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: February 2000
Going Bananas May Be A Good Thing
Ever get tired of pears? I do. With a limited list of fruit to choose from it can get so-o-o boring. But just because you have a very diet-sensitive bladder doesn't mean you're stuck with nothing but pears forever. Some other fruits may be worth a try.
One of the fruits I've recently been able to add back into my diet occasionally is a banana. Bananas are a good source of fiber and are a great energy snack. Though not as high in vitamin C as oranges or green bell peppers, bananas do have some vitamin C. (Vitamin C helps heal wounds, fortifies the immune system, protects from bruising by strengthening capillary walls, and helps the body produce collagen). Bananas are high in magnesium too, a mineral that may help fight off colds and flu this winter. Stress hormones drain magnesium from immune system cells and impair their ability to fight off viral invaders. Increased magnesium intake has also been shown in some studies to reduce anxiety and help people sleep.
Years ago bananas were restricted on the IC diet because they were thought to be very high in tyramine, a substance linked to bladder flares. Recent evidence however, indicates that they may have less tyramine than originally thought. In fact, only banana skins or extremely overripe bananas may have enough tyramine to bother IC bladders. Unlike many other fruits, bananas are fairly low-acid so they make an ideal choice for IC patients to experiment with.
There is however, one downside to all this: Dr. Lowell Parsons, urologist and IC researcher at the University of California San Diego, believes that some IC patients may have potassium sensitive bladders. Two of the things potassium does in the body is to help muscles contract and nerves to conduct signals. In theory at least, if your bladder muscles tend to spasm and bladder nerves are conducting pain signals, the last thing you'd need is a lot of potassium to help the process along. Excess potassium is excreted in the urine and, according to Dr. Parsons, could leak across a defective bladder lining to irritate bladder muscles and nerves.
Bananas are well known to doctors as the "potassium food". One ripe banana has about 450 mg. of it. There is no Recommended Daily Allowance for potassium, but the American Dietetic Association suggests a minimum of 2,000 mg a day for adults. Cardiologists may suggest more (3,000 mg to 3,500 mg per day) because it has been shown to protect against high blood pressure.
Dietary potassium (contained in many fruits and high-carbohydrate vegetables as well as some meats) helps regulate the body's fluid balance. Have you ever sprinkled salt on a cucumber slice and watched as the water in the cells came out and formed beads? Electrolytes like sodium (in salt) and potassium work to maintain the right amount of fluid inside and outside of our bodies' cells too.
Dietary Potassium vs. Potassium Instilled in the Bladder
At Dr. Parson's clinic in San Diego, California, he instills a solution containing potassium (KCl) in the bladders of patients. He does this as a test when he suspects they have leaky bladder linings as a result of IC. Many patients react to the instilled potassium with horribly intense pain-- not a fun way to get a diagnosis. However, some IC patients have noticed that their bladders' don't react to potassium-containing foods the same way they react to the instilled potassium solution. So while an intense reaction to the KCl test may be a clue that you should approach bananas carefully, it's not an iron-clad law that your bladder will react badly to high-potassium foods.
You may be able to test your reaction to high-potassium foods by consuming otherwise bladder-safe high-potassium foods such as whole milk (1 cup= 370 mg. potassium). About 1-1/4 cups of whole milk have about as much potassium as an average banana. Another choice for testing would be roasted skinless turkey (3 oz. = 255 mg.). About 4-1/2 oz. of roasted turkey would have the potassium of a banana. Just be sure the turkey is free of bladder-irritating preservatives. (Potassium-based salt substitute is not a good choice to test your bladder's reaction to potassium. Salt substitute should only be used under a doctor's guidance.)
The American Dietetic Association also suggests potatoes, sweet potatoes, winter squash, broccoli and mushrooms as good sources of potassium too.
The Best Time to Experiment
I've learned the hard way that it's best to wait to experiment with new fruits until you're on a stable drug treatment regimen. Over the last ten years I've tried various medication combinations for my IC and each time I change regimens, my pattern of dietary sensitivity changes. So now I try not to experiment with foods while trying a new IC treatment. If I get a bad reaction, I want to know for sure whether it's the food or the new medication causing the trouble.
If you've had a painful KCl test, and are starting on Elmiron, here's another idea: Since Elmiron is thought to coat the bladder and protect it from irritants in the urine, it might be wise tio give the Elmiron time to build up a good coating before trying high-potassium foods like bananas.
Another valuable tip from the IC "old-timers": try new foods in their purest form. Don't use banana bread to test whether bananas make your bladder symptoms worse (if your bladder symptoms get worse, how would you know if the bananas or some other ingredient caused the problem?) Then too, banana breads are often made with very soft overripe bananas. Better to experiment with fresh bananas. If it turns out that fresh bananas cause a problem for you, you may still be able to have some banana flavor in your diet. Experiment with banana flavoring (check the aisle of your market where vanilla extract is sold). Although made with an artificial ingredient, you may find your bladder can tolerate it better than it tolerates bananas.
This old recipe is from the 1981 Better Homes and Gardens Cookbook but is one of my favorites. Without the bananas, it makes a silky-smooth and mild vanilla cream pie.
Vanilla-Banana Cream Pie (serves 8)
1 cup sugar
1/2 cup flour (or 1/4 cup cornstarch)
1/4 tsp. salt
3 cups milk
3 Tbsp. margarine or butter
1-1/2 tsp. vanilla extract
1 9-inch baked pastry shell (preferably home-made and preservative free)
Meringue for pie topping
For filling, in a medium saucepan combine sugar, flour or cornstarch, and salt; gradually stir in milk. Cook and stir over medium heat till thickened and bubbly. Reduce heat; cook and stir two minutes more. Remove from heat.
Separate two egg yolks from whites. Set whites aside for meringue. Beat egg yolks slightly. Gradually add only 1 cup of the hot mixture into the egg yolks. Return the egg mixture to the saucepan and bring to a gentle boil. Cook and stir two minutes more. Remove from heat. Stir in butter and vanilla.
Slice 3 fresh ripe bananas into the bottom of the baked pie shell. Pour hot filling over bananas. Make meringue and spread over the top of the filling, sealing it to the edge of the crust. Bake pie in a 350 degree oven for 12 to 15 minutes (watch carefully) or till golden. Cool gradually at room temperature for 2 hours and then refrigerate. Make sure pie is thoroughly cold before serving.
This article originally published February 2000, revised and updated by the author Oct 2003.
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