Category Archives: GAPS

Before You Give Up On Your Diet

By NMajik at en.wikipedia (Own work (Original caption: “Source: Self”)) [Public domain], via Wikimedia Commons

By NMajik at en.wikipedia (Own work (Original caption: “Source: Self”)) [Public domain], via Wikimedia Commons

This is the last post in my little Specific Carbohydrate Diet series. The Specific Carbohydrate Diet (SCD) is just a real food diet, with some added food tweaks that good observers throughout history have discovered reverse disease and promote healing. It is not the holy grail of diets, although for some patients, it is the cure they were looking for. (You may prefer the word “control” instead of the word “cure,” since these patients will probably never be able to go back to DiGiorno pizza.) I definitely suggest the SCD for Crohn’s and ulcerative colitis as a starting point diet because there is research behind it. (See here for a short summary of the evolution of the SCD diet with references.)

When I used a form of SCD for my gastrointestinal issues (not inflammatory bowel disease), I ran into a few issues and the diet stalled for me, even regressed. I don’t give up easily when I think there’s a way to accomplish something, and so I played around with the diet and I read what other people trying the diet were saying. I’ve compiled a little list of things to try if SCD is not working for you.

Remember, nothing here on my site is medical advice and should always be investigated and explored. Talk with your doctor and maybe get a referral to a dietitian for help. This is the internet. Believe nothing. Question everything.

Eliminate “pesky” foods that are allowed on the diet: nuts, peanut butter, eggs, dairy. Foods that we know cause life-threatening allergies can also cause other immune reactions in the body that aren’t nearly so serious. Even though they aren’t life threatening like true allergy, they still can cause bad, uncomfortable immune reactions, especially at the interface of the gut lining (but not limited to the gut lining).

Common food allergens like nuts, peanuts, dairy, and eggs are notorious for more than just anaphylaxis and hives! If you read research studies, you’ll see them coming up again and again for things like migraines, eosinophilic esophagitis, and eczema! I feel like medical doctors only communicate the life-threatening aspect of these foods (which is super important, of course), and ignore their involvement in so many other disease states. So people walk around treating their problems with creams, puffers, and pills, when they could be investigating their diet.

The Specific Carbohydrate Diet allows eggs, almonds, nuts, peanut butter, homemade yogurt, cheeses and butter. All good foods! But also all known top allergens that can perpetuate illness in susceptible people.

(Coconut is not necessarily a top 8 common allergen, but I’ve read of many SCD’ers having trouble with it, particularly the flour. I’d add it to the “pesky” list.)

How do you know which “pesky” to take out? Well, you can start with the one you have a sneaky suspicion about. Or you can see if your doctor will order you an IgG blood panel (which has such variable results for people), although you need to know up front that many conventional medical doctors disapprove of them. Or you can eliminate them all, and slowly bring them back in one at a time.

Whatever you do, be smart and make sure you’re getting any nutritional deficits accounted for!

Cut down on baked goods. When people switch to the SCD, they often, understandably, try to recreate the diet they had been eating: muffins, breads, pancakes, and cookies. ALL of these things can be made on the SCD and are super tasty! However, the ingredients for them come from the “pesky” category (almond flour, eggs, butter, and so on), so they really shouldn’t be routine food fare. They also come with a big whop of sugar; yes, I know it’s honey, but fructose in excess has its own negative effects. Baked goods are great as a transition to ease families into eating more real, wholesome foods. If my kids hadn’t had a baked good, I would  have had some runaways.

In any area of the diet you may be lapsing and skimping in, get strict again. Get back to eating only the legal foods with “no exceptions.” It’s so easy to let products back into our kitchens. A little guar gum here. A little BHT there. Some maltodextrin there. Some modified food starch. And then you’ve walked down the slippery slope and fallen. Crash and burn for a few little ingredients that really weren’t even that important to you!

Studies indicate that emulsifiers may cause problems for inflammatory bowel disease, so if you’re struggling, get the “small stuff” back out!

Alternatively, perhaps the idea of “being strict” is sabotaging adhering to the diet well, and adding in a few select real, whole, foods, like rice and/or potato may be helpful in overall adherence to the diet.

Even though certain foods are not allowed on the diet, that doesn’t mean that a person’s body and disease will not tolerate them. Yes, it’s best to adhere to the diet as it is written, but it is VERY likely that adjustments will have to be made. Remember, the diet is not magic. It can’t prophesy exactly what your body will and will not tolerate. If adding in a food that may not be problematic anyhow is the price to pay for keeping on the diet instead of giving up completely, it’s worth a trial! Make sense? (But do talk with your healthcare provider who is overseeing your diet. They might have some other tips they’d like you to try first.)

Elaine Gottschall, the author of the diet, did not intend for The Specific Carbohydrate Diet to be a forever diet. She advocated moving off the diet once symptoms were well-controlled.

Read about FODMAP foods. Foods have natural sugars and molecules that we don’t absorb and that feed our gut bacteria. It’s actually a good thing. But sometimes, guts that are compromised need a break from these too, or else they’ll have painful bloating, gas, diarrhea, and/or constipation.  FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. FODMAP foods can cause pain outside of actual inflammatory disease and would be worth exploring. I have noticed that many people suggest cutting down on fruit if the SCD isn’t working well for you, and I can see where certain fruits will exacerbate a FODMAP condition. Here’s a good site with FODMAP information. Just click on the symbol, and it brings up a nice handout.

Take away the power struggle. When it comes to kids, they MUST understand the diet and their bodies. Kids usually make good decisions when they’re given good information and see the impact of certain foods on their bodies. Make it a point to understand the diet and read the book, then paraphrase it and explain it to your child. Kids need empowered, not controlled. Sometimes our fears lead to a strong need to control, but kids will buck this. Well, at least mine do!

The mind-body idea. We KNOW that there is a BIDIRECTIONAL process between the brain and the gut and conversely, the gut and the brain. It works from the bottom up. And the top down. If you’re ready to take it beyond diet and supplements, maybe it’s time to move inward. Google things like mindfulness and IBD. Or hypnotherapy and IBD. See what you think. This area has definitely piqued my interest. It takes me months and years to write, so you’ll definitely want to read in this area before I get any posts up on it!

