lavendar mint iced tea

Lavender Mint Iced Tea

Hello Summer weather! I am so happy when the sun is shining and I can be dressed in short sleeves. :) Russ, Lucy and I have been having way too much this Spring at our new Maine cottage. The weather has been amazing!  Being able to walk to the beach in the mornings has been priceless for all three of us.  Hearing and seeing the waves crashing on the shore is so good for the body and the soul.  Lucy, our chocolate lab, is especially in her glory!  As expected, she truly loves swimming in the ocean!  Click here to see my Lucy!

With the warmer weather, hydration becomes more important as we lose more water from our body through sweat.  I am a big fan of water as my primary hydration source {your body is about 60-65% water}…but sometimes it’s fun to get a bit fancier.  Today is all about fancy.  I made some delicious lavender mint iced tea today…and I thought I would share the recipe with you!lavendar mint iced teaUsing fresh edible herbs and flowers is not only fun…but pretty.  I was inspired to try lavender and mint tea after my daughter Chelsea had shared she tried some iced tea infused with both herbs last weekend in Woodstock, NY. IMG_4663To infuse the tea with lavender, I purchased culinary grade lavender from a local farm.  I added about 1 teaspoon of the flower buds into my hot tea. Be sure to purchase lavender deemed for culinary use as some lavender plants have been sprayed with pesticides and you don’t want to ingest the residues. There are many dried culinary lavender products online. FODMAPers: To my knowledge, lavender has not been officially tested for FODMAP content–so use at your discretion.IMG_1847I created iced tea with lavender infused black tea, fresh mint, organic lemonade and plenty of ice. Just a hint of sweet from the lemonade in this refreshing drink!IMG_1877

Feeling fancy?  Well, then, give this recipe a whirl!

Lavender Mint Iced Tea

Ingredients

  • ~6 servings
  • 4 cups hot black tea
  • 1 teaspoon fresh lavender buds or 1/4 teaspoon dried lavender (purchase culinary grade lavender)
  • 1 1/2 cup lemonade (I used Santa Cruz organic lemonade)
  • 10 mint leaves, chopped
  • lavender stem and mint leaves for garnish

Instructions

  1. Prepare tea and add lavender buds to hot tea, stir to immerse and let sit for about 1 hour. Let tea come down to room temperature.
  2. Using fine mesh colander, strain out lavender and place cooled tea in glass pitcher.
  3. Add lemonade and mint to tea.
  4. Add ice to serving glass and pour in lavender mint tea.
  5. Garnish with fresh mint leaves and sprig of fresh culinary grade lavender sprig, if desired.
http://blog.katescarlata.com/2015/05/29/lavender-mint-iced-tea/

Digestive Disease Week Updates

About a week and a half ago, I had the pleasure of attending DDW:Digestive Disease Week 2015, an annual US conference devoted to the GI tract.

DDW

{Sorry poor photo quality!!}

To be completely honest, to me, being at DDW felt like being at Disney World. So much to see and do, and yet, too little time to take it ALL in. So many great talks occurred at the same time! I really wanted to attend ALL of them.

DDW is a BIG GI event…not only for the US gastroenterologists, dietitians, nurses and other health professionals interested in gastroenterology, but it attracts worldwide attention and attendance.Unknown-7If you are a health professional interested in digestive health, I highly recommend you attend this event! Next year, DDW will take place in the beautiful city of San Diego!

In addition to the talks, the expo and poster sessions were another big area of learning opportunities. The poster sessions were FULL of numerous abstracts, each providing a brief synopsis of a research project…I have NO idea how many posters were present at DDW–but let’s just say, too many to read them all!  Typically, one of the researchers involved in the study was available to review their research with you. It is such a great opportunity to talk to the researchers directly and get their thoughts of the data they collected during their research. The benefit of going to these conferences is that you have access to research much sooner than most people will see it, as it takes quite some time to get research published in a peer reviewed journal.  The expo was full of manufacturers of scoping devices,medications, vitamins, supplements and probiotics…and much more.

Here are a few topics presented at DDW that I found interesting:

Biomarker for IBS-D? New research suggests the pathophysiology of IBS-D may be acquired by a bout of acute gastroenteritis and subsequent alteration in GI function. Research has led to uncovering 2 potential biomarkers for IBS-D:

  • Anti-CdtB (cytolethal distending toxin B)
  • Anti-vinculin

You can find more about this study by Cedar Sinai and Beth Israel Deaconess Medical Center researchers  here.  Measurements of the anti-CdtB and anti-vinculin antibodies may help identify patients with IBS-D with a simple blood test. This is important news in the IBS-D world because if a simple blood test can provide answers regarding the cause of your symptoms, you may be able to skip more invasive tests such as repeated colonoscopies.

