients that were leeched out of the veggies as they cooked. If you don’t want to drink it, save the liquid for stock for soup!

 

  • Whole grains.  Oatmeal, whole grain pasta, and whole grain breads are full of fiber and can be used to make your recipes stretch—which not only provides you with fiber but also can lower your food budget and keep you full longer.

 

  • Legumes and nuts.  Beans are an excellent source of fiber, as are nuts.  These foods, like those listed above, have a ton of other nutritional value as well, making them good not only for your digestive system but your whole body.

 

Next time you go to the grocery store, shop for foods high in fiber; fiber helps to regulate digestion and reduce both constipation and diarrhea and prevent further problems with your digestive tract!

Processed vs. whole foods: Video showing how they are processed through the gastrointestinal tract

Processed vs. whole foods: Video showing how they are processed through the gastrointestinal tract

 

Artist Stefani Bardin along with Dr. Braden Kuo conducted a clinical trial to show how the gastrointestinal tracts processes whole foods vs. processed foods. Amazingly, using a small pill sized camera they were able to record the entire process of the route to digestion. You will be shocked to find that even after 2 hours of eating processed ramen noodles they retain their shape because of the ingredient TBHQ which is essentially an antioxidant made from petroleum that is related to butane. The homemade noodles on the other hand broke up within 20 minutes after eating them. In addition the Gatorade that one patient drank retained it’s color even in the digestive tract. Having this kind of extensive research on how the body processes food is a real eye opener to many who still commonly eat processed foods.

To watch this eye opening video go to: http://www.youtube.com/watch?v=zi_DaJKsCLo&feature=player_embedded

 

Do you notice a difference in your digestive process or how you feel after eating processed foods?

 

Do you notice a difference with whole foods? what is the difference?

 

Paula Tipton-Healy L.M, CiHom

Homeopathic & Nutritional Consultant

www.diverticulitisinfo.com

Don’t Let Your IBD Stop You From Taking Your Dream Trip!

Category : Healthy Products, Ulcerative Colitis · (1) Comment · by Feb 5th, 2012

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Don’t Let Your IBD Stop You From Taking Your Dream Trip!


Have you experienced digestive upsets while traveling? Was it in a developing nation or an industrialized country?

Good news for those with IBD (Inflammatory Bowel Disease) such as Crohn’s Disease or Colitis! A recent study published in the latest issue of Clinical Gastroenterology and Hepatology about travelers with IBD says that if you have IBD you are not at a higher risk for digestive upset than those without IBD when traveling to developing countries.

The details are discussed in a recent MSN Health Article:  “Illnesses occurred in 17 percent of the trips among the people with inflammatory bowel disease, compared with 21 percent among those who didn’t have the condition. The researchers said people with the condition are at no higher risk for intestinal infections, such as traveler’s diarrhea, when visiting developing nations than the general population.”

Where the numbers differ is actually more surprising. Many assume that digestive upset comes with the territory when traveling in developing countries. However, those with IBD have a higher risk of illness(14%) than those without it (3%) when traveling in industrialized nations rather than developing nations. Infact, when traveling in developing countries, those with IBD who have not suffered any flare-ups or symptoms related to the disease in 3 months run the same risk of digestive problems as people without the disease.

Dr. Shomron Ben-Horin, of the Sheba Medical Center said, “If an inflammatory bowel disease patient has been in remission for at least three months, I recommend they take their dream vacation.”

Things that can help IBD sufferers prevent flare-ups are a good high-fiber diet and supplements like Digest Plus and others from DiverticulitisInfo.com!

To see the full article go to- http://health.msn.com/health-topics/digestive-health/ibd-and-crohns/tropical-trip-ok-for-most-with-crohns-colitis

 

 

Please leave a comment with your responses!

