The Failsafe-ish Diet: Day 5 or “Why Laxatives in Elimination Diets Defy the Scientific Method”

I’ve been on this new diet for four and a half days now.  Long enough to know if it’s working?  Not really, no.  Some practitioners advise four to six weeks on an elimination diet before you start assessing its impact and even the most casual would proscribe two weeks as a minimum.  The reason being of course, if you’re intolerant to something you’ve been eating say, every day or so, for the last year, the residual effect of it is going to linger in your body for some time before the new clean eating approach allows you to flush it out.  Put short: you need to give it time.

But what if you feel worse?  Well, again, this is no indication of the diet’s long term impact.  With dietary changes, especially those designed to help kill off fungus or parasites, you’re probably going to feel a bit worse at first!  In addition of course, your body is most likely in a bit of withdrawal too if you’ve just given up sugar, alcohol, dairy or gluten, all of which are known to have addictive properties.

Anyway, enough rambling.  I feel… well… ok.  Not much has changed yet, I’m still plagued by the same old daily abdominal pains, reflux and assorted ailments.  My back hasn’t hurt much, but this is intermittent and it’s not uncommon for me to go weeks before the spasms resurge.  One difference I have noticed is today’s bowel movement.  It was… er… different to usual.  Much softer.  Sorry for the graphic description, but the source of so many illnesses is the gut and I feel confident in saying that constipation is a major, if not the only contributor to my ongoing illness.

Laxatives

Before you get your flags waving in joy (what kind of flags would you wave to celebrate faeces?  Brown ones, I suppose.  Let’s not think about emblems.) there’s a catch.  The naturopath put me on laxatives.  Two scoops nightly of “Osmolax” a gentle laxative that works via osmosis, drawing water into the bowel to soften the stool naturally.  Clearly it works, but this is the problem.  If constipation is the sole cause of my problem and the constipation is caused by my dietary intolerances, how are we to isolate which foods I am intolerant to by elimination diet if my body is not allowed to display its natural responses?  Or, to be more concise, how do I know if it’s the diet helping me or the laxatives?

This is of course the exact same conundrum I found myself facing with the GAPS Diet with the sole exception that GAPS prohibited any kind of laxative other than an enema and my enema experiences were so negative that I point blank refused to do them.  Three months into GAPS and I was still terribly blocked up and experiencing as many symptoms as ever.  Maybe if I’d had the darned enemas I’d have felt better, but then would that be as a result of the diet or the enema?

The Scientific Method

All of this comes down to the magic of the scientific method.  Some of you may remember this from high school.

  1. Hypothesis

First, you make a hypothesis, for example, my constipation is caused by dairy.

  1. Experiment

Then, you construct an experiment and guess at what will occur, eg. “I will abstain from consuming dairy for two months and I expect at the end of this time, my constipation will have alleviated itself”.  You then remove as many variables form the experiment as possible, such as other dietary changes, laxatives, enemas and medications, and perform the test, taking careful notes.

  1. Analysis & Conclusion

After performing the test you examine your notes and draw what conclusion you can.  If you have not eliminated all variables, you have not achieved a conclusive result.  In real life, if you want to prove a theory, an experiment must be able to achieve the same results when performed multiple times.  How do you know that will happen if you haven’t removed the variables?  You don’t.  You might spend a year off dairy and say, “

This is why laxatives are not the cleverest thing to use whilst performing an elimination diet.

What Should I Do Then??

The thing is, your body is not a science experiment.  While it is great to be as scientific as possible when testing these cures to prevent yourself buying a year’s supply of snake oil, it does not mean you should always adhere to the method stringently.  If you’ve been unwell for a long time, you just want to feel better and sometimes it’s good to mount a multi-pronged attack.  The Failsafe diet does this by eliminating most known allergens and irritants and then gradually re-introducing them after the patient begins to feel improvements.  There’s nothing wrong with this approach, it’s still quite scientific, just performed sort of in reverse.  Try everything all at once and keep doing it until you feel better.  Then, when you’re sure you’ve improved, try gradually re-introducing all the potential nasties, one by one.  Or indeed, try going off the laxatives whilst maintaining the diet and see what happens.

I’m putting myself in the hands of my naturopath right now to see what magic she can work but if the answer is long term laxative use, well, that’s no answer at all.

The Failsafe-ish Foodie: Week 1 Meal Plan

Urgh… elimination diet.  There’s just nothing about that phrase that sounds fun.  Well, you know what?  It’s actually not so bad.  I had envisaged days on end of eating the same bland, textureless mush ( a la GAPS Intro) but given the degree of flexibility my naturopath has given me, I’ve been able to create some pretty enjoyable food.  It even works nicely with the other half who, whilst supportive of my continuously changing and generally nutty eating habits, is not about to adhere to them.  I just add a bread roll, a piece of buttered toast, a sprinkle of parmesan or a splash of coconut milk to his version of the dish and he’s happy, while I’ve still only had to cook one meal.

With an abundance of fresh green vegetables and seasonal stone fruit permitted, for an honourary herbivore such as myself, this hardly feels like a diet.  Fish, eggs, chicken and a little bit of lamb add much needed protein and garlic, parsley and lemon juice allow for punchy, versatile flavours.  The only thing I truly miss is bread and one can easily learn to live without that… just look at most of Asia, they manage without it!

I decided to pre-empt the elimination diet by gorging on every variant of junk food I could obtain and, in the process, also try to rid my house of temptation.  Two bread rolls, a serve of salt ‘n’ pepper squid, one beer, two glasses of wine, a slice of banoffee pie, two packets of crisps (corn and potato), a coffee eclair and half a tub of cookies & cream ice cream later, I was feeling wretchedly ill and the junk-food-hangover that ensued the next morning reinforced my determination that the healthy food I would be consuming over the following weeks was not a limitation, but a luxury.

Here’s what I’ll be eating in Week 1*:

*NB: All eggs, meats & rice milk are organic.  All fruit & veg are well washed in filtered water.

Monday

Breakfast

2 x eggs, scrambled in olive oil

1 handful wilted baby spinach

½ cup brown rice

1 x rice milk latte

Morning snack

1 peach

Lunch

Chicken & vegetable fried rice with garlic

2 sm apricots

Afternoon snack

1 boiled egg

Handful of rice crackers

Dinner

Crispy skinned salmon

Oven baked sweet potato chips (fries)

Rocket, avocado, snow pea & grated carrot salad w olive oil & lemon juice

Mineral water w lemon juice

Dessert

Sm bowl macerated strawberries

Tuesday

Breakfast

2 eggs, fried in olive oil

2 thin rice cakes, warmed in pan

Chopped parsley

Morning snack

1 nectarine

Lunch

Chicken & vegetable rice (same as Monday)

Handful of blueberries

Afternoon snack

Sweet potato crisps (chips)

Dinner

Poached chicken breast

Bok choy, fried in garlic and olive oil

Steamed jasmine rice

Scallions (spring onions)

Dessert

Sticky black rice (made with rice milk and minimal sugar)

Fresh mango

Wednesday

Breakfast

Zucchini slice (made with rice flour)

Morning snack

Rice milk latte

2 sm apricots

Lunch

Chicken soup w vermicelli noodles

1 plum

Afternoon snack

Rice crackers

Boiled egg

Dinner

Pan fried salmon

Sweet potato mash

Steamed carrots & snow peas, drizzled w olive oil

Chopped parsley, to garnish

Mineral water w lemon juice

Dessert

1 big handful frozen blueberries

Thursday

Breakfast

Zucchini slice

Morning snack

Rice milk latte

1 plum

Lunch

Chicken soup

Peach

Afternoon snack

Rice crackers & crudités with guacamole

Dinner

Pan fried swordfish steak

Mixed lettuce, cucumber, green capsicum (bell pepper) & avocado salad

Sweet potato chips (fries)