Histamine Intolerance.  There was a paper presented at DDW by a group from Berlin, Germany noting that histamine intolerance is a non-immunologically mediated reaction toward oral intake of histamine-containing foods. You may have noted I did a post on this a while back, here.  Histamine intolerance syndrome can present with various intestinal symptoms and should be considered as a differential diagnosis in patients with IBS-like symptoms. Serum DAO and urinary methyl histamine do not suffice to diagnose histamine intolerance because they are only sporadically correlated with the symptoms. Thus, an oral histamine challenge remains the gold standard for the diagnosis.  I was happy to see this paper present at DDW as I believe this to be an issue in some of my clients. Histamine intolerance is highly unrecognized and misunderstood. 

Probiotics contaminated with gluten? One of the BIG news items from DDW was from Peter Green’s group at Columbia in NYC. Researchers at Columbia evaluated 22 commonly purchased probiotics, revealing that 12 of the 22 had gluten contamination.  Four of the brands contained greater than 20 PPM (above the acceptable limit per FDA for a product to be considered gluten free) an unacceptable amount, especially for those with celiac disease, an immune mediated condition in which gluten is toxic to the intestine. Here is a recap of this study. Tricia Thompson, owner and founder of Gluten Free Watchdog will be testing probiotics for gluten.  Gluten Free Watchdog provides a great service to those with gluten intolerance, which serves to independently test products to assess for gluten contamination. In order, to test numerous probiotics, Gluten Free Watchdog will need donations to fund the extensive research needed to test a variety of products. Tricia Thompson, MS, RD, gluten expert and founder of Gluten Free Watchdog, notes, “Probiotics are supplements and are regulated by the FDA under the category of “food.” Unlike medications, supplement manufacturers do not need to prove through scientific study that their products are safe and that they work. On the positive side, supplements labeled gluten-free must comply with the FDA’s gluten-free rule. If a product, including a probiotic is not in compliance it should be reported to the FDA.”  If you are willing to donate to help fund further probiotic testing via Gluten Free Watchdog, please contact Gluten Free Watchdog at: info@glutenfreewatchdog.org

PLEASE note, the results of this probiotic testing will only be available to those who subscribe to Gluten Free Watchdog which is $4.99/month.  If you require a gluten free diet or educate patients on gluten free living, I think this subscription is well worth the money.  

Low Vitamin D linked with inflammatory bowel disease? Rush University researchers presented data on Vitamin D and Vitamin D receptors and a potential connection with inflammatory bowel disease, infection risk and cancer. Their research suggests that if the vitamin D receptor is not functioning properly this can impact the gut microbial community and that identifying this defect and restoring its function may have future implications in maintaining a healthier balance of bacteria in the gut.

Fecal incontinence (FI) is more common than you might think, is not a consequence of aging, AND there are effective treatments!  UNC researchers: Whitehead, Heymen, and Palsson reveal that FI impacts about 9% of US adults and embarrassment is the primary reason that patients don’t discuss this issue with their doctor.  There is a misconception that FI is a natural part of aging and yet, there are many effective treatments!  {low FODMAP diet seems to help patients as just one option! An area of ongoing study underway at U. Michigan! }

Dr. Raja at John Hopkins discusses the notion of ‘shy bowel disorder’ an under-recognized form of functional gut disorder.  When using a public restroom is difficult and you avoid at all costs…consider biofeedback and pelvic floor physical therapy.  For what it is worth–there is also ‘shy bladder disorder’!

Italian researchers presented their findings that there was a high prevalence of lactose malabsorption found in patients affected by gallstones, suggesting that an alteration of bile composition could destroy or alter lactase enzyme in the intestine, the enzyme that allows our body to digest lactose. Interestingly, the researchers also found high prevalence of methanogenic flora in the patients they studied, suggesting a relationship between methane producing microbes and the formation of gallbladder stones. Methane producing microbes are as many of you know, associated with constipation or a sluggish intestine.

Researchers from University of Nottingham presented their results of their study using MRI (magnetic resonance imaging) and hydrogen breath testing looking at the  impact of fructose and inulin on symptoms in 29 patients with IBS. As you know, FODMAPs have been shown in research to pull water into the intestine (osmotic effect) and are rapidly fermentable, causing a rise in gas.  Individuals with IBS have been shown to be more sensitive to the aftermath of FODMAP ingestion.  This study showed that  Inulin induced symptoms in more IBS patients than the well absorbed sugar, glucose.  Symptoms from inulin correlated with the time of the peak in gas production in the large intestine. The peak in gas production from inulin occurred at 240 minutes post consumption. Fructose, had the greatest impact in pulling in water into the small intestine and symptoms peaked at about 50 minutes after fructose ingestion.  The same study was done with healthy controls that showed that fructose increased water content and inulin increased colonic gas, as well, however, the healthy controls did not have any GI symptoms. This study can be assessed here.

Lovastatin lactone, a medication used to lower cholesterol, was shown by Cedar Sinai researchers to reduced methane production in a rat study.  Perhaps lovastatin will be used as an adjunctive medication to reduce methane production in constipation predominant IBS patients, if methane microbes are part of the picture??  Further study is needed to elucidate the potential role in humans.

