Gluten Free Goodness

I’ll just try to stick to the facts here: I am extremely diligent about following a strict gluten-free diet. I do eat Amy’s products, and have for years.

Earlier this week, I was having a can of Amy’s Lentil soup, and something felt funny in my mouth…and it was a kernel of grain. In speaking to a colleague and looking online, I’m quite certain it is wheat or barley.

I’m extremely frustrated. I feel lousy and grumpy. I’m also upset professionally, as I’ve been recommending Amy’s for years. I also realize that there are many larger issues at play in terms of general contamination of lentils with wheat. It’s been an issue for several other companies, as one of my eagle-eyed clients discovered a few years back. Gluten-free Watchdog addressed this several times…this is unfortunately not a new problem with lentils. But it’s also not yet a resolved issue.

It’s a reminder to me of how much of a toll it can take to be strictly gluten-free. I have absolutely no problem not eating regular bread or asking questions or bringing my own foods, but not to be able to trust that items that are marked gluten-free are actually gluten-free…that’s a big stressor. Usually, soups are my go-to especially when I go on meditation retreats. The last thing I need is to feel like I need to scrutinize every single lump in my bowl.

So…check your beans, especially lentils. Support companies like Gluten-free Watchdog that keep the community safer. And keep writing and advocating as you can.

I’ve contacted Amy’s and will post their follow up here. Thus far, they’ve asked for the lot # and the grain itself. My hope here is to provide a reminder/nudge for awareness; this problem is not limited to Amy’s, and I’m certainly hopeful that this leads to better and safer practices.

I know, there are many things to worry about in the world, and this is low on the list. I do get frustrated when I see RD publications giving the same party line about the risks of a Paleo diet and not mentioning the growing group of studies actually examining the relative pros/cons of the diet. For the record, I know the staff has a commitment to good work and quality writing. I think this story missed the mark in terms of providing a balanced view of the current research.

If there’s a belief that there’s a value in seeing a nutrition professional, because nutrition is about facts, not beliefs, professionals should be talking about the data and not opinions, right? Even and especially when it doesn’t line up with what we learned in school.

I know grains are the bottom of the food guide pyramid, or plate. Citing data on whole grains vs refined actually isn’t relevant to the question of the relative merits of grain-free diet and how that may differ by disease state. It actually fully misses the point.

From my perspective the data is interesting and encouraging, but it also isn’t a slam dunk. I’d rather see bigger studies and ones that are better controlled. I went into some of the weaknesses in the early literature in a prior post.

FWIW, I’m not a Paleo advocate per se. I am a research advocate. 😉  It seems like Paleo advocates say there are mountains of research (nope) while others suggest there’s no study, which isn’t true, either. I have mixed feelings about Paleo and think there are pros and cons–and more importantly, pros and cons giving a given person’s needs, medical history and lifestyle. Generally, I am more interested in what is on someone’s plate than what trendy label is attached to it.

I think the newest study on autoimmune Paleo and IBD is fascinating, and so is the MS research and the rest of the studies below. And it does seem that a Paleo diet has helped people safely lose weight and improve CVD risk factors, which is what counts at the end of the day.

Because I’m short on time, I’m only including research here through 2016, which is the last time I did a thorough lit review. Detailed references are below the charts. I don’t have time right now to update for 2017-18

Frassetto LA, Schloetter M, Mietus-Synder M, Morris RC, Jr., Sebastian A: Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet. Eur J Clin Nutr 2009.

Jönsson T, Granfeldt Y, Ahrén B, Branell UC, Pålsson G, Hansson A, Söderström M, Lindeberg S. Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovasc Diabetol. 2009;8:35

Lindeberg S, Jonsson T, Granfeldt Y, Borgstrand E, Soffman J, Sjostrom K, Ahren B: A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Diabetologia 2007, 50(9):1795-1807.

O’Dea K: Marked improvement in carbohydrate and lipid metabolism in diabetic Australian aborigines after temporary reversion to traditional lifestyle. Diabetes 1984, 33(6):596-603.

Osterdahl M, Kocturk T, Koochek A, Wandell PE: Effects of a short-term intervention with a paleolithic diet in healthy volunteers. Eur J Clin Nutr 2008, 62(5):682-685.

Boers I, Muskiet FA, Berkelaar E, Schut E. et al. Favourable effects of consuming a Palaeolithic-type diet on characteristics of the metabolic syndrome: a randomized controlled pilot-study. Lipids Health Dis. 2014 Oct 11;13:160. doi: 10.1186/1476-511X-13-160.

Bisht B. A multimodal intervention for patients with secondary progressive multiple sclerosis: feasibility and effect on fatigue. J Altern Complement Med. 2014 May;20(5):347-55

Pastore RL, Brooks JT, Carbone JW. Paleolithic nutrition improves plasma lipid concentrations of hypercholesterolemic adults to a greater extent than traditional heart-healthy dietary recommendations. Nutr Res. 2015 Jun;35(6):474-9.

Boraxbekk C J, Stomby A, Ryberg M, Lindahl B, Larsson C, Nyberg L, Olsson T, Diet-Induced Weight Loss Alters Functional Brain Responses during an Episodic Memory Task. Obes Facts 2015;8:261-272

Stomby A, Simonyte K, Mellberg C, et al. Diet-induced weight loss has chronic tissue-specific effects on glucocorticoid metabolism in overweight postmenopausal women.Int J Obes (Lond). 2015 May;39(5):814-9.

Manheimer, E.W., van Zuuren, E.J., Fedorowicz, Z., Pijl, H. Paleolithic nutrition for metabolic syndrome: systematic review and meta-analysis. Am J Clin Nutr. 2015;102:922–932.

Otten J, Mellberg C, Ryberg M, et al. Strong and persistent effect on liver fat with a Paleolithic diet during a two-year intervention. Int J Obes (Lond). 2016 Jan 20.

