Gastroenterologists debunk 12 myths about indigestion and gut health

Following is a transcript of the video.

Austin Chiang: “Your stomach shrinks if you eat less.” Is that true?

Fola May: Myth!

May: “Jumping or exercising after eating will give you an appendicitis.”

Chiang: What? I have never heard of this. I’m tossing that one out.

Chiang: Ooh. So, “You need to wait 30 minutes to swim after eating.”

May: I caught myself almost saying it to my own children the other day, and then broke out into laughter, because it’s an absolute myth.

Chiang: Hi, I’m Austin Chiang. I’m an assistant professor of medicine at Jefferson Health in Philadelphia, and I’ve been practicing as a gastroenterologist since 2017.

May: My name is Fola May. I’m an assistant professor of medicine at UCLA Health. I’m a general gastroenterologist and have been practicing gastroenterology for the last six years. I love this field because it allows us to optimize people’s digestive health, and we get to prevent important cancers like colorectal cancer.

Chiang: And today we’ll be debunking myths about indigestion.

Chiang: “It takes years to digest gum.”

May: This is an absolute myth. And I remember this as a child, hearing that it takes seven years to digest your gum. The reality is that everything you eat, going in one end, is going to come out the other. The slight truth of the myth is that gum is insoluble. So we don’t have the enzymes to break down gum like we do other foods. But it doesn’t stay in your stomach for seven years. Just like everything else you eat, it gets emptied from the stomach usually within 30 and 90 minutes, and it comes out in your stool.

Chiang: “Smelly farts always means something is wrong.” I don’t know, Fola. Is there such a thing as a good-smelling fart?

May: I get this one a lot from my patients. So, everyone thinks that if your farts smell really bad, then there must be something wrong with the digestive tract. And it’s not true! Some of the most healthy foods that we eat, like fiber, broccoli, asparagus, cause the smelliest farts. I will say, though, that it is important to pay attention to whether there are other symptoms, particularly people who have lactose intolerance, which means that they don’t have the enzymes to digest milk products. And if you’ve noticed smelly farts over and over again after eating milk products or after having products like gluten frequently, then it’s probably worth looking into whether you have a food intolerance or a food allergy. The other symptoms to keep an eye out for are severe abdominal pain with your smelly farts, loose stools or diarrhea, fevers. This can indicate an abdominal infection.

Chiang: “You should be pooping every day.”

May: So, this is another unfortunate misconception that human beings have. It can be normal to have a bowel movement up to three times a day, and there are actually people who are normal who have bowel movements every three days, and anywhere in there in between can be normal. What I typically will tell my patients is that the most concerning thing is if you are having infrequent stools that are causing constipation-like symptoms. Straining a lot when they’re on the toilet bowl, have developed blood in their stools when they have a bowel movement. And that’s generally when we would prescribe a medication to help you have more frequent, yet gentle bowel movements.

Chiang: The reason why it’s important to sometimes get this checked out by a professional is because there are a lot of different causes for infrequent stools and constipations.

May: And then there’s the other end of the spectrum. Some people have what we call inflammatory bowel diseases. These are conditions that cause frequent stools but also blood in the stools, severe abdominal pain, and bloating, weight loss, fatigue, other manifestations throughout the body. And that’s concerning. So I usually like to tell people that it’s not the number of the bowel movements you’re having, it’s whether or not there are any of these concerning symptoms.

May: Myth or fact? “Only spicy foods cause ulcers.”

Chiang: If this were true, I’d be very sad, because I love spicy food and I eat spicy food all the time. Spicy food does not cause ulcers, but that doesn’t mean that spicy food doesn’t cause pain. What does cause ulcers can be a bacteria called H. pylori that can live under the surface of the lining of the stomach. And this can cause ulcers, as well as certain medications, like NSAIDs, which are basically those over-the-counter pain medications like Motrin, Advil. We want to be careful when we’re taking medications like that.

Stress typically does not cause ulcers, although it may make existing ulcers worse. There are certain conditions that are called stress ulcers, but this really applies to people who are very, very sick, like, hospitalized sick, and not the typical type of stress that we think of when we’re stressed out.