Can seasonal allergies make IBS symptoms worse?  There was a wonderful talk by Craig Friesen on the topic of infective and allergic causes of IBS.  The role of mast cells and eosinophils in IBS was discussed.  Individuals with IBS have elevated mast cells in ileum and colon.  This talk proposed the potential connection with birch pollen allergy, oral allergy syndrome and exacerbation of IBS symptoms. Birch pollen cross reacts with: apple, almond, carrot, celery, cherry, hazelnut, kiwi, peach, pear, plum. Learn more about oral allergy syndrome here.

I was fortunate to meet, Julian Walters, the researcher and gastroenterologist I had interviewed about bile acid induced diarrhea for my post on this subject, found here.

And that is just a small taste of all that I learned and was presented at this conference! Now let’s move onto a couple new products!

Product updates:

IBgard

home-logo A new targeted delivery of peppermint oil to the small intestine improves symptoms associated with IBS.  Peppermint oil has numerous studies to support its use in IBS. It functions in relieving symptoms in many ways, as an anti-spasmodic, anti-inflammatory, & anti-microbial agent.  IBgard is a medical food with FDA approval, it is a triple-coated controlled release product that allows release in the small intestine.

IBS-check

The new biomarker blood test for IBS-D available from Commonwealth labs based on research from Mark Pimentel’s group at Cedar Sinai and Beth Israel Deaconess in Boston.IBSchek_banner2I will stop here! Congrats if you made it this far!

And a couple of announcements:  If you are a dietitian or health professional, I will be joining Monash University at an upcoming scientific meeting in Prato, Italy in November 2015.  Registration is open for this event, is limited to 120 health professionals and should be a great learning opportunity! Click here to learn more.  And, hey, who needs an excuse to travel to Italy?

If you are a FODMAPer and live in the Boston area, my friends at Weigh to Go, will be providing a low FODMAP cooking class on June 12, 2015. Click here to register!

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Cucumber and Dill-infused Cottage Cheese Appetizer

It’s time to gear up for summertime outdoor entertaining! I love this time of year!

Today, I am sharing a very simple and healthy appetizer recipe that you can bring to your next party or enjoy as a hearty snack. Cucumber and Dill-infused Cottage Cheese Appetizer.  Don’t worry FODMAPers: you can sub in lactose free cottage cheese for this recipe! Easy Peasy.IMG_4581Simply mix lactose free cottage cheese (I used Lactaid brand) with fresh or dry dill, add a smattering of garlic infused oil and blend. Wash cucumber and cut into 1 1/2 inch slices. Hollow out some of the seeds with a melon scooper and add a dollop of your seasoned cottage cheese mixture. Garnish with course black pepper and a few green scallion slices. You are done. :)IMG_4381

Cucumber and Dill-infused Cottage Cheese Appetizer

Ingredients

  • 1 large cucumber
  • 3/4 cup lactose free cottage cheese (I used Lactaid brand)
  • 2 teaspoons garlic infused oil
  • 2 teaspoons fresh dill, chopped or about 1/2 teaspoon dried
  • 1 scallion, sliced, for garnish (green part only)
  • Course ground pepper

Instructions

  1. Wash cucumber, trim ends and cut into 1 1/2 inch slices.
  2. Scoop out small amount of the seeds and flesh with a melon scooper (in the center of the cucumber slice) be sure not to scoop through the other side!
  3. In small bowl, season cottage cheese with garlic infused oil and dill.
  4. Place tablespoon of cheese mixture over each prepared cucumber slice.
  5. Garnish with scallion slices and ground pepper.
http://blog.katescarlata.com/2015/05/20/cucumber-and-dill-infused-cottage-cheese-appetizer/

I just returned from DDW15–Digestive Disease Week, an annual US GI conference, that was in  Washington DC this year.  My mind is still digesting all that I learned. There was so much interesting research shared, new product developments and more! It was such an amazing experience! I will post a re-cap on some of the top stories that I think you will be interested in early next week. Stay tuned!

For my US friends, I hope you get to enjoy a nice long weekend of relaxing this Memorial Day weekend. And of course, I want to take time to remember the veterans that gave their life to provide the freedom we enjoy daily.

 

 

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Greek Pasta Salad

Chickpeas, fresh oregano, feta, Kalamata olives and heirloom tomatoes were the inspiration for this delish recipe.IMG_4479

Russ wanted wheat pasta. I talked him into trying some gluten free rice pasta instead.  We tossed the warm rice pasta with these delightful ingredients. The verdict: YUM.

IMG_1774Fresh herbs always add nice color and a yummy flavor to a recipe.  I chose fresh oregano for this recipe. Although chickpeas like most other legumes tend to contain a fair dose of FODMAPs, canned chickpeas make the Monash cut-off if you stick with a 1/4 cup portion of drained, rinsed canned chickpeas.