Mineral water w lemon juice

Dessert

Small bowl of puffed rice with rice milk, blueberries & a sprinkle of sugar

Friday

Breakfast

Zucchini slice

Morning snack

Peacharine

Rice milk latte

Lunch

Salmon, lettuce, cucumber, green capsicum (bell pepper) & avocado salad

1 green apple

Afternoon snack

Rice crackers

Boiled egg

Dinner

Grilled (broiled) frenched lamb cutlets

Pea puree

Steamed carrots & broccolini, drizzled with olive oil & lemon juice

½ glass of fresh pear juice mixed with mineral water

Dessert

Sticky black rice

Mango

Saturday

Breakfast

2 eggs, fried in olive oil

Fried zucchini

Wilted baby spinach

2 rice cakes

Morning snack

Rice milk latte

2 apricots

Lunch

Sweet potato, leek & pea frittata

Rocket & blanched green bean salad w olive oil

Handful of strawberries

Afternoon snack

Kale chips

Dinner

Chicken, asparagus & pea risotto

Green salad

Mineral water w lemon juice

Dinner

Fresh raspberries (my favourite!)

Sunday

Breakfast

Sweet potato rosti

Scrambled eggs

Wilted baby spinach

Morning snack

Rice milk latte

2 apricots

Lunch

Chicken, asparagus & pea risotto

1 plum

Afternoon snack

Kale chips

Dinner

Grilled (broiled) whiting

Baby spinach, green capsicum (bell pepper), cucumber & pea salad w olive oil

Sweet potato chips (fries)

Mineral water w lemon juice

Dessert

1 poached pear

Toria’s Modified Failsafe Diet

 

The difficulty with having a digestive disorder and being a food lover is, the two just don’t go hand in hand.  In fact, quite the opposite, as soon as you present as ill any health professional in the educated world is most likely going to put you on some kind of a restricted diet.  The first time I went to a GP with what we thought was gastro, he advised me to go on a 24 hour fast, drinking only lemonade to sustain my energy.  Years have passed and since then I’ve tried gluten free, dairy free, grain free, paleo, primal and GAPS… all without success.  Tempting as it is to throw in the towel and gorge on ice cream sandwiches, I’m still seeking the answer to my symptoms (I might add, if you are reading this blog in chronological order, my “transit time test” has thus far proved to be inconclusive.  *sigh*).  And so… another day, another “crazy diet”!

 

Many of you with long term health concerns will be familiar with the Royal Prince Alfred Hospital (RPAH)elimination diet, designed to isolate and ascertain food allergies and intolerances or, as it’s more commonly known on the interwebs, the Failsafe Diet.  The diet eliminates salicylates, amines, glutamates and additives.  Having read Sue Dengate’s enlightening book on the subject, Fed Up, I was already aware of the myriad of problems intolerances could cause, ranging from an itchy throat to a foul mood.  As digestive problems didn’t feature strongly in the text, I dismissed the Failsafe Diet as being a last resort for me, something I probably wouldn’t need to do.  Yet here I find myself, stationed firmly at the last resort, considering all kinds of desperate measures.

 

Having undergone Vega testing with my new naturopath (the Vega machine reads your body’s energy and then contrasts how that changes when you are in contact with certain food substances… yes, I told you I was considering all sorts of weird and wonderful methods!) we established that salicylates are probably not an issue for me.  While I confess, I’m not 100% sold on the effectiveness of Vega, I wasn’t about to argue with a decision which had just opened up a whole world of edible possibilities.  Salicylates, you see, means a whole gamut of fruit and vegetables and, as such, the cornerstone of my eating habits.

 

With salicylates included, but dairy and most grains out, my diet looks less like the classic RPAH diet and more like Toria’s Modified Failsafe Diet.  For the next 2 weeks I will consume only the following:

 

Protein

Fresh fish

Eggs (organic)

Chicken (organic)

Lamb (organic)

 

Vegetables

Carrots

Sweet potato

Green vegetables (including peas, leeks, avocado and scallions, but not cabbage, kohl rabi or any herbs bar parsley)

Parsley

Garlic

 

Fruit (max 3 serves per day)

Apples

Pears

Stone fruit (including mango!)

