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Gastric Bypass Surgery has gained much notoriety in recent years as a fairly safe and efficient way to deal with weight issues which are difficult to manage. For many people the operation became a life-saving step, totally transforming their existence. However Gastric Bypass Surgery has its own setbacks, and it can and does affect the ability to absorb nutrients well from the foods ingested. It can also inhibit the effect of oral supplementation of vitamins. Gastric Bypass can affect B12 and other nutrient absorption on several levels.

1.  The daily food intake is a bariatric patient is often greatly reduced, as the procedure prevents one from ingesting large portions.

2. The new stomach structure is made to bypass a portion of the digestive portion of the tract where most of the absorption of many vitamins and minerals occurs.

3. The gastric pouch is so reduced in size that it produces negligible amounts of the enzymes needed for the complete digestion and absorption of many foods.

4. The new digestive system prevents normal levels of production of gastric acid and intrinsic factor which are necessary for the proper absorption of vitamin B12

We will now discuss these points to clarify exactly how bariatric surgery hampers with the proper absorption of B12 vitamin and other nutrients. Firstly, as mentioned above, much of the absorption of vitamins and minerals from food occurs within the small intestine. Although only a small portion of the intestine is actually affected by the surgery (specifically in the hopes of avoiding problems with malabsorption), issues with intake of minerals and vitamins still arise. Many bariatric patients are told in post-treatment that it may be optimal for them to begin B12 injection therapy, and some doctors suggest that this 1000 mcg injection be administered daily, as the effect of surgery on the intrinsic factor could be damaging.

The surgery heavily affects the production of the intrinsic factor and gastric juices, which can end up causing a severe B12 deficiency in a matter of weeks (to read more about the importance of the intrinsic factor for B12 absorption click here). With the functions of intrinsic factor unable to properly bind to the vitamin and be reabsorbed in the small intestine, the individual is at high risk for developing the symptoms of the deficiency. It will also poorly influence the general wellbeing of the individual just recovering from surgery.

Alzheimer’s Disease or Dementia is the most common type of age related cognitive disorder, which usually begins affecting individuals over the age of 65. The illness systematically destroys the brain tissue of the individual, until he/she is no longer able to function on his/her own, robbing one not only of their lifelong memories but as well of their freedom. An estimated 26.6 million individuals worldwide and 2.3 million Americans are currently suffering from Alzheimer’s and the prevalence of it continues to double every five years after the age of 60 – the likelihood of developing the disorder increases from 1% among those 60 to 64 up to 40% among those aged 85 years and older.

Although this disorder has been described in the medical community for over a century, the direct cause behind it remains unknown. Some scientists however take the approach that the origin of the degeneration is multi-causal and can even be related to diet and lifestyle. When a meta-analysis of over 500 studies was conducted some very interesting and promising trends were noted.

Firstly it seemed that the more time the individual devoted to their cognitive health throughout their lifetime, the more likely were they to avoid developing the dementia or suffering from more advanced forms of Alzheimer’s. Consuming a Mediterranean diet and having a semi-active lifestyle also seems to act as a preventative measure. Very importantly some studies uncovered that vitamin and mineral deficiencies may be at fault for the developing and progression of the cognitive disorder.   

A  Swedish study of persons 75-years-old and older found that more than half (46 out of 78) of those diagnosed with dementia had both low levels of vitamin B12 or folate and Alzheimer’s type dementia. Several other studies have examined the effect of vitamin supplementation on Alzheimer’s disease. It appeared that the degeneration could result from too-low serum levels of vitamin B12. According to the scientists who conducted these studies repleting B12 vitamin could reverse up to 75% of the related dementias if the condition is uncovered early enough.

All mammals, including humans, are born with natural serum levels of B12 at about 2,000 pg/ml. These levels are noted to decline throughout the lifespan, often due to the ramifications of modern lifestyle choices. According to John V. Dommisse in his 1991 reports in “Medical Hypotheses” a staggering number of Alzheimer’s dementia cases are in actuality undiagnosed B12 deficiency. This common misdiagnosis occurs due to the fact that the accepted clinical sets for “normal in low-range B12 serum levels” are in fact much too low for most of the population, who eventually begin to suffer the effects of the deficiency