This recipe is great at room temp, but makes a tasty leftover too.  For the dressing, I used a commercial dressing that looks good for FODMAPers and is gluten free! The dressing is called Christo’s Yasou Greek Salad Dressing…but you certainly can substitute my Mustardy dressing for a homemade dressing to make this pasta dish tasty too.  I love a good homemade dressing but sometimes it’s nice to simplify the mealtime prep and use a commercially prepared dressing. Unfortunately, there are very few dressings that are made without garlic and onion. FODMAPer tip: If the dressing ingredients contain the words: natural flavor this could be hidden garlic and onion.

We enjoyed this delicious pasta salad with grilled chicken that was marinated in the Greek salad dressing (noted above) with a little fresh lemon juice and oregano.  It was a perfect light dinner meal–just right for the warm weather we have been enjoying here in New England!IMG_1776Here’s the recipe! Hope you enjoy it! :) I think it would make a great side dish at your next summertime BBQ!

Greek Pasta Salad

Ingredients

  • Serves 4
  • 4 ounces uncooked gluten free pasta (cook according to package directions)
  • 1 cup canned chickpeas, drained and rinsed
  • 1/2 cup crumbled feta cheese
  • 1/2 cup pitted Kalamata olives, rough chopped
  • 2 cups chopped fresh tomatoes
  • 2 tablespoons chopped fresh oregano
  • 1 tablespoon fresh lemon juice
  • 1/4 cup favorite low FODMAP dressing (savory style with oil and vinegar base) I used Christo's Yasou Greek Salad Dressing

Instructions

  1. Drain pasta and place in medium size bowl. Add in chickpeas, feta, olives, 1 tablespoon of oregano and tomatoes.
  2. Drizzle with lemon and dressing. Gently stir to mix.
  3. Season with salt and pepper, as desired.
  4. Garnish with a little more fresh oregano on top.
http://blog.katescarlata.com/2015/05/14/greek-pasta-salad/

todaysnewsgraphic

Let’s talk about bile acid

Hello. I thought it would be nice to talk about bile acid today, are you with me?

todaysnewsgraphicBile acid diarrhea is also known as BAD. Perfect acronym, right? You might have BAD if you have been experiencing IBS-D like symptoms: chronic diarrhea, urgency, incontinence, bloating and discomfort. Unfortunately, bile acid diarrhea or malabsorption of bile is an under recognized problem–often not on the radar of many gastroenterologists or primary care doctors.

I have been talking about bile acid malabsorption and diarrhea with some top GI docs around the globe. Trying to learn from the best so I can provide new and updated findings on this topic. Perhaps, for some of you, this post may provide valuable information as you attempt to connect the dots between your symptoms and potential causes. Because GI problems, truly, can be one big puzzle with many overlapping puzzle pieces.

What is bile acid? There are primary bile acids formed in the liver: cholic and chenodeoxycholic acid and secondary bile acids produced from primary bile acids deoxycholic (created by from cholic acid) and lithocholic acid (created from chenodeoxycholic acid). Before the primary bile acids are secreted into the digestive system,  they are conjugated (combined) with either of the amino acids glycine or taurine. This conjugation process makes them less toxic. Conjugated bile acids have a key role in absorption of fats. Conjugation is a very important step in bile acid synthesis converting weak acids to strong acids.

Bile acids play a key role in absorption of fat in the small intestine. They are released from the gallbladder into the bile duct when you start eating a meal. A good analogy: bile acids act like Dawn dishwashing liquid–help breaking down fat into small globules, allowing the fat to be digested!

Normally, about 95% of the conjugated bile salts are reabsorbed in the terminal ileum and returned to the liver via the portal venous system, a recirculation process known as enterohepatic circulation; only a small proportion (3-5%) are excreted into the stool. When bile acids are NOT re-circulated, they arrive in the colon. Bile acid in the colon increases the motility of the colon and draws water in contributing to diarrhea, bloating and urgency.

Have I lost you yet? I hope not!

Bile acid diarrhea can be misdiagnosed as IBS-D.  There are several reasons how and why bile acids may wreak havoc.  

Bile acid diarrhea can result due to overproduction of bile acids, malabsorption of bile acids due to intestinal re-section, or due to small bowel bacterial overgrowth where the bacteria de-conjugate the bile acids, rendering them inactive.  There are three types of bile acid diarrhea:

Type I:  When the terminal ileum, the site of reabsorption of bile acids is removed or surgically by-passed reabsorption of bile acids is altered.

Type 2: no definitive cause found also known as primary bile acid diarrhea.

Type 3: May occur with SIBO, post gallbladder surgery, radiation enteritis, chronic pancreatitis.

I asked Dr. Julian Walters, professor of gastroenterology at Imperial College London to share his expertise on bile acid diarrhea, “Bile acid diarrhea is most common in its idiopathic (primary form) where there has been no previous surgery and no obvious intestinal or other disease.  This is usually then diagnosed as chronic functional diarrhea or irritable bowel syndrome.  Recent work suggests that there may be excess formation in the liver of bile acids and this can be more than can be reabsorbed fully.  Liver synthesis of bile acids is controlled by a newly identified hormone,  FGF19 (fibroblast growth factor 19) and patients with bile acid diarrhea have lower levels of this hormone which can lead to making excess bile acids. Primary bile acid diarrhea accounts for a third of patients with diarrhea-predominant IBS.  This will be about 1% of the overall population.  Diagnosis can be a problem in the US.  People get loose, watery bowel movements, an increased frequency (up to 10 times/day), an urgent need to go, and sometimes fecal incontinence. This leads to fears which affect social life, work opportunities and so on. Current treatments rely on binding excess bile acids in the bowel with drugs such as Cholestyramine. Research is looking at new ways to affect the FGF19-bile acid synthesis pathway.”

