I’ve been wanting to write a post about gut health for a while now because it seems like everyone’s got a digestive issue these days. On your next girl lunch/night/breakfast, mention your bloating issues and see how many people chime in and share theirs. I bet you at least 1 out 3 will start talking about how they suspect dairy and gluten to be the culprit. Or better yet, mention stubborn weight you can’t get rid of and do the count. The truth is, most women over 30 start experiencing digestive and/or weight problems and they might try different things but never really get to the bottom of it. So many questions arise: who should they consult? What should they eat? Why is this happening? Should they do intolerance testing? Where? Will probiotics help? Is it hormone-related?
Today, I am excited to introduce you mammas to someone who has been a great source of information and inspiration to me. She also happens to be one of the best nutritionists I’ve met in Dubai so far: Stephanie Pech. I got the opportunity to sit down with her last week to discuss and some of the most common gut-related issues women have today. As always, I hope this is helpful and gives you some good insight. Enjoy!
WM: How do you work with patients? What are some of the tools you use to help them?
SP: Before I actually meet a client, I ask them to keep a food diary for a week, where they basically write down every single thing they eat over the course of 7 days. This is really key because we often think we eat healthier than we actually do. Unknowingly, we consume quite a bit of processed foods but aren’t necessarily aware of it until we actually monitor everything we put in our mouths.
Another really useful tool I use is to make patients fill out an extensive questionnaire. It of course includes their medical history but also assesses their other systems for signs and symptoms that can be related to the gut. Do they have mood swings? Are they having trouble sleeping? Do they have trouble focusing? Do they experience anger or impatience more than before? All these things indicate that something internally is not working and can give us useful hints as to where the problems can stem from.
WM: Some of the symptoms you mention above like mood, focus and sleep sound like they relate to hormones. How related are hormones and nutrition?
SP: Hugely related.
The gut is often cited as the second brain because it has its own autonomous nervous system. Also, it is where all you find all the bacteria that regulate your digestion, metabolism and much more. Together, the gut’s microbiome and enteric nervous system impact your endocrine system (and vice versa) in many ways. If your intestinal wall is compromised like in the case of leaky gut syndrome, undigested foods can enter your bloodstream and attack the endocrine glands. Looking at specific hormones, there are many examples. If you look at serotonin, the mood-related hormone, over 90% of it is produced in the gut. That’s why there are a lot of cases of depression among individuals diagnosed with IBS and other chronic digestive issues. Thyroid hormones also get metabolized in the gut. Cortisol, our stress hormone, influences digestion and inversely, poor gut health increases cortisol levels. Hormones and our gut health are intricately linked.
WM: The food diary and questionnaires seem like a lot of “homework” for a patient to do – is that standard practice?
SP: Increasingly, yes. I don’t want people to expect me to prescribe a one-size-fits all plan or magic pill to fix their gut or weight issues. If you want to get down to the root cause you need to get involved in the process.
All this “homework” might appear tedious but it is so important. Not only for the information it provides but also because it forces patients to take notice of things. Our body is continuously sending us signs and often, with our busy lives, we stop paying attention and actually get used to ignoring them. When patients take the time to truly check-in with themselves physically and emotionally, they get more engaged in their quest for digestive health and actually start owning it. That’s when we can work together and the magic happens.
WM: The gut, auto-immune diseases and intolerances have become huge topics today – how do you explain that?
SP: The quality of food has gone down in the last 50 years. There are so many examples of this: fruits and vegetables are picked much too early and as a result, are poorer in vitamins and minerals. The soil itself also isn’t as rich as it used to be and there is rampant use of chemicals and pesticides. Fish contains an increasing amount of heavy metals. Dairy, meat and poultry are filled with hormones, antibiotics and chemicals.
And that is just fresh produce. When you start looking at processed foods, the amount of toxic load we take in is even higher. Start reading the labels of everything you buy and you will realize just how little of it is real food.
Medication is another culprit: we often get prescribed things we don’t really need. There are so many cases of people with gut-related issues who take antacids, antibiotics or other treatments which may solve their problems in the short-term, but destroy their digestive health in the long run.