May: I think that is a common myth though, Austin, right? I mean, you hear people say all the time, “I’m so stressed I’m going to get an ulcer.” When I was younger, I would just listen to that statement. And now I kind of want to interrupt and say, “No, actually, that’s not how it works.”

Chiang: Exactly. But it doesn’t mean that stress doesn’t trigger, like, belly pain, because, you know, stress can certainly exacerbate and worsen those types of symptoms.

May: Absolutely. Absolutely.

Chiang: But yeah, in and of itself, it’s not going to cause an ulcer to just form out of nowhere.

May: Thank goodness, right?

Chiang: Yeah. We’d be seeing a lot more ulcers then.

Chiang: “Your stomach shrinks if you eat less.” Is that true?

May: Myth! This is part of what people think they can do to control their weight. There’s this misconception that if you eat less, your stomach will become smaller and then you won’t need as much food to survive and live your daily life. Unfortunately, it is very false. The size of the adult stomach stays approximately that size your entire life. The stomach is actually a pretty flexible organ, so it does expand when we eat big meals, but then it goes right back to its normal size when the stomach empties itself about 30, 90, 120 minutes later.

Chiang: Naturally, our stomachs won’t shrink, but there are procedures out there where we can actually reduce the volume of the stomach and then help patients lose weight that way. But that requires a procedure.

May: A good analogy is probably a rubber band, right? So a rubber band has a defined size and you can stretch it out if you have a big meal, but it will always go back to that size. And it’s not until you’re really pushing the limits over and over again that it starts to develop those little breaks, get a little bit wobbly and larger, but generally it has its innate size.

May: “Jumping or exercising after eating will give you appendicitis.”

Chiang: What? I have never heard of this. I’m tossing that one out. I have my handy-dandy plushy here. The appendix is this pocket that comes off of the beginning of the colon. Sometimes it can get inflamed or blocked off, and that’s called appendicitis. But exercising or jumping around after eating, no. We would be seeing people dropping like flies at the gym if that were the case.

May: First of all, that thing is really cute. And second of all, I agree completely. Can you imagine all the athletes that would be developing appendicitis?

Chiang: Most of the time it just comes about. There’s nothing that sort of leads up to it, it just suddenly happens.

May: And, luckily, appendicitis is something that’s very treatable.

Chiang: Ooh. So, “You need to wait 30 minutes to swim after eating.”

May: So, this is the hogwash that every parent has told every child. The reality is after you have a large meal, your body does shunt blood flow to your stomach and your digestive organs to help you digest this meal. And I think what’s happened is that people have then feared that because it’s shunting blood away from your arms and your legs and the large muscles that you need to swim, that if you immediately jump into a pool you won’t be able to swim or use your arms and legs to save yourself. But the reality is your body has enough blood flow to supply both your stomach and your digestive organs and your legs and arms. There are some people that will experience some abdominal cramping if they swim immediately after eating a big meal. And that’s just because the digestive muscles are already busy at work and you’re stressing them more by putting them under the exertion of being in a swimming pool. But I don’t think we need to worry about drowning risk here.

May: “Probiotics will fix your gut.”

Chiang: We wouldn’t have jobs if probiotics cured everything about the gut. I think what this statement is trying to get at is that there’s a lot about the gut microbiome, the bacteria that live in our gut, that can potentially impact our health. We simply just don’t know enough about it.

May: There is an actual bacterial environment that lives in your gut. Most of them are not bad bacteria. They’re good, healthy bacteria that you need to have normal bowel movements, to avoid pain and other diseases. But every once in a while, that can get imbalanced. So probiotics became really popular with this concept of resetting your microbiome. But the reality is that the science is so new in this area and there’s really very few conditions where we’ve figured out how to use probiotics the right way.

Chiang: And part of the reason behind this is because there’s very little regulation on probiotics by the FDA, for instance, there’s very little consistency in the formulations. We don’t know what dosage actually works for certain conditions as well. So there’s still a lot that we don’t know about probiotics.