Dr. Michael Camilleri, a world renown researcher and gastroenterologist at Mayo Clinic in Rochester, Minnesota shares his update on testing for bile acid diarrhea, “Mayo Clinic has made available through Mayo Medical Labs a test to diagnose bile acid diarrhea/malabsorption. This total fecal bile acid excretion in 48 hours can be performed on the same collection for fecal fat estimation.  Thus, when the doctor needs to investigate the cause of chronic diarrhea, one 48 hour collection performed while ingesting 100 gram fat diet will provide both estimates of fat and bile acid malabsorption. In the next year, it is anticipated that Mayo Medical Labs will launch a fasting blood test to screen for bile acid diarrhea based on the rate of synthesis of bile acids in the liver (serum C4).There is accumulated evidence that 25-40% of patients with chronic functional diarrhea or IBS with predominant diarrhea have bile acid malabsorption.”  

I look forward to better testing than collecting poop for 48 hrs…which, really doesn’t sound like fun!

How do you treat bile acid diarrhea? If there is a correctable disease such as small intestinal bacterial overgrowth or celiac disease, treating the underlying condition is the first step to managing bile acid diarrhea. But often, the cause is not determined so a trial of bile acid sequestering medications might be prescribed. A side effect of bile acid sequestrants is constipation so titrating them to the ideal dose for you body is key. Also, bile acid sequestrants can contribute to malabsorption of some medications and vitamins so be careful to  time dosage accordingly. It is advised that other drugs are taken 1 h before or 4–6 h after taking a bile acid sequestrant.

Three bile acid sequestrants include: colestipol, cholestyramine and colesevelan are on the US market. Dr. Sue Kelly, gastroenterologist at Beth Israel Deaconess Medical Center makes a key point,  ” Stop taking the bile acid sequestrant if constipation develops. You can always start at lower dose and titrate the amount up.” Finding the proper dose is very individual with bile acid sequestrants.

Dr. Kelly provides some tips, “Colestipol is a large pill, so it may not be the best option if you have trouble swallowing big pills.  Start with one pill. Some people need up to three per day and some need it only 2-3 times per week.” Cholestyramine (Questran) is a gritty powder that is taken daily. Dosing varies per person 1/2 a packet might work or some individuals use up to 3-4 packets per day!  Start slow and titrate up!

 A great review article on bile acid diarrhea can be found here! And another article by Dr. Walters here! These are medical/research articles though…not designed for the consumer but still has valuable information.

Of course, not all diarrhea is bile acid induced!

Osmotic diarrhea is associated with FODMAP intake.  FODMAPs are very small carbohydrates that are commonly malabsorbed. The small size of FODMAPs contributes to their ability to pull water into the intestine.  Secretory diarrhea can result from bacterial toxins, reduced absorptive surface area caused by disease (celiac disease) or intestinal resection,  laxatives over-use, drug side effects and medical disorders that reduce intestinal function. 

If unrelenting diarrhea is stopping you in your tracks, discuss the possibility of BAD with your gastroenterologist!

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Green Bean Bundles

Happy Friday!  Russ and I are headed to Maine this weekend. I am looking forward to a nice, relaxing Mother’s Day Weekend.  Happy Mother’s Day to my fellow Mom’s out there.  Today, I  thought I would share a fun recipe I made last week that you can enjoy as an appetizer or a side dish, Green Bean Bundles.IMG_1723I trimmed green beans cutting them into even pieces. I wrapped them with a 1 inch strip of ham (prosciutto would be nice too!) and thinly sliced provolone cheese. Drizzled with a little splash of garlic infused oil and roasted them up.  When they finished cooking, I added a little sprinkle of Parmesan cheese.  And there you have it, Green Bean Bundles! YUMMO!

It this recipe time consuming to make?  Yes, a little.  It’s not hard to do, but this is not a recipe you want to whip up on a busy school night.  They are super yummy though…and kid approved.  You can also prep them early in the day and bake them up later.IMG_1721

It’s best to cook them on a cookie sheet lined with parchment paper as they do tend to get stuck on the cookie sheet due to some melted cheese escaping!

A few side notes for the health professionals following this post or my blog….Monash University is sponsoring an upcoming talk in Italy.  I am  honored to be part of this event. Numerous Monash University researchers coupled with UK and US digestive health experts will meet in Prato, Italy for a meeting.  This is open to health professionals: scientists, dietitians and doctors etc. Limited seats are available and it should be a fantastic learning opportunity.  More on this event can be found here.