Berries

Lemon juice

 

Fats

Olive oil

 

Beverages

Water

1 cup of freshly brewed espresso coffee per day (phew!)

Rice milk

Mineral water

Herbal tea (not fruit tea though)

Diluted pear juice

 

Grains

Rice

Rice crackers

Rice noodles

Rice cakes

Rice flour

 

Sweeteners

White sugar (used sparingly)

 

 

By the end of 2 weeks, any benefit or lack thereof should be realised and we can being to “challenge” my stomach with amines, glutamates, dairy or the much maligned grain group of food products.  Strangely, I’m actually feeling a little bit excited about the whole experience!

Bowel Transit Time and Redundant Loops – The Hunt for a MegaColon

 

In the continuing efforts to discover the cause of my ongoing digestive troubles, today I am testing my “transit time”.  No, it’s not how long I spend on a bus (which, as I loathe public transport with an unrivalled passion, would not be very long) it is how long my bowel takes to process food.  You see, if your bowel takes too long to process food, it may be that you have a redundant loop and that can cause constipation, pain and potentially other symptoms too while all that toxic waste that should be ejected is still lurking about your body.

 

What Is A Redundant Loop?

It’s pretty much as it sounds!  It’s an extra length of bowel which usually forms a loop, that serves no purpose.  It’s a genetic inheritance so if you have it, you’ll be born with it.  Sometimes, redundant all that extra colon can get twisted up, causing all sorts of blockage problems and abdominal pains, just like when you twist a garden hose and the water stops flowing.
A redundant loop is also sometimes referred to as “megacolon”, which to me sounds like a really anatomically correct Transformer.  Awesome!

 

 

Why Is That a Problem?

The digestive system is ideally a pretty efficient operation.  Products come in (food) and are unpacked (digested by the stomach) and sent through to the factory (the bowel) where the energy, water and useful parts are extracted and the waste is shipped out quickly, before it starts to become unhygienic.

If your waste removal guys aren’t working very hard though, you can be in trouble.  You see, the engineers who extract the energy, water and nutrients are hard workers, and they keep ploughing away regardless of what else is going on.  Even if the waste removal team has gone on a prolonged cigarette break, the engineers keep working.  Now, there’s only so much energy and nutrition they can extract, but the real problem is the water.  If your bowel is too long, as it is in those of us with a redundant loop, your bowel “engineers” will just keep taking water out of your faeces until it is finally shifted through.  This means you can end up with rather nasty constipation.

 

What’s the Test?

The initial test is a really easy test you can do at home, in fact I’m doing it right now!  You simply eat some corn (whole kernels, not popcorn or corn syrup!) and monitor your stools until it passes through.  It’s important not to take any digestive aids like, for example, betaine hydrochloride, when you’re doing this test as the corn may be so worn down by them that you won’t see them on the way out.  Corn is one of those foods that never really breaks down and those bright yellow globes of fibre should be easily recognisable undigested in a stool.  Most normal humans will pass food matter completely through their system within 24 hours so if yours comes out after that, it requires further investigation.

If you’re lucky and you digest food easily, you might not be able to perform the “at home” test, as your corn would be well processed by the time it comes out.  You’ll need your doctor about a digestive marker test.

The next step is an abdominal X-ray for which you swallow barium will show whether or not your colon is “mega” or twisted.  Quite a few people have this problem discovered while they’re actually X-raying for other things!

 

How Do You Fix It?

Well, there are two options here.  Have surgery or don’t!  For some people, a redundant colon won’t cause problems and for others it can be managed with supplements and diet but for the unlucky few, surgery is required to correct the problem.  I am not a doctor and can’t tell you what to do if you have this, but it is a serious concern and you should get yourself to a competent gastroenterologist to have it investigated.

