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Alyssa Luck

Alyssa Luck

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Vegan Diets for Ulcerative Colitis and Crohn’s Disease

Alyssa Luck · Mar 16, 2022 · Leave a Comment

Summary: Vegan diets are one popular intervention for IBD, and for good reason – a well-designed vegan diet may confer beneficial effects on intestinal health via modulation of the microbiome, increased nutrient density, and elimination of food irritants. However, diets completely devoid of animal products are not viable long-term for the vast majority of people, and nutritional deficiencies are a serious risk. All the potential health benefits of a vegan diet can still be leveraged within an omnivorous diet, but for those who are vegan for ethical or sustainability reasons, careful supplementation or strategic inclusion of certain nutrient-dense animal foods (such as bivalves) are potential options for avoiding some of the pitfalls.

This article is part of the IBD Index. Last updated on March 16, 2022.

It is well known that high intakes of meat have been associated with IBD (example source; there are many!). And while yes, these are epidemiological studies and no, correlation does not equal causation, I’d consider it a bit disingenuous to brush off these results as a mere artifact of the “healthy user bias” (as many in the keto, carnivore, and paleo communities are wont to do).

I’ll say right at the outset that, on the basis of anthropological, biological, and other scientific knowledge and data, I don’t believe a strict vegan diet to be viable for the vast majority of humans. That said, many people have anecdotally had astonishing success managing their IBD with a vegan diet, and considering those experiences in light of the epidemiological evidence I mentioned above, I think it would behoove us to pay attention to what this information could teach us about the disease processes involved in IBD, and how to best address them.

[Read more…] about Vegan Diets for Ulcerative Colitis and Crohn’s Disease

Is the Low-FODMAP Diet Effective for IBD?

Alyssa Luck · Mar 14, 2022 · Leave a Comment

Summary: A low-FODMAP diet, which is a common intervention for IBS, is being increasingly studied in IBD patients. Unfortunately, the diet does not currently show efficacy for reducing inflammation, but has been shown in clinical trials to be effective at managing functional gastrointestinal symptoms in patients whose disease is in remission. Although a common concern with low-FODMAP diets is potential adverse effects on the microbiome from removing fermentable substrates, its actual effects on the microbiome in practice have not yet been clearly characterized, with inconsistent results across studies. For those who wish to support their microbiome on a low-FODMAP diet, resistant starch and Sunfiber are good low-FODMAP prebiotic options.

This article is part of the IBD Index. Last updated on April 20, 2022.

The low-FODMAP diet is somewhat unique among IBD interventions because it promises to intervene in the common but oft-overlooked situation of continuing functional gastrointestinal symptoms even in the absence of inflammation.

I cover the basics and practical aspects of a low-FODMAP diet in The Low-FODMAP Diet for IBD: Everything You Need to Know. In this article, I take a deep dive into all the evidence regarding the effectiveness of a low-FODMAP diet for IBD, both from the perspective of reducing inflammation and managing symptoms. I also address the most common concern about a low-FODMAP diet: its effects on the microbiome.

[Read more…] about Is the Low-FODMAP Diet Effective for IBD?

The Low-FODMAP Diet for IBD: Everything You Need to Know

Alyssa Luck · Mar 14, 2022 · Leave a Comment

Summary: The low-FODMAP diet originated in 2005 out of a hypothesis about IBD pathogenesis, but quickly became a go-to treatment for IBS. For IBD, the diet has found its niche as an intervention for addressing lingering functional gastrointestinal symptoms in patients whose IBD is in remission. For this purpose, the diet has demonstrated successful symptom reduction in clinical trials, but no evidence yet indicates that it is helpful for quelling inflammation. The biggest risk associated with a low-FODMAP diet is adverse effects on the microbiome from depriving it of fermentable carbohydrates, but this can be addressed by including low-FODMAP prebiotics (such as Sunfiber and resistant starch) and by reintroducing FODMAP-containing foods as tolerated.

This article is part of the IBD Index. Last updated on April 20, 2022.

This article aims to give a high-level overview of the low-FODMAP diet, as well as practical guidance. For a deeper dive into the science, you can check out my article Is the Low-FODMAP Diet Effective for IBD?.

[Read more…] about The Low-FODMAP Diet for IBD: Everything You Need to Know

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Hi! I’m Alyssa. This website is where I house all of my musings and investigations and pet research projects – topics ranging from autoimmune disease to nutrition to adult palate expansion to psychology and nervous system therapy. I hope you enjoy this awkwardly cropped poor resolution photo of me playing mini golf. If you want to know more about me, click here!

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Photo dump from the last year. Thanks to everyone Photo dump from the last year. Thanks to everyone who made 28 the best yet - excited for 29🥰

(PS. In case anyone wants to know what it’s like in my head, I was going to write something like “year 28” or “my 28th year” but then I realized that the year between your 28th and 29th birthdays is not your 28th year of life, it’s your 29th year. I am turning 29 because I have been alive for 29 years. So then I had a whole thing about how to word it without being inaccurate and ended up going with what you see above which is vague and weird but the point is it was a good year and I love all the people in my life dearly)
Biology of Belief (2005) was written by Bruce Lipt Biology of Belief (2005) was written by Bruce Lipton, who earned a PhD in developmental biology in 1971 and was an anatomy professor and academic researcher in the 70s and 80s. Despite the book's presentation and Lipton's background, this is not a science book. It is an exposition of an ideology, supported by haphazard and poorly contextualized nuggets of evidence, rhetorical leaps, and a mind-boggling overuse of analogies. 

The book largely failed to deliver on its promised content. What it does is argue for the primacy of the environment over DNA in controlling life; propose that the cell membrane rather than the nucleus is the "brain" of the cell; invoke quantum physics to explain why modern medicine fails; explain that our behavior is largely controlled by our subconscious mind; inform parents that they therefore have a great deal of control over the destiny of their children; and conclude that humans must become nonviolent protectors of the environment and of humanity because Everything Is Connected.

It’s not that these points aren’t relevant to the topic at hand - they are. But they were not connected in a coherent way that would explain how “belief” actually works (like…biologically), and the treatment of scientific concepts throughout was careless, or perhaps disingenuous.

I think he's correct about many things, some of them being common knowledge. For instance, the "new" science of epigenetics is now old news, as is the critical role of parenting and early environment in shaping a child’s future. But however important these and attendant concepts may be, the book did not do a good job explaining, supporting, or connecting them. 

As far as practical guidance, he refers the reader to a list of resources on his website, which is fine, but I expected some scientific insight into how/why those modalities work. None was given. 

On the plus side, the book was quite thought-provoking, and I came away with loads of references and topics to follow up on. My favorite line? "There cannot be exceptions to a theory; exceptions simply mean that a theory is not fully correct."
Friedrich Nietzsche, The Gay Science (section 382) Friedrich Nietzsche, The Gay Science (section 382), as quoted in the introduction to Thus Spoke Zarathustra because I like the translation better.
This paper totally changed the way I think about e This paper totally changed the way I think about early nervous system development and the relationship between physiology and sociality. 

The authors propose that newborn babies are not inherently social, and have just one goal in life: physiological homeostasis. I.e. staying alive. This means nutrients, warmth, and regulation of breath and heart rate, i.e. autonomic arousal (it’s well-accepted that newborns sync their breathing and heart rate with caregivers through skin to skin contact). 

All these things are traditionally provided by a loving caregiver. So what the baby experiences during the first weeks of life, over and over, is a shift from physiological perturbation to homeostasis (a highly rewarding event inherently) REPEATEDLY PAIRED with things like the sound of a caregiver’s voice and seeing their face. Thus, over time, the face/voice stimuli become rewarding as well. 

The authors argue that THIS is the beginning of humans’ wiring for sociality, and may explain why loving social interactions can have such a profound regulating effect on physiology throughout life: because the brain was trained for it at an early age. 

This framework holds all kinds of fascinating implications for what happens if that initial “training” isn’t so ideal. What if the return to nutritional homeostasis via feeding is paired with negative expressions and vocalizations rather than loving ones, perhaps as could occur with PPD? What happens if the caregiver has poor autonomic regulation, such that social stimuli become paired with cardiorespiratory overexcitement in the baby? Could that have potential for influencing later introversion vs extroversion? (Because if social interaction is paired with autonomic overexcitement, that could lead to social interaction literally being more energetically draining, which is what introverts experience. Thoughts?)

For my energy metabolism enthusiasts: Table 1 in the paper draws a link between metabolic rate and sociality across species. Swipe for a screenshot. 

Anyway, check out the paper! It’s free, just google “growing a social brain pdf.”
I’ll be under general anesthesia in a couple day I’ll be under general anesthesia in a couple days to have two tooth implants placed, and I think I’ll take the opportunity to have a little heart-to-heart with my subconscious mind. A bit of medically-assisted self-hypnosis, if you will. 

I randomly stumbled upon these papers a couple months ago - an RCT showing reduced post-op pain in patients who listened to recorded positive messages while under general anesthesia, plus a post-hoc analysis of the same data that found reduced post-op nausea and vomiting in a subset of high-risk patients. 

The full review paper from the first slide is unfortunately in German, but it has long been recognized that even when unconscious, the patient is listening (for better or for worse). 

It boggles my mind that it isn’t standard of care to have patients listen to recordings like this while under sedation, considering that almost nothing could be easier, safer, or cheaper, and we have at least some evidence of significant efficacy. I mean c’mon, what more could you want from an intervention? 

(Yeah, I know. Profit. If anyone still thinks that our medical system operates with patient well-being as the foremost goal, you’re deluding yourself.)

“There should be a fundamental change in the way patients are treated in the operating room and intensive care unit, and background noise and careless conversations should be eliminated.”

“Perhaps it is now time to finally heed this call and to use communication with unconscious patients that goes beyond the most necessary announcement of interventions and is therapeutically effective through positive suggestions. When in doubt, assume that the patient is listening.”
If you've seen "vagus nerve exercises" that have y If you've seen "vagus nerve exercises" that have you moving your eyes or tilting your head, you've probably encountered the work of Stanley Rosenberg. The exercises he created and introduced in his 2017 book now appear in instructional videos all over the internet. 
 
The book itself has much to recommend it: it's accessible, it's practical, it's inspiring. But it has one major flaw: the solid practical and informational content regarding the cranial nerves is framed in terms of the scientifically dubious polyvagal theory. 
 
I particularly enjoyed the book as an introduction to the therapeutic arena of bodywork, of which Rosenberg is a skilled practitioner. His book is full of case reports that demonstrate how immensely powerful extremely subtle movements and physical manipulations can be. These do need to be kept in perspective: it's a small sample size of the most remarkable cases, and the results were achieved within the supportive clinical environment of a skilled practitioner. You can tell from his descriptions how refined his technique is. But nevertheless, it was a paradigm-shifting read for me, and the exercises give you something concrete to play around with. 
 
The book also brought the cranial nerves and the concept of “social engagement” to the fore as arbiters of health. Rosenberg has a solid background in cranial nerve anatomy and shares many interesting tidbits and considerations that you don’t typically hear; for instance, the potential impact of dental and orthodontic work on cranial nerve function.
 
So, is it worth reading? If any of the above piques your interest, go for it! Just read my post on polyvagal theory first – you can use the book to practice separating the wheat (solid informational content) from the chaff (pseudoscientific framing). If nothing else, the book is a nice reminder that genuine healers who get lasting results for their patients do exist.

But if you just want to try the exercises, you can easily find them all on YouTube. 

“You learn techniques to understand principles. When you understand the principles, you will create your own techniques.” -Stanley Rosenberg
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