The Goods (Recommendation) - Living Without

Living Without is a magazine dedicated to those of us living without certain foods, including options (and substitutions) for excluding all of the major food allergens.   Ingrid and I have subscribed to Living Without for years and find it an invaluable resource.

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Elimination Diet

An elimination diet, modifying food habits with the sole purpose of identifying foods that trigger symptoms of inflammation (headaches, night sweats, blurry eyes, brain fog, fatigue, etc), was one of the most significant elements of my road to health.  My elimination diet trial phase lasted the better part of 8 years due to my experiments.  However, an elimination diet need not take nearly that long.  Below is a summary of lessons learned and a suggested starting point for a comprehensive elimination diet.  The results should help you to understand what foods your body reacts poorly to so that you can make intelligent decisions on when to indulge in those foods.

WHERE TO START

Eliminating Food-Born Inflammation

From my research and experience, reactions to food are specific to the individual and can include a very broad list of foods.  There are a number of recommended low-inflammation diets with conflicting lists of foods to include.  In fact, one weekend I saw two programs on PBS with conflicting low-inflammation diet information.  So where do you start?  The simple answer is with the most common food allergens.  I recommend three lists of common food allergens to start your elimination diet:  (1) a list of comment allergens – modified from the FDA list, (2) common allergens known or suspected in alternative medical communities as irritants, (3) your unique identified list of possible food irritants.   

Modified Food & Drug Administration (FDA) List of Common Food Allergens

The Food and Drug Administration (FDA) requires food manufacturers to list the eight most common ingredients that trigger food allergies.  These foods are (1) Milk, (2) Eggs, (3) Peanuts, (4) Tree Nuts (e.g. almonds, cashews, walnuts), (5) Fish (e.g. bass, cod, flounder), (6) Shellfish (e.g. crab, lobster, shrimp), (7) Soy, and (8) Wheat.  The items in these foods that the body reacts with are often the proteins.  For example, in milk two proteins are known allergens, lactose and casein, and in wheat the protein is gluten – a wonderful.  Therefore, the FDA list is recommended to be expanded to the following categories: 

1. Dairy (e.g. milk, cheese, cream, butter)
2. Eggs
3. Peanuts 
4. Tree Nuts 
5. Fish
6. Shellfish
7. Soy
8. Gluten (Wheat, Barley, Rye, and non GF-Certified Oats)

Allergens Known or Suspected in Alternative (and Non-Mainstream Western) Medical Communities as Irritants

Diet is often overlooked by western doctors but is one of the first items looked at by a number of practitioners of alternative medicine.  The following is a partial list of foods known or suspected of being inflammatory by alternative medical communities.

1. Alcohol
2. Corn
3. Sulfates & Sulfites (Often used as preservatives in Wines)
4. Nitrates & Nitrites (Often used as preservatives in bacon, coldcuts, etc.)
5. Nightshades (Tomatoes, Potatoes, Chilies, Eggplant, Tomatillos, etc.)
6. Refined Sugars (Read Grain Brain by Dr. David Perlmutter)
7. Grains (Read Grain Brain by Dr. David Perlmutter)
8. Caffeine (Coffee, Chocolate, Teas)
9. Genetically Modified Foods – those approved for use in US designated as such.

o   Alfalfa (US)

o   Argentine Canola (US)

o   Beans

o   Carnation

o   Chicory (US)

o   Cotton (US)

o   Creeping Bentgrass (US)

o   Eggplant

o   Flax (US)

o   Maize, i.e. corn (US)

o   Melon (US)

o   Papaya (US)

o   Petunia

o   Plum (US)

o   Polish Canola

o   Poplar

o   Potato (US)

o   Rice (US)

o   Rose (US)

o   Soybean (US)

o   Squash (US)

o   Sugar Beet (US)

o   Sugarcane

o   Sweet Pepper

o   Tobacco (US)

o   Tomato (US)

o   Wheat (US)

Your Unique List of Food Items

During my experiments, at various times, I suspected a number of foods that were on and off the list based on daily fluctuations.  Below is a sampling of my list (though only to give you a sense of how diverse a list can be).

1. Coconut
2. Citrus (Lemons, Oranges, Grapefruit)
3. Beets 
4. Swiss Chard

EXECUTION

Execution of an elimination diet is the most difficult aspect.  The starting point for this diet is usually as restrictive as you are able to accommodate.  If you think it will be too difficult to eliminate everything on the above list, I recommend starting with the minimum restrictions.

• All items on the modified FDA list;
• Corn, Nightshades, and Genetically Modified Foods from the alternative list; and
• Items that you have previously identified as inflammatory for yourself.

*Note that this is not a restrictive diet, meaning you can eat as much as you want of foods that you have determined are safe.

Stick to the following regimen:

1.      Stick to the initial elimination diet for a minimum of two weeks and benchmark your health issues to see if they are getting better, worse, or staying the same. 

2.      If after two weeks your health is worse or the same…

a.       Attempt to make correlations between the remaining foods you are still consuming and ongoing symptoms (for example, if you feel great in the morning and then feel horrible in the afternoon, look at the food items consumed at lunch to draw conclusions on if a particular food item is still affecting you.  If you identify additional food items during this process, eliminate them from your diet and continue to track your progress.  Repeat this process of reviewing and eliminating foods for as many iterations as you continue to positively identify foods that cause inflammation.  Keep a list of all foods that you identify during this period.

3.      If after two weeks your health is better or after you have identified all foods that cause you irritation in Step 2a above…

a.       Start to reintroduce one food at a time that was initially excluded from the diet.  Consume this new food daily for the following 1 – 3 days, charting any aggravated symptoms during that time period.  If your symptoms increase in number, intensity, or frequency during this food reintroduction, exclude it from your list.

   

4.      Once all foods that you aggravate your symptoms have been identified and eliminated, the remaining list of good foods is your optimal diet for health. 

Sacramento Blues - In Real Time

I recently went to a conference for work in Sacramento, CA. The conference was for the California Water and Environment Association (CWEA), an organization of wastewater treatment professionals. My goal was to balance the consequences of deviating from my diet with the benefits of socializing and doing business on the road. The socializing and business - accomplished. Striking a balance - failed.

The first morning, I had milk, orange juice, and a banana - very nearly the only gluten- and egg-free choices at the continental breakfast at my hotel. So far so good, but not nearly enough calories to get me through a morning of listening to speakers. Lunch - pasta, meatballs, and salad - was provided by the conference. I skipped the pasta, but the meatballs surely had gluten (and probably eggs). For the rest of the day I walked around in a daze, trying to pay attention at talks and be polite and attentive to those I stopped to chat with. I'm sure I faked feeling well pretty good, but I paid for it later that night with nearly five hours of stomach pains and an inability to sleep. The next day was not much better. Breakfast at the hotel, lunch at an awards luncheon, and then a beer with my boss before the flight home took my body into a tailspin. My neck started to ache on the flight home, and I became anxious - barely able to sit still. I wanted to sleep but couldn't. In the middle of the night, I woke up feverish. The night remained difficult.

The question of how I can integrate traveling, business, and socialization with my dietary needs remains...

The Limitations of Western Medicine

Tests that I've had: Abdominal CT Scan with contrast, Abdominal CT Scan without Contrast, Pelvic CT Scan with contrast, Pelvic CT Scan without contrast, Abdominal MRI with contrast, Abdominal MRI without contrast, Pelvic MRI with contrast, Pelvic MRI without contrast, Prostate Exam, neurological exams, blood tests, stool tests, urine tests.

Things I've been tested for: Lyme Disease, Diabetes, Celiac Disease, Food Allergies, HIV, RPR, Chlamydia, EB virus, Typhus, RMSF, West Nile Virus, Ehrlichia, rare bacterias, Giardia, Cryptosporidium, and more.

Drugs I've taken: Ciproflaxen, Metronidazole, Levaquin, Flagyl, Zithromax, and Doxycycline.

All of this could not cure me. While I do believe that western medicine is one of the greatest tools in diagnosing and curing ailments, it is not without limitations. A few of these limitations include but are not limited to (1) Diagnostic tests can have false positives and false negatives, (2) All ailments are not defined, (3) Treatments have not been developed or proven for numerous ailments, (4) Existing treatments are not 100% effective, (5) Some treatments cause more problems than they solve, and (6) The economics of diagnosis and treatment is sometimes prohibitive.

My diagnosis and treatment was not limited by economics; nor was it limited by physician resources; it was limited by knowledge. My father ran out of illnesses to test for and specialists to consult. All medical tests that I've had been subjected to over the past couple years have pronounced me a normal, healthy 30-year-old male.  It took years for me to contemplate and rationalize why western medicine pronounced me healthy when I was anything but.  In an attempt to help shorten that time frame for others who are suffering, I have started a new series in this blog titled The Limitations of Western Medicine, which will expand on particular reasons why western medicine fails.