Substantial improvement with (strange) dietary adjustments

[Wonkmonk]

I am currently testing two things:

(1) What degree of wateriness or runniness of a meal triggers symptoms?

The goal is to eat solid or thick, viscuous foods that do not get flushed quickly into the lower intestine where microbes can ferment the nutrients. My hypothesis would be that everything that drips quickly from a spoon is too runny. So food should be solid (bread, spaghetti) it should at least have a mashed potatos or custard-like consistency. So hummus would be fine, but lentil soup wouldn't.

(2) Would it be beneficial to slow gastric emptying? I am looking at (mostly natural) ways to accomplish that and see if it has a positive effect.

 

[linusbert]

Slowing gastric emptying can probably be achieved with many things.

For example, this weight loss drug — which I do not recommend — slowed it down extremely for me. It made me vomit because the stomach emptied so slowly, yet I still had to eat every two hours. The upper digestive tract was faster than the lower one. Fortunately, the injection effect wears off significantly each day and is gone after 6 to 7 days. However, I heard there's also a pill version.

Other things that should slow gastric emptying include meat.

When I eat a steak, it slows my motility and stool normalizes again.

Maybe cheese does too, not sure. But the best candidate for me is steak — it works. And it's not like the injection.

The gut is complex. There are multiple factors: too little or too much stomach acid, too few enzymes, too little base/bicarbonates to neutralize acid... and each of these is crucial for gut health and nutrition. If one step is impaired, it can lead to deficiencies, dysbiosis, and other issues.

Cooking potatoes and noodles, then refrigerating them for 12+ hours, transforms them into resistant starch. This can improve the gut — or worsen it if SIBO is present. Probably a viable way to test for SIBO.

 

[Wonkmonk]

Slowing gastric emptying can probably be achieved with many things.

Thanks for the hints. Interestingly, I have been thinking about this again and thought if I really would want to slow gastric emptying, which would probably lead to the problem of subsequent meal-mixing which I generally feel like I should avoid. Maybe I should try to fasten gastric emptying? Not sure...I will think about it.

 

[Wonkmonk]

I think I have to pay attention to gastric emptying and digestion times for different foods.

I have found this study, which says that lentils take long to digest. They also slow down the gastric emptying time of later meals.

https://www.gastrojournal.org/article/0016-5085(92)90159-V/pdf

This is interesting, because I always felt like lentils (or legumes in general) need a longer time afterwards to prevent meal mixing.

Therefore, I might have to wait for 6-7 hours after lentils until I can drink water again, unlike the 5 hours that seem to suffice for spaghetti. I would also have a small meal next because meal mixing is more likely, so the next meal after lentils (or legumes) especially shouldn't contain fat even if it's 6+ hours later.

 

[linusbert]

Therefore, I might have to wait for 6-7 hours after lentils until I can drink water again, unlike the 5 hour

careful we are in summer, at least in europe. should supply with enough water.
you can sip water through.
the stomach does somewhat magically separate things for digestion, so water can pass the stomach without affecting digestion too much. it goes along the stomach lining. really nuts.

 

[Wonkmonk]

careful we are in summer, at least in europe. should supply with enough water.
you can sip water through. The stomach does somewhat magically separate things for digestion, so water can pass the stomach without affecting digestion too much.

Thanks so much for the warning, we have 32 C right now and it's really important to stay hydrated. Maybe I wasn't clear about this, I drink about 2 liters of water every day. I just drink about 0.7 liters about 1 hour before each meal so it doesn't mix with the meal, therefore, I should be reasonably hydrated over the day. I haven't felt any problems with my water intake so far and I am not thirsty between meals, which is also a good indicator.

Regarding the separation in the stomach, you are of course right, the watery parts of a meal are just going through the intestine much faster and the solids follow, but I think the problem with drinking water together with the meals is that nutrients the microbes need to make the harmful fermentation products (per my hypothesis) are water soluble and therefore would pass through the intestine much faster with a watery meal and escape digestion to some extent and then be available for the microbes to ferment.

That's why I hope to slow food passage down by eating only solid or thick and paste-like meals so nutrient absorption can happen early and less is available for the fermentation, which I think takes place in the lower small intestine and in the large intestine.

Thus the water intake always 1 hour before each meal on an otherwise empty stomach and avoidance of watery or too runny meals (exception: milk).