May: I do think that for some people it has an impact, but it’s not a cure-all, and it doesn’t work for everyone.

May: Oh, good one. “‘I got food poisoning from the last thing I ate.'” In reality, it takes hours, right, for your stomach and your small bowel to process each meal. So it’s usually the second-to-last thing you ate. And I think there’s a big misconception about this, because patients will come in and swear that it was the breakfast they ate, and I tend to ask them, “Actually, what’d you have dinner the night before?” Or if they’re saying that they developed their symptoms in the evening, it’s, “What did you have at breakfast?” Because that might be the culprit. How bad is that word, by the way? “Food poisoning”?

Chiang: I know! Who came up with that? ‘Cause it’s not the food itself that’s causing the poisoning, right? The definition of food poisoning, first of all, is very broad. It can involve different types of bacteria, the toxins that they create, it can involve viruses. The key things are to rest and to try and stay hydrated. You want to start with one or two bland items and small bites of that to see if you tolerate it, and then in a few hours, maybe a few more bites. The last thing you want to reincorporate to your diet after a bad bout of food poisoning are lactose products, because the lactate enzymes that line your intestines are some of the last enzymes to come back and to repopulate. So you’re really not prepared to digest lactose-containing foods for a while.

Chiang: What? “Women don’t need regular colonoscopies”?

May: Is that what it says? I’m going to rip this one up. This one is absolutely a myth!

This is your colon. Unfortunately, a reasonable percentage of us will grow what we call polyps in your colon. They look like pimples, but the dangerous thing is that a small percentage of them, over years and years and years, can develop into colon or rectal cancer. Because unfortunately there’s been this myth that colorectal cancer only occurs in men. It’s important for women to know that colorectal cancer occurs in women as well. It follows just lung and breast cancer in being the most common cancers for women, and unfortunately it’s the third most common cause of cancer-related deaths in women. So all you women out there, get your colonoscopies. Everyone who is average risk for colorectal cancer, meaning that you don’t have a family history and meaning that you don’t have a predisposing condition for colorectal cancer, should start screening at age 45 or 50.

May: “‘I feel really bloated, so it must be IBS.'” To have a diagnosis of irritable bowel syndrome, or IBS, you actually have to meet defined criteria that have to do with your bowel movements and pain. But bloating itself doesn’t necessarily mean that you have irritable bowel syndrome.

Chiang: Bloating is so common. Having some bloating here or there is totally normal. That’s normal fluctuations depending on what we eat. It’s usually related to what we’re putting into our bodies.

May: Fiber, which we know is very helpful and very healthy, can cause increased bloating.

Chiang: There are other conditions that can also cause bloating, including bacterial overgrowth or certain intolerances like lactose intolerance. And, actually, there’s set criteria in how we define what IBS, or irritable bowel syndrome, is, and bloating isn’t technically part of that definition. It more depends on kind of the appearance or the form of the stool, the frequency of the stool, but not necessarily bloating per se.

Chiang: “‘I just know I have a gluten allergy.'” Oh, this is also a very good one, because everybody thinks that they have a gluten allergy, and oftentimes it’s not true. It’s really important to distinguish between celiac disease, which is an autoimmune disease that doesn’t allow you to digest gluten, from non-celiac gluten sensitivity. And those are the two most common things that people are confusing when they talk about gluten allergy.

So let’s talk about celiac disease first. It impacts the lining of your small bowel, and it makes it impossible for you to tolerate or digest gluten. But to have a formal diagnosis with this autoimmune condition, you need to have testing. The other thing we’ve seen recently, though, is that there are many people that don’t have a positive celiac test but still have some symptoms when they have food with gluten. So we don’t want people to be on a celiac diet unless they really have celiac disease. We want people to get the nutrition that their particular body needs to function and process normally. And unfortunately, we have such a problem in this country with inappropriate diets that people are putting themselves at harm.

Chiang: When you’re hearing bold health claims online, double-, triple-check, reach out to your doctors to ask whether or not what you’re reading is true, if there’s any science behind it. Look at the science yourself. Just keep asking questions. And we’re always happy to answer those questions and help out in whichever way we can.