For Mother’s Day, Russ bought me a flower time share at Tangerini’s Spring Street Farm! Every week, I can go to the farm to cut my very own fresh flowers!  Having any excuse to go to Tangerini’s makes me happy.  It truly is one of my happy places…..you can feel the love that goes into growing fresh organic produce, flowers and animals!  So…I am so excited about this early Mother’s Day gift for me!

I wish all the Mom’s a day of rest and relaxation! YOU deserve it!   

Green Bean Bundles

Ingredients

  • Serves 4
  • 2-3 cups green beans (about 40-50 green beans)
  • 1/4 pound thinly sliced imported ham
  • 1/4 pound thinly sliced provolone cheese
  • 1 tablespoon garlic infused oil
  • 1 tablespoon grated Parmesan cheese

Instructions

  1. Preheat oven to 375 degrees
  2. Trim green beans by cutting ends keeping size of green beans the same
  3. Slice ham into 1 inch strips the long way
  4. Slice provolone cheese into 1 inch strips
  5. Wrap three green beans with both ham and cheese- in the middle.
  6. Place on cookie sheet lined with parchment paper.
  7. Repeat with remaining green beans.
  8. Drizzle green beans evenly with garlic oil.
  9. Roast for about 30 minutes or until green beans fork tender.
  10. Remove from oven and sprinkle with Parmesan cheese.
http://blog.katescarlata.com/2015/05/08/green-bean-bundles/

 

sunflower

Spring Cleaning…your life!

There is nothing quite like springtime! The days are longer and WARMER! The trees are budding with fresh leaves and new flowers are blooming, by the day. Springtime is a time of new beginnings. Your life with a fresh new view.sunflower

Today’s post is not about actual Spring cleaning, but rather tips on looking at your life as a fresh clean start. Taking a moment to identify what is working in your life and what is not.  Stop, re-group and adjust your sails.

What do you want the rest of your year to look like? Are there things in your life you could stop doing and ask someone else to do, instead? Do you take enough me time?  Is your health where you want it to be? Do you have the best health team to care for your health needs? Are you in the right job? Are you spending quality time with the people who make you happy?

Occasionally,  it is good to take a little my life inventory.  Make a list of what you love about your life and what you don’t.  Then make an action plan on how you can modify. See if you can create a life filled more with what you love and less of what you do not. I encourage you to spend more time with those you love (and love you back!), engage in activities that bring you joy and plan something for the future–as it’s so important to have something to look forward too! Maybe it is a guy/girl weekend away, taking a special class, attending that musical you have always wanted to see, a special museum exhibit…or maybe just a day alone to read a book.

If you can afford it,  “farm out” jobs you dislike to do or rob you of your ‘me time':

  • Instead of ironing ALL of your work clothes, bring some to the dry cleaner.
  • Swap a chore with a friend. Some people are great at organizing–ask for help! In return, cook a meal or offer up something else that you are good at and enjoy doing!
  • Don’t have time to add buttons that fell off your shirt, leave that to the tailor.
  • Feel like you are always rushing home to take the dog for a walk, hire a dog walker or a neighborhood kid, once a week, or ask someone else in your family to do it… so you have a day with no rush!
  • Hire house cleaners–even if it’s a one time treat! Perhaps ask for this as a holiday or birthday gift.
  • Hate grocery shopping? Use a delivery service. You can often save on impulse buys and use the service only during very busy times in you life.

Ditch the downers:

  • Minimize your interactions with negative people or try to change the conversations to more positive upbeat topics!
  • Re-evaluate the parts of your job you love and the parts you don’t…try to tweak your job description to include more of what you love.
  • Create a positive, de-cluttered home and work environment so you can function at your best.  “A clutter home/office is a cluttered mind.” 
  • Focus on the good in your life and try to be patient with the not-so-good.

New beginnings create new endings.

Take small steps to create the life, health and surroundings you deserve. 8b6e6bcf81070690bc98d1ccd4dcf873

 

Happy Spring! Here’s to a great year ahead for all of us! :)

 

Strawberry Salad and Coconut Chicken

Coconut Chicken and Balsamic Marinated Strawberry Salad

My son is a fan of coconut chicken, so I decided to try to create a low FODMAP version. No major adjustment needed, I simply used some corn starch and gluten free Panko bread crumbs (such as Ian’s original GF Panko bread crumbs) instead of wheat flour and wheat bread crumbs. Coconut chicken

I can’t wait to try this recipe with shrimp too. I served the coconut chicken with another new low FODMAP recipe I created, Balsamic Marinated Strawberry Salad.Balsamic Marinated Strawberry Salad

Strawberries pair nicely with baby greens. I am excited for all the fresh local summer produce! Strawberries and greens

Another nice complement to strawberries is a light balsamic vinegar dressing.  I simply mixed some high quality balsamic vinegar with garlic infused oil and seasoned with freshly ground pepper and salt. I drizzled some of this dressing on the sliced strawberries. FODMAPer tip: Per Monash University app the cut off for balsamic vinegar is 1 tablespoon per serving.

