EXTREME CUISINE: We need to look for solutions to digestive problems in the most obvious of places - what, when and how we eat, writes Haydn Shaughnessy
In Belgium a good restaurant still honours the tradition of offering customers a digestif, on the house, at the end of a meal. Conspiratorially, the maitre d' will ask, a little cognac, Armagnac, whiskey, perhaps? Oh, and what about you, you ask, as you turn to your friends.
I took to ordering calvados in my past couple of years there, to reminisce about a trip to Normandy and the perpetual high quality of French pork and apples.
Now my priority when cooking and eating is to prevent an attack of gastritis or arrest the wave of acid indigestion, the product I fear of poor food combinations and bad food choices on my part but also on the part of the chef.
Surprise, surprise: the statistics suggest that only 3.5 per cent of the population in most advanced countries suffer indigestion (the American Census Bureau saw fit to investigate the issue).
Surprise because when I wrote an Extreme Cuisine on indigestion some time ago, the article found its way virally around the world wide web, cropping up on innumerable sites, illegally. And indigestion is the most visited page on my blog, after dentists!
Contrast the 3.5 per cent of indigestion sufferers with attacks of acute gastroenteritis. A survey conducted across Ireland in 2000/2001 found that acute gastroenteritis creates about 3.2 million episodes of ill health each year. That's an incidence of 0.6 incidents per person. It means if you look around the average family, three people will be poleaxed by food at least once each year.
Now what are we really talking about here? The Cochrane foundation puts indigestion incidence at 25 per cent of the population a month. Gastroenteritis, inflammatory bowels, indigestion? The cross-over between these is inevitable. Over half of those surveyed had no idea why they had a gastric problem.
In the US, home of the health statistic, people spend around $4 billion (€3.11 billion) a year on antacids over the counter (OTC). What are called "H2 receptor antagonists" lead the way.
These drugs used to be prescription only. When scientists discovered that ulcers were caused by a bacterium and could be cured by antibiotics, pharmaceutical company profits were severely challenged. OTC sales were a well-lobbied solution.
Today they continue to recoup their research investment by providing a medical solution to an eating problem.
In the spirit of Extreme Cuisine though, we need to look for solutions to digestive problems in the most obvious of places - what we eat, how we eat, when we eat.
People with severe chronic digestive problems of course need medical treatment. Those of us with milder problems can take our cue from Zantac-type drugs. These drugs were developed because it was known that histamine (that's the stuff that goes crazy during the summer pollen months, causes hay fever and provokes allergies) stimulates stomach acids.
It's also known that histamine production increases when people are dehydrated - think summer again. There are those who argue that histamine production acts as the body's main signalling system telling us to drink. The less notice we take of it, the more is produced. And in the summer the problem is all the worse.
Histamine is also found in products such as wine that's been poorly made and stored. Those of us who've been on the voyage from beer drinking to wine drinking may be suffering late night coughing, a tight chest and indigestion because of poor quality wine rather than anything we've eaten.
We're suffering also because many of us have adopted the continental habit of eating late. The days are long, the weather is sultry and we're hanging out at the cooker . . . okay, so it's a microwave. We go to bed with our digestive systems still hard at work.
And we eat far more grains now - in pasta, pizza and similar dishes, where once we ate natural alkalisers like potatoes.
It might seem naive to propose drinking more water as a cure for indigestion but water should certainly be part of the risk management strategy.
The big argument in the alternative health world, though, is what effect the natural acid-alkaline balance of foods has on our digestion.
Scientists know that inflammation is the cause of many diseases. Some commentators, such as writer Felicia Drury-Kliment, argue that an element of that inflammation may arise in the acidity of our bodies caused by diet.
That's led people to look at how acidic certain foods are and at the way a food stimulates acid or alkaline production in our stomachs.
The problem with this debate is that the science is under-developed and the speculation rife. Do some foods stimulate our acid secretions more than others and is that significant in hurting us? Much of the evidence is anecdotal. Here's a bit more.
I find grains generate a huge acid overspill. Likewise, if I eat confectionary from the sweet shelf, my throat takes an acid bath. Meat does pretty much the same, as do fizzy drinks.
Paul Pitchford, who writes about the healing power of food, warns also against the complex combinations of food that are now so popular in restaurants. I guess the theory is our guts can't interpret all the signals they get from so many foods and the result is digestive confusion.