Food Sensitivities & Arthritis

It’s amazing how many people with the various types of autoimmune arthritis have allergies and food sensitivities. Kinda makes you wonder if there’s a connection.

Unfortunately, some people assume that food allergies are a figment of the imagination. I recall years ago telling my daughter’s rheum that she was allergic to dairy, soy, and eggs. That doctor asked no follow-up questions, yet the letter back to our family physician put quote marks around “food allergies” as if we were making things up. Had the rheumatologist bothered to ask (or at least expressed skepticism), we could have clarified that an allergist said that she had food allergies.

One school of thought has studied which foods are most likely to cause reactions in people with autoimmune diseases, then put together an eating plan that eliminates all those foods that might be causing problems. After a suitable period of time not eating foods that tend to be problematic, those foods can then be re-introduced one at a time – paying careful attention to whether or not the reintroduction causes a reaction.

This seems like a reasonable approach. For myself, I know that if I ingest milk, within one day I have tiny red bumps all over my upper arms. It takes six weeks of no-milk for those bumps to go away. So when people talk of eliminating a food for a month, I tend to squint at them and question what they hope to accomplish in only one month.

I know a few people who have tried this particular elimination diet, but they didn’t make it sound especially attractive – lots of restrictions and no real meals. As it turns out, I suspect that they didn’t really comprehend all that it entailed. They understood the “eliminate” portion, but not the “eat healthy” part. The goal is to focus on nutrient-rich foods and work on eating a well-balanced diet while avoiding potential allergens. I’m finding lots of delicious recipes (and a few strange ones).

Focus on eating:
• Meats
• Seafood
• Leafy greens (lettuce, spinach, kale, etc)
• Cruciferous veggies (broccoli, Brussels sprouts, cauliflower, cabbage, etc)
• Colorful veggies (carrots, yams, beets, squashes, asparagus, etc.) (avoid nightshades)
• Herbs
• Healthful fats (olives, avocados, coconut, olive/avocado/coconut oil)
• Berries & fruits (limit fructose to 10-20g daily)

I don’t know about you, but I think that looks like lots of pretty nutritious foods!

According to this theory, certain food groups are most likely to cause people to react, and it amazes me how many of these foods I’ve known for years to be a problem.  Categories of foods to be avoided for a period of time under this plan, are:

• Dairy (I already know that I have problems with milk & cheddar cheese)
• Eggs (I can eat duck eggs but not chicken eggs)
• Grains (I know I have problems with some grains)
• Legumes (I’m allergic to soy, and don’t eat peanuts or peas)
• Nightshades (I refuse to eat eggplant; potatoes make me ill; paprika makes my mouth feel like it’s on fire)
• Nuts
• Seeds
• Refined/processed sugars
• Refined/processed fats/oils (I know that some fats cause me to flare)
• Alcohol
• Sugar substitutes

Based on what I know about how my body reacts to some of these foods, I’ve decided that it might be worth taking the time to do the full-blown elimination diet while focusing on nutrient-dense meals. I’ll also be incorporating what I’ve learned helping my mom get her diabetes under control (considering the glycemic load of foods, balancing protein:carb ratios). Since I know that it takes a full six weeks to get rid of the rash that milk gives me, I’m planning to try this eating plan for at least two months, then start re-introducing foods.

Reports are that many people with autoimmune diseases are able to identify food sensitivities and then adjust their diets accordingly, and are able to put their disease into remission.

I tend to be skeptical. Unlike much in the CAM world, though, nobody’s getting rich fleecing sick people with this elimination diet. The information is available freely on the internet. We’re going to eat anyway – this just has us make healthier choices. I don’t know if I’ll get remission, but I’m certainly willing to adjust my diet if it means that I’ll feel better.

Some people go cold-turkey, jumping in all at once. I think that’s a good idea – in theory. In practice, I just haven’t managed to write up all the menus yet. I’ve tried, but life keeps encroaching on my time! What seems to be working is easing my way into it, finding and trying recipes when I can.

I’ve managed to write menus for three weeks’ worth of breakfasts. My goal is 18g protein with 39g carb, and the glycemic load 10-15; I’m rarely exact, but usually close. The wonderful thing from a time-management perspective is that many of these can be prepared in advance and stuck in the freezer. So if a recipe serves 8, I can eat it once and put seven servings in the freezer – so I actually have many more than 3 weeks’ worth of menus. 😊

The key to success seems to be careful planning.  If you walk into the kitchen hungry and wonder what to fix, it’s easy to default to the familiar — which might not be what’s best.  Planning in advance so that there are no decisions to be made at mealtime seems to make a huge difference (at least for me).

