fbpx
Open

MAIL US TODAY

info@thebalancednutritionist.com.au

Contact Us:

Email: info@thebalancednutritionist.com.au
Phone: 0422 888 114

Category Archives: GENERAL HEALTH

BRISBANE NUTRITIONIST KATIE KING   →  GENERAL HEALTH
Categories GENERAL HEALTH

PROBIOTICS – WHAT YOU NEED TO KNOW

Author Arlie Miguel Posted on Leave a comment

Thanks to the emerging interest in all things ‘gut health’ related I am seeing many clients coming into the clinic who are already taking a probiotic.

9 times out of 10, after taking a case history, I arrive at the inevitable point that the probiotic they are taking isn’t going to work out for them and it’s probably doing very little to help their specific condition. So, to help your hip pocket, here are some basic things to consider if you simply want to purchase a probiotic for ‘general gut health’ so you spend your $ on something useful.

  1. Is there anything wrong with your gut? Are you uncomfortable after eating, feeling bloated or over full, experiencing pain or reflux or have constipation or diarrhea? If yes to any of these then consider a consult because 1 probiotic isn’t going to fix it. You need to look at food, lifestyle and potentially other supplements instead of an immediate probiotic.
  2. Probiotics are ‘strain specific.’ The strains should be listed on the bottle. This will generally mean that each ingredient has 3 parts. E.g. Bifidobacterium lactis Bi-07. If it doesn’t list all 3 names then you don’t really know what you are taking. So you can’t really be sure what the probiotic is for. Because each of these strains may benefit different systems. E.g. some strains may assist with immune health, others help in diarrhea management, others assist with constipation, some have research to support their use in allergies. You see what I mean? Do you go car shopping and buy a car? Or do you go and but a Ford Mustang 2017? (nice car by the way).
  3. If you know the strain and you are hungry for knowledge, you can look it up yourself. Type the strain into google. What comes up? I mean, scientifically validated research etc. Is there science to back up its use?
  4. Fridge stable… are you sure? Did you read the label? Does it say ‘fridge stable’ to 25 degrees? Remember we live in QLD… some of these fridge stables are likely fine off the shelf in Tasmania but not in Brisvegas. No point taking ‘dead’ bacteria.
  5. CFU: colony forming units. These bacteria are little. Teeeny tiny. And they are measured in ‘colony forming units.’ Get something a bit gutsy. Some of the brands available have 1 to 2 million CFU per capsule and that’s not going to really do too much. Therapeutically, very generally speaking, a good probiotic will offer 10 times this amount minimum. (N.B. with the exception of sacchroymysis boulardi strain, measured differently, more a yeast than a bacteria).
  6. Is there someone in the shop you can talk to? A nutritionist or a naturopath on the floor? A lot of pharmacists and health food shops will have someone professional on the floor. And hopefully I am hoping your eyes to the fact that ‘taking a probiotic’ doesn’t fully answer the question ‘what are you taking.’
  7. Have you thought about feeding your own friendlies? Maybe that’s a good place to start? You can encourage the health of your own gut bacteria by eating fibre rich foods and resistant starches… probiotics are transient.
  8. Are you buying online? Is the product TGA regulated? Reread my post on supplements, I personally don’t stock anything anymore that is not TGA listed. Or promote anything for that matter.
  9. More is not necessarily better. I..e if there are heaps of bacteria in it, doesn’t mean necessarily its better than just 2 or 3 strains. Refer to point 2 and 5. Also if it is just for ‘general health’ consider that strains in the ‘bifido’ and ‘lacto’ families are the main ones in our gut.

I hope that helped. And not confused you. I simply see many people spending hundreds of dollars on well marketed natural supplements including probiotics and then deciding it doesn’t work. It does. It’s just that there’s a bit more too it then just picking something off the shelf like dress shopping and trying it on for size. Furthermore, supplements are supplements… they don’t work unless you do. I.e. they supplement a good, basic, whole foods diet. And make up for the extra demands we are putting on our bodies in this day and age.

Categories GENERAL HEALTH

Cutting The Crap

Author Arlie Miguel Posted on Leave a comment

In the past few months I’ve made a couple of observations. Firstly, health and wellness has been identified as a ‘trending’ industry. One that big food, big pharma and network marketing giants are closing in on with dollar signs for eyeballs. Heck, as I write this, I’m about to board a flight from Melbourne and you know what hit me as I turned out of airport security into the airport lounge area? A massive neon sign that read ‘health and wellness’ above a bunch of poor quality vitamins, wedged between the confectionery and alcohol stands.

Second, I’ve noted that health and wellness is now ‘trendy.’ If you’re not hash-tagging #foodasmedicine #cleaneating or #greenjuice you’re just not cool. Gosh I’m clearly a complete dag.

This has all been challenging for me and one of the reasons I’ve been so quiet on social media. So I thought I’d cut through the crap and tell it as I see it. Let’s be honest, that’s my style.

In a nutshell, health and wellness is not a trend, it’s a lifestyle that we should all embrace. On the surface it may seem that we are. But underneath, are we reversing obesity and chronic disease? Sadly, no. In fact, our current approach is only creating a whole new problem at the opposite end of the scale which we’ve now found a name for; orthorexia. Us humans. We can never find a happy medium can we?

So, seeing as there’s so much confusion out there right now, let me cut through the crap and tell you what health and wellness really is, minus the drive to make big bucks from the latest fad.

  1. First and foremost, a good, wholefoods, nutrient dense diet is the foundation for a life that promotes a state of health and fights disease. This is the basis of being healthy and well.
  2. The fork in the road between wellness and sickness begins pre-birth, in utero. So babies and children are not exempt from eating a good, wholefoods, nutrient dense diet. Parents please take note of this and collectively, as adults we need to push back against the marketing that Big Food is pushing on our little ones.
  3. Following a good, wholefoods, nutrient dense diet doesn’t have to mean excluding any major food groups. Bread can be a part of a good, wholefoods, nutrient dense diet. Fruit is not the devil. Bananas aren’t the reason you’ve got belly fat. Most people don’t have to cut out coffee. Wine is generally ok in moderation and balanced with an appropriate number of alcohol free days every week. Legumes for many people are an inexpensive, fibre rich protein and complex carbohydrate source – not a gut abrasive nightmare.  Drumroll please….. the entire human population doesn’t have to be gluten free, dairy free, grain free, flavour free or fun free. Eating well doesn’t have to cost the Earth. It doesn’t mean you have to join a club or follow a rule book. If you do want to join a club fine, but not all of your friends have to if they don’t want to.
  4. Following a good, wholefoods, nutrient dense diet means listening to your own body. Finding what works for you. Cutting out the noise from social media, forgetting about the ingredients in the shake that fitness model drinks everyday and ditching this week’s Woman’s Day solution to cellulite free legs. Guess what? Food, like life, can be enjoyable. ‘Normal’ food can be healthy. You don’t have to survive on a diet of kale and sauerkraut to be healthy.
  5. Stress around food is currently a MAJOR issue. I am literally seeing clients who have panic attacks about what they can and can’t eat. This is not cool. Stress will interfere with your sleep, it will drive you insane, it will ruin your quality of life, it will drive both weight gain and weight loss, it may cause you to bloat, get reflux, have constipation or diarrhoea. If stress around food is currently an issue for you, please re-read point number 4. Then if that does not help please use the contact form or call me on 07 3398 1977 to book in for a consultation.
  6. Actual food is the basis to health and wellness. Processed food is not food. It’s a ‘food like substance.’ It does not give us nutrients. It is not processed by the body. It does not promote wellness. I don’t care if a processed, chemical filled bar says high protein, low carb, gluten free, natural, low calorie, muscle food or any other magic – it’s all shit. And you should try to skip it the majority of the time. Guess what? It takes 0 food prep to reach for an apple, a handful of nuts or a few slices of real cheese. And to be honest, eating real food is pretty much as challenging as it will get for most of us!

BUT… occasionally, convenience food is going to be the only option. Sometimes, we all eat some chips. Or a bowl of ice cream. Or a handful of lollies. Sometimes you will eat the before mentioned shit food. Like I did, this very weekend. And that is okay. As long as it is occasional. You don’t need to punish yourself for the next month. You just need to make sure that most of what you eat, the majority of the time, is actual food.

  1. Stress, in general, is currently a MAJOR issue. ‘Stress’ basically means several hormones in your body are going stir crazy. What happens when one domino falls? Lots of them fall. So yes, expect that if stress is a big issue for you other crazy things might happen. (N.B. many people don’t even know they’re really stressed because it’s ‘normal’). Some symptoms include… your immune system falling apart. Your hair starting to thin. Your thyroid going nuts. Or you going nuts. This is why we have to think about health holistically. Eating well is just the beginning. Lifestyle is just as important. Because health and wellness is not just about the physical. It’s mental, emotional and spiritual as well.
  2. Suddenly adding turmeric to your food won’t cure your arthritis. Seriously, if you want to harness #foodasmedicine for real you need to consider therapeutic concentrations. And you need to acknowledge that going the natural way takes time. And you also need to know that even though tumeric is the flavour of the month (right now) there are heaps of other magic nutrients and herbs that do some pretty explosive stuff. But none of it is any good unless you build the foundations of a good, wholefoods, nutrient dense diet as discussed in the previous 7 points. And if you aren’t going to start with that foundation, don’t pick a random supplement off the chemist shelf and expect it will fix everything. And on that note, some random probiotic isn’t going to fix chronic IBS in a week.
  3. If you’re currently in a ‘disease state’ there is no magical diet that will take 0 food preparation, taste amazing and suddenly see you disease free and jumping out of bed next week. Getting healthy and well takes time, consistency and patience. And after that you have to commit to it. Forever. This is a fact that’s hard to swallow in our current society which revolves around instant gratification.
  4. Don’t bother with any magic pills unless you build the foundations of a good, wholefoods, nutrient dense diet first. And even then, understand what you’re taking, why you’re taking it and ask for the research to back it. See my post on supplementsfor more information around this.
  5. No matter how healthy you think you are becoming, don’t give up your meds until your Doctor says you can.
  6. You can’t hate your body and expect to be healthy and well physically, mentally, emotionally and spiritually. So work on that relationship. Honour yourself, be grateful for what your body can do day in and day out and love it no matter what. Stop comparing yourself to the shit you see on your computer. Most of it’s fake, air brushed or took an hour to set up.

Let’s keep it real people. Because health and wellness is not a joke. It’s lifesaving.

If I offended anyone I’m sorry. Just calling it as it is.  And living up the the true definition of ‘cutting the crap.’ And even if no one reads this, it was therapeutic for me just to write it :).

Categories GENERAL HEALTH

Supplements

Author Arlie Miguel Posted on Leave a comment

Following are some important points about supplementation with vitamins, minerals and herbs.
Firstly, a large part of my degree was focused around the prescription of specific and therapeutically dosed supplements for relevant conditions and situations. I do feel strongly that the prescription of high quality and appropriately dosed nutritional medicine supplements can bring someone’s health to a whole new level and furthermore, that this is important in chronic or acute situations.  Hence I do have a relatively large dispensary in my clinic.
I feel that those who really understand nutritional biochemistry –
that we really are the sum of the nutrients we take in – may have some understanding of how powerful the right supplement prescriptions can be.

However, there are some key considerations to keep in mind…

Quality: consider the quality of your supplementation. Look for fillers, if the supplement is vegan or vegetarian friendly it is likely to have less ‘crap’ in it. Some cheap supplements have been featured in the media as they may be up to 50% filers. On this note, I generally do not recommend purchasing supplements in supermarkets…. for the most part. Supplementation given on script from a chemist, nutritionist, naturopath or some other health professional will generally be of the highest quality and only available with a valid prescription.

Dosage: do you understand how much you are taking? Do you know what the therapeutic dosage is? Are you taking enough to have benefits? Or are you taking too much? This can be a complex question and its best to consult a practitioner if you truly aren’t confident with this.

Form: many supplements are available in different ‘forms.’ Oxides, citrates, picolinates, chelates, activated, methylated etc. All of these will absorb at different rates, having different bio availability in the body. In general, cheaper supplements often contain forms that the body can not absorb, meaning they are merely expensive urine.

Prescription drugs: Are you also taking pharmaceutical medication? Then don’t supplement unless you know its safe alongside the drugs you are taking! Speak to your GP. Some supplements can be easily purchased such as St John’s Wort and yet they interact and contraindicate with a whole heap of drugs….

Day to day nutrition and lifestyle: are you also paying attention to the food you are putting into your mouth, moving your body and engaging in appropriate self care to minimize stress as much as possible? These are the foundations of health. Don’t throw a pile of pills on top of a lifestyle that consists of take-away foods and sedentary living. And eating well does not mean you necessarily have to cook everything yourself; good nutrition is accessible to incredibly time poor people too. It’s your choice.