Well, that’s it for today. I’m sure there are other tweaks. I think the best tweak is to know you’re going to be okay. Know that nothing can get you, because you’re bigger inside than anything you can comprehend. If you’re on the religious side, know that you’re a spiritual being forever with a human body but fleetingly.

Feel welcome to post any tweaks you’ve found beneficial.

Over.

Terri

 

A Stay-At-Home Mom’s Diet Enters Medical Research

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When I used to work as a physician, I wondered what it’d be like to stay home with the kids full-time. Some moms would say, “I HAVE to work. My kids drive me crazy.” I always thought to myself that I’d still like to try it and see. Maybe crazy is a state of bliss that I’d like quite a lot.

I did get to stay home, and to my chagrin, I did fall into crazy. Crazy nutrition. At first, I honestly did wonder if I had taken neurotic to its pinnacle, but I kept reading and reading. And over the short four years since I began having any interest in nutrition at all, other than having the best chocolate chip cookie recipe, there have been some major upheavals in medicine regarding nutrition, particularly regarding fat and cholesterol. But I know there will be more.

One upheaval that intrigues me, because I swear real food is pixie dust, is doctors using a real food diet to throw inflammatory bowel disease into remission without medicine. At Seattle Children’s Hospital, researchers are reversing serious cases of ulcerative colitis and Crohn’s disease using the exact same voodoo, or pixie dust (if you prefer), diet that Elaine Gottschall, a stay-at-home mother of two, used in the 1950s to save her 8 year-old daughter’s life from near-terminal ulcerative colitis. The diet, called the Specific Carbohydrate Diet (SCD), was the last hope that Elaine had for possibly saving her child’s colon, maybe even the child’s life itself. Permanent poop collection bag? Death? How about we try this weird diet.

Dr. Sidney Valentine Haas’s Stodgy, Misinformed Diet

The SCD is not a new diet. It has been around in some form since approximately the 1920s, when Sidney Valentine Haas, MD was using it on his celiac and severely afflicted gastrointestinal patients.  At this time, there was no known celiac disease and gluten connection. Dr. Haas, using close observation skills and taking good patient histories (all things falling into disfavor in today’s medical climate), felt that starchy carbohydrates and table sugar were bad for his patients. So he developed a diet which removed starchy foods and sugar, making it inherently gluten-free and grain free. He found that his patients did fine with fruit, and he strongly encouraged bananas, and he even thought there was something special about the banana.

His “banana” diet was pretty popular and was used to manage celiac disease until the gluten connection was verified. Then, Haas and banana diets fell into disfavor, ridicule even. However, Dr. Haas, a reportedly kindly man who lived into his 90s, never acquiesced that gluten elimination should be the sole treatment of celiac disease. He remained adamantly suspicious that most starchy carbohydrates were problematic and needed removed for a time (not a lifetime). He genuinely believed in his diet, and if you read closely, he is scorned for never succumbing completely to the hypotheses that gluten is the sole problem for celiac patients.

(Now, I don’t know whether he was right or wrong about gluten. I DO KNOW that there are celiacs who follow a STRICT gluten-free diet, never eating away from home, and I know they still have abdominal issues. So, perhaps his intuition is not as laughable as it seems. Perhaps, as time passes and we learn more, we will find facts that make him more right than wrong. I don’t know. History repeatedly shows genius in ridicule, and maybe there’s more to treating celiac than just taking away gluten.)

A Doctor -Shopping, Stay-at-Home Mom
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This photo of Elaine Gottschall came from http://www.breakingtheviciouscycle.com, the official Breaking the Vicious Cycle and SCD website.

 

The SCD would  have probably stopped right there if it hadn’t been for Big Magic (you really should read the book by this title, very good). Elaine Gottschall (now deceased, 1921-2005) called herself an ordinary, happy, stay-at-home, 1950s’ mom. She had two young daughters. One of her daughters, Judy, began experiencing incapacitating gut issues and was diagnosed with ulcerative colitis at the tender age of four years old. Little Judy was so sick and malnourished by the time she was 8, she had stunted growth and even her neurological system was shutting down. Elaine and Herb were told their daughter had two options: colon removal or death. Elaine wouldn’t hear it and refused to take death or colectomy (colon removal) as an answer for her daughter if she could do anything about it.

So she did what all desperate patients do (or parents of patients), she doctor shopped. After much doctor shopping and no hope in sight except surgery, an acquaintance of a friend pointed her to an outdated, nearly ancient physician. She finally landed in the arms (figuratively) of our now 92-year-old Dr. Sydney Valentine Haas. He started her daughter Judy on his version of what is now the Specific Carbohydrate Diet. Her daughter improved dramatically within days and even more in the months that followed, living a full life, even being able to eat a very diverse diet eventually.

Humiliating Success

Dr. Haas died within two years of meeting the Gottschall family. Would his diet die with him? No. Elaine Gottschall made it her mission to understand that man’s diet, even going back to school and earning degrees in biology, nutritional biochemistry, and cellular biology. If this diet helped Judy live and get her life back, she wanted to know why and share it with the others who were sick. Many times she wanted to give up, but her husband was convicted that the world needed this information that would be lost without Dr. Haas, and he knew Elaine was just the woman to do it.

Herb encouraged Elaine to write a book eventually called Breaking the Vicious Cycle, do health consults, and speak. She functioned at a grassroots level, and she touched thousands of lives, helping people turn their health around with the SCD. But, sadly, she could never break through to medical circles. Her daughter said: “She also wanted the acceptance from–if not approval of–the medical mainstream, which she never got. She was told stories by mothers who said their doctors would refuse to treat their children if they followed her diet…”

Doctors refusing to treat patients if they tried this diet? A diet that has now entered the halls of medical research with initial success? Elaine’s diet brought success to many suffering patients, but the patients’ doctors wouldn’t have it. How could a simple diet help? How could a stay-at-home mom know what she’s talking about? Who was she to challenge medical management?

Because of Elaine’s tenacity and courage (and ability to persist despite medical contempt), people today may have an opportunity to try diet over drugs. Some doctors are listening to patients and trying the SCD in clinical research. (See my last post.)

Elaine, Herb, and Judy (their daughter), thank you.