Dommisse writes that almost all of his patients have had B12 levels in the lowest one-third of the “normal range”, levels that he currently regards as deficient and inadequate for healthy cognitive functions. According to Dommisse when the levels of B12 were raised to the highest third of the “normal” range every single patient reported feeling better. Some patients came out of their depression or mood disorder, despite the fact that this was the only new or different therapy that they had received. In subsequent instances when B12 levels had again dropped their affective disorder apparently worsened. Dommisse is now wishing to calculate the proportion of cases of mood-disorder which may be caused or seriously affected by a B12-deficiency and what percentage remain idiopathic

Another theory suggests that vitamin B12 or folate deficiencies affect Alzheimer’s disease by influencing neurotransmitters or the levels of homocysteine in the body (this would also explain why depression is one of the emergent symptoms).  Either vitamin B12 or folate deficiency can increase the levels of homocysteine in the body. Homocysteine is required in the metabolic functions of the body, but when too much of it accumulates in the bloodstream it begins to act as a neurotoxin, the effect of which causes cell death and possibly neurological conditions such as Alzheimer’s disease. The effect of B12 deficiency on homocysteine and the body will be discussed in future posts.

Today we will continue to discuss B12 friendly foods and how we can modify recipes even more to reap the most nutritional benefits from our meals and snacks. This coconut cake is already fortified with b12 in some sense, but a few adjustments to the ingredients used will cause each bite of this cake  to boost your B12 levels in the best way possible and how had nature intended: by drawing it from your food.

You will need these ingredients 

• 1⁄2 cup plain flour (replaceable with whole, unbleached and nutrients fortified flour – this type of flour will help with the absorption of the nutrients in the GI tract)
• 3⁄4 cup castor sugar (you can grind regular sugar in your blender for a few minutes to get the fine grain of castor sugar. This can be replaced by unrefined cane sugar which possesses healthy yeast which will further help you digest and absorb the vitamins in this cake)
• 1 cup dry coconut  
• 4 eggs
• 100 g butter, melted (butter, as a milk product is rich in B12. However it can be replaced with margarine if needed but this is not advised)
• 2 cups of milk ( replace with kefir, creme fresh or any cultured milk product to reap full benefits. Kefir is VERY rich in the vitamin and helps the digestion through its powerful combinations of amino acids, probiotics and healthy bacteria cultures. If needed these can be replaced with fortified soy milk or even coconut milk. Recently a new type of vitamin fortified coconut milk, So Delicious Coconut Milk Beverage, has been available on the market which professes to provide 50% of your daily recommended value of B12)

Instructions:

1. Combine dry ingredients in a bowl.
2. Combine eggs, butter and milk in a separate bowl. Gradually add liquid ingredients to dry ingredients while whisking.
3. Pour into a lightly greased ovenproof dish.
5. Bake at moderate heat (around 180°C) for 45 minutes or until set.

When serving this and any other sweet food always add fresh fruits and kefir/cream whips (recipe for these to follow in another post) to powerfully increase your nutritional intake, and possibly your metabolism, mood and of course overall health. This particular cake goes very well with passion fruit, lychees, raspberries and star fruit (carambola). Enjoy this light cake knowing that it provides you with incredible nutrition.

• 1 to 2 Whole Beaten Eggs
• Instead of refined bread: Whole wheat 7+ grain bread – somewhat stale
• instead of regular milk:  milk mixed with a bit of kefir, creme fresh, soured cream or even cultured yoghurt
• a tiny pinch of salt
• and sugar to taste – these can be both sweet and savoury

Although food sources of B12 are considerably many and varied, most happen to be (if not all true sources) proteins, which means animal products. This is why so many vegans and vegetarians are at risk for a B12 deficiency. However, those items high in B12 are also fairly well known for their ability to add toxicity to the body. The RDA does not recommend much red meat or seafood high in mercury as part of the daily diet, but these are the items which possess the highest B12 values.

For example the items which are highest in the amount of B12 would be canned mollusks and clams in liquid – averaging 500 mcg of B12 (They average around 134 mcg of B12 if in a raw, unprocessed state). These widely popular foods are often extremely high in mercury and can actually be detrimental to your health if you eat too many.

Same sort of problems occur with meat. The meats highest in B12 would be lamb, beef and moose variety meats, by-products and internal organs such as kidneys, liver and even the brain (cooked and uncooked). These items average between 130 mcg to 85 mcg of B12 per type of protein. Most of these meat items however are too high in toxins to be consumed on a daily basis. In fact eating too many of these items too often will result in the individual developing a case of gout – arthritis like stiffening of the joints caused by the buildup of too many uric acid crystals.