In case you’re interested in some new (sometimes strange) breakfast recipes, I’ve included links below.   Many of these can be made ahead, frozen, and reheated at a later date.

Week 1:

Week 2:

Week 3:

Weekends:
Traditionally, my family eats pancakes (preferably huckleberry) or waffles on Saturday mornings.  Sunday’s breakfast is prepared Saturday night, with a ham going into the crockpot to slow-cook, and cinnamon rolls prepped and set in the oven to rise overnight, and with the oven on time-bake so that we can wake up Sunday morning to the wonderful aroma of fresh-baked cinnamon rolls and ham (served with applesauce on the side).

Obviously our traditions do not fit into my new way of eating. I’m still making my family their traditional foods. For me, I’ve searched for similar replacements:

Note: because I’m trying to carefully balance proteins:carbs at 18:39 per meal, the serving sizes that I’m using do not always (ever) match up to the recipe creators’ serving sizes — which is what has taken me so long to find menus that work without tons of repetition.  It’s not just “eat this, don’t eat that,” but working on the macro-nutrient quantities, too 🙂

FOOD

Now that breakfasts seem to be under control, I’ll begin working on supper menus.  Please chime in if you have favorites to add.

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Does It Really Matter What We Eat?

How much do we really need to eat? What kinds of foods provide the best fuel for our bodies?  How do we know?

A year ago, Andrew did an excellent series about metabolic syndrome.  In part 3, he mentioned a book, which I bought.  Like many books, The Insulin-Resistance Diet has a could this be you? list:

A family history of diabetes, overweight problems, abnormal cholesterol or triglycerides, heart disease, or stroke.  yes, yes, yes, yes, and yes

Frequent cravings for sweet or salty, crunchy snack food. no – well, unless you count and skittles and pralines, and… okay, maybe that’s a yes

This was not a happy beginning to the list, but I continued, and before long said, “Wait! How many ‘yes’ answers do you need before this is something to be concerned about?”  Well, it turns out the answer is three, and when I finished the risk-test, I had a whopping thirteen yesses!  Most depressing.  It could, however, explain why all my clothes seem to have shrunk (and I can’t blame prednisone this time).

What struck me when reading the book were the similarities between this diet and the Zone. The Zone, in turn, has some similarities to Atkins.  The biggest distinction between Insulin Resistance Diet and the others is that there are no restrictions on what can be eaten.  You can eat whatever you want as long as you have protein every time you eat.  With Atkins, by the second day people are climbing the walls with cravings for a piece of fruit or glass of orange juice.

After reading The Insulin-Resistance Diet, I re-read Dr. Atkins New Diet Revolution and Barry Sears’ The Zone: A Revolutionary Life Plan to Put Your Body in Total Balance for Permanent Weight Loss.  I own these because I inherited them from my father, who died of a heart attack at age 59.

As I continued looking for more information, I discovered Sears’ follow-up:  The Anti-Inflammation Zone, and a book by neurologist David Perlmutter: Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar–Your Brain’s Silent Killers.

These books all subscribe to a very different nutritional theory than the USDA and NHS.

NutritionTheoriesGovernment recommendations are that people should consume a significant amount of grains.  Really?  When we fatten up our cows for slaughter (the butcher will be here in a week), we bring them in off pasture and feed them lots of grain.  It should not surprise anyone that a diet rich in grains leads to weight gain — in people as well as cows.

How do we choose which theory to believe?  Lots of grains or no grains?  How do we know the best way to eat?  One thing I did was to look at credentials and motivation.

  • Dr. Atkins was a cardiologist who had spectacular results getting his patients to lose a lot of weight quickly.  Contrary to popular misconception, he only advocated extremely low carbs during the induction phase of his diet.  Long-term, his lifetime eating plan is quite similar to the carbs recommended by both Sears and Perlmutter.
  • Barry Sears is a well-respected researcher who comes from a family in which the men all die of heart attacks in their 50’s; he was searching for the truth to prolong his own life, not dabbling around in the lab looking to support the pet theory of his financier.
  • Dr. Perlmutter is a neurologist who found a common thread between diet and metabolism; he has helped patients with a variety of ailments, and refers to a number of credible studies in explaining the affect of food on our health. Lustig, Phinney & Volek  have similar work that is cited by Dr. Perlmutter.
  • The nutritionist and physician who wrote Insulin-Resistance Diet have helped people lose weight after all other diets failed them.