Paula Tipton-Healy L.M, CiHom

Homeopathic & Nutritional Consultant

www.diverticulitisinfo.com

 


Turmeric (Curcumin) for inflammatory bowel disease

Category : Healthy Products, Ulcerative Colitis · (8) Comments · by Jun 28th, 2011

Turmeric (Curcumin) for inflammatory bowel disease

New clinical studies show that turmeric may help in relieving symptoms of Inflammatory bowel diseases

 

 

A recent study on the effects of curcumin, more commonly known as turmeric, has shown positive results in treating inflammatory bowel disease. Those participating in the study have found significant relief from the painful symptoms and flare-ups associated with inflammatory bowel diseases.

As it is well-known, turmeric has been used as a spice in curries and many other Indian, Asian and African dishes for centuries. But, what is lesser known is that this perennial herb has historically been used in to treat a plethora of ailments in traditional Chinese, Hindu and ayurvedic medicine as well, due primarily to it’s anti-inflammatory properties.

Inflammatory bowel diseases can be painful and embarrassing. There are medications on the market aimed at relieving symptoms of IBD, but many patients find that these harsh medications are difficult to take because of their side-effects, high cost and likeliness of producing drug-resistant antibodies.

Researchers conducting the study on the effects of curcumin found that most patients participating in the clinical trial saw considerable improvement after taking curcumin. Some patients found such significant relief from their painful symptoms, that they were able to stop taking conventional medications all together, eliminating unpleasant side-effects. Those with Crohn’s Disease also found relief from symptoms like frequent bowel movements, diarrhea, abdominal pain and cramping.

Curcumin is one of the main ingredients in our all natural UC Support Botanicals! Diverticulitisinfo.com products are always natural, safe and without side-effects.

Check out diverticulitisinfo.com products!

Check out the curcumin study here! http://www.altmedrev.com/publications/16/2/152.pdf

 

 

What natural medications (such as local honey for allergies or homeopathy) do you use regularly?

 

How has natural medicine changed your health or your life?

 

 

Please leave a comment with your responses!

Paula Tipton-Healy L.M, CiHom

Homeopathic & Nutritional Consultant

www.diverticulitisinfo.com

Vitamin D3 Treatment with Inflammatory Bowel Disease

Category : Healthy Products, Ulcerative Colitis · (2) Comments · by May 28th, 2011

Individuals suffering with Inflammatory Bowel Disease (IBD – which refers to two chronic diseases: ulcerative colitis and Crohn’s disease) have been found to be significantly deficient in vitamin D. A recent study showed that in this population, vitamin D supplementation greatly reduced the likelihood of experiencing a relapse of the symptoms associated with IBD.

http://ncp.sagepub.com/content/26/2/204.extract

Review of 19 Studies show Importance of Good Fats & Fiber

Category : Healthy Products, Ulcerative Colitis · (31) Comments · by Apr 18th, 2011

INFLAMMATORY BOWEL DISEASE ( IBD)Diet, Fat, Protein, Fruit, Vegetables


In this systematic review of studies investigating the role of dietary factors on the risk of inflammatory bowel disease (IBD), which included an analysis of results from 19 studies involving 2,609 patients with IBD (1,269 Crohn’s and 1,340 ulcerative colitis) and 4,000 controls, the authors found a negative association between dietary fiber and fruits and subsequent Crohn’s disease risk, a positive association between high intake of saturated fats, monounsaturated fatty acids, total polyunsaturated fatty acids, total omega-3 fatty acids, omega-6 fatty acids, mono- and disaccharides, and meat, and a significantly increased risk of ulcerative colitis associated with high intakes of total fats, total PUFAs, omega-6 fatty acids, and meat. The authors conclude, “High dietary intakes of total fats, PUFAs, omega-6 fatty acids, and meat were associated with an increased risk of CD and UC. High fiber and fruit intakes were associated with decreased CD risk, and high vegetable intake was associated with decreased UC risk.”

“Dietary intake and risk of developing inflammatory bowel disease: a systematic review of the literature,” Hou JK, Abraham B, et al, Am J Gastroenterol, 2011 April; 106(4): 563-73. (Address: Section of Gastroenterology, Baylor College of Medicine, Houston, Texas, USA).