Surprisingly however there are items which are both high in B12 and are safer to eat on a regular basis. Certain Alaskan fish such as whitefish and eggs each contain around 108 mcg of B12, while also providing omega-3s, healthy cholesterol and even choline. These are the sorts of items which may replace the unhealthier version of protein in your diet while delivering optimum dosages of the vitamin.

Ocean fish brings much less B12 – averaging around 2 mcgs of the vitamins. This is about the same as most cheeses, lean young fresh ground meat, crustaceans, and whey. The best option for a B12 rich diet is to consume plenty of dairy, egg and healthy fish sources very often, while enjoying the hotdog, the burger, the liver spread, ocean fish and mollusks should be left for a treat to keep your system healthy and strong.

Vitamin B12 is an essential vitamin for healthy brain function. It is important in helping to manufacture the myelin sheath which acts as a protective layer surrounding nerves in the brain and allows for extremely quick transmission of neural messages. It helps the brain to produce neurotransmitters, which are vital for communication within the brain. Some research has noted that among the many possible causes behind autism a thin myelin is a common symptom. Some believe that autism can be caused or symptoms worsened by severe nutritional deficiencies. What this means is that the body is not receiving enough of certain vitamins, or that it is not able to absorb the nutrients that are fed through the system; causing the body to lack the essential elements it needs to function properly. Recent research shows that more than 50% of children with autism have GI symptoms, food allergies, and maldigestion or malabsorption issues.

Altered intestinal permeability was found in 43% of autistic patients, but not found in any of the healthy control subjects. Intestinal permeability, commonly referred to as the “leaky gut”, means that there are significantly large spaces present between the cells of the gut wall. When these large spaces exist in the small intestine, it allows undigested food and other toxins to enter the blood stream. When incompletely broken down foods enter the body, the immune system mounts an attack against the “foreigner” resulting in food allergies, inflammation and sensitivities. This constant aggravated inflammation is an incredible uncomfortable experience for the individual.

This process also halts the absorption and utilization of vitamins and minerals, resulting in deficiency and its subsequent consequences. The deficiency further aggravates the well being of the autistic individual, and causes a sleuth of unpleasant symptoms. The food particles which pass through the wall cause the release of antibodies which trigger inflammatory reactions when the foods are eaten again. The chronic inflammation lowers IgA levels, which are needed to protect the intestinal tract from bacteria and yeast. The decreasing IgA levels allow for even further microbe proliferation in the intestinal tract. Vitamin and mineral deficiencies are also found due to the leaky gut problem.

An example of the problems created by the vitamin deficiencies that occur within a leaky gut is vitamin B12 deficiency. B12 absorption is inhibited early in this process as microbes enter the small intestine because B12 is absorbed in the ileum (last section of the small intestine). Another important function of B12 is repairing damaged, flattened microvilli. With sufficient B12 and folic acid in the bloodstream, the intestinal cells and microvilli can rejuvenate every 3-4 days.

In a healthy intestinal tract the small intestine and stomach are not inhabited by bacteria. When the flora balance in the colon is lost, the microbes can migrate into the small intestine and stomach, which hampers digestion. The microbes compete for nutrients and their waste products overrun the intestinal tract. One of the toxins produced by yeast is actually an enzyme that allows the yeast to bore into the intestinal wall. The yeast also produce other toxins such as organic acids, which can also damage the intestinal wall.

In the case of malabsorption, undigested carbohydrates left over in the small intestine cause the body to draw water into the intestinal tract. This pushes the undigested carbohydrates into the colon where the microbes can feast on it, and allows for even more proliferation of the unwanted microbes and continued increase in malabsorption problems. Low intestinal carbohydrate digestive enzyme activity was found in 43% of patients with autism. Recent studies point out that ongoing carbohydrate malabsorption keeps the digestive system constantly weakened, leading to systemic disorders. The vicious cycle of malabsorption, inflammation and food allergies seen in children with autism can be broken with B12 supplementation, beginning a cycle of healthy digestion which assists with the child’s overall well being.

Obviously the use of oral b12 supplementation is out of the question as it would not absorb and assimilate in the body. Injections are an extremely viable option but not when the patient has extreme sensitivity to touch, as is common in autism.