May: The way that I think about it, everyone wants to be able to eat comfortably and to be able to poop. We give people that power to enjoy their food, to feel comfortable without abdominal symptoms, and to go on enjoying their life.

Read the original article on Business Insider

I paid $150 to try the popular weight-loss app backed by investors like Tony Xu and Scooter Braun. It taught me better eating habits, but keeping the weight off was harder than expected.

Health Weight Loss Fork Food
Noom uses science and psychology to promote healthy eating and living.

  • Noom is a weight-loss app that uses a psychology-based approach to change your eating habits.
  • One freelancer tried Noom for over 8 months to shed some pounds and prevent pandemic weight gain.
  • She lost seven pounds and now implements the healthy habits she learned every day.
  • See more stories on Insider’s business page.

Like many people, I’ve been losing and gaining the same 10 pounds every few years.

In my latest attempt to lose weight, I turned to the Noom app. The TV and Facebook ads feature statements like, “Just 10 minutes a day keeps the weight off” and testimonials from people who claim they worked out every day for a year and only lost 10 pounds, but with Noom they lost 30 pounds.

Noom promises to be life-changing, easy to follow, and different from other weight-loss plans. For instance, on Noom, no food is forbidden, and its ads reinforce this concept by showing a woman grabbing a brownie while the scale flips to a lower and lower weight.

Although it seems like Noom is a newcomer to the weight-loss game, the company was founded more than a decade ago, in 2008, by two best friends, Saeju Jeong and Artem Petakov.

Read more: The entrepreneurs making bank through Clubhouse by leveraging their networks and associating their services with the popular app

Last year, the company reported it had over 45 million users. A 2016 study published in Scientific Reports found that about 78% of the 35,921 participants who used Noom lost weight over an 18-month period, and a 2017 study published in the Journal of Health Communications found that Noom appeared to help people lose weight over a six-month period.

In 2019, Noom raised $58 million, with investors including Sequoia Capital, Groupe Arnault’s tech arm AglaĆ© Ventures, Jan Koum, cofounder of WhatsApp, Tony Xu, cofounder of DoorDash, Josh Kushner, cofounder of Oscar Health, Scooter Braun, founder of SB Projects, and Samsung Ventures. It’s now the largest venture-backed digital weight-loss startup, having raised $115 million to date, a company spokesperson told Insider’s Patricia Kelly Yeo in April.

I signed up in October 2019. It cost about $150 to test out for eight months.

noom lisa
My “new normal.”

After completing a short quiz about my weight, height, desired weight-loss goal, and daily eating and exercise habits, I received my “customized” plan with a budget of 1,200 calories a day – a standard recommendation for women trying to shed a few pounds.

Noom broke my 1,200-calorie budget into three categories:

  • Green – essentially vegetables and fruits, to be eaten generously
  • Yellow – multigrain bread, lean proteins, beans, and brown rice, to be eaten in moderation
  • Red – the brownie in the ad, cheeses, pizza, anything fried, all to be eaten sparingly

Essentially, the food budget encourages participants to eat more protein, fruits, and vegetables and fewer fats and processed foods.

Other key daily aspects of Noom included recording your weight, tracking your food intake and exercise, drinking at least nine cups of water, and spending 10 minutes completing interactive readings and quizzes about food and cravings on the app.

One of your first assignments is to declare your “Super Goal” and “Ultimate Why” for losing weight, then envision how your life will be different once you reach your goal.

Super Goal.PNG
My Noom “Super Goal.”

I imagine that this is a powerful exercise for someone who has more than 10 pounds to lose.

In fact, I’ve noticed that the people who have the most weight to lose have the most success with Noom. But it felt strange to me because, while 10 pounds would help me feel more confident, it probably wouldn’t be life-changing for me.

I’m in a Facebook group for Noom users that I joined in January 2020, and the transformational photos people post constantly amaze me. It’s not uncommon to see photos of people who have lost 100 pounds or more. Most people post about their successes and their challenges, particularly when they find the scale is creeping up. But I was more of a lurker than a poster or commenter.

