food as medicine
My relationship with food has always been complicated, and I want to be honest about that, because I think so many people look at other people and assume that it's easy for them. That because I'm a nutritionist or in public health or into wellness or WHATEVER that eating healthy comes easy to me. It doesn't.
Moderation has always been a hard balance for me to achieve and understand and my black and white personality certainly functions better in an all or nothing mentality. I know what I should eat, but does that always happen? Certainly not.
I have had periods where I successfully did a "detox" with no sugar, gluten, dairy, etc. but if I'm being honest it was about losing weight, it wasn't about listening to my body, understanding my food sensitivities, or health for that matter. It is somehow easier (although still ridiculously hard) to eliminate out all of those wonderful things that taste so good when it's your choice, your decision. Until it isn't.
I mentioned here that I went to the ER in June and it was suspected that I had eosinophilic esophagitis. I had experienced trouble swallowing after my pregnancies but never did anything about it because I wasn't taking time to listen to my body. It was something I didn't want to pay attention to. Until I had to.
Lying on a bed in the hospital, about to go under anesthesia for an endoscopy to remove the food that was lodged in my throat and to do a biopsy, I asked the doctor what the next steps were. I was instructed that I would be on medicine for 2 months and if that didn't work I could try diet. Wait, what? If the pill doesn't work first, then we can resort to diet? If the pill that has been linked to renal failure in patients who use it long term doesn't work for a 34 year old who would have to be on it for presumably 50 years doesn't work, then we go to do diet? As I was drifting off to sleep I asked if I could try diet first and the doctor said I'd have some information.
I woke up from the procedure in recovery and didn't even get to see the doctor. They handed Joe a single piece of paper that had two sentences on it, and a list of foods that I should eliminate that were associated with my condition: wheat, nuts, dairy, eggs, soy, and seafood. That's it, no instructions or recipe ideas or resources. I left the hospital that night determined that I would do the diet, but feeling helpless and overwhelmed. The next day I went to two grocery stores and spent 1.5 hours at each store reading label, after label, after label filling my cart with things I could eat. I left both stores in tears and feeling small and frustrated. I'm a nutritionist, if this is paralyzing for me, how do other people feel?
The majority of messages that we see every day have missed the mark on healthy eating. There isn't one bad food group, there isn't one magic food you can eat that overrides all the other bad foods, and there isn't one way of eating that is best over everything else. The truth is that we all have to figure out individually which foods are complimentary to our bodies. An elimination diet is one way to do that and a true elimination diet can be done in as short as three weeks. I don't even like that it's called a diet, so let's call it a plan :).
Most people, myself included, don't even realize that symptoms we experience everyday could be resolved with changes to the foods we eat. Foods can be related to a long list of health conditions including digestive problems, headaches, low energy, depression, skin irritations, and asthma to name a few (source: IFM). Another thing that blew my mind is that more than 70% of our immune systems are in our gut. What the what?! And if what we are eating is irritating our gut, it affects digestion, absorption and more. An elimination plan gives your gut some time to heal, and then as you reintroduce foods you may become aware of sensitivities.
The irony of how hard this has been is not lost on me, but as I've mentioned so much of clinical training is focused on treatment. Most of my nutrition classes were centered around medical nutrition therapy and how different disease states required different diets. On the other hand for a long time I've thought of food from the preventative angle, we all know that if we eat more fruits and vegetables it reduces our risk of certain disease, but even that viewpoint is not focused on the healing power of what we choose to eat.
If we are completely honest this process of the elimination diet has been very, very hard. I live in New Orleans, hello, and everywhere you turn there is something battered in wheat, filled with dairy, or the best seafood you've ever tasted. There was a point where I had to come to terms with my emotional attachment with and relationship with food and I'm still working through that, but I keep reminding myself that in the end, knowing what is truly best for my body will ultimately be worth it.
At this point you may be thinking "oh I'm so glad I don't have to do that" or "I could never do that" and I wouldn't blame you, I was there 3 months ago, but what I can say is for those of you reading this thinking "I wonder if this would make me feel better?" or "I've tried so many medicines and I still feel bad" there is hope. Food can be your medicine, there is another way besides feeling tired all the time and taking a pill and not taking care of ourselves. I wanted to share some simple steps I've learned through this, and these will be helpful even if you aren't interest in an elimination plan:
Read Labels: We think we know what's in the foods that we buy, but we don't. Soybean oil in every dang spaghetti sauce, wheat in my favorite enchilada sauce, and eggs and soy and nuts in most gluten free items. Most elimination plans include wheat, dairy, eggs, soy, corn and processed foods, mine was special in that I also had to avoid nuts and seafood, so I had to be extra careful with every item. It can be frustrating at first but thankfully there are many allergy free brands, just read, read, read.
Plan Ahead: This is nearly impossible for me for some reason but when you can't eat many things you have to. I would bring a lot of extra snacks to work and knew I needed to have things on hand. I failed at this many times but it became second nature. If I was going to a restaurant I would look at the menu ahead of time because the first few times I didn't I would stand there overwhelmed and ended up with a very expensive breakfast with barely any food. Help. I also call restaurants to ask what kind of cooking oil they use and most of the 5 places I go eat now knows everything I'm excluding :)
Work with Someone: I mentioned that my Integrative Medicine specialist made all the difference for me. Find a dietitian who specializes in integrative or functional medicine. Keep asking questions and if you don't like how they are responding, if they aren't listening, or helping you see the big picture related to yourself, find someone else.
Don't Give Up: You're going to want to. You may actually feel worse before you feel better as your body is adjusting to not eating certain foods. It's not fun to go to a party and not be able to eat the cake, it really isn't. But honestly, knowing that you can make lasting health impacts with these small decisions, one day at a time, one meal at a time with your food choices is a game changer.
For most of us, if we are honest, the healthy choice is not the easy choice. I've spent the past 12 years studying food environments, food access, and social determinants of health and I know for many of us, the cards are stacked against us in the form of food stores in our neighborhood, practitioners who have time to listen, time to focus on ourselves and what we eat. But I'm going to spend my time helping people find simple ways that they can work towards wellness, because sometimes the simplest solutions are right in front of us.
What questions do you have about elimination plans or food sensitivities? I want to know your thoughts!