Closing

The SCD studies are small and sparse, but they’re pretty remarkable, especially in kids, whose healing capacities are always amazing. IF diet makes a difference, then I think Elaine Gottschall is right, the only way it’s going to get to medical doctors is if patients keep showing them. Dr. Suskind’s studies from Seattle are shedding some light, but they’re so small. With just a snap or a new successful medical discovery, his work will be trampled over forever, as Dr. Haas’s almost was.

Did Dr. Haas have it ALL right? No. Did Elaine Gottschall? No. Does the doctor named Natasha Campbell-McBride (who has taken Elaine Gottschall’s work further in her clinical practice, renaming her diet GAPS)? No. Does Dr. Suskind, a researcher using SCD in his studies? No. But continuing to cut out colons and continuing to prescribe immunosuppressants without ever trying significant dietary modification such as the SCD is irresponsible and, to me, unethical. Medical doctors maliciously, scornfully, and condescendingly name-call and ridicule diet theories they don’t agree with like pompous elitists. And guess what! When we do that, nurses, dietitians, pharmacists, and the public follow along. Then, we end up in a big mess. Like Days of Our Lives. Please stop the division.

You are never too small. You are never too insignificant. You are always enough. Your experience is for you. Your experience is for others. Live boldly with love and compassion.

Even your cooking can change someone’s life.

Ciao.

Terri

Sites and links I followed for information, which should always be verified before you even think about trusting anything…

Frontiers in Celiac Disease, pages 5-7: https://books.google.com/books?id=gqaDD3jkcfYC&pg=PA6&lpg=PA6&dq=haas%27s+banana+diet+celiac+disease&source=bl&ots=pPA2rdAt9_&sig=tgEgHivZWbdeSKX5j1Dajx243Iw&hl=en&sa=X&ved=0ahUKEwi1xNTukc_RAhVG4IMKHdtmBKo4ChDoAQglMAI#v=onepage&q=haas’s%20banana%20diet%20celiac%20disease&f=false

http://www.breakingtheviciouscycle.info/p/about-the-author/

Recipes for the Specific Carbohydrate Diet by Raman Prasad

Explaining That Diet Does Help Severe “Stomach” Problems

baadsgaard-alfrida-ludovica-vi-opstilling-med-ananas-druer-ogImagine having diarrhea 15 times a day, every day. Add some blood to that. While you try to walk across a university campus. Or coach basketball.  Or serve on a Navy ship in the middle of the vast ocean. Or learn to add, subtract, and multiply.

This is life with Crohn’s disease or ulcerative colitis, collectively called inflammatory bowel disease (IBD). And when I was a medical student on general surgery, I swear it seems like we were digging around every day in some poor patient’s intestines due to his or her inflammatory bowel disease. Many emerged from surgery with bags to collect their liquid bowel movements.

I feel like I’ve heard it a thousand times. “My doctor says it doesn’t matter what I eat for my Crohn’s disease.” Have you heard that? Do you believe that? That’s 100% false. Research since the 1970s shows that patients can go into remission with special “nutritional shakes.” 

Patients are often convinced that food impacts their disease, but they can’t always pinpoint how or which foods. Medical studies weren’t very helpful in the past; they looked at things like fats, amino acids, and vitamin D, finding some correlations, but nothing to hang their hats on. So hard-working doctors just shrugged their shoulders and said, “It doesn’t really matter, dear patient. Just eat.” [Scram. I’ve got 8 patients waiting to see me. I don’t have time to listen to you speculate about whether or not milk gives you diarrhea.]

But fascinatingly, studies have shown for forty years now, plus or minus, that IBD can be controlled with nutrition! Well, more accurately put, researchers and patients controlled IBD with exclusive enteral nutrition. Exclusive enteral nutrition, EEN for short, is basically just a “nutrition” shake kind of like Ensure or PediaSure, only it tastes much worse. The ingredients in the shake have been pre-digested so they can be absorbed completely in the small intestine.

Studies have repeatedly and reproducibly shown great results for IBD patients and EEN, particularly Crohn’s disease. How great? Well how does upward of 100% sound to you for a remission rate? Would you even settle for a 70% rate? Yeah. That good. I’m cherry picking a little; some studies didn’t have such high success rates, but most did. And some studies that didn’t look all that good to begin with looked better after the study results were adjusted for patients who just couldn’t tolerate the special liquids (often quite a few). Also, results were consistently better for pediatric patients [who often heal more quickly and have to be compliant whether they like it or not—and sometimes choose to be compliant because they feel so much better!]. (Kansal, 2013)

But patients and doctors, I guess, weren’t having that. Too yucky. Too restrictive. (Just for interest, I notice that Nestle seems to make many of these nutritional EENs.)

What’s in that shake?

Great minds pontificated about what it was in the EEN drink which could cause these patients to do so well. They played around with the liquid formulas with good success, trying to make them less repulsive and less expensive. Then they pondered, “Well, can we let our patients eat [cake] and take some of this EEN stuff?”

So researchers let patients drink the liquid EEN formula and have free access to table food at the same time. Yum! With free access to table food, despite the nutritional “shake,” the remission rates weren’t as good as when a patient ate only EEN liquid—but they were better than the patients who received no EEN at all. Aha! So it’s starting to look like something in table food perpetuates increased inflammation in inflammatory bowel disease patients. (Triantafillidis, 2015)

Okay. All Mama’s good table food really threw a wrench in the great effects of the EEN shakes. What next?

Well, allowing table food was a step backward, and researchers thought, “We need another twist. What can we do? This is fun.”

So researchers gave patients nutritional “shakes” and they let them eat only certain allowed foods. (NO CAKE this time. Sorry.) Bingo. Success rates held at about 70% of patients showing improvement and or sustained remission. (I know a lot of doctors who made just 70% in class and are successfully practicing. Pass equals MD, baby. Seventy percent is pretty good.) That’s awesome. How happy would you be to be symptom-free and able to eat some real food?  (Sigall-Boneh, 2014)

It’s 2017. Can we ditch the EEN altogether and just eat real food?

Now, we have to cap it off. Could patients get off of the disgusting “shakes” altogether? (Good-bye, Nestle…) Well, the Journal of Clinical Gastroenterology is about to publish a study done by a Dr. Suskind (and his team, of course!) from Seattle Children’s Hospital. Ten pediatric patients followed a diet called the Specific Carbohydrate Diet for three months, and 80% of them had symptoms improve significantly and even resolve and lab markers normalize. Eighty-stinking-percent! Let me repeat: eighty percent success. WITH FOOD.

