GI Virus? What to eat now?

IMG_1196I’ve been fortunate enough to be  in my daughter’s school a lot lately teaching nutrition.  Our lessons have focused on healthy eating, know your food groups, fluid consumption, sugar, eating local and how to try new foods (just to name a few topics).  While I’ve been at her school, I’ve noticed lots of kids are going home with a stomach bug.  I hate stomach bugs (both as a mom and as patient)!!

The GI virus or “throw-up virus” as my daughter calls it can be a real pain to deal with.  Caregivers and parents always ask me lots of questions about keeping hydrated and what liquids and foods to try after the vomiting has stopped.  Here are some helpful tips:

1.  Once the vomiting has stopped, try sucking on ice chips (if over 2-3 yrs old).

2.  Then if tolerated, try 1 teaspoon of a clear liquid (water, apple juice, tea (cold or warm), lemonade, ginger ale, seltzer water or sports drink) every 10 minutes.  (Yep, you read right, every 10 minutes!!).

3.  If tolerated, increase to 1 Tablespoon every 20 minutes.  Keep doubling the amount every hour. (If you are experiencing diarrhea, you may want to try a beverage with some electrolytes added).

4.  Once you’ve been throw-up free for 8 hours, try adding some solid food in small amounts.  I’d recommend foods low in fat and low in insoluble fiber.  Eliminating spicy foods is also a good idea.  Some of the best foods are dry crackers, pretzels, rice, baked potato, dry toast, chicken broth, baked chicken, hard boiled eggs, yogurt, frozen pops (juice type, not the kinds with lots of fruit).

5.  Continue alternating with liquids and solids until you are feeling better.


Coconut, Dementia and Aging: Part 2

A few weeks ago I posted about coconut oil and the aging brain. If you do decide to try this with your older adult, here are some ins and outs on the use of coconut oil.

Coconut oil can be used to replace many cooking oils and is even safe for frying and baking. It is a solid at room temperature, but melts very easily. Some people will prefer to simply use coconut oil where they are already using other cooking oils, but what about the most effective dose for dementia patients?

For that we look to Axona, the FDA-approved medical food mentioned in the March 22 post. In total, each day’s worth of Axona contains 20 grams of medium chain triglycerides (MCT). Fast-forward through the math and that translates to 7 teaspoons per day of pure coconut oil to get the same amount of MCT. As with any oil, this is going to contribute about 275 calories and 32 grams of fat to the diet. Unlike many cooking oils, most of this fat is saturated.

If this regimen helps your older adult, the first signs of improvement will take weeks to months to appear and continual use of coconut oil will be necessary to sustain the benefits. With all of this coconut oil consumption, you might need to stock up. One of my students, who is an avid fan of coconut oil, suggested Spectrum and Nutiva if you’re looking in stores and Tropical Traditions if you prefer to shop online or buy in bulk.

As always, I would encourage you to talk with your physician or your registered dietitian about this before you begin.

Guest Blogger:  Hannah Martin




Coconut Oil, Dementia and Aging: Part 1

Do you drink coconut water?  Do you cook with coconut oil?  What are the benefits of each? I’ve been getting a lot of questions about coconut and health.  I thought it might be time to bring it up here.

First, let’s have a quick lesson on coconut and it’s components.  Coconut oil is the oil that is withdrawn from the meat of matured coconuts.  Coconut water is the liquid inside the coconut that has a milky looking consistency.  Coconut oil is of interest to many because it holds up well at very high temperatures (especially during frying) which is due to its high saturated fat content  (something that isn’t that great for your heart).  Coconut water has peaked in popularity because it is a natural source of electrolytes, like that found in many popular sports drinks.

Recently, there has been more and more in the press about the benefits of coconut oil for patients with dementia.  I know many of you may have watched this video on YouTube:

This video has also been on Twitter and is under discussion in support groups.

The component of coconut oil that is of interest is MCT.  MCT’s or Medium Chain Triglycerides are commonly used in dietetic practice as a type of replacement fat for clients experiencing fat malabsorption or having lots of GI distress after eating fatty foods.  They are helpful because they do not require bile acids for digestion.

