Gluten and Dairy and Sugar ... Oh My!

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I'm tired of struggling with food and thinking about food so much. I don't know if I should avoid carbs or sugar or gluten or what. And every time I do one of those things, I end up eating more of the crap that I don't want to eat.

One of my clients wrote that. I think it resonates with so many people’s experience of what I call Nutrition Information Overload. Many clients come to me after reading about someone’s journey to health and wholeness since going off dairy or gluten or all animal products or flour or sugar or (the list goes on...) They wonder, “Should I cut it all out, too?”  When I thought about writing on this topic, I had an image of the characters in the Wizard of Oz, huddling close in the forest repeating, “Lions and tigers and bears, oh my...”  On our way to the Emerald City of perfect health or contentment or a more peaceful relationship with food, we may be afraid of the forces lurking in our food supply, sure to take us off our paths down the yellow brick road.

Well, Oz imagery aside, I have become increasingly aware (over the 20+ years since I studied nutrition in college) that we are collectively more and more afraid of food. And I am not just talking about the increased number of eating disorders that are treated. I am reflecting on the way that it has become rather mainstream to give up gluten or dairy or sugar or meat or soy or all of the above... And while I will never argue that more fruits and vegetables are a good thing, I am concerned about the way in which certain styles of eating are making some of us feel more virtuous than others. And how badly people feel when they aren’t able to stick to a more “virtuous” way to eat.

As someone who has family members with food allergies and sensitivities -- and even has one herself -- I can appreciate the way in which certain foods can make us feel better or worse. Celiac Disease is a very real condition in which it is quite dangerous to be eating foods that contain gluten. Gluten, a mixture of two proteins that are found in cereal grains, particularly wheat, gives dough its elastic texture. It is wonderful that someone with Celiac Disease can find many restaurants and stores here in the greater Boston area with items that meet their dietary restrictions. It’s also great that food allergies are being taken seriously -- as many of them are life-threatening -- and that frequently ingredient lists are available.

Food sensitivities (versus allergies) are more difficult to identify and many clients come in wondering if they have some. The only real way to pinpoint whether or not you are sensitive to a certain food is to eliminate the one food (even little amounts of it) for 2 to 4 weeks, and then reintroduce the food back, monitoring for any symptoms. Symptoms are so subjective, so only you can determine if you feel better on or off certain foods. Food allergies/sensitivities mostly show up as symptoms in the lungs, throat, sinuses, or skin. They can also have behavioral consequences, like irritability, that are harder to pinpoint.

Gluten sensitivity is not Celiac Disease, but there is evidence that it is a real condition. Some people are indeed less able to tolerate gluten and will feel better if they don’t include foods with gluten in their diets. Again, when a true elimination is done for a short time, and then the foods with gluten are added back, those who are sensitive notice symptoms. One of my friends who is gluten sensitive swears that when he eats gluten, he feels like “his emotions have him instead of him having his emotions.” Who am I to disprove this experience? I always recommend that when someone feels that they might be sensitive to gluten, they get the test for Celiac Disease first. (They have to be eating gluten, though, in order for the test to be read correctly.) That way, the client knows if their gluten sensitivity could lead to more serious life-threatening problems if they don’t fully eliminate this food component. People with Celiac Disease shouldn’t even nibble on wheat bread or use cutting boards that were used to slice it. It’s that dangerous for them to eat gluten, so being clear about what kind of intolerance you have is important.

About two-thirds of people have a hard time digesting cows’ milk. Some people are intolerant of the carbohydrate portion of the milk (lactose) and have digestive symptoms. Some people are intolerant of the protein portion of the milk (casein) and have lung/sinus/skin symptoms. Some have both. With lactose intolerance, symptoms can vary from person to person. In other words, someone might have no symptoms with yogurt because the cultures added to yogurt help to break down the lactose and make it easier to digest, but then have major symptoms (diarrhea and bloating) after drinking milk. Some people’s lactose intolerance is mild, and they can eat all kinds of dairy products as long as they don’t have more than, say, two in one day.

When I discovered my daughter’s cows’ milk sensitivity, I noticed skin and sinus changes that completely disappeared when she stopped eating cows’ milk products for awhile. We kept allowing small amounts of cows’ milk in baked goods and butter here and there, giving her body a chance to slowly build up a tolerance. Today, she is adding back a little cheese when she is with friends without consequence and may be growing out of it. The way we manage and treat non-life-threatening food allergies and sensitivities in children is changing. (This could be another whole blog post some day...)