Vitamin B12’s position in the upkeep of one’s health is central. Among many of the aspects of health-maintenance B12 helps to control, minimize and flush the levels of an extremely toxic by-product of hormonal metabolism named homocysteine. Recent research has uncovered that a dangerous condition of elevated homocysteine levels can result from even minor B12 depletion. Individuals most at risk for having elevated levels of homocysteine are those who are most in need of vitamin B12 supplementation – vegetarians, individuals nearing middle-age, individuals suffering from poor absorption and unhealthy lifestyles. For all these groups, homocysteine levels soar and remain undisturbed as the body is unable to control and lessen its amounts.

Homocysteine appears to be a nerve and vessel toxin, promoting mortality, cardiovascular disease (CVD), stroke, Alzheimer’s Disease, birth defects, recurrent pregnancy loss, neural tube defects, eye disorders, increased fractures in elderly persons and nerve damage. Cardiovascular disease (CVD) includes Ischemic heart disease (IHD/heart attack), coronary artery disease (CAD/ plaque obstruction of the coronary arteries to the heart), and stroke. An elevated level of blood serum homocysteine is a powerful risk factor for all these issues

Homocysteine auto-oxidizes and reacts with reactive oxygen intermediates and damage endothelial cells (which are extremely important for protection of the blood vessel) and result in a higher risk of forming a thrombus (blood clot). Although homocysteine does not affect bone density, it appears to affects collagen by interfering with the cross-linking between the collagen fibers and the tissues they reinforce. The damage inflicted on these connective tissues results in increased cases of fracture, bone damage and importantly atherosclerosis which is specifically linked to high homocysteine levels.

Diseases which are associated with elevated homocysteine levels are long-term emergent problems. In other words these illnesses occur due prolonged exposure to elevated homocysteine which damages the tissues through its toxicity. In fact, elevated homocysteine levels are a part of aging, whether due to poor absorption in the GI or other reasons. As people are now living longer, the elevated homocysteine has more time to do its damage to the body, thus a spike is noted in illnesses associated with homocysteine levels and aging. Logically everyone should eventually attempt to control their homocysteine levels through B12 supplementation if they wish to lessen the risk of these illnesses

How is homocysteine produced in the body?
Methionine is an essential amino acid involved in hormonal metabolism which is obtained exclusively from ingested protein. In the processes of hormonal metabolism some methionine is turned into homocysteine. The body converts much of the homocysteine back into methionine through an intricate process involving the vitamin B12. If the individual is B12-deficient, homocysteine levels will begin to increase as the reaction of the compounds cannot take place. There are several studies discussing the benefits of B12 supplementation on homocysteine levels and health, and following are several excerpts from these studies.

Medically established normal serum levels of homocysteine range from 2.2 to 13.2 µmol/l. The levels of homocysteine in a typical Western population are around 12 µmol/l. Although this is considered to be within the “normal” range, it is not necessarily healthy.

The analysis of the Oxford Vegetarian Study reported in 2002 showed that overall mortality was the same between vegetarians and non-vegetarians. But vegetarians had 2.2 times the death rate from mental and neurological diseases as non-vegetarians.

The vegetarians had higher homocysteine and lower B12 levels leading to more neurological damage and problems.

Appleby PN, Key TJ, Thorogood M, Burr ML, Mann J. Mortality in British vegetarians. Public Health Nutr. 2002 Feb;5(1):29-36.

11 prospective studies of IHD and 8 of stroke tried to examine and anaylize the effects on health if homocysteine levels were lowered by 25%. The studies involved 9,025 people.

• A 25% lower homocysteine level reduced the risk of IHD by 11%, and the risk of stroke by 19%.
• In 16 prospective studies of IHD, a 5 µmol/l increase in homocysteine increased the risk of contracting IHD by 23%.
• In 8 prospective studies on strokes, a 5 µmol/l increase in homocysteine increased risk of a stroke by 42%.

Homocysteine is better controlled through adequate level of B12, B6 and folate (also known as folic acid). Since vegetarian diets are typically high in folate, the elevated homocysteine levels are normally due to a low B12 intake which, as studies have shown, cannot be viably obtained from ingestion of plant-life. The greater effect of elevated homocysteine on stroke compared to heart disease could explain why vegetarians have not been shown to have lower rates of death from stroke, while they do have lower rates of death from heart disease.