MCTs may also help with managing some forms of dementia.  Why is this?  Well, the brain uses two types of fuel:  1.  glucose and 2.  ketones.  Glucose, which comes from the breakdown of carbohydrates, is the brain’s preferred source of fuel or energy.  As we age and cognitive decline sets in, the brain doesn’t use glucose quite as well.  The aging, cognitively impaired brain seems to continue to use ketones well, if available.  Ketones come from the breakdown of body fat and/or from including MCTs in the diet.

The big questions is:  Does the aging brain, in someone with dementia, work better on ketones?

One of the speediest ways to get ketones to the brain is to increase the number of MCTs in your diet.  Coconut oil is made up of ~50-60% of MCTs.  Other sources of MCTs are Axona (~50% MCT), a medical food, or  straight MCT oil (100% MCT).

Some patients, with some forms of dementia, have seen mild improvements in their memory and in performing simple tasks when increasing the amount of MCT in their diet.

Is coconut oil safe? Want to know how much to add?  For how long? AND What type of coconut oil to use?  Be sure to re-visit the blog next week as our discussion continues…

Edible Ammunition: Defend Your Digestive Health with Prebiotics and Probiotics

I hope this blog post finds each of you staying healthy and avoiding the GI bug that is running wild through the nursing homes here in North Carolina.  Grandma C  had it for 2 days (ugh!) and it was awful!  Like any Registered Dietitian, I’m already thinking about how she can restore her  good gut flora/bacteria from the nasty stomach-bug.

I asked Katrina Levine (MPH/RD Student) to remind us  how prebiotics and probiotics can help us maintain a healthy GI tract.


Ugh…there goes that gurgling, bloating, gas, and uncomfortable pressure again…

If you’ve caught yourself thinking this recently, you are not alone.

Fortunately, there is something YOU can do to improve your digestive system and avoid all those awful symptoms – eat foods that contain prebiotics and probiotics!

What are prebiotics and probiotics?

Probiotics are live bacteria that can be added to food products to help our digestive system run smoothly, promoting health and preventing disease.

Now, hold on a second! Live bacteria??  Don’t worry, these bacteria are not the kind that cause illness – they are the “good” kind that are naturally found in our intestines.  Our bodies need certain types of bacteria to help us digest our food.  Lactobacillus and bifidobacteria are some of the most common strains, and these are the types you want to look for on food labels.

Prebiotics, on the other hand, are like food for those bacteria.  Prebiotics are undigested carbohydrates that are broken down by probiotic bacteria, where they help the bacteria to grow.  Prebiotics can act like fiber in our guts, but ultimately they just serve to help probiotic bacteria do their jobs.

Benefits of prebiotics and probiotics:

  • Help prevent malabsoption that can lead to nutrient deficiencies and malnutrition
  • Decrease constipation and diarrhea, especially antibiotic-related diarrhea
  • Alleviate lactose intolerance
  • Reduce symptoms of chronic diseases causing gastrointestinal stress, such as Irritable Bowel Syndrome
  • Help with the absorption of calcium and reduce the risk of osteoporosis
  • Increase immune system activity

If you’re experiencing any of the problems listed above, then adding pre- and probitotics to your diet may make eating more enjoyable.  However, talk to your doctor or dietitian first before you make any major changes to your diet.

Where to look for pre- and probiotics:

  • Fruits and vegetables— Jerusalem artichokes, onions, chicory, and banana are natural sources of prebiotics
  • Whole grains—also natural sources of prebiotics
  • Fermented dairy (yogurt, milk-based drinks)– look for “live active cultures” and the types of bacteria listed in these probiotic foods
  • Supplements—may contain either pre- or probiotics or both, but  check to make sure the types of bacteria listed are proven to have probiotic benefits


Hamilton-Miller JM. 2004. Probiotics and prebiotics in the elderly. Postgrad Med J. 80:447-451.