Those are all much better credentials than a theory based on research done to prove that a vegetarian diet is superior to any other — which (rumor has it) is where the food pyramid came from.  What if the government quit subsidizing wheat, corn, and soy farming, and started subsidizing green beans, lettuce, and spinach? Would that lead to a change in the USDA’s dietary recommendations?

It’s interesting to compare these theories.  What’s the same?  What’s different? What will work?

Zone and IRD both recommend consuming protein and carbohydrates in specific proportions.  7 g protein to 9 g carbohydrate for the Zone, and 7g protein to 15 g carb in IRD.

PCFZone

Atkins takes a slightly different approach, claiming that people whose diet has been drastically out of balance due to overconsumption of starchy foods and under-consumption of protein ought to compensate by first eating plenty of protein and no starchy foods; then, as excess weight comes off, increase healthy carbs to a more appropriate balance between carbs and protein.  Grain Brain, too, starts out recommending very low carbs, then increases after a month

All of these dietary plans reach the same conclusion:  It does matter what we eat.  To be healthy, people need to eat the right foods in the right proportions.

The reason this matters is something that I will elaborate on in a future post. Sears & Perlmutter are both adamant that there is a link between diet and autoimmune diseases.

To be continued

Gluten Free

Last Friday, the USFDA announced more regulations (because there aren’t enough of those already).  Yesterday those regulations were officially published in the Federal Register, which means that food manufacturers have one year to comply with the new food-labeling rules.  The US now has an official definition of the term gluten free.

The final rule defines the term “gluten-free” to mean that the food bearing the claim does not contain an ingredient that is a gluten-containing grain (e.g., spelt wheat); an ingredient that is derived from a gluten-containing grain and that has not been processed to remove gluten (e.g., wheat flour); or an ingredient that is derived from a gluten-containing grain and that has been processed to remove gluten (e.g., wheat starch), if the use of that ingredient results in the presence of 20 parts per million (ppm) or more gluten in the food (i.e., 20 milligrams (mg) or more gluten per kilogram (kg) of food); or inherently does not contain gluten; and that any unavoidable presence of gluten in the food is below 20 ppm gluten (i.e., below 20 mg gluten per kg of food).

Since the FDA will have to enforce the regulation, they chose 20ppm as the cut-off, because 1) that’s the level that they claim can be scientifically validated by testing, and 2) medical advisors say that those who must avoid gluten can usually tolerate trace amounts.

Saying that 10mg of gluten per day is safe for most people with celiac, Health Canada cited 20ppm in similar regulations published last year.

It is prohibited to label, package, sell or advertise a food in a manner likely to create an impression that it is a gluten-free food if the food contains any gluten protein or modified gluten protein, including any gluten protein fraction, referred to in the definition “gluten” …

“gluten”

(a) any gluten protein from the grain of any of the following cereals or the grain of a hybridized strain created from at least one of the following cereals:

(i) barley,
(ii) oats,
(iii) rye,
(iv) triticale, or
(v) wheat, kamut or spelt; or

(b) any modified gluten protein, including any gluten protein fraction, that is derived from the grain of any of the cereals referred to in subparagraphs (a)(i) to (v) or the grain of a hybridized strain referred to in paragraph (a).

Tight regulation is helpful to those who can’t tolerate gluten, but listing “oats” as a gluten-containing food is ludicrous. Oats do not contain gluten, and when farmers are not rotating gluten-containing crops with their oat crops, there is zero chance of cross-contact. How sad that shoppers in Canada will not have any way to find certified GF oats, even though there are GF oats on the market.

soapboxThe correct terminology is “cross contact” not “cross contamination.” In the food industry, cross-contamination refers to bacteria. For instance, we don’t want bacteria from meat to get on our other foods so we use separate cutting boards for meat and produce. We don’t want fertilizer made from pig waste (this fertilizer contains bacteria) sprayed on vegetables that people are going to be eating raw because the bacteria can make people sick.  Cross contamination is bad.  Cross contact, on the other hand, is when two different foods come in contact with one another.  It is only a problem for those with food allergies/intolerances. If you fry your eggs in butter, someone who can normally eat eggs but who is allergic to dairy products cannot eat those eggs due to the cross-contact because butter is a dairy product. If you measure flour, then dip that measuring cup into the sugar canister, people who are sensitive to gluten cannot afterward have any sugar from your sugar canister due to the flour (gluten) cross-contact.

There are many good resources for people who need to eat gluten free.  It would make sense to simply eat meat, eggs, fruits, and vegetables to be assured of a healthy diet that contains no gluten.  However, people often begin eating GF by looking for substitutes for their favorite bread, muffins, pizza, granola, etc.

For good recipes and helpful tips: