DR MICHAEL MOSLEY: The simple drug

Release time：2024-05-21 23:32:42 Source：Culture Chronicle news portal

People sometimes stop me in the street to chat about a health problem. And because gut health is my pet topic, the thing they often want to discuss is their bowels — and in particular, irritable bowel syndrome (IBS).

That's not surprising, given that as many as one in three of us suffers from it, according to the charity Gut UK.

IBS symptoms — such as cramps, bloating, pain and diarrhoea or constipation — normally rumble on for a while, but often get worse when patients hit their 30s, though we don't know why.

In fact we don't really know what causes the condition itself, either — and there is no known cure.

But increasingly research suggests simple lifestyle changes could help prevent (and perhaps also minimise) symptoms.

In a study just published in the journal Gut, not smoking, vigorous exercise and getting at least seven hours' sleep at night appeared to have the biggest effect — possibly because smoking raises inflammation, while exercise and sleep help regulate bowel function and support immunity.

Patients who followed dietary plans did much better than those on medication, with 76 per cent of the low-FODMAP group, and 71 per cent of those on the low-carb diet, reporting significantly improved symptoms

Now an even more recent study, reported just last week, has confirmed the benefit of cutting out certain carbs, showing that this can be more effective than medication.

Researchers at the University of Gothenburg randomly allocated patients with moderate to severe IBS symptoms to a low-carb diet; a low-FODMAP diet (where you cut out particular carbohydrates, known as FODMAPs, that our small intestine often struggles to absorb); or medication to treat their particular symptoms, such as constipation or diarrhoea.

The patients who followed either of the dietary plans did much better than those on the medication, with 76 per cent of the low-FODMAP group, and 71 per cent of those on the low-carb diet, reporting significantly improved symptoms, compared to 58 per cent in the medication group.

After six months, while some had returned to their previous eating habits, 68 per cent of the low-FODMAP group were still reporting benefits, compared to 60 per cent on the low-carb diet. 

By this point most of those who'd started on medication were also on one of these diets and were delighted with the results.

So what's going on? One of the more plausible theories about IBS is that it's the result of an overly sensitive large bowel (or colon), or possibly a problem with your immune system, either of which could be the result of having had a previous gut infection.

Once your gut has been sensitised by an infection, there are certain carbs that can trigger an attack of IBS. 

These are the FODMAPs — or fermentable oligosaccharides, disaccharides, monosaccharides and polyols. The trigger foods vary with the individual, but typically include:

• Dairy products, such as milk, cheese, yoghurt and ice cream

• Wheat-based foods, such as bread, cereal, biscuits and pasta

• Beans and lentils

• Vegetables, such as artichokes, asparagus, onions and garlic

• Fruits, such as apples, cherries, pears and peaches

FODMAPs in these foods can be poorly absorbed, so reach the large bowel largely undigested, where they're fermented by gut bacteria which produce gas and cause symptoms such as bloating.

Kombucha — a fermented fizzy drink made from yeast, sugar and black tea — is the health tonic of the moment. 

I've seen claims that it helps digestion, rids your body of toxins and boosts energy levels — though few of these have any serious science behind them. 

But a recent study showed that drinking kombucha can lower fat levels — if you're a worm, at least. The journal PLOS Genetics reports that when researchers fed worms kombucha, it led to changes, including reductions in body fat. 

The low-FODMAP diet was developed at Monash University in Melbourne, Australia, around 15 years ago, and has been shown to improve IBS symptoms and help patients identify their triggers (because it is highly restrictive, it's not meant to be used long term and should be supervised by a medical professional).

The difference it can make became clear to me last year when I made a TV series, Secrets Of Your Big Shop, for Channel 4.

One of the people we filmed was 34-year-old Natalie Sharpe, who suffered from terrible bloating and pain caused by IBS. With the help of a nutritionist we devised a new eating plan for her, cutting out garlic and onions, along with most foods containing wheat or dairy, and swapping to a diet with rainbow veg — e.g. peppers, carrots, courgettes and broccoli — which are fine on a low-FODMAP diet — plus, fish and chicken.

Before Natalie started on her new diet, we tested her poo to see what was happening to her gut microbiome — there were hardly any good bacteria, particularly those that play a role in calming down inflammation in the gut.

After a couple of months of her new diet, Natalie had lost 6kg (just under 1st) and 3in from around her waistline. Her gut microbiome flourished and her symptoms had all improved.

As she said to me at the time, 'I just feel really wow to be honest'.

I spoke to Natalie this week and she told me she's now eating some wheat and dairy, but not as much as before. She's lost more weight and still feels fantastic.

If you have severe IBS then do talk to your doctor before starting a new diet, and you might want to pay to see a dietitian.

There's plenty of information about low-FODMAP or low-carb diets on the internet (though it is meant to be a temporary measure, while you figure out which foods trigger your symptoms). My book, the Clever Guts Diet, is all about this, too. Whatever you decide to do, good luck!

Why music doesn't bring me joy 

Many of my friends love music and can hum the tunes and quote the lyrics from hundreds of songs.

Sadly, although I do quite like music, it has never really touched my soul. And when it comes to the music round in pub quizzes, I'm useless.

My musical anhedonia (the term for not gaining joy from music) could be because as a family, we never really listened to music at home. But there could also be a genetic component, which was the suggestion from a new study of more than 9,000 twins by the Max Planck Institute for Psycholinguistics in the Netherlands.

The study found that genes play a significant role in whether you enjoy music, and that this pleasure doesn't depend on whether you can play an instrument or sing.

Just as well I haven't been invited on to Desert Island Discs yet.

The exercise that's best for workaholics  

We know that one of the best ways to reduce our risk of having a heart attack or stroke is to do plenty of aerobic exercise (walking, swimming, cycling) and strength-building exercises, such as squats. These can help by lowering blood pressure, for instance — but they also have a big impact on stress, which is important.

At university I remember doing a personality test which showed I'm a Type A — this means I'm an impatient, driven, high-achieving workaholic. I was also told that stressed-out Type As have a greater risk of dying from heart disease, so it would be a good idea to slow down and smell the flowers. Now new research suggests it's stressed-out Type As who might benefit most from being more active.

In a study published this month in the Journal of the American College of Cardiology, researchers analysed data from more than 50,000 people over a ten-year period. This showed that people who did at least 150 minutes of moderately vigorous exercise a week had a 23 per cent lower risk of developing heart disease than those who didn't.

But the researchers also found that the people whose brain tests showed they were highly stressed got twice the benefit from doing exercise as their more chilled-out colleagues.

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