Zeratsky, K. 2011. Are probiotics and prebiotics important for health: is it important to include probiotics and prebiotics in a healthy diet? Mayo Clinic. Available from:

A Peculiar Pest: Urinary Tract Infections in Older Adults

A Peculiar Pest: Urinary Tract Infections in Older Adults

If you have had a urinary tract infection or UTI before, you are not alone. UTIs are one of the most common infections in older adults2. Normally this condition is seen more often in women, but as we age UTIs are known to occur more often in men1. UTIs may develop because of normal aging or because of existing illnesses like diabetes, kidney stones, an enlarged prostate, dementia or problems using the bathroom. You may also experience a UTI if you get hurt or have surgery, and are not able to move around as much as normal, or if you have a urinary catheter3.

What exactly is a UTI? Watch this short video to learn more about how infections can develop in the urinary tract:

The most common symptoms of a UTI in older adults include pain when urinating, urine that looks or smells unusual and mental confusion2. If you are diagnosed with a UTI, don’t be alarmed. Treatment normally consists of antibiotics from your doctor and drinking plenty of water to flush the bacteria from your body. To help with recovery try to avoid alcohol, caffeine and citrus juices that may irritate your bladder.

Cranberry juice is often suggested as a preventative measure because of the products acidity.  A recommended dose is 300mL of cranberry juice each day.  However, it is important to remember that cranberry juice may interact with warfarin, a medication commonly used for preventing blood clots, you should first consult your doctor before consuming large amounts4. You may also want to talk with your doctor about using vitamin C tablets as another option for preventing UTIs.

In conclusion, UTIs are one of the most common infections in older adults. In addition to antibiotics from your doctor, be sure to drink plenty of water and avoid irritating liquids like caffeine and alcohol to help treat existing infections. Finally, ask you doctor before consuming excessive amounts cranberry juice as a preventive measure for UTIs.

Guest Blogger:  Amber Mosher


  1. Griebling TL. Urinary tract infections in men. In: Litwin MS, Saigal CS, editors. Urologic Diseases in America (2007). US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington DC: US Government Printing Office. pp. 623–645.

  1. Juthani-Mehta M. Asymptomatic bacteriuria and urinary tract infection in older adults. Clinics in Geriatric Medicine (2007); 23 (3): 585 – 594.

  1. National Kidney Foundation. (2010). Urinary tract infections. Retrieved from

  1. Sumukadas D, Davey P, Mcmurdo MT. Recurrent urinary tract infections in older people: the role of cranberry products. Age Ageing (2009) 38 (3): 255-257.

Farewell Constipation…I’m Seeking Relief!

Farewell Constipation…I’m Seeking Relief!

Constipation doesn’t have to be here to stay! In fact, you can start seeking relief today by making the following changes in your diet.

Let’s start with fluid…

Did you know that dehydration contributes to a dry and firm stool? 1 Drinking fluids helps your digestive system prepare food for breakdown and keeps your stool from hardening. When your digestive system does not have enough water to work with, the colon absorbs water from the food and causes the feces to harden.

Drinking more fluid:

• Strive for 8 8-ounce glasses of water a day

• Carry a water bottle with you wherever you go

• Drink a glass of water with every meal

• Add lemons or limes to your water for zesty taste

Let’s talk fiber…

Fiber helps gel the stool together, making it easier to pass.2 It is very likely that you are eating less than your recommended fiber intake.1

You should be getting about 21-30 grams of fiber per day.3 You can do this by eating whole grains, fruits, vegetables and beans. You can also check the nutrition label on packaged foods to see how much fiber you are eating.

If you are not drinking enough fluid or getting the right amount of fiber, constipation may stay around longer than you would like. Try seeking relief by making these changes in your diet and say farewell to constipation.


Additional Information:

Constipation Handout: Constipation Age Page.pdf

10 Tips to Get Your Daily Fiber



Guest Blogger:  Ashley Kitchens

References and photos:

1. Read, N. W., Celik, A. F., Katsinelos, P. (1995). Constipation and Incontinence in the Elderly. J Clin Gastroenterol. 20(1):61-70.

2. Arnaud, M. J., (2003). Mild dehydration: A risk factor of constipation. European Journal of Clinical Nutrition. 57(2):88-95.


4. (photo: man)

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