Like so many people, Charlottesville has left me feeling sick, scared, and very, very sad.

Afraid for this country in a way that I never have before, and deeply discouraged.

I wanted to share my grandmother’s story, because it’s more important than ever.

In the 1930s, Nazi sentiment affected many countries around the world, including Iraq. There weren’t Nazis per se, but “just” people who believed that Jews should die because they were taking the jobs, money, etc. Yes, there were once Jews living peacefully in Iraq—many people have never heard of them because Iraqi Jews no longer exist.  In the 1940s, there was an outbreak of violence, known as the Farhud, and it simply was no longer safe to be a Jew in Iraq.

Savta (Bela) lived outside of Bagdad in a very wealthy Jewish family. She had two babies, and by the early 1950s, the danger was so great that she fled with my grandfather, father, and uncle. They lost all their money and possessions. Someone at the border tore up her wedding photo out of spite.

My family members fled anywhere that would take them: Israel, Canada, Australia, England. Eventually, many did come to the US.

My grandmother never stopped grieving the loss. As she got older and had issues with dementia, she would get in loops of repeating the same thing again and again. And her upset was not at the mobs who hated the Jews, or losing her house nor her comfortable lifestyle.

She never got over the abandonment by her neighbors who were once her friends.

They did nothing to protect her.

They once would celebrate each other’s holidays, and eat together, and they did nothing to help her.

50 years later, she still felt the pain of good people doing nothing.

Yes, white supremacists and Nazis are a problem, but that’s just a piece of it. It’s all of the people who harbor hate, and all those who turn a deaf ear because their (tush) is not on the line.

There’s so much talk, and labeling people alt right, alt left, and a lot of name calling. I can admit that it feels good in the moment, but I also suspect it’s counterproductive.

In terms of promoting a healthy society, the people who will make the most difference are likely those “good people” who voted for 45 and still defend him. It’s the people who want their “history”–their statues and monuments, the people who are saying that our current leader represents jobs and growth. Most people hate admitting they are wrong, and calling them Nazis causes them to double down on their commitment to El Naranja. Alienating those people is going to push our country in a (more) dangerous direction.

Like so many, I do not know what to do, and I do not have any of the answers. I’m grieving that history is repeating itself, and I don’t want to be one of Savta’s neighbors. All I can do is donate money, practice kindness, and see where I can be a tiny voice sending support all of the many people who are vulnerable now.

I am so sorry for all of the suffering around us right now.

With love,

Cheryl

April is IBS awareness month, and for way too many of my years, I’ve been entirely too aware of IBS. You could say it owned me for parts of the past decade. I know many of you can relate.

So here’s my story and a few thoughts on IBS—and this applies to other digestive disorders, too.

In 2003, I started having massive digestive issues. It actually began around Easter, and I remember this distinctly, because I couldn’t manage to stomach my favorite candy eggs. I was in the bathroom 20+ times a day, and I was physically and emotionally wrecked. I lost 40 pounds, 30 in one month. I didn’t think that was physiologically possible, but indeed it was.

At that point, I was already a nutritionist, running the breastfeeding programs for DC WIC and didn’t have a clue about digestive disorders. Neither did the gastroenterologist I was seeing, apparently. He did an endoscopy (no biopsies) and a colonoscopy, and told me that since I was a dietitian I should figure it out.

In desperation, I saw a wide range of practitioners. I spent a whole lot of money, did a whole lot of tests, and not much useful happened. Lots of people told me to go on antidepressants. On a lark I went gluten-free and I was pretty immediately less miserable. It helped my digestion a bit, but the biggest change was in my fatigue, balance and stability and overall pain levels.

Over many, many years and gobs of trial and error, I’ve found the foods that fit me and those that didn’t. Getting diagnosed with SIBO really did wonders for my digestion. This happened first in 2005, then I had a re occurrence in 2010. And for many years I’ve been great without any issues. However, thanks to a recurrent dental issue needing gobs of antibiotics, I’m unfortunately staring down round 3 of SIBO.

So…key take home messages:

There’s a lot you can do for yourself. Anyone who says diet doesn’t help digestive disorders needs to update their medical reading. There’s good data on low FODMAP for IBS and IBD, SCD for IBD (I have a paper on it coming in June!) and…you know, different things work for different people. Sometimes it’s FODMAPs, sometimes grains, sometimes meat, sometimes fatty foods…we may all have different irritants.  Mindfulness can be a huge help for digestive and other pain, and so can physical activity and overall self-care.

Listen to your doctors and health care team…but not too much. Lots of doctors said I wouldn’t walk again—I can now, even if not perfectly. All the docs I consulted said PCOS is lifelong and only treatable by medication, and my levels have normalized for more than a decade without meds. I had a Sjogrens’ flare in 2011 and was told I’d have to learn to live with the symptoms, but (knock on wood) those symptoms have been gone for the last 5 years.  I do take the input of my health care team seriously, but I do my best not be limited by their expectations. I’m only interested in working with people who will help me try to get to my best and healthiest self.

And lastly—none of us have total control over our genes and bodies. The idea that our actions influence our health is really empowering and also very accurate. The flip side of that is falling into the idea that if we’ve got illnesses it’s a personal failing or flaw, and if we just work harder, everything will be perfect. So the wholesome message that we can influence our health can be distorted into a really destructive message of pain and body shame.

I think it’s important to talk about stories of hope. I can’t count the number of times people come to see me and say, I have *fill in the blank* (IBS, gastroparesis, SIBO, etc.) but no one ever gets better. That’s just not true! and it’s a sad and limiting message to hear.

If you’re interested in sharing your journey to a happier tummy, check out posts #IBelieveinyourStory from Kate Scarlata.