Way to go Dr. Suskind and team. Way to take medicine back to truly patient-centered, do-no-harm care! And most importantly: WAY TO GO PATIENTS AND PARENTS WHO PARTICIPATED IN THIS STUDY! Changing how you eat is hard work, and most people balk, standing in the corner cowering with too much fear to leave their pizza and bread behind. Not you. Not you. (Suskind, 2017)

[Click here for a readable summary of Suskind’s report and here for an abstract of it.]

Meh. Study needs to be bigger.

Now, I showed someone Suskind’s research summary, and she replied, “But there’s only ten patients. I wish it was bigger.”

Sigh. So do I. But it’s what we’ve got. And it’s so promising. I’m ebullient. Diet alone! Eighty percent remission! With real food. No diarrhea! No bleeding! No stomach cramps! Virtually 100% safe. No injections! No risk of white blood cell counts crashing. Why won’t people try this?

Reminds me of a verse I learned from a big book, although I’ve adapted it. “The fiddle plays and you won’t dance. The singer wails a mournful tune, and you will not cry.” We are hard to please. Impossible nearly. What do we want? A magic bullet pill with no side effects?

I must close now. But you will not want to miss my next post about the amazing stay-at-home mom who made it her life mission to show the world that inflammatory bowel disease can be controlled most of the times with real, whole food. And I’ll explain a little about the diet that saved her 8-year-old daughter’s life and which she spent her life studying and evangelizing.

Terri

Citations:

Kansal, S., et al. “Enteral nutrition in Crohn’s disease: an underused therapy.” Gastroenterology research and practice 2013 (2013).  https://www.hindawi.com/journals/grp/2013/482108/

Triantafillidis, John K., Costas Vagianos, and Apostolos E. Papalois. “The role of enteral nutrition in patients with inflammatory bowel disease: current aspects.” BioMed research international 2015 (2015). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4352452/

Sigall-Boneh, Rotem, et al. “Partial enteral nutrition with a Crohn’s disease exclusion diet is effective for induction of remission in children and young adults with Crohn’s disease.” Inflammatory bowel diseases 20.8 (2014): 1353-1360. https://www.researchgate.net/publication/263548102_Partial_Enteral_Nutrition_with_a_Crohn’s_Disease_Exclusion_Diet_Is_Effective_for_Induction_of_Remission_in_Children_and_Young_Adults_with_Crohn’s_Disease

Suskind, D. L., Cohen, S. A., Brittnacher, M. J., Wahbeh, G., Lee, D., Shaffer, M. L., … & Giefer, M. (2017). Clinical and Fecal Microbial Changes With Diet Therapy in Active Inflammatory Bowel Disease. Journal of Clinical Gastroenterology. Abstract only: http://journals.lww.com/jcge/Abstract/publishahead/Clinical_and_Fecal_Microbial_Changes_With_Diet.98120.aspx

Are You Still Doing GAPS? Part II

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Welcome back to my self-interview about this voodoo diet called GAPS–

Wait–why do you call it a voodoo diet? Ha! I took to calling all this alternative stuff “voodoo” because, as a conventional medical doctor, I didn’t believe in it. It seemed like tricks and magic without real, tangible evidence and results. (Snake oil. Voodoo. Quack, quack. $Ching, ching, ching. All these people seemed in cahoots together.)

The GAPS diet especially seemed like spooky voodoo because it repeatedly talks about making and drinking broth from bones–bone broth– and eating animal organs. If that ain’t  “voodoo” sounding to a refined, civilized girl who eats cereal for breakfast and a sandwich for lunch…

Do you still think it’s spooky? Nah. Now I realize it’s just a traditional way to recoup the needed minerals, proteins, and vitamins that are stored in bone and the organs of animals. It’s basically just using the whole animal, as cultures historically did before us.

I mean, it seems even a generation or two before us, kids were still forced to eat their liver. Not “their” liver, but the cow liver on their plate. They didn’t all run to the store to pop some vitamin D, folic acid, calcium, magnesium, and vitamin C pills. And ask the grandparents! You’ll find some of them who have an affinity for an organ they haven’t eaten in years!

My dad loves liver. My father-in-law heart. I remember eating the tongue with my own farming grandparents when I was a kid. Each meat cut and organ has its own vitamin, mineral, and amino acid profile! So by only eating white meat or steak, we are completely missing the gamut of beneficial nutrients, due to our snobbery and “advancement.” It’s a sad misuse of an animal. I’m so sorry to be perturbing  my vegetarian friends’ sensibilities. I know it sounds yucky.

Well, it does sound a little gross, I have to say. Anyhow, I have read some bad things about the GAPS diet? Can you mention some of those concerns?

Yes, well, there’s the concern of lead toxicity in the daily broth requirement.  If the animal is raised on a bucolic, yet lead-laden farm, then the animal can have a higher concentration of lead in its bones, seeping into your broth. I’ve read you can’t really predict which land will be high in lead levels because the lead can permeate the air, travel, and settle in a different area, remaining for years and years. Remember, we used to use lead in gas for our cars. So I’m not sure you could predict without testing, which farms will have higher lead than others. But I’m no expert. So, sure, there may be an unpredictable risk of lead.

Another concern is the effect of a sudden carbohydrate drop on the body. GAPS doesn’t have to be a low carb diet, but the introduction diet is way too easy to be almost no carbs at all! Most people just enter ketosis with uncomfortable symptoms, like headaches, fatigue, and a little nausea.

Other people, and kids are pretty sensitive, react violently to the ketosis transition, with horrible nausea and persistent vomiting. This really puts them at risk for electrolyte disturbances, which could land them up in the hospital! Most likely, and I’m not a GAPS provider or expert and you shouldn’t use my blog for medical advice, this could be avoided by making sure to eat carrots, winter squashes, pumpkin, and honey in the recommended tea. I personally think a slower transition to a low carb diet is much safer. When I transitioned, when I felt that low-carb feeling, I eased it with some cooked carrots and honey in my tea. I’m a weenie. But a safe weenie.

Food obsession is a definite concern too. The GAPS food list becomes a Bible. I remember my husband coming home when I was doing GAPS and showing me an article about orthorexia. This is an eating disorder where people obsess about eating healthy, judge themselves and others by how they eat, develop anxiety due to food choices, and basically, their whole life simply become wrapped up in food. I was glad he showed me this article. We talked about it together, decided no, that’s not where I was at, and then I proceeded with a new awareness of something that can easily afflict health-conscious people–myself included—if awareness is not high.

And then we get into raw eggs and raw milk and raw fish…

Oh, uh, yummy…by the way, what do you eat on GAPS? Well, the book has a whole list of do’s and don’ts. But, basically you eat lots of vegetables, like broccoli, cauliflower, zucchini, carrots, squash. Meats, trying to incorporate grazing animals that roam pretty freely outside–and not just eating one cut of meat, but the whole animal, including organ meats.

Eggs, seafood. Fruits. lentils and specific beans, soaked. Nuts. Honey. Peanuts are okay, too. And then daily consumption of fermented foods for probiotics and homemade broths (using leftover scraps and bones) for the minerals and amino acid profile.

But what shocks most people is that there are no grains or potatoes allowed. Not even sweet potatoes. GAPS’ carb foods are things like carrots, squashes, lentils, honey, navy beans, fruits, peas.

Did GAPS “cure” you?  No. It did improve me, though to the point that my GI symptoms were very tolerable. It also showed me that the many headaches I was getting wasn’t just my kids. (Love you, girls!) Ha! I had some sensitivities to particular foods, like eggs, which give me headaches. But I had to carefully do and re-do the introduction, elimination type part of the diet to figure that all out.

What do you mean? Sensitivities? Geesh! You had to take out MORE foods? Yes! A full GAPS diet would have been disastrous for me, but because I went through the introduction and followed the author’s suggestions on watching for food intolerances, I was able to identify problem foods I had: dairy, nuts, eggs, chicken, coconut.  After 18 months on GAPS, those foods still bothered me (and still do).  GAPS helped me but did not cure me.

But the GAPS diet is laden with foods that will bother many autoimmune-ish people, like dairy, nuts, eggs, and legumes. All very “healthy” foods that I think should be in a person’s diet if they are tolerated.

WAIT a minute. Are you kidding me? Some people have to take it further than GAPS or Paleo?

Well, nobody has to do anything! Right!? It’s important to remember that! This is always a choice! But, yes. Some people will find much relief in taking their diets down to whole food and then further eliminating nightshades, legumes (beans and lentils), all nuts and seeds, all dairy, eggs, all grains (wheat, soy, corn, even rice and quinoa). Also, watching out for reactions that are very individual, like avocados or shellfish or coconut, etc.

But remember, the goal is not to be a martyr or to be “cool,” the goal is to feel better, to feel like yourself. And your own diet tailoring will take you there, not somebody elses.

Are you sure this stuff, it’s not all in your head? Or those people’s heads? Could be. But my head really wants it to be okay to eat pizza. I’d love me some pizza. My head wants pizza. It’s my favorite food. But when my head starts eating pizza, my body gets mad. My head is like, “Ah, see! That wasn’t so bad, and it was delicious.” And my belly is like, “What did you just do to me?”

Would the “you now” recommend the diet to the “you back then”? 

When I started this nutrition stuff, I needed an extremist to bring me to my eating knees. All my food came from a box. It all had dairy and wheat. And I didn’t really see anything wrong with that. Mostly, I’m not extremist in anything. I always thought that a really good diet (and life) allowed absolutely anything in moderation. But my gut and headaches didn’t agree, and food definitely played a role. I haven’t read a better book at explaining how to eat 100% unprocessed food than Dr. Natasha Campbell-McBride’s Gut and Psychology Syndrome (GAPS) book.

I mean, she taught me that even tea bags were processed and that “whole food” tea would be the loose leaf tea, or even better, the mint you grow in your garden. However, the GAPS book is not really written in a scientific manner, it is more evangelical–and maybe even fanatical?

It is written to drive things home and to allow for no exceptions.  I needed Dr. Natasha Campbell-McBride’s unique, rigid approach. There’s no looking for GAPS-legal processed foods because honestly, none exist.  (Heck, even nuts are supposed to be soaked!) If I had a loophole, I would have wriggled my logic right through it. 

Dr. Campbell-McBride’s GAPS diet book breaks things down in a simple, general way for pretty accurate reading–but could definitely be considered reductionisic or “fruity” by anyone with a medical or scientific background.

I would recommend to myself back then that I not be afraid of any real, whole food, and that I introduce it slowly, seeing how I do. Not just follow the GAPS list of foods. Start with those, and then not be afraid to journey forward.

Do you believe everything in the book?

No.  Not as stated.  But yes, I do see now with my research that the gut and its bacteria play a huge role in the body’s pathology. I see where soaking nuts and beans helps. And where eating organ meats and bone broth supplies needed nutrients.

I do not find her “allergy testing” on the skin to be useful or practical. It may even be dangerous. Someone with a severe food allergy may think, because their skin doesn’t have any changes after putting some of that food on their skin overnight, it’s okay to eat a known allergenic food.

I’m still not a fan of raw milk. Sure, if it’s my cow, I wash the teats, and I milk the animal.

Mostly, I know that one plan will NOT fit all. Ever.

Well, let’s stop talking and see if anyone wants to comment. Okay. Good. I hope people remember that this blog is a place of sounding ideas, sharing ideas, not one of guidance. Ha! “Like the blind leading the blind, shan’t they both fall in the ditch…”

Questions? Comments? Gripes? Complaints?

Terri

 

 

 

 

Are You Still Doing GAPS?

Chunky squash chicken soupI’ve fallen completely in love with nutrition. So I decided to do an interview with myself about the first, crazy, named diet I ever tried: GAPS. Read with a mild sense of humor at times. Please don’t use anything on my site as medical guidance. (I always say “please,” but I mean it…) Use what I write to scoff. Laugh. Plagiarize. But not as medical treatment or recommendations. Even thought I think I’m right, you should know that I’ve been known to lock myself out of my house, leave fully loaded grocery carts standing in the parking lot, and call my husband by my first real boyfriend’s name.

Are you still doing the GAPS diet?  No.

Got a longer answer than that?  Of course!