The gut is where all your nutrients get dispatched to benefit your organs, nerves, muscles and rest of your body. So if it gets loaded with waste, it can’t function properly no matter how well you eat. That is where intolerances, Crohn’s disease, ulcerative colitis, chronic acid reflux, irritable bowel syndrome and other problems come into the picture.
WM: What would you say to women who want to lose weight?
SP: I have a lot of patients in their 30s and 40s who have tried everything but cannot seem to shed their unwanted weight. Once we look at their current eating habits and assess their profiles, we can take different courses of action depending on their needs and objectives. One thing I would say to all women however is that you shouldn’t confuse weight loss and fat loss. For example, a lot of people think they can just restrict the number of calories they consume and up their exercise to lose weight. Though there is truth to this, the body is a lot more complex. Calories are not all created equal. If you eat poor quality, processed and refined foods, you are potentially consuming a lot of toxins and not nourishing your body with what it needs. It then goes into starvation mode and starts eating into your muscles. So you might lose weight and fit better in your jeans, but really, your fat % is going up. And this is compounded by the fact that poor nutrition is affecting your metabolism in many ways – your endocrine system can get deregulated, your nervous system isn’t getting what it needs, your gut becomes less efficient – and in the long run that actually makes you process energy less effectively and gain weight. So if you want to lose weight, make sure that whatever method you are using involves as many high quality, organic whole foods as possible.
WM: Are there any specific diets you recommend or specific nutrition tips?
SP: As far as diets go, I don’t believe in traditional dieting because being restrictive is not sustainable. One should just change the way they eat in a way that is suitable for them – everyone has a unique body chemistry that changes over time. For example, eating vegan may work great for some and create havoc for others. The same goes for paleo, ketogenic, etc. Everyone should test, tweak and figure those things out for themselves.
However there are certain habits everyone can adopt to improve their digestive health:
- Cut out sugar. It is addictive and has little, if any, benefits. It feeds disease, bad bacteria, yeast overgrowth and all the things we don’t want in our bodies. I know this is difficult because it is incorporated into so many foods, but being mindful of it is a good first step.
- Eat whole, non-processed foods. Getting organic fruits and vegetables is easy in Dubai these days and it is becoming more and more affordable because an increasing number of people are buying it. I love going to the Farmer’s Market in Business Bay on the weekend, it’s a great place to stock up on fresh produce.
- Educate yourself. Read, listen and ask questions. Don’t just buy something because it says it’s low fat, sugar free or good for you on the box, read the labels and ingredients. Also, don’t use over the counter medication too easily, look into natural alternatives, they often work just as well and no hinder your immune system and gut. Same for antibiotics, ask your doctor to see if you really need them or if there are natural ways of getting over the infection.
WM: Are there any supplements you suggest?
SP: Yes, there are some that I would encourage most people to consider.
Bone broth is great for anyone who wants to heal their gut and keep it in check. It is filled with minerals and compounds such as collagen that reduce inflammation and soothe the intestinal lining. You just need to ensure that it’s made from grass fed organic beef. There is a great Dubai-based company called Cleanliving.ae that makes very “clean” bone broth.
Probiotics are also a great way to feed the gut with good bacteria. It is good to test different kinds and find the ones that suit your chemistry best. I personally love kefir because it is an amazing source of good bacteria – you can make it yourself or buy it. I get mine from The Organic Cafe.
Omega-3 fatty acids are also something we often don’t have enough of. They have a lot of benefits, and one of them is their anti-inflammatory properties which is useful for anyone dealing with digestive issues.
About Stephanie
Stephanie is a certified Nutritionist, Metabolic Balance Coach and graduated from the Metabolic Balance Institute in 2012 in Munich, Germany. She helps patients overcome their health challenges through nutrition, education and the right mindset. She is also a regular contributor to wellness magazines in the region and hosts nutrition-related events throughout the year.
If you want to connect with Stephanie, check out her website and get inspiration from her Instagram account.