I started Noom before the COVID-19 pandemic, when I thought we’d be going to two weddings and my daughter’s high school graduation in 2020, so losing 10 pounds for these events were my Big Why. Then the pandemic hit and my Big Why became my desire to not gain 20 pounds during lockdown.

Initially, I found the daily readings and quizzes really insightful.

Everything is written in easy-to-digest blurbs and based on science and psychology. There are daily quizzes to help you retain the information and opportunities to read and reflect, and then add your own thoughts and experiences.

For instance, a lesson on stress eating ends with two questions: “What is your stressor?” and “What is your stress response?”

10 mindful eating tips.PNG
10 mindful eating tips.

The app invites you to list all the possible ways in which you can prevent yourself from stress eating. My list of ways to intervene included taking deep breaths, going for a quick walk, drinking a big glass of water, and calling or texting a friend. I can honestly say that none of these methods have worked for me.

There’s also a lot of emphasis on mindful eating, including how to assess how hungry you are before you start eating, ways to slow down your meal, and how to tell when you’re full.

Noom also arms you with ways to handle social situations and family members who expect you to clean your plate.

For instance, the app explains why we tend to eat more when we’re out to dinner with friends and why we might arrive at the restaurant determined to order a salad but then change to a burger when everyone else at the table orders one.

And, if your mother, grandmother, or aunt insists that you eat the special meal they made for your visit, Noom has a great list of responses like “I can’t make it work in my plan,” and “Me and [insert food] aren’t on speaking terms.”

Despite what the ads say, Noom also emphasizes exercise.

Food pusher strategies.PNG
Food pusher strategies.

There’s an initial goal to walk 3,000 steps a day, and after a week you’re encouraged to walk 10,000 steps each day and to add yoga, weights, and other workouts.

Noom pairs every participant with a goal specialist, who checks in with you every week. Each week you set a new goal – such as eating a new vegetable with every meal or exercising four times a week – and then the goal specialist checks to see if you succeeded.

If you didn’t, the specialist asks you open-ended questions that are similar to the reflections in the readings about what you could have done more of or differently.

Those open-ended questions definitely got on my nerves. Like most dieters, I know what I need to do – I just don’t always follow through.

It’s true that no food is off limits. However, losing weight wasn’t as easy as Noom promised.

One of the best lessons I learned is I can eat anything I want in moderation, and just because I gave into my craving for a bag of potato chips at lunch doesn’t mean I should give myself permission to eat an entire pizza and then a pint of ice cream for dinner.

noom lisa
How to assess your hunger.

I was on Noom for eight months and lost seven pounds. About three months after I went off Noom, I gained a few pounds back, so I decided to go back on Noom, hoping to lose six more pounds (the three pounds I’d regained and the three pounds I didn’t lose the first time) but nothing happened the second time I joined – I didn’t gain weight and I didn’t lose any either.

I asked health and fitness coach and weight-loss specialist Candice McDaniel why I was struggling to lose six pounds when I see photos of people who have dropped 100 pounds.

“Losing 10 pounds on a diet plan versus losing 50 to 100 pounds is harder because of how close you already are to a healthy weight,” she said. “When you have 50 to 100 pounds to lose, you don’t need to make very many changes to your diet to start seeing results. Typically at that weight, you can try following a diet plan, and even if you aren’t perfect, you’ll start seeing progress quickly. But people who only have about 10 pounds to lose have to be a lot more vigilant and follow the program very closely to see results.”

While I no longer use Noom, I’ve managed to keep off four of the seven pounds I lost and retained many of the healthy habits I learned.

For instance, I have a fruit or vegetables with every meal, I don’t eat when I’m bored (though I do still eat when I’m stressed), I exercise every day, I write down everything I eat each day, and if I slip up and have a bag of chips or a slice of cake at lunch, I don’t go whole hog in the evening. Now if I could only lose five more pounds …

Read the original article on Business Insider