Following a Vegan Diet. And, a Gluten Free Diet. And, and, and…

Couldn't Resist This Photo Op In Switzerland!

It’s time for some praise for doctors. Surprised? I know you are used to my airing my complaints here, for inappropriate, unconstructive assumptions some doctors make. And, for their misinformation not infrequently conveyed to patients, when it comes to diet and disease management. Just last week, a patient with type 2 diabetes shared her experience about her follow up MD visit. Jane has been eating well, resulting in a significant and appropriate weight loss. She’s moving more, and watching her carbohydrate intake, improving her post meal blood sugars. But given that her morning numbers remained quite high, in spite of her fabulous lifestyle changes, I encouraged her to address this with her doctor, hoping for a shake up in her diabetes medications.

Can you guess what he told her? 

You guessed it. Just lose weight. Yes, he wanted her to continue to stay with sugars almost 100 points too high, potentially causing damage to her blood vessels and her organs. Perhaps continued weight change will improve her sugars—but that takes time, and with the 50 or so pounds she has already lost, the numbers haven’t changed significantly. But it’s easier to pin the responsibility on the patient to change.

Oops! I was planning on praising a doctor today!

The wisdom of Dr. Mars

His patient was not an obvious referral for nutrition counseling. She did not present with any complaints about her health, and her rudimentary labs did not flag any concerns of disease in the works—normal cholesterol, blood sugar, thyroid, to name few. Other, more detailed nutrient assessment is pending. Her blood pressure is fine, low in fact, with that “healthy runner’s pulse”. And her weight? It had dropped from her usual place many years ago, from the normal range, when she had been diagnosed with cancer, now in remission; but it had increased somewhat since then.

“What brings you here?” I asked, as it was not so clear, at first glance. “Dr. Mars suggested I get in to see you”, she replied.  “His concerns?” I continued. “He’d like you to assess my diet and be sure it’s adequate.” Fair enough, I thought.

At least she's left with these--if they're uncooked!

And here’s what I heard. Di moved from a vegetarian diet to a vegan diet some years ago, presumably to be healthier. She then cut out soy products because of inconclusive evidence of a link between soy and some cancer. Only she did not have the type of cancer that might have even been impacted by soy. She then decided that she should cut out gluten, because she thought she might be allergic. She didn’t notice any change, but had heard (from reliable sources, no doubt) that it helps. So she stuck with it. Rumor had it (Hollywood tabloids, perhaps?) that the raw food diet was a means to extend life and stay fit, so she tacked on those rules too. 

I’m not sure I could have created such a patient from my imagination. The only thing she hadn’t reportedly restricted was fats. But judging by her food selection her intake of fat was quite low, unhealthily low. Oh, how wise of Dr. Mars to send her my way!

My confession

We do the craziest things for our cause.

I get it, at least to some extent. If you’ve been handed a diagnosis for which there is no cure, or one which can easily take your life, you feel quite vulnerable. So anything you can do to potentially help your situation makes perfect sense. And so early in my diagnosis with Multiple Sclerosis I embarked on my own gluten free adventure. Armed with anecdotes spread across the Internet, I was determined to take charge of my condition in any way I could. I knew that the science was sketchy, at best, in its infancy in fact. Much had been written about other auto-immune conditions and the benefits of a gluten free diet, but little to no research existed for MS. I had my MD check my labs, which revealed some abnormal levels—so maybe there was a link, I thought. Celiac experts (those that address the autoimmune disease truly caused by consuming gluten) dismissed these labs as inconclusive, but I was determined.

Three months of strict adherence to a gluten-free diet cured my MS!

Don’t I wish! Rather, meticulously following a gluten-free diet was a constant reminder that I lived with this medical condition; kind of like following a meal plan with an eating disorder. But if it worked, I would follow it forever. Only it didn’t work. Sure, I felt I was taking charge, doing my part to control my disease. But in those three months I had more new lesions on my brain and spinal column than perhaps at any other time in my 9 years with MS.

There’s a point you have to ask yourself “Is this strategy working for me?” Is it really meeting the need I intended it to meet?

 Gluten-free failed. But fundraising and riding with my team of friends and
family (almost half of whom are MDs) has helped me enormously.

Did Di’s strategy improve her health with her myriad of diets rules? Hardly! She now had irregular periods (potentially due to a low percent body fat), and she likely will be experiencing muscle wasting, as her total calories and total protein are insufficient for her need. Osteoporosis or osteopenia , its precursor, is inevitable, with her low calcium intake and vitamin D, and with her questionable estrogen levels, given erratic periods. I could go on listing the pitfalls of her diet, but I think you get the point.

Focusing on her food rules may very well work for Di—on some level. But if she allows herself to be honest, she’ll realize that this is not a healthy diet at all.

And you?

Is it time to reexamine your own patterns of eating or food rules? Are your eating behaviors really working for you? And is it in your hands to change?

I’d love to hear from you.

Thanks for reading and for giving me your invaluable feedback!

A Slave to Diet Deprivation?

Pastry from French Memories, Sharon, MA

I just bought and ate a delicious Napoleon pastry—cream layered with flaky dough—and loved every bite. But was I hungry? No. Stressed? No. Mindlessly triggered by its appearance? No. I sought out a parking spot to purchase it at a favorite local French bakery and made a bee-line for the display, comforted that one remained. This was not the result of a fresh, enticing baked good on the kitchen counter luring me to eat it.

Being one to overanalyze things, I can tell you why I ate it. Deprivation. No, I’m not embarking on some weight loss diet (no need to panic) nor have I become diabetic, necessitating a controlled carb plan. This is anticipatory deprivation, knowing that I will soon be without the foods I love and cherish—if only for a week.

Just 8 more days!

Tonight starts the festival of Passover, which I observe. From a food perspective it is potentially a holiday of deprivation. That is, unless you are a lover of gluten-free style, bad-tasting baked goods. We give up a wide array of foods to help us remember, to feel as if we each personally experience that which our ancestors lived through as slaves in Egypt. Whether we believe the story as myth or historic truth, we follow these dietary rules quite rigidly.

We avoid anything leavened, for our hasty departure from Egypt left no time for our bread to rise. And so a week without is what follows. But it doesn’t stop here. There’s a very long list of foods to be avoided which includes most of my favorite starches—rice, pasta, legumes and of course, bread and most baked goods worth eating.

Friday I was food shopping and already feeling deprived. I found myself wanting to stock up, even hoard, the soon-to-be-forbidden starches. I recalled the many patients who reported binging the night before their first visit to the nutritionist’s office, fully expecting it would be their last supper, so to speak. And yes, they were pleasantly surprised by my message! And the many stories I hear from those who get anxious thinking about running out of food—not because of money—but because someone, perhaps even themselves, might restrict them from eating sometime soon. Trauma from a history of past diet experiences, perhaps. So now I really get it.

I do love these coconut macaroons! NOTHING like the canned ones in the market!

The remedy for my patients and for those of you still struggling with such deprivation is permission. Permission to eat whenever you need to, regardless of who you are with. Permission to eat whatever you feel like, in amounts appropriate for your body. Permission to eat any time you need to—yes, even at 11 pm, if you’re hungry.

Grandma Bea's sponge cake. Guaranteed to raise
your cholesterol level after only 8 days!

As for me? I had to remind myself of all that I love to eat that I can give myself permission to have. That includes the obvious fruits, vegetables, nuts, and all. And, my favorite baked goods, acceptable for Passover. So last night I baked 4 dozen coconut macaroons, 2 dozen almond ones, and a moist sponge cake. I packaged them up and removed them from the kitchen counter.

And I plan to enjoy them whenever I am hungry, to satisfy my need. On the positive side, at least I didn’t have to sacrifice use of my Kitchen Aid mixer and Cuisinart, although I don’t think the slaves had the benefit of these either.

Yummy almond macaroons.

Passover observant or not, these baked goods are delicious and so easy to prepare. The macaroons are high in sugar, but quite satisfying, requiring only a small dose to hit the spot. And perfect for those with celiac or others following a gluten-free diet.

If you are a follower and would like the recipe, please email me.

Enjoy!