Why did you start the GAPS diet? It seems a bit loco sounding. I mean, bone broth and sauerkraut? Really? How did a legit, well-trained, seemingly-normal MD like you go off the nutritional deep-end like that?  Well, honestly, it doesn’t sound too extreme anymore. Now, it all just sounds like good, old-fashioned, traditional food minus a few things. But to answer your question, I had a severe form of a very common problem. In fact, I was told never to talk about it with people, they don’t like to talk about it and they don’t want to hear about it. I suppose I can tell you. I trust you. I started the GAPS diet because my stupid gut wouldn’t move, even with medicines, more than twice a month. Anal retentive woman, I guess.

Did you try any other more normal diets before this?

Oh, like– vegetarian-in-a-box? I’m kidding. A traditional vegetarian diet I think is actually a powerful way of eating, especially if one throws in an occasional egg and/or some fish. But so many vegetarians think a vegetarian diet is about just not eating meat–and they sacrifice their own bodies to the industrialized food package.

Well, anyhow, the standard medical repertoire and more than 4-5 doctors had finally 100% failed me, and I scoured the internet hours and hours for alternative “cures.” I started reading tons on-line and trying this supplement and/or that food, falling into the idea that “one” thing would help.  I tried a gluten-free and dairy-free diet for a couple of months while I researched.  I tried an elimination diet with only sweet potato, lamb, and white rice too.  Repeatedly, though, I kept hitting on people talking about special “healing diets.”

A healing diet? Pft. What in the heck is a healing diet? I know. I know this sounds so stupid to newbies and nutritional novices. When I first started reading about this stuff, I thought, “These people are crazy. CRAZY. WHAT do they eat? How can they think a person should cut THAT out of their diet? Oh, the gullible heap.” (I have a little judgmental problem. Life is working on it.)

And this leaky gut they keep talking about? I can’t remember which staff doctor in training told me that leaky gut wasn’t a real thing, but I know I was taught that!

To answer your question, a healing diet takes into account the fact that the condition of our gastrointestinal tracts helps determine our health—whatever part of the body we want healthy (skin, brain, intestines, joints, etc.). And food predominately determines the condition of your gut.

So, using food, a good healing diet will look to keep the immune cells of the GI tract happy. It will look to offer the nutrients the cells lining the intestines need. It will look to make sure the GI’s immune system is not barraged. It will look to make sure the mucous (Did you know mucus is the noun form and mucous the adjective? Cool, huh.) protective layer of the GI tract is regenerating. And it will nurture beneficial gut microorganisms and weed out not-so-beneficial microorganisms.

A healing diet will remove foods that commonly inflame the entire body and will provide abundance of foods which carry necessary nutrients and restorative properties. The best healing diets will also force you to address more than food, things like sleep, stress, skin care products, and so on.

Okay. I see what you mean about a healing diet now, I guess. But why GAPS?

SCD (Specific Carbohydrate Diet) then GAPS (Gut and Psychology Syndrome) were the first “nutritional intervention” diets I kept hitting on. They seemed maybe to be the rage, fad diets of the time. I don’t know. (I later learned of others. And I’m sure there will be plenty more.)

I read all the pertinent websites and bought the books to read. I decided to set out on the GAPS diet to give diet a full attempt to prove to myself that nutrition would not change anything in my health–because I was 100% convinced that diet would change nothing.

Why GAPS?  It seemed the most radical and extreme!  (Have I made it clear enough that I seriously thought all of this was INSANE.  Detoxification?  Gut dysbiosis?  Leaky gut?  Liver support?  Adrenal fatigue?)  But if there was something I could do to avoid a colectomy later in life, I was willing to try! And GAPS seemed, at the time to me, to be one of the most stringent diets, and I wanted to cut to the chase, do the hardest first, and cross diets off my list.

I knew nothing about nutrition, and that’s how I made my choice. Brilliant, eh.

How long did you stay on GAPS?  I stayed on GAPS for about 18 months.

Eighteen months! New humans are turned out in less time than that. Did you cheat? Sometimes on accident. And  sometimes I’d choose to “cheat” and see if I could expand my diet without having any problems from it. But the GAPS diet book says it can take up to two years, so I wanted to give it its due chance. If I clearly could see I had no issues with a food, I’d eat it on special occasions, like maple syrup or a baked potato. And dozens of times I struggled with eating too many dates, honey, almond flour, and peanut butter, all “allowed.”

Why did you stop GAPS?  My constipation finally became manageable with lots of magnesium and the GAPS diet. I became enchanted with nutrition and kept reading. I stumbled across something called butyrate for gut health when I was interpreting a Metametrix stool test I had taken (I know. Weird. A stool test.) and decided to try it as a supplement for my GI tract. Its effect was magic on my gut–GAPS had gotten me part of the way and this seemed to finish it!  But butyrate is still a supplement, and I don’t like supplements.  We (well, our gut bacteria) can produce butyrate naturally from certain foods, so I next added in potato starch (Bob’s Red Mill) and began eating food sources of butyrate, like sweet potato (cold), rice (cold), green plantains, green bananas, potatoes (cold), and a few, diverse legumes.  So after about 18 months, I think you have to technically say I came off of GAPS because I was routinely adding in foods not on the diet.

I still keep a lot of the ideas that GAPS taught me in my diet:

  • Homemade broths for gelatin, calcium, magnesium.
  • Fermented foods such as sauerkraut and kimchi.
  • Offal, such as liver, heart, tongue, and marrow.
  • Vegetables, vegetables, vegetables. (Some say GAPS doesn’t advocate carbohydrates and raw vegetables.  I don’t think that is accurate.  It is not written as a low carb plan per se. It allows a person to eat navy beans, lentils, parsnips, pumpkin, butternut squash, peanut butter certain fruit, and honey as tolerated by a person. And it only excludes raw vegetables until a person’s symptoms improve. Now, how each person will interpret and follow the diet will vary.)
  • Minimizing exposures to environmental things I can control and helping the body deal with them–such as avoiding plastics, excessive fluoride, unnecessary skin care products, etc.  Taking Epsom salts baths.
  • Well-placed supplements.
  • A never give up attitude.

I will continue this long, verbose self-interview later. My kids need food and school…

Hypoallergenic Food

Listen, you’ve heard the term hypoallergenic as it relates to your jewelry, your skin care products, and your laundry detergent, but have you ever thought about the food you eat? Have you ever thought about if what you eat is hypoallergenic? No, no. NOT sterile. Hypoallergenic doesn’t mean sterile!

You don’t blink an eye when a friend says, “Oh, I can’t wear cheap earrings. My ears get sore.” You get that! We can all relate to people needing hypoallergenic jewelry or skin products. But have you ever thought about the food you eat and whether or not it’s hypoallergenic to your system?

Yes, indeed! Just like these external substances can lead to immune reactions, so can the food you eat! However, the food you eat leads to a chain reaction of internal immune system activation that doesn’t just sit right there at the gastrointestinal (GI) tract.

You have immune cells lining the intestines which sample the foods you eat and decide whether or not they like it. Whether you like the food doesn’t matter. Whether the food you eat is healthy or not doesn’t matter. If the immune cells sample it and don’t like it, they are going to send out signals (histamines, prostaglandins, interleukins, interferons, and other cytokine signals) in the blood stream which can affect any organ system in your body: you stomach, your brain, your skin, your reproductive system, your lungs, your connective tissue (joints, as an example), your thyroid.

My Oligoantigenic (What!?!?) Diet

When I first started down this fascinating nutrition avenue a little over four years ago (from a classic diet of cereal for breakfast, a sandwich for lunch, and pizza or pasta for supper), one of the first things I learned about and tried was an “oligoantigenic diet.” I had read that some people with the same gastrointestinal malady that I suffered from had been treated in a medical research study with an oligoantigenic diet!

What in tarnation is an oligoantigenic diet? I’d never heard of that! Basically, it is a strict, hypoallergenic diet that allows only foods which are accepted to be very mild on the body’s immune system. Once I figured out that I could think of an oligoantigenic diet as a type of “hypoallergenic” diet, I got it! Choose foods which cause the least known reactions! For those of you familiar with a strict elimination diet, you know what I’m talking about here too.

So I started on a (miserable) diet consisting of three foods which don’t seem to rile up people’s immune systems too much: lamb (I didn’t even like lamb), plain sweet potato (I had only ever eaten those as fries), and white rice (which I had never eaten plain). Did I mention it tasted miserable? But persistence led me on a food journey of a lifetime (for a lifetime).  And as I’ve heard it said, “I didn’t know I was feeling so bad till I started feeling so good!”

An oligoantigenic diet (or hypoallergenic diet) is NOT meant to be a long-term diet. A person starts with a small group of 3-5 foods and builds from there, learning to observe signs and symptoms that tell him or her that a particular food category raises immune reactions (by observing for headaches, GI changes, spikes in fatigue, skin rashes, and other clues).

The Pesky Foods

Never once going through pharmacy school, medical school, residency, and hundreds of hours of continuing education did I ever hear about a hypoallergenic, oligoantigenic diet or even an anti-inflammatory diet. (I was served plenty of donuts, bagels with cream cheese, and pizza, though.) It took me going after my own health to learn about nutrition.

Since my oligoantigenic diet, I’ve done a lot more reading. What I’ve found is that the same foods that doctors KNOW are immune provoking because they cause true, life- threatening food allergies, are the same foods that can be removed to lighten the load of a body stressed by health problems. By removing known immune-provoking, inflammmatory-producing foods, the body gets a rest from the prostaglandins, histamine, interleukins, interferons, and other cytokines that it makes in response to something it thinks is harmful.

Although any food can cause allergic and sensitivity issues, there are eight foods that are medically known to cause the majority of the reactions. Why? These foods have what I call “pesky proteins.” They have proteins in them that have very, very strong bonds, making them difficult for our digestive tracts to break down. The better food is broken down into its smallest parts in our intestinal tracts, the less inflammatory it is to us.

The pesky eight foods are:

Peanuts
Tree nuts
Milk products
Egg
Wheat
Soy
Fish
Shellfish

These are the common drop-dead if you eat them allergenic foods. But I’m not talking about drop-dead allergies here. I’m talking about you and me and Mr. Smith walking around with headaches, bloating, fussy guts, allergies, asthma, psoriasis, eczema, depression, fatigue, puffy eyelids, puffy faces, coronary artery disease, increasing forgetfulness, dry and itchy eyes, chronic sinus problems, joint pain–do I HAVE to keep going? I sure can. Sometimes by simply eliminating the above food categories (with NO cheating), a person can gauge how much food is affecting their health.

Enter Anti-Inflammatory Diets

Since trying my three ingredient, hypoallergenic diet, I’ve discovered a whole world of anti-inflammatory type diets, which aren’t as strict as an oligoantigenic (hypoallergenic) diet. I find it fascinating that these diets often eliminate the Pesky Eight foods, capitalizing on what we know about the immune system and health! However, anti-inflammatory type diets incorporate and expand further on the idea of the immune system and inflammation in the role of health problems.

Each named anti-inflammatory diet (sometimes called autoimmune diets) has its own unique quirks. In general, though, these diets do three things.

  1. Eliminate most of the Pesky Eight foods (although seafood is usually encouraged if a person knows they are not truly allergic) and a few other problematic foods which don’t make the top eight. (Things like corn, any gluten grains, beef, chocolate, citrus, tomato, and beans)
  2. Eliminate processed foods, refined foods, including sugars.
  3. Include abundant vegetables and fruits.

Anti-inflammatory diets (autoimmune diets) seek to eliminate the most common food problem causers and also try to bring in food problem solvers.

Conclusion

Diets in general can be overwhelming, and when they talk about restricting food groups, diets can be downright terror-provoking. As I’ve journeyed away from an oligoantigenic elimination diet, my own diet landed very similarly to many of these anti-inflammatory type diets. It wasn’t by choice and planning. That’s just how it fell. I can’t eat many of the Pesky Eight foods and feel good doing so. My body likes hypoallergenic food best.

I hear a lot of people say that no good diet restricts food groups. I really, really understand what they’re saying. However, LOOK AT THE PESKY EIGHT! They are good, healthy foods!!!!! But if the GI tract immune system triggers a cascade that sets the rest of the body on edge, you’re not going to feel good.

So please, when someone says they can’t eat dairy or wheat, give them a break. When they say they can’t eat eggs or beef, give them a nod. It’s just as frustrating for them as it is you. And if you have any nagging health problems, talk with your doctor about a dietary referral to see if an oligoantigenic food trial helps you gain control of any of your issues.

Don’t use anything on my site as medical guidance or instruction. I hope it sparks curiosity to help you want to learn more. And, oh yes, I like to think that for most people, autoimmune type diets can be expanded with a whole health approach.

Be well. Be curious.

Terri

Eleven Reasons THAT Won’t Work For You

Xiao_er_lun_-_Confucius_and_childrenIt’s so easy to let jealousy torment you when your husband loses 30 pounds eating very low carb (while sneaking in Snicker bars)–and you only lose 5 and swear it makes you manic. Why does it work this way?

It’s so easy to cry and wallow in yourself when you try everything for your multiple sclerosis (MS) and nothing seems to make it budge–well, not like it did for Terry Wahls, who changed her diet and lifestyle and went from a zero-gravity recline wheelchair to riding a bike. What does she have that you don’t?

And how about these people with cancer? The people who go to Mexico and get coffee enemas? Why does one come back glowing and cured and the other one we remember with love and frustration, saying, “Tsk, tsk. She wouldn’t take chemotherapy and look what happened to her. Goes to show. . . ”

I could go on and on. He dropped gluten and his arthritis went away. She started coconut oil and frankincense for her dementia and now she recognizes her family again. He gave up dairy, started some aloe, and his constipation is gone for good. Going raw, vegan cured her chronic fatigue and fibromyalgia. Dropping all grains and all dairy and all sugar and starting physiologic folate helped his autism. Fish oil cured her depression.

Can I stop? Do you get the idea? Is this you?

Shocker. Spoil alert.

Stop reading if you’re completely sold on a new diet or have just spent big money on a new supplement because I have some bad news.

It may not work for you. (Gasp. Shocker.)

But I have some good news too! It MAY work!

Today I want to help you understand maybe why you’re not getting better doing the good things you’re doing. Why each person’s health plan (diet, supplement, exercise, sleep, etc.) must be tailored individually. It sounds overwhelming to think you actually have to formulate your own health plan, that it’s not written out there for you in some book, but isn’t that really the journey of our whole life? Finding out what makes us tick? What brings us peace? Coming to terms with our limitations and expanding our strengths?

“I Don’t Have MS, Terri.”

Medical doctors group symptoms and tests together to arrive at a diagnosis. A label. A name. The name helps us to know what to expect for a patient’s outcome. What we’ve tried before that has helped or not helped.

Dementia. Psoriasis. Ulcerative colitis. Multiple sclerosis. Migraines. Crohn’s Disease. These are labels. They are necessary labels! For example, we know that the group of people who have ulcerative colitis symptoms and tests will need monitored for colon cancer, and that many celiac patients can be symptom-free following gluten-free diets. Having a label helps!

But there are tough cases. Cases which don’t fit, and sadly, they’re more common than medical doctors want to admit or even know about. These patients doctor shop, so often a doctor isn’t given the chance to even know that refractory cases are as rampant as they are. There are diagnoses that don’t have good treatments, like irritable bowel syndrome and fibromyalgia.

These patients, these refractory cases, are like a nebulous cloud which floats around looking for answers. Why can’t they get their answers?

I have a friend (actually I have many friends with MS, sad to say) with classic multiple sclerosis (MS) symptoms and diagnostic tests. She repeatedly tells me, “Terri, I don’t have MS. I’ve never believed I have MS.”

You’d think as a medical doctor, I’d laugh my head off silly.

Maybe you, as a vociferous alternative health proponent are thinking, “She must not be doing it right. She needs to do this [insert your desired diet or supplement]. She needs to try harder. She needs to try longer. . .”

Now, my friend is a little frustrated. She has had MS for years, and sometimes it’s better. Sometimes it’s worse. She has tried nearly everything.

What I want you to think about for people–is the possibility that our labels group similar health cases together which may stem from different causes. And when that is the case, when the underlying cause of presentations which LOOK the same is NOT the same, a person can bang her head into a wall (this is one of my favorite images because I’m so prone to doing this if I’m not careful) wondering, “Why not me? Why can’t I? Why did it work for her?” Except in a highly motivated individual who says, “I’m moving on. I can do this. That failure taught me something,” this can be counterproductive and harmful.

One Leukemia: 11 Diseases

And now I get to the crux of my post. When I was in medical school, I learned about acute myelogenous leukemia (AML). I learned it as ONE disease entity. ONE (a bad disease entity at that). New research shows that this AML that I learned about as one disease, is actually 11 diseases, with 11 different causes–which show up looking the same! This helped explain why some people responded so well to treatment and some people tragically did not. We weren’t treating ONE disease, we were treating ELEVEN!

See: Genomic Classification and Prognosis in Acute Myeloid Leukemia

I think that most of our clinically diagnosed diseases will ultimately be found to be caused and/or impacted in different ways. Until that day that you know exactly what the cause of your illness is–your obesity, your thyroid problem, your irritable bowel, your IBD, your arthritis, your insomnia, your depression, your constipation, your MS, and so on–until that day, you’re just going to have to take a flat-out comprehensive approach to have the best outcome.

So…

  • Should you eat low carb?
  • Should you eat high fat?
  • Should you eat dairy?
  • Should you eat meat?
  • Should you eat grains?
  • Should you take calcium?
  • Should you supplement with CoQ?
  • Should you take iodine?

And so on and so forth. Whether you should or shouldn’t may depend on your genes, how they are expressed, your gut microorganisms (bacteria, fungi, viruses), and how your environment (sun, exercise, sleep, diet, daily doses of inadvertent toxins) interacts with those.

There is no ONE diet. There is no ONE lifestyle. In fact, there’s probably no one dementia. No one MS. No one IBS. There may be 11.  So find a platform which resonates with you. Try it. Be willing to modify it. Don’t abandon what works. Keep what works and build your plan. Don’t despair. Don’t give up. Start with absolutely real food if you have a problem you really need to tackle. And move forward, tweaking as your body tells you.

(And, of course, seek medical advice and always be safe.)

Terri

Photo credit: By An unknown Chinese artist [Public domain], via Wikimedia Commons