The British Medical Journal published an analysis of 12 studies on the effectiveness of reducing homocysteine levels with folic acid and vitamin B12. They concluded that folic acid in the range of 500-5,000 µg/day reduced homocysteine by 25%, and that B12 supplements (average intake of 500 µg/day) reduced it a further 7%. An addition of B6 did not show any further homocysteine level reduction.

Vitamin B12 (Cobalamin) is the largest B vitamin, it is a red crystalline substance, necessary in reconstruction of DNA, and maintenance of healthy red blood and  neural cells. Just as mercury may cause B12 deficiency in the nervous system, so alcohol can cause deficiency in the tissues of the liver and the intestine. Unlike social drinking which often results in a spike of appetite, habitual alcohol consumption heavily and repetitively depresses the system, causing a general lack of hunger and increased nausea. Often in this diet alcohol replaces food, resulting in numerous deficiencies caused by the lack of an adequate intake of nutrients. Nutritional deficiencies are common among alcoholics, but they can also be found in people who just consume alcohol on a regular basis.

Excessive alcohol consumption may damage the GI tract absorption in such a manner that the body is effectively experiencing starvation from the lack of nutrient assimilation into the system. It heavily impairs the body’s ability to break down and absorb the vitamin compounds in the stomach and intestinal lining. Alcohol also seems to raise serum levels of vitamin B12, so that the deficiency is masked and the subject may look like they have higher than normal B12 levels. In case of severe damage of the GI linings and impaired B12 metabolism supplementation of the vitamin will have to begin, and oral administration is not an option in this case.

Alcohol’s effects of the stomach

Even moderate drinking can still cause changes in gastric acid secretion, cause acute gastric mucosal injury, and also interfere with gastric and intestinal motility.

Pernicious anemia, the autoimmune disease in which the body’s own white blood cells are directed against the intrinsic factor or the mucous stomach cells can be caused by an excessive alcohol consumption. It can also be aggravated by moderate to low alcohol consumption. Pernicious anemia causes a severe B12 deficiency, as the intrinsic factor is necessary for the absorption of the vitamin compound into the system.

Alcohol’s effect on Gastric Acid Secretion?

Alcohol consumption affects gastric acid secretion. In low to moderate doses it stimulates gastric acid secretion—in higher doses it causes inhibition.

Chronic alcohol consumption causes shrinkage of gastric mucosa and decreased gastric secretory capacity. This means the stomach is less able to kill bacteria that enter the body, which may lead to the colonization of the upper small intestine with potentially harmful organisms. These bacteria begin to devour all available nutrients which enter the body, often causing severe malabsorption of a number of vitamin and mineral substances

Even a single episode of heavy drinking can induce mucosal inflammation and hemorrhagic lesions. An inflamed GI lining is heavily impaired in terms of absorption capacity which may lead to severe vitamin and mineral deficiencies.

Alcohol causes damage to the muscle layers of the stomach wall and decreased GI smooth muscle contraction which mix incoming food with gastric fluids.

After chronic use of alcohol an increase in propulsive contractions occurs. These contractions cause diarrhea. The nutrients from the food ingested are not properly absorbed, and over a period of time this acts effectively as starvation, draining the body of all necessary nutrients and minerals. Increased hydration during periods of gastric distress further dilute and flush the vitamin and mineral reserves in the system.

Alcohol’s effect on the small intestine

The small intestine is the area where most nutrients are absorbed. Alcohol causes interference with absorption of nutrients and can cause interference with the enzymes needed for digestion, the transportation of nutrients to the bloodstream and the effectiveness of enzymatic metabolism.

Alcohol can cause mucosal damage even in healthy people during a single drinking episode which can lead to erosion and bleeding. Alcohol also causes an increase in intestinal permeability which lets large molecules that normally would not be able to cross the intestinal wall to get through. .

Diseases of the oral cavity and esophagus related to high alcohol consumption

Barrett’s esophagus: The lining of esophagus is replaced by abnormal cells which leads to abnormal acid production.

Gastroesophageal reflux disease (GERD): The sphincter weakens or relaxes, and the contents of the stomach splash back up into the esophagus.

Esophageal stricture: Cells lining the esophagus are damaged and cause narrowing of the opening. A person with this condition will have trouble swallowing foods.

Gastritis: The inflammation of the lining of the stomach.