Many new clients that I see are taking between 5-15 supplements at a time that they are ‘self prescribing’ and purchasing at random from health food shops and supermarkets. As we work through this list I ask the inevitable questions including ‘why exactly are you taking this?’ and ‘do you know if you are getting any therapeutic benefit from this’ and ‘how long are you planning on taking this for?’ Generally, the client responds with ‘well I just heard that this was good for you so I started taking it.’

I think supplementation is an incredibly important consideration for many people, including:
-Athletes: due to the rapid turnover of B vitamins, zinc, magnesium in particular as they churn over energy cycles at a much higher rate than those that aren’t athletic
-Those experiencing mental health complications (under guidance so as not to interfere with any medication)
-Those with gut issues (for repairing the gut lining and encouraging healthy gut flora restoration)
-For those in high demand ‘jobs’ which might include being the sole carer to young children or paid work that demands many hours and brain power (to assist with stress management and compensate for an increased need for nutrition)
-Pregnant and lactating women and both women and men preconception
-Those recovering from weight loss surgery

There are other situations too. But these are just some examples.

Bottom line. Have a plan. Have an understanding. Be safe.

Categories GENERAL HEALTH

I Can’t Believe It’s Not Bread!

Author Arlie Miguel Posted on Leave a comment

That’s right. It’s not bread.  I’m talking about those loaves you buy in the supermarket for $2 a pop. I hate to be the messenger of bad news. You see, each week when I sit in front of new clients, I get the same feedback – ‘bread seems to make me bloated and give me wind.’ Sure, some of these clients have genuine issues with gluten and wheat, but many…. could simply benefit from addressing quality rather than giving it away entirely. 

You see, I really do think, when it comes to bread, that ‘quality and cost’ are correlated.  Let’s just compare the ingredients in a cheap loaf courtesy of **** supermarket (left) against the stuff in an organic rye loaf I pulled out of my freezer (right):

$2 LOAF ORGANIC RYE
Wheat flour, water, Hi-maize®, oat fibre, yeast, vinegar, canola oil, iodised salt, wheat gluten, acacia gum, cultured wheat flour, soy flour, vegetable emulsifiers (471, 481, 472e), fortified vitamins Organic rye flour and certified organic sourdough, kibbled rye, kibbled corn, linseed, lentils, sesame seed, sunflower seed, poppy seed, filtered water, olive oil, sea salt.

(Note: I originally photographed the panels but it was too difficult to read them).

Without even getting technical, note that the ingredients on the right are all recognizable. I mean, its actual food. Basically a collection of seeds, different types of traditional flours, quality oils (olive) and some sea salt.

There are a couple of questionable ingredients on the left when compared to the rye loaf. Soy for example is a common allergen for people and can present a problem in itself. But it’s cheap so its added. Plus, what is the registered ingredient hi-maize? The manufacturing and ingredients in that compound are not disclosed…. somewhat convenient. Numbers and letters can also be an issue for some people particularly kids – some additives and preservatives have been linked to serious behavioral and social issues. I mean, the way I see it, this ‘bread’ isn’t really ‘bread….’

 

Let’s go beyond the ingredients themselves and consider the manufacturing process. To assist me with my research, I interviewed the local baker Brad at ‘Stone Artisan Bakers’ Stones Corner. These guys churn out quality bread products, made the traditional way, specialising in sourdough loaves.

Brad said that it takes 48 hours to rise each loaf of bread they produce allowing a natural fermentation process to take place. Only natural leavens (yeasts) are used and no chemicals are added at any stage. See exhibit A above – chemicals, emulsifiers, cheap fats and commercial yeasts are added. You simply can’t dispute this, you can see them on the ingredient list!

Allegations against major supermarkets in recent years indicate that their bread may not even be baked on the premises. The process may begin overseas, following by freezing partially cooked loaves and then selling them as ‘fresh’ products in store. For more information, check out this investigative news article here.

The lengthy fermentation process of properly made bread ensures the product is full of good cultures and bacteria. These assist with blood sugar stabilisation unlike ‘cheap bread’ which is usually high GI and low in fibre, wreaking havoc with blood sugar levels and leaving you hungry again within a couple of hours.

Whilst Brad’s bakery doesn’t produce any true gluten free products as yet, many with a sensitive stomach will handle artisan bread due to the superior quality and treatment of the ingredients. Spelt flour in particular can be a good option for some to try who may be left bloated, gassy and generally unhappy after consuming other types of bread.