 

[Wonkmonk]

My mom erroneously bought lactose-free milk, so this is a good opportunity to experiment with it. In theory, lactose-free milk should be better tolerated because lactose doesn't get fully digested (even in non-lactose-intolerant people) and can later serve as a fermentable substrate for lactic acid bacteria.

In lactose-free milk, it's broken down into glucose and galactose which are readily absorbed. So in theory, there should be less to ferment for the gut microbse when I use lactose-free milk.

It's also a bit sweet, so I can maybe leave out the bananas as a sweetener. Ripe bananas themselves ferment a little and contain lactic acid bacteria, so not having them would probably be a plus.

 

[linusbert]

I just drink about 0.7 liters about 1 hour before each meal

there is a max capacity of water the body can use in one hour, 0,7 liter could potentially be too much in a short time. but this heavily depends on your body. 0,7 liter is for reference one bottle of water in germany.
if you get too much water in the body is peeing it out , which can be good for flushing out kidneys, but potentially can dilute electrolytes which isnt optimal, and in too much dilution can be problematic.
sipping the water in like 50-100 ml steps could be more physiological. but you will notice if you do not hydrate well.

 

[Wonkmonk]

there is a max capacity of water the body can use in one hour, 0,7 liter could potentially be too much in a short time. but this heavily depends on your body.

Hey there, this is absolutely right, I picked 0.7 liters because this is what medical science says the kidneys can still filter without any problems:

https://en.wikipedia.org/wiki/Water_intoxication#Prevention

So far, I haven't noticed any negative effects.

sipping the water in like 50-100 ml steps could be more physiological

This is certainly true, but I cannot do that because it would take some time to sip all the water I have to drink to stay well hydrated and some of the the water would then mix with meals, which I have to avoid. 700ml 1 hour before each meal currently seems to work well without any noticable negative effects and it amounts to just over 2 liters a day, which should be enough for reasonably good hydration.

 

[Wonkmonk]

I repeatedly run into problems with lentils and potatos, which is a shame because I love them and they add important nutrients to my diet.

I think is because of their high choline content. With this table, I calculated that they contain about 150-200 mg of choline per 800 calories.

https://www.ars.usda.gov/ARSUserFiles/80400525/data/choline/choln02.pdf

I usually steam potatos in the microwave and the lentils usually absorb all their cooking water, so no cooking water gets discarded (choline is water-soluble) which would eliminate some of the choline.

I suspect that with a too high load of choline at once, the rate of absorption drops and more of it reaches the lower small intestine and is then available for fermentation there.

I will experiment with cooking methods where cooking water is discarded or try to avoid these foods (which would be a real loss to my already severely restricted dietary options).

Inconsistent with this theory, however, I have always felt that kidney beans, which also absorb the cooking water the way I cook them and have similar amounts of choline than lentils, are better tolerated than lentils and I don't have a good reason for that so far.

 

[linusbert]

I think is because of their high choline content. With this table, I calculated that they contain about 150-200 mg of choline per 800 calories.

if you eat 800calories from potatoes you would eat over 1kg of it because 100g = 70cal.
if you eat 1kg of potatoes you got other things more likely to cause trouble besides choline, like for example 4000mg of potassium. a LOT of (resistent) starch. also potatoes are driving insulin output a lot.

did you try to test your theory just one raw egg yolk without any egg whites? it has lots of choline.

 

[Wonkmonk]

if you eat 800calories from potatoes you would eat over 1kg of it because 100g = 70cal.
if you eat 1kg of potatoes you got other things more likely to cause trouble besides choline, like for example 4000mg of potassium. a LOT of (resistent) starch. also potatoes are driving insulin output a lot.

That is correct, about two pounds of potatos, I do that quite often. I don't think any of these things are a problem. Potassium: My blood pressure is never too low (<90:60) and I never felt like it's a problem. Resistant starch: No GI tract problems after potatos. Insulin output: My insuline sensitivity is very good because of the very-low-fat and largely vegetarian diet and my strong weight loss due to the very-low-fat diet (BMI close to 21), Blood sugar returns to baseline quickly and I never experience a crash or anything because of high insulin after eating lots of potatos.

What I believe is the problem is that I probably should not have an intake of >100mg of choline per meal. There appear to be no studies on how much can be fully or almost fully absorbed, but I would suspect that it is about 100mg per meal.

That's what I think is going on with potatos. I will test this by cooking the potatos very long in copious amounts of water next time. This should remove a good deal of the choline, which is partly water soluble. So potatos cooked in lots of water (which is then discarded) should be much better tolerated.

