I've been embroiled in a debate on different eating habits for a
few weeks. It's been a heated debate. Information has been passed
back and forth, but the science is a hard sell for those that don't
know or understand it. I say, science, because it's not just the
facts about Paleo, gluten-free, Mediterranean, or whatever eating
patterns/diets, but about nutrition in general. It's about how our
bodies handle food and what they need to be healthy.
There are a million and one (and probably more) "diets" out
there. Right now, Paleo and gluten-free seem to be trending the
most. Celebrities are using them to "get healthy." People are using
them for weight loss or to control the symptoms of one disease or
another. Some are using them to lower their inflammatory levels.
But few seem to know the actual science behind any of it.
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I'm admittedly biased. I've been a diagnosed Celiac, and gluten
free for 16 years. The more information that I learn about grains,
etc. -- the more I'm glad that I don't eat gluten. But the general
public doesn't have the information that I have. In fact, it seems
that most professionals don't either. But that's not the purpose of
When I started out writing this, I thought about my friend and
how vehemently she adheres to her beliefs about "nutrition" and
eating. She's a registered dietician. We've argued back and forth
about grains, about how she thinks that Paleo/Mediterranean is bad
for athletes, about how impossible it is to follow, and about how
there's a lot of "false" science/claims about that particular
eating pattern. The whole experience has been a major illustration
on the adherence to beliefs that people have -- not just for her,
but for me. It's also been an exercise in frustration.
I can only "recommend" what science (and anecdotal evidence --
but that's another story) shows to be true. For example, I can
explain that zonulin destroys tight junctions in the gut, brain,
and reproductive organs, and that the main sources of tight
junction destroying proteins are grains and legumes. I can quote
studies all day long (and all night long) -- and I have. I can
distill the science down to very simple words that anyone could
understand by using pictures, analogies, and more broad terms. I
can do all of these things, but that doesn't mean it's going to
change anyone's mind, and it also doesn't mean that they're going
to be willing to put it into practice.
We're very steeped in our beliefs. Usually, those beliefs have
absolutely nothing to do with evidence. My friend, for example,
focuses on athletes and sports nutrition. The concept of
carb-loading with pasta or the use of sports drinks is very much a
part of her reality. She's concerned about having energy available
for use. She's not concerned about inflammation, overall health and
well-being, the prevention of disease, or whether or not someone
might develop cancer or an autoimmune disorder. She wants to run
marathons, or play 4-hour-long matches. Her reality and mine are
very, very different. Chances are, that no matter what I say or
provide her with, she will always adhere to her thoughts about
nutrition. It will always be about the quick fix. My hope is that
she'll come across a difficult case and be forced to broaden her
concept of what healthy eating is.
Patients aren't any different. Some may have more or less
information than my friend. They may be coming in with a copy of
some new fad diet book, or a cookbook of recipes that their Aunt
Sally said worked really great to help her lose weight. People may
walk into the office carrying a well-worn copy of the all-carrot
diet, asking what to do about their increasingly orange skin.
They'll be emphatic about drinking their diet coke, eating their
bowl of pasta, or consuming 3 Tablespoons of apple cider vinegar
before every meal.
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It will be our job to walk them through their questions,
hopefully bring some experience and education to the table, and
talk them through ideas and possibilities that will help them find
some form of healthy, sustainable ground. They may resist with
everything that they have in them. As I write this, I'm thinking
about how much I struggle with sugar or eating rice, and how hard
it has been for me to give them up; I'm not there yet. It's our job
to work with them, using their limitations (even if those are
beliefs), and our education to help them get to someplace
My friend and I will probably continue to argue about what we
should or shouldn't be eating. The only thing we've been able to
agree on so far, I think, is that there's no one single "right"
way. There's no perfect way that everyone should be eating. We're
all human, and each body is different. The science may figure out
that everything we "know" is wrong, and everything must be changed.
I may never be able to fully give up sugar or rice. But whatever
happens, we'll all hopefully be happier and healthier because of
what we learn -- about food, about our relationship with it, and
our relationships with each other.
Have a great week, everybody.
Did everybody enjoy the long weekend? Wow! What a weekend?!?
First, I need to say thank all the powers of the Universe for
days off. I've been sneezing my fool head off ever since, but I
spent most of the day cleaning. Having a clean house is Zen. I can
now sit in the middle of my living room in the lotus position
holding my fingers together. I won't (because I don't have time),
but the important thing is -- I CAN.
I spent some time out in the world this weekend, when I wasn't
cleaning or studying. We get so sheltered, living in academia, that
we forget how different it is. I came across a lot of stigma about
chiropractic. Education helps fix that. Sometimes people just have
to be exposed to what we're doing, what we're learning and
practicing, and the basis for our practices in order to step beyond
the conditioning they've received. Some won't. And that's OK. We'll
love them anyway.
I received a big reminder about how difficult it is to practice
"lifestyle medicine." We spend a lot of our time talking about
changes that have to be made to the diet or lifestyle. I honestly
don't know how many times a week that I tell someone something
like, "Well, that could be fixed with removing XYZ from the diet."
Here's the thing though: People don't want to remove XYZ from their
diet. We're all familiar with people who continue to eat fast food
or candy or soda and their effects on the body. We're also familiar
with how many of those people end up injecting insulin or taking
metformin. People do not respond well to change. The prevailing
opinion is that it's easier to either accept the condition they
have (and the symptom management) rather than to prevent or cure
the issue by making change.
I'm honestly not sure where this mentality comes from. Perhaps
it's the American adage that a pill fixes everything. I have a hard
time believing that people are that *bad word alert* lazy (sorry).
For some that I've talked to, they can't believe that making a
change to their diet or activity levels will make them feel better,
or that they've tried everything and nothing has worked. After all,
they're dealing with complex health issues like autoimmune
disorders, diabetes, and heart disease. Some will listen to reason
and participate in education and others won't. Age doesn't seem to
have a bearing on this -- people of all ages fall into this
grouping. Perhaps I'd be the best physician ever, if I could figure
out what would get through to people that have this block. But for
right now, I'm struggling with the acceptance (which really sounds
like defeat) that people have of their dysfunctions, and the lack
of willingness to do anything about it. On compliance with lifestyle recommendations --
what do you think?
Since stress management is a big part of lifestyle, here is a
sunset picture I took on Monday. Remember. Zen.
As a self-reported "lifestyle change queen", I'm all too ready
to make changes in my own life with the goal of feeling better. Dr
S. tells us, as students, that we need to try things in order to be
able to recommend them to our patients (speaking of dietary
changes). Given that one of my own issues is Celiac disease, a
change in lifestyle was the ONLY option for becoming healthy. I
can't even begin to express how drastically my life changed in
response to that.
Some changes are harder to make. Cutting down my rice
consumption has been one of them. I'm down to only 2-3 servings per
week at this point. But others are so much easier. For me, it comes
down to the information, and hope. How will I feel once this change
has been made? What are the possibilities? What information can I
find that supports this decision?
Is there a change that you need to make? What's stopping you?
What if you felt a million times better, increased the quality and
quantity of your life, and it only took a short period of
Maybe these are the questions we should be asking our (future)
Have an amazing week, everyone.
On Easter, this year, while everybody's eating their dark
chocolate Paleo-friendly bunnies (I like to bite the ears off
first), I'll be celebrating 15 years of being gluten-free. It's
hard to believe. "Back in the day", things were a whole lot
different than they are now. It seemed that few people had celiac
(or were gluten-free) or knew anything about it--including the
professionals. The testing was different--biopsy and IgG
anti-gliadin or anti-endomysial blood tests. The pre-made food was
a lot harder to find (and surprisingly less expensive) and the
education of the medical community was nearly non-existent. My how
things have changed! There are sensitive and specific blood tests
now (tissue trans-glutaminase), everything seems to have a
gluten-free label on it, and docs--especially those in our
profession, seem to know more and more about the benefits of going
My household has been gluten-free--exclusively--for the last 5
years. It's so important that the whole house be in support of the
diet. For me, it was a no-brainer. Both Grey and I are Celiac, and
Forest has never purposely had gluten. All the support groups
stress how important it is to avoid contamination (and NOT cheat!).
In order for a product to be considered gluten-free, it has to have
less than 200 ppm of gluten.
For Celiacs, even small/accidental exposures are dangerous.
People might not have an overt reaction to contamination amounts,
but they might still cause sub-clinical symptoms--flattened villi,
malabsorption, deficiencies, and constant damage to the
GALT--leading to lymphoma and GI cancers. Yikes, right?! These
small amounts can remain in cooking utensils, porous cooking pans,
and shared equipment. So, after a major move and shift within the
family, we started over with new utensils, new pots and pans, and a
completely clean house. Other than the occasional poison-carrying
visitor and the cats (whose food smell reminds me of wheat bread
toast), we don't even allow lickable envelopes (Did you know that
glue contains wheat?).
I can't begin to say how much of a difference going gluten-free
has made in my life. Besides feeling infinitely better, I've
experienced a number of benefits--from clearer thinking to better
skin and hair (and most importantly, a happier gut!). For Grey, the
benefits were a lot more dramatic. He was born at the
95th percentile, and before being diagnosed,
dropped to less than 5th percentile. Of course,
that was a long time ago--and now he's bigger than I am!
I've been asked if I'd endorse a gluten-free diet. I absolutely
would. I'm not so sure that I'd endorse all the pre-packaged foods
being sold on store shelves right now. Processing is pretty much
always bad. But, with all the research that's coming out about
lectins, gliadin, and grains, it's making more and more sense for
pretty much everyone to be gluten-free. So, I'll leave all of you
with this: Educate yourselves about what you CAN put into your
body--and what effects it might have. If you're not doing it for
yourselves, do so for your patients. Remember that not all cases
are textbook (in fact most cases of Celiac aren't). If you need
help, feel free to contact me. And for some other resources, check
And one last thing: I'll leave you with some "crack" containing,
non-Paleo, yet gluten-free yummies--just in case you're going
gluten-free and missing something sweet. (Don't hate me, Dr.
These are gluten-free, can be made egg-free and dairy-free, are
vegetarian (but not vegan) and are most definitely NOT
Gluten-Free Chocolate Chip Cookies
No baking adventure is complete without flour all over the
kitchen LOL. Please do your part to continue the tradition.
Next Food Adventure: Converting gluten-free to Paleo. I accept
Have a GREAT week everybody!
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