Now let’s look at cost. I realise there is appeal in a $2 loaf for a large family feeding many mouths. Yes, a quality bread product will cost between $5 and $9 loaf. But we should also consider what we are actually paying for. If food is nutrients then the value of a $2 loaf is dismal to put it politely. Quality nutrients are not found in chemicals. Perhaps also, we need to consider the use of bread in the diet. It must always be accompanied by some quality protein, vegetables or salad and healthy fats to constitute a proper, nutritious meal. Even a sandwich can tick these boxes – throw some chicken breast, a whole heap of colourful salad some avocado between 2 slices and you have a nutritious meal. Or, throw a piece of quality sourdough on a plate with a couple of eggs, some mushroom and spinach cooked off in olive oil and you’ve got a rocking breakfast. Using ‘cheap bread’ as a ‘filler’ or ‘focus’ for 2 or 3 meals per day is going to lead to long term nutrient deficiencies, simple carbohydrate overload and probably a fair bit of gas and bloating to go with it. Yes, I am prepared to pay $6 or $7 for a good loaf because when prepared in this way and rotated with lots of other nutritious meals and grain sources, it lasts us (2 people) up to 2 weeks in the freezer.  If a family is rotating through many loaves a week then maybe it’s time to bring in some different flavours, textures and meal options? With young kids, the younger you can introduce variety to the diet, the easier it will be in the long run… food for thought.

So, long story short. If you are suffering the bloats and the pffts (out the rear end) and you suspect bread is a culprit then consider selecting an option made traditionally and check the ingredients are actually recognizable. If it’s featuring in the diet several times per day, then it’s time to increase your repertoire of healthy meal options. Try different grain options too – spelt, rye, millet and even quinoa bread is now a ‘thing.’ Many bakeries, markets and delis will have these options available. If it still doesn’t sit right then maybe opt for a traditionally made gluten free option. And remember, consider value for money and not just the cost.

Need help? Overwhelmed by this information? Already tried this and still looking 6 months pregnant by noon each day? Book your consultation here or give me a call 07 3398 1977.

Many thanks to Brad at ‘Stone Artisan Breads’ for his assistance with this article. Get on down and get some sourdough on your plate. 500 Logan Road, Stones Corner 6am-6pm and 271 Grey Street, South Bank 7am – 7pm. Read about them here and plan your next brunch catch up at Brad’s bakery.

Categories GENERAL HEALTH

Reflux – In Defense Of Stomach Acid

Author Arlie Miguel Posted on Leave a comment

Reflux and Stomach Acid: what you need to know

Let’s talk about reflux or more specifically Gastro Oesophageal reflux disorder (GORD) as I am seeing it increasingly in clinic. If you ever taste acid in your mouth after you eat or you experience burning in the chest portion of your digestive tract this is what I am referring to as reflux. It is a serious condition. Not only does it disrupt quality of life, it can cause  irreversible damage to the lining of the oesophegas. Basically, it can ‘burn’ the digestive tract and lead to ulcers and structural changes in the mucous lining. This is not intended to frighten, it’s merely an invitation to be proactive about treatment. Because I know a lot of people put it down to just a normal part of life. But if things are working well, we shouldn’t be dealing with heartburn after every meal. 

To clarify we have acid that gets produced in our stomachs and allows us to digest all nutrients. Yes the stomach is naturally an acidic environment. Most of the clients I see, seem to have this idea that reflux occurs as a result of excess stomach acid production. Not entirely accurate; GORD is stomach acid in the wrong place i.e. instead of remaining in your tummy its back flowing into your digestive tract. It might be due to over eating, eating foods that don’t agree with you, eating too quickly or lack of tone in the lower sphincter. The sphincter that acts as a barrier between your digestive tract and the entrance to your stomach that is.

Typically, sufferers are recommended proton pump inhibitor therapy (PPI). Think Nexium. These drugs act to block the pathways that stimulate gastric acid secretion (Ament, et. al. 2012) and they are one of the highest selling drugs in Australia and the US so clearly a lot of people are dealing with this issue. While they offer a great deal of relief to sufferers its still important to work out what’s driving the reflux in the first place. Why? Well, stomach acid is kind of important…. consider the following key points:

  • Research indicates that stomach acid did in fact evolve to serve as a pathological filter; the pH environment kills microbes (Beasley, et. al. 2015). I.e. stomach acid protects us from bad bugs! This consequence is of most concern in elderly adults already at higher risk of infection.
  • It may be more difficult for beneficial microbes to recolonize the gut in a less acidic environment (Beasley, et. al. 2015). Gut health is all the rage right now, hey? And for good reason. Your entire immune system and many of your neurotransmitters are produced there…. so we kind of want to preserve gut health and retain the goodies!
  • Prospective trials have shown an increased risk between vitamin B12 deficiency and suboptimal stomach acid. I can attest to this…. most of the clients I see in clinic who have been using PPIs for a long time have shockingly low vitamin B12 levels. B12 plays a critical role in so many functions including mental health, healthy red blood cell production, energy production, cellular renewal and protection against various cancers thus the long term effects of suboptimal B12 may lead to other issues. (N.B. For the biochemistry on this, for those interested consider that pepsin – an enzyme in the belly – is responsible for cleaving B12 from proteins and binding it with R proteins (Heidelbaugh, 2013). I.e. pepsin is needed to make B12 available to the body. And pepsin needs gastric acid to do its job. See the connection?)
  • Clinical evidence shows that PPI use reduces the availability of vitamin C in gastric juice and reduces the amount of the active vitamin C available in antioxidant form. Again, vitamin C deficiency has significant consequences to a host of systems in the body (Heidelbaugh, 2013) as its super important.
  • Calcium absorption, serum iron levels and magnesium may also be compromised when stomach acid is suboptimal (Heidelbaugh, 2013). Trials seem to suggest that less stomach acid means higher incidence of bone fractures.

This is not an invitation to stop taking a PPI, because you should only do that with your GP’s consent. But it is my little defense case on the importance of stomach acid because as a nutritionist, it kind of all starts there in the gut. And if you don’t have the juice mixed up with your food then you won’t breakdown the nutrients. So… you really aren’t capable of getting much nutritional benefit from your food whatsoever. And given that every hormone, neurotransmitter, enzyme and cell is physically made via the food we eat (this is true on a biochemical level!) then accessing the nutrients your food offers is pretty darn important. Ummm its kind of the key to overall health and keeping everything working in the body. Remember, it all starts with food.

A nutritionist can assist you with doing some preliminary work to ensure that one day you are able to kick the reflux and the drugs as well. Many people that suffer refux have a highly inflammed gastrointestinal tract and may even have ulcers and intestinal permeability which needs to be healed as a priority. Concentrated forms of nutrients including vitamin A, D, slippery elm, the herb liquorice, tumeric and aloe vera are backed by research to support gastrointestinal healing. Don’t do this yourself. Work with a professional. Adding an extra teaspoon of tumeric to your curry won’t do it; you need high quality, high concentration extracted form of the right nutrients in supplement form and these come prescribed by a practitioner. They don’t come from your local supermarket.

There is some neat new research indicating that reflux may be more of an immune mediated reaction then a mechanical one. You can read about that in this article on Medscape here if you are interested. This does not discount the rest of this article, it simply means that down regulating inflammation is important for healing too.

If you are burping up acid and feeling pretty rotten in general then its time to get some help. Drop me an email here or call the clinic on 07 3398 1977 to book.

Note: it is not only PPI’s that change the pH of the stomach. Bariatric surgery involves partial removal of the stomach which may increase the stomach pH to between 5.7 and 6.8. Thus weight loss clients must be supported long term in order to ensure the small amounts of food that they are eating are optimally absorbed. Furthermore, they are at higher risk of microbial overgrowth particularly in the small intestine – SIBO (Beasley, et. al. 2015)

REFERENCES

Cho, C. & Yu, J. (2012). From Inflammation to Cancer. World Scientific, London.

Heidelbaugh, J. (2013). ‘Proton pump inhibitors and risk of vitamin and mineral deficiency: evidence and clinical implications.’ Therapeutic Advances in Drug Safety 4(3). Doi: 10.1177/2042098613482484

Agostan, T,. Dunbar, K., Odze, R. (2016). ‘Association of Acute Gastroesophageal Reflux Disease With Esophageal Histologic Changes’ Journal of American Medicine 315(19).Doi:10.1001/jama.2016.5657

Ament, P. Dicola, D., James, M. (2012). ‘Reducing Adverse Effects of Proton Pump Inhibitors.’ American Family Physician.  86(1). Available from  http://www.aafp.org/afp/2012/0701/p66.html  

1 2 3 4
Copyright © 2018 - 2019 The Balanced Nutritionist. All rights reserved.