 

[Wonkmonk]

"Dietary free choline is quickly taken up by the enterocytes, mediated by the saturable organic cation transporters ... PChol and GPC are rapidly absorbed and appear in plasma predominantly as free choline.
Water-soluble choline compounds (PChol and GPC) can also enter the portal circulation of the liver intact. Lipid-soluble compounds (PC and SPM) are either hydrolysed by PLs or enter the lymph incorporated into chylomicrons. Unabsorbed choline is catabolised by the intestinal microbiota. The Panel notes that the amount of choline absorbed is restricted by the capacity of the transport system via the saturable CTL1 or SLC44A1. The Panel notes that the available data do not allow defining the percentage of intestinal absorption of choline in humans."

https://efsa.onlinelibrary.wiley.com/doi/full/10.2903/j.efsa.2016.4484

"More than 90% of both isotopes was absorbed from the intestine."

https://www.sciencedirect.com/science/article/pii/S0022227520380500

"Most of the daily intake of choline is readily absorbed in the upper-gastrointestinal tract. ... Unabsorbed dietary choline can also be metabolized by gut bacteria."

https://www.sciencedirect.com/science/article/pii/S1931312817303505

However, the main microbial metabolite of choline seems to be TMA which is then converted in TMAO, and I am fairly certain that the problem can't be TMA/TMAO because I was on a vegan diet for many months and microbial TMAO production is known to drop to zero after long-term vegan diets. It must be something else.

 

[Wonkmonk]

I have long thought about why extra virgin olive oil seems to cause problems, and I now think it is because there appear to be bacteria in olive oil and that under certain circumstances, they even can reproduce:

https://pmc.ncbi.nlm.nih.gov/articles/PMC7022595/

https://pubmed.ncbi.nlm.nih.gov/30622964/

I had suspected that this might be a potential cause for concern about EVOO a while ago.

I suspect that olive oil and avocado oil may not be problematic because of the monounsaturated fatty acid content, but because they are produced from "wet" fruit (botanically), olives and avocados. That opens up the possibility of bacterial fermentation during the storage and production process.

So I would probably have to treat EVOO as a pre-fermented food or as a bacterial donor similar to feta cheese and yoghurt. In the latter case, pasteurization/heating might alleviate/solve the problem. Notably, olives for oil production aren't usually deliberately fermented, unlike olives for eating directly.

I had suspected for a while that refined olive oil is better tolerated. I don't find the past anymore, but I also suspected that heated EVOO in cooked meals is better tolerated than raw (e.g., in hummus).

5. I'm not entirely sure of this, but cooking with refined olive oil (as opposed to extra vergine) appears to not cause symptoms or at least cause less. I always suspected that suspended compounds in the extra vergine oil like oleuropein are problematic.

All of this was brought to my attention when I made fresh basil pesto this week, which is super-delicious, but contains a copious amount of raw EVOO. I also always suspected that hummus gets more or less tolerable depending on the amount of EVOO I put in it.

 

[Wonkmonk]

Latest observations:

*Blueberries and prunes (in high amounts) cause symptoms for several days, most notably recurrent sleepiness/somnolence, I would suspect berry anthocyanins as a cause, because it seems that that the effect is stronger for lowbush (high-anthocyanin) blueberries than for the larger, white-fleshed highbush (lower in anthocyanins) variety.

*I revisited the calcium question and found (again), that both too high calcium intake (over several days) and too low intake causes symptoms, so the effect of calcium appears to be a standalone effect and not contingent on other dietary choices. Notably, calcium was one of the very first nutrients I linked to my symptoms. I had it in the opening post of this thread already:

9. Avoid high loads of calcium

*I seem to do best with 600-700mg a day

*I had mushrooms in the freezer for several months and they started to taste slightly sour. Mushrooms usually don't cause strong symptoms, but these ones did. I am not sure though if this is a standalone effect, i.e., the mushrooms developed some substance that's harmful to me during storage, or if it is a contingent effect. When I ate them, I had strong calcium overload because I was testing what a high cow's milk consumption does, so I am not sure if the mushrooms only caused the symptoms because calcium intake was way too high (>2000 mg on some days).

*I think I benefit from having a high-oil/fat meal at least every once in a while, but I am at this point not sure how to incorporate that into my diet as oil/fat generally needs to be avoided. I feel like I need a certain amount of oil/fat. I can't go completely low-fat and limit fat to the absolute essential Omega 3/6 intake, which are essential fatty acids.