Studies have shown that both moderate and heavy alcohol consumption will affect vitamin B12 levels. One study showed a 5% decrease in mean serum vitamin B12 concentrations when consumption of alcohol increased from 0 to 30 grams of alcohol/day.

Researchers investigated the effects of moderate consumption of alcohol (1 or 2 drinks each day) in 53 postmenopausal, healthy, well-nourished women. There was a 5% decrease in the amount of serum vitamin B12 concentrations from 0 to 1 drink/d treatment. Alcohol intake had no significant effects on serum folate concentration. Among healthy, well-nourished, postmenopausal women, moderate alcohol intake may diminish vitamin B12 status.

Source: Laufer EM, HartmanTJ, Baer DJ, Gunter EW, Dorgan JF, Campbell WS, Clevidence BA, Brown ED, Albanes D, Judd JT, 2004. The Effects Of Moderate Alcohol Consumption Of Folate And Vitamin B12 Status In Postmenopausal Women. European Journal Of Clinical Nutrition.

Currently a new hype is taking over the nutrition community, and it is all about whether B12 supplementation can help you lose weight. Some companies are already focusing on bringing B12 rich dietary formulas to their consumers, but can this vitamin truly help you lose weight? And if so, how would it work.

Healthy B12 levels are necessary for the proper functioning of the body, as has been previously discussed. It is absolutely necessary in the formation of new tissues and protecting the DNA, but it also may have some influence on one’s overall metabolism rates. Especially if the individual is experiencing general issues with absorption in the stomach, as is common with B12 deficiency.

Lack of all the needed vitamins and minerals will cause the system to slow down when it comes to metabolism. This is the body’s way of assuring its own survival, as the malabsorption of nutrients is interpreted by the system as starvation (which by most definitions is accurate), and while slowing down the living processes may make one feel ill, it does keep the body from extreme further damage.

Once properly supplemented though this vital nutrient allows the body to operate more effectively and efficiently, which in the long run results in weight loss and improvement of overall health. Vitamin B12 is also an energy booster, and in properly administered amounts it results in the body having healthy, long-lasting energy.  This of course will not take off the pounds by itself, but the extra energy stores replacing the feeling of fatigue is often a great motivator to get up and move, resulting in weight loss.

Individuals with compromised absorption in their GI tract face a series of issues concerning their quality of life. As has been discussed before, impaired absorption in the stomach and the intestines results in vitamin and mineral deficiencies, which compromises one’s health and often causes existing medical conditions to worsen. Many individuals suffer with a number of symptoms of mineral/vitamin deficiency, starting from minor aches and pains, leading to affected mood in the form of depression and anxiety, and even to damage of neural and organ tissues. More so, research seems to indicate that individuals with impaired absorption are more likely to be overweight.

A number of causes may lay behind the extra weight carried by individuals with a compromised system of absorption. The most likely explanation is that the body tries to compensate for the lacking nutrients by increasing the feeling of hunger and forcing the individual to self-medicate using food. The absorption is not increased by the extra calorie intake however, and the waste products may begin to compact in the intestines causing further weight gain, bloating, absorption issues and general physical malaise.  

Although supplementation may still be necessary for these individuals, there is hope to dealing with the unruly digestive system. A change of dietary habits and specific intake of certain foods may not only increase your metabolism and general well being, but as well boost the absorption throughout the GI tract. Try adding a number of the following items to your dietary schedule for better mineral/vitamin intake and a health boost for your system.

Vitamin C – Add this in fresh form, using citrus fruits and other C rich foods. Vitamin C helps increase the absorption of Chromium, Zinc and Iron. Other foods that contain Vitamin C: Red and Green Peppers, Tomatoes and Broccoli.

Ginger – adding ginger to your diet can help digestive movement through the stomach and the stimulation of digestive enzymes.

Mint –mint aids digestion by stimulating the flow of bile to the stomach as well as calming the muscles of the digestive system.

Avoid drinking tea with your meal – although tea has many health benefits, it shouldn’t be imbibed with meals. Tea contains caffeine and can interfere with iron absorption. This is particularly bad for women who tend to have lower levels of iron. Avoid drinking tea for an hour either side of a meal.

 Some other foods that aid digestion – pineapple (contains Bromelain), papaya (contains Papain), figs, licorice and bean sprouts all aid digestion and help the absorption of needed nutrients.