 

Oestrogen Dominance: The Wonder Woman Condition

wonderwoman

[image courtesy of DC Comics]

A couple of years ago, when I graduated from university and got my first “professional” job, my brother bought me a mug to put on my desk.  It was a Wonder Woman mug, featuring a picture of the lady herself, powering through the sky in a pose of triumphant glory.  I was highly bemused by this gift as I have never watched, especially liked, or expressed any kind of interest in Wonder Woman.  I put it simply down to yet another of my brother’s delightful idiosyncrasies and chuckled every day I saw the mug sitting on my desk.  Years later however, when I got my hormone test results, it became clear that I was indeed a “wonder woman”… my oestrogen was through the roof!  Did my brother have some bizarre psychic insight to the cause of my ailments, as he likes to claim?  We’ll never know, I suppose, but one thing was for certain, this was another imbalance that needed to be addressed before I could get well.

So, what’s wrong with high oestrogen, you might well wonder.  Your skin would be hairless, your voice high and flirty and if you’re lucky, your breasts might even get bigger, right?  Well, maybe that would be the case if the only problem was “high oestrogen” but unfortunately what I and many other women suffer from is actually “oestrogen dominance” and it means not necessarily that your oestrogen levels are higher than they ought to be, but that they are too high in relation to your progesterone levels.  It’s all about the relationships and balance between the two hormones.  A healthy ratio of progesterone to oestrogen would be, respectively, 1:6.  Mine was closer to 1:300 and it is with a dubious sense of honour that I say my doctor claimed she had never seen a reading so high in all her career.

Symptoms

Oestrogen dominance, while it may conjure images of single-breasted Amazon woman style matriarchal societies, is not all fun and games.  A handful of common symptoms are:

  • Acne (the nasty, painful hormonal kind… you know, big blind pimples on the chin and jaw)
  • Anxiety
  • Depression
  • Unpredictable mood changes and teariness (think: bursting in to tears at the supermarket because you just saw some biscuits your grandma used to like, and she passed away nearly 10 years ago.  Yes, I did it.)
  • Painful ovulation and menstruation
  • Mastitis (swelling of breasts)
  • Bowel disturbances (I love this term… sounds like something you might hear over a police radio “we’ve got a bowel disturbance in North Brooktown”… *chuckle*)
  • Cravings for simple carbohydrates (oh, hello!)
  • Weight gain around hips and thighs

Treatment

So, you’re oestrogen dominant.  It’s nice to put a label to a problem, it feels like a step in the right direction.  But the satisfaction this brings is short-lived when you realise that you haven’t actually gotten any better yet.  So how do you get better?  Well, oddly enough, it’s about re-balancing those naughty female hormones.

Direct Hormone Therapy

If your oestrogen is up the wazoo, you probably need more progesterone.  One of the quickest ways to get that is to take, you guessed it, progesterone!  You can get progesterone cream and pills by prescription from your friendly doctor or, if you’re looking for a cheaper option, you might find a progestin-only contraceptive (like the mini-pill or Implanon) helpful.  For many women however, these aren’t options.  The progesterone supplements can be very expensive and the mini pill didn’t make much difference for me.  For these people, it’s all about lifestyle changes.

Diet

Hippocrates, the founder of modern medicine, is noted to have said, “all disease begins in the gut”.  Many medicos seem to have forgotten this in their eagerness to prescribe drugs, or perhaps it’s just that they know the likelihood of most patients adhering to a diet is slim (an example is my dear old mother who, shortly after being advised by her dietician not to eat fruit, I caught eating a bag of apricots).  I’m not looking to start a doctor-bashing session, their heart is in the right place and if drugs can help us quickly, then of course they would want to see a fast recovery.  But for those of us for whom medication isn’t an option though, diet is a great way to heal.  You just need to know how.