If someone does a real food elimination challenge and feels better not eating a certain food, then who am I to tell them that they must eat it?  However, I do always ask my clients to evaluate how much is the food elimination in the service of feeling better in their body versus trying to control their body -- or feel more control in their lives.

What I find most worrisome is the way that so many people today avoid certain food categories without really testing the reality in their own bodies. They just believe that because some celebrity feels good off gluten, then they must, too. I also worry when someone believes that taking away certain foods is the answer to their challenging relationship with food. For example, they believe that by eliminating sugar, flour, and gluten, they will halt their compulsive eating. I rarely find this to be true, even though I strive to work with my clients’  food preferences as they heal from whatever pain and suffering underlies the drive to cope using food. Most of the time, cutting out certain food groups just feels like another diet, and the research shows that most diets fail to be sustainable. (See my previous blog post about this:  Lose The Diet for Swimsuit Season.)

I acknowledge the addictive quality inherent in some foods in our food supply, but there is also more work to healing an addiction than just eliminating the addictive substance. Sometimes a client will cut out sugar, believing that it will make them feel more in control of their food choices or their life. At first, that is often how it feels, but generally the real reasons that their eating or their lives feel out of their control still exist. Instead of admitting that sugar-free was not the answer to their deeper life challenges, they often feel like a failure. And if someone tries to cut out lots of carbohydrate foods, they often end up craving these foods that are vital to our health.

All bodies are different and they respond to foods differently. In fact, our mood can effect how we respond to food, too. If you’ve ever had a stomachache before a major interview, do you blame the food you just ate or do you blame the stress about the interview? Sometimes it’s both. Certain foods “mix” better with stress than others. (Yes, comfort foods sometimes really are soothing.) Sometimes we aren’t even aware that we are stressed or anxious or keyed up about something. If our digestion is effected by it, we sometimes blame the food we ate, but it may simply be that the stress constricted and slowed down our digestion.

So, if you are wondering if it would help you feel better to eliminate some food or food group, go deep inside and ask yourself the following questions:

  • Do I want to eliminate this food because I truly believe that I will feel better in my body if I don’t eat it -- and not because I want to feel more in control of my eating, or my body, or my life?

 

  • Am I willing to try eliminating this food for 2 to 4 weeks (and is it safe and feasible for me to do so), then adding it back to notice the changes in my symptoms?

If you answered “yes” to these questions, then you might be ready to entertain the idea of testing yourself for a food sensitivity. But first ask the next two questions...

  •   Am I frequently under-eating, over-eating, or eating erratically (going long times without eating and then eating a lot all at once)?

 

  • Do I frequently eat emotionally, so that my emotions, thoughts, and stress might be effecting the way I feel when I eat food as much or more than the actual foods that I eat?

If you answered “yes”  or even “maybe” to one or both of these questions, then work on finding more balance in your life and eating before investigating food sensitivities.  Erratic eating is very often the culprit when it comes to gastrointestinal symptoms. Also, we ALL eat emotionally sometimes, but if you do so often, then working on your relationship with food may be more important than finding out if you have a gluten sensitivity.

A registered dietitian /nutrition therapist  who has expertise in disordered and emotional eating may be able to help you find some balance in your eating and help you decide if decreasing or eliminating foods might make you feel better. Beware of any nutrition professional who tries to give you a prescriptive way of eating or tells you to eliminate some foods that you don’t have a self-tested allergy or sensitivity to. Find a nutrition therapist who is interested in your relationship with food and your body and will tease out any of those issues first before doing a food sensitivity challenge. My clients often hear me saying that there is a difference (and it can be a fine line) between not eating something because it’s aligned with your values to not eat it, and not eating something because it’s aligned with your eating disorder -- or desire for control over your body and weight.

On our way to the Emerald City of health and well-being, it is often not whole food groups or foods that we need to fear. In fact, the more that we eat with presence and mindfulness and listen to our bodies, the more we find that our bodies can handle a wide variety of foods, and that they most enjoy foods that are prepared with love, care, and attention. If you believe that not incorporating a certain food into your diet will help you feel better, work with your nutrition therapist to do so in a way that really listens to your body and what it has to say, instead of giving up gluten or flour or sugar or meat because it’s fashionable in certain circles to say that you do. Be your own investigative reporter, and get help and support if your relationship with food also needs help. Find a way to eat that makes YOU feel your best and allows you to get on with living your very own fantastic life!