A winning combo.Drizzling strawberriesI let the strawberries sit for a few minutes to infuse the amazing flavor of the dressing.
Marinating strawberries

Drizzle the remaining dressing on the baby salad greens and then top with the marinated strawberries. Salad ready to eat!

I think this makes a great low FODMAP meal. I doubled up on the portion size shown.  So good. Adding some jasmine rice would be nice too! :)Strawberry Salad and Coconut Chicken

Coconut Chicken with Balsamic Marinated Strawberry Salad

Ingredients

  • Serves 4
  • Chicken:
  • 1 pound boneless and skinless chicken, cut into about 12 strips
  • 1/2 cup corn starch
  • 2 eggs
  • 2 teaspoons garlic infused oil
  • 1 cup sweetened flaked coconut
  • 1 cup gluten free Panko bread crumbs
  • salt and pepper
  • Balsamic Marinated Strawberry Salad:
  • 6 cups baby lettuce greens (baby spinach, romaine etc)
  • 2 cup chopped strawberries
  • 1 tablespoon balsamic vinegar
  • 1/4 cup garlic infused oil

Instructions

  1. Preheat oven to 350 degrees F.
  2. Lightly oil large baking sheet.
  3. Place corn starch on medium size plate, set aside.
  4. Whisk eggs with 2 teaspoons garlic oil.
  5. Mix coconut with bread crumbs and place on medium size plate.
  6. Dip chicken strips individually into corn starch, then eggs, then into coconut/breadcrumb mixture. Pressing crumb mix firmly into chicken; repeat with all 12 chicken strips.
  7. Place chicken on baking sheet and add salt and pepper, to taste.
  8. Place prepared chicken in oven and bake for about 25 minutes or until cooked through.
  9. While chicken cooks; prepare Balsamic Marinated Strawberry Salad
  10. Add strawberries to small glass bowl.
  11. Whisk together balsamic vinegar and oil. Add salt and pepper to taste.
  12. Add 1/2 of balsamic mixture to strawberries and gentle stir. Set aside.
  13. Place salad greens on platter and lightly toss greens with the rest of the balsamic dressing.
  14. Layer strawberries in the middle of the salad or as desired.
  15. Serve salad with baked coconut chicken.
http://blog.katescarlata.com/2015/04/30/coconut-chicken-and-balsamic-marinated-strawberry-salad/

I hope you are having a  great week! Are you following me on Instagram? I know not all of you are tech savvy but I do post recipe ideas and new food product finds when I am at the grocery store etc…so it’s just another resource for you if you are new to the low FODMAP diet.

fruit kabob

Portion Size Matters on the Low FODMAP Diet

I receive numerous questions weekly about portion sizes and the low FODMAP diet. Portion size does matter on the low FODMAP diet.  Strawberries, for instance, are low FODMAP but NOT low FODMAP if you eat a full bowl the size of your head of them!

Make portion control more inviting…such as serving low FODMAP fruit kabobs! You can serve these cute kabobs with lactose free vanilla yogurt as a dipping sauce. 1 or 2 kabobs are a nice healthy treat.fruit kabobA very useful resource regarding portion control for the low FODMAP diet can be found at Monash University’s FODMAP blog here.

The Monash Uni low FODMAP app serves as another portion control resource.  Remember that 20 blueberries is a serving of fruit for the low FODMAP diet but you CAN eat multiple servings of fruit per day. Limit to the 20 blueberries at one meal but allow yourself another low FODMAP fruit at the other meal or snack times, if you desire. If you choose to have 20 blueberries at breakfast and want to have 20 blueberries with dinner..that is OKAY! Making a fruit smoothie can work on the low FODMAP diet but remember to add the equivalent of one fruit serving.  This could be 1/2 of a medium banana and 5 strawberries.

Oatmeal is a wonderful grain–rich in fiber.  But the portion size is just 1/4 cup dry or 1/2 cup cooked per meal.  Again, you can eat oatmeal multiple times during the day, but limit the portion size while on the elimination diet. When experimenting and learning more about your personal FODMAP tolerance, you can try adding more oats to your meal.  If 1/2 cup of oatmeal is not enough to fill your tummy, consider adding quinoa flakes to the mix so you can indulge in a larger bowl of hot cereal for breakfast….without the bellyache.

Tolerance to FODMAPs is very individual— listen to your body and experiment with low FODMAP foods. Despite the low FODMAP serving of 20 blueberries, You may find you can tolerate 30 blueberries without any tummy distress.  If so, eat 30 blueberries as your serving size once you are done with the elimination phase and have a good sense of how the low FODMAP diet is helping your symptoms. Conversely, you may find 10 blueberries is the right amount for you, then stick with the lower number.

Protein foods such as plain beef, chicken, fish and eggs are FODMAP free,  if you are particularly hungry perhaps choose a larger portion of these naturally low FODMAP foods. Rice and white potatoes are very low FODMAP too–so if you need a few more bites–go with an extra scoop of these starchy foods.

I find most of my patients do very well on the low FODMAP diet when they eat a balanced meal full of low FODMAP foods.  What’s a well-balanced low FODMAP meal? Well for starters, choose a carb rich low FODMAP option such as a baked potato, 1/2 sweet potato, quinoa or brown rice, add a protein option such as firm tofu, peanut butter, hard cheese, chicken, fish, lean beef or pork and adding a serving of  low FODMAP veggies, one serving of low FODMAP fruit and of course, a smattering of healthy fats such as chia seeds, pumpkin seeds or a drizzle of olive oil. {Of course, I didn’t list all the many options you can eat on a low FODMAP diet–adjust to your liking!} But, a balanced plate provides a nice variety of nutrients while keeping the belly calm and satisfied.

For easy tips on creating a balanced low FODMAP meal, use one of my favorite handouts!  Click here for PDF.How-to-make-a-low-FODMAP-meal-final-pdf

As with most things in life, it’s all about balance.

 

Pad Thai

Low FODMAP Pad Thai

Since our recent trip to Thailand, I continue to crave all the amazing dishes Russ and I indulged in on our visit. The food, seriously, was so delicious and full of fresh ingredients.

One of my favorite Thai dishes is Pad Thai.Pad ThaiMost of my low FODMAP diet followers seem to do well when ordering Pad Thai while dining out. It is an easy dish to find at your favorite Thai restaurant.  Most recipes for Pad Thai call for red curry paste.  I just happened to have brought some home from our recent trip to Thailand but it is easy to find in the Asian section of the grocers.  BUT: red curry paste often contains garlic and onion! I seem to tolerate the small amount found in the entire Pad Thai recipe, but if your tummy is particularly sensitive, you might try to make some homemade red curry paste to substitute in this recipe.  I found an interesting  Pad Thai recipe here and it included a low FODMAP version of red curry paste.

For my recipe, I julienned a zucchini and a couple carrots, ( did I mention that I love my julienne peeler?), washed about 2 cups of Mung bean sprouts and a small bunch of cilantro. I prepped the veggies earlier in the day so I would feel less rushed putting the recipe together at dinner time.

Julienned  vegetables need very little time to cook (bonus)! They wilt in moments once added to my prepared chicken.saute veggies in pad thaiWhile the chicken, noodles and veggies cooked, I mixed up a nice peanut pad Thai sauce…so tasty. I used my red curry paste from Thailand in my recipe, but again, if your tummy is very sensitive or you have just started the elimination phase of the low FODMAP diet, you should try to make your own red curry paste or perhaps leave it out of the recipe.

Pad Thai low FODMAPThe dish was a big hit. Really…there was not even one noodle left on the plate!

And in the spirit of Thailand, I thought I would share a couple pictures from my trip!

Ancient Buddha in Ko Samui.Ancient buddha

2 week old elephant nursing, Chiang Mai.
2 week old elephant

Low FODMAP Pad Thai

Ingredients

  • Makes 2-3 servings
  • 4 ounces of Pad Thai rice noodles
  • 2 teaspoon toasted sesame oil
  • 2 tablespoons all natural peanut butter
  • 1 tablespoon soy sauce
  • 1 tablespoon red Thai curry paste (often contains some garlic & onion-can sub in homemade find link to recipe in post)
  • 1 teaspoon brown sugar
  • 1 teaspoon rice wine vinegar
  • 8 ounces skinless boneless chicken breast, cut in bite size pieces
  • 2 tablespoons garlic infused oil
  • 1 tablespoon ginger, minced
  • 3 large carrots, julienned
  • 1 medium zucchini, julienned
  • 1 cup mung bean sprouts
  • 1 lime, cut in 1/4s
  • Fresh cilantro or basil, chopped (2 tablespoons or so)
  • 1/4 cup salted peanuts, chopped

Instructions

  1. Cook noodles per package directions, rinse and drain well.
  2. Add 1 teaspoon toasted sesame oil and chicken to large non-stick skillet and cook over medium heat. When chicken is almost cooked through, add garlic oil, ginger, carrots and zucchini until veggies are al dente.
  3. While noodles and chicken are cooking, prepare sauce by combining remaining 1 teaspoon sesame oil, peanut butter, soy sauce, red curry paste, brown sugar and vinegar.
  4. Add cooked and drained noodles to chicken and vegetables. Turn off heat. Drizzle sauce over and gently mix. If sauce seems too thick, add some warm water to the dish.
  5. Transfer mixture to a platter. Garnish with bean sprouts, fresh cilantro or basil and nuts.
  6. Squeeze 2 of the lime quarters over dish and reserve 2 for garnish on platter.
http://blog.katescarlata.com/2015/04/23/low-fodmap-pad-thai/

Five winners have been selected to win the free iTunes promo code to download the Monash University app.  You will receive an email today with instructions! Thanks for all the great food suggestions: Please note that some food items listed in the comment section by blog followers may or may not be suitable for the diet! Always read ingredients!