A diet for an oestrogen dominant person would look like this:

Things to Eat Less Of

  • Simple sugars
  • Refined carbohydrates and “white food” (rice, pasta, flour, bread, etc)
  • Grains
  • Processed food, especially diet food which tends to be low fat but high sugar
  • Dairy (although this is only a problem for some, you will need to do your own experimenting)
  • Fruit should be limited to 2 pieces per day, less if the fruits are of the high fructose variety
  • Artificial additives- really, nobody should eat this stuff anyway, so that’s a no-brainer
  • Alcohol and non-essential drugs- as with additives, this is applicable not just to folks with oestrogen dominance, but everyone who wishes to be healthy

Things to Eat More Of

  • Fish and fish oil- you want high omega 3.  3g of fish oil a day or 3 fish meals (mercury free) a week is good
  • Organic, grass-fed meats, organic chicken and organic eggs
  • Lots of lovely vegetables, especially the ones with bright colours as this indicates high levels of antioxidants!  Brassicas, like broccoli, cabbage and bok choy are good for oestrogen dominance too as they contain Indole-3-carbinol, but watch out of you have IBS, as these can cause excess gas
  • Non GMO monounsaturated fats like olive oil, peanut oil, sesame oil, sunflower oil, nuts, seeds and avocado (yum)
  • Fermented soy (fermented only please).  Miso, tofu, tempeh and soy sauce are good.  Soy milk and its derivatives are a thumbs down.

Supplements That Might Help

  • B vitamins
  • Vitamin C
  • Vitamin E
  • Selenium (I eat 4 Brazil nuts a day to get my selenium, so that’s one less pill to swallow!)
  • Chromium
  • Indole-3-Carbinol
  • Calcium-D-Glucarate
  • St Mary’s Thistle (aka Silymarin)
  • Probiotics
  • Minerals for bone protection (calcium, magnesium, manganese, zinc, etc)

Obviously you will need to talk to a doctor about starting on any new course of supplements, particularly if, like me, you have multiple health problems.  Manganese, for example, can be a very good bone strengthening mineral for oestrogen dominance but for somebody with methylation problems, it could cause more difficulties.  Everyone’s puzzle is a little bit different but with time, I hope we can all put the pieces back together.

If Not GAPS, Then What?

Having a chronic illness does not stop time.  Life trundles along and the days slip by and the next thing you know, years have passed.  I looked at the calendar and realised, the other day, that almost a year has passed since I lost my law job due to illness (I got the sack on Valentine’s Day in 2012… and a big “I love you” to you too!) and almost two years since I first became unwell.  My goodness how time flies when you’re having fun.

My health has most definitely improved since this time last year when my daily nausea was so severe that I had to carry a bucket in the passenger seat of my car, just in case, but I’m still yet to say, “I’m cured!”.  Two years is definitely long enough for most treatments to make a difference but it seems I have plateaued in what my pills and potions are going to do for me, so the question is, what next?

I have done my dash with GAPS for now.  Most GAPS advocates and specialists tell me that if GAPS doesn’t work, you’re doing it wrong.  I confess, I wasn’t 100% vigilant, slipping the occasional square of chocolate in on the weekend or eating a steak fried in “mystery oil” at a restaurant, but surely after three months of 95% adherence I would have felt some benefit?  Apparently not.  Some patients even said they were on GAPS for years before they felt better.  That’s right, years.  Well, call me stubborn and foolish but I simply can’t endure years of bland, mushy food with hours of preparation time on the vague promise that it might help me and if it doesn’t, I must have been doing it wrong.  The whole premise reminds me somewhat of The Secret, a self-help book by Rhonda Byrne that posited you can bring anything to you in life if you just believe it hard enough.  Based on this theory, if you desire to be say, a professional basketballer, all you must do is desire it and wish for it, ignoring the fact that you may happen to be only 120cm tall.  Of course, not all wishes come true, but Byrne’s response to this dilemma?  Ahh, you just weren’t wishing hard enough.

Ok, so I don’t begrudge the power of positivity and there is much truth to what Byrne was saying but my point is, these self-fulfilling prophesies always seem to place the blame externally to themselves.  Now I do not for one moment accuse Dr Natasha Campbell-McBride of casting such irrational assertions, she is a scientist and bases her statements on research and observation.  However, when anyone says, “it didn’t work because you did it wrong” without actually even knowing what I did, I find it a little (ok, a lot) insulting.  It implies an assumption that I am either unable to understand the requirements of the regime or have some kind of maverick attitude and throw caution to the wind, blatantly ignoring rules but expecting the benefits.  Hmm, perhaps I go a little overboard, but I’m sure you can sense (and maybe even relate to?) my frustration at GAPS not working.

So what next?  I went back to my GP for further testing.  What else could be making me feel rotten?  We made a new connection, that I had started to feel really, really bad shortly after ceasing the oral contraceptive pill (Brenda or Dianne 35, for those of you playing along), so decided to test my hormone levels and guess what?  I’m oestrogen dominant.

But what does that mean?

Giving up GAPS

You’re probably wondering what’s happened to me.  Is she miraculously cured?  Did she die? Did she just get sick of writing about being sick?  Well, I’m still alive, I’m not cured and yes, maybe I am just a wee bit tired of writing about my ailments and endeavours.  I’ve actually written several posts, created a bunch of new recipes, cooked quite a few tasty treats and meals and even photographed them with the intention of pasting all of the above on this blog but somehow doing so just didn’t feel right…  The longer I left things, the more I felt I ought update my wellness and when I couldn’t say that I had improved yet, I didn’t want to say anything at all.    It’s emotionally exhausting to vest so much hope in each attempt at wellness, only to have them fail.  And I guess that’s why I’m giving up GAPS… for now at least.

I have nothing against Dr Natasha Campbell-McBride or the GAPS diet at all and I wholeheartedly believe there are people for whom this programme works wonders, but for me it has not been the saviour I was seeking.

After almost three months on the diet with about a 95% adherence rate, I am still experiencing the same symptoms as I was beforehand; abdominal pain, bowel irregularity, anxiety and reflux.  Then I underwent dental surgery and I figured, if I have to live on soft foods for the next 2 weeks, I’ll be having that white bread, pasta and ice cream thanks!  Two weeks later and I can honestly say I felt exactly the same as I did on GAPS which was disappointing but liberating.

Now, there will always be critics no matter what you do in life and I have already copped some flack for my lack of commitment to the GAPS programme.  A number of people are adamant that it will work for everybody but only if you are strictly 100% compliant.  Others have said it would have worked, but can take a year or two for symptoms to change.  The problem with a dietary programme like this is, if it doesn’t work, it’s very easy to blame that failure on the patient, not the diet.  100% compliance with the diet is practically impossible or at the very least, extremely difficult.  Unless you happen to live on an organic farm and prepare every single morsel that passes your lips from scratch, there will always be doubt as to whether what you just ate was GAPS legal.

Working full time and trying to juggle menu planning, shopping, cooking and cleaning is hard enough, but trying to manage all that when you are also chronically unwell is beyond a struggle.  There are days when everyone just wants to eat something ready-made.  Worse, as most social activities throughout the ages have and continue to revolve around eating and drinking, it is very difficult to stick to GAPS without a) Asking a million tricky questions at restaurants and then praying that they don’t spit in your food, b) bringing your own food from home and embarrassing yourself, and/or c) pissing off all your friends and family no end.  It is one thing to request the side salad be changed from Caesar to garden because of the dressing, it is another to ask for a grass fed, organic, locally sourced, country-killed cut of beef fried in coconut oil, thank you!

In addition to the practical difficulties, I had a well-qualified, although mainstream, healthcare professional in my very impressionable ear, berating these “alternative health therapies” as nothing more than glorified placebos and advising I attempt a return to “normality”.  My anxiety, she felt, was the cause of my Irritable Bowel syndrome and if I could just calm down, stop obsessing over what I ate and try to be “normal”, it would subside.  Of course, I objected, explaining that my General Practitioner, a medical doctor, had tested me and had scientific evidence I suffered from these conditions, but psychiatrists will be psychiatrists and of course, to them, everything is in the mind.  I explained, ad nauseum, that I had been eating a “normal” and “healthy” diet before I became ill.  In fact, my diet was a model example of a Western nutritionist’s dream, most of my meal plans coming straight from a dietician’s magazine.  The shrink simply smiled and said, “Ahh yes, but you were uptight then.  Try it again now”.

I wondered if there could be an element of truth in what she was saying.  Could my anxiety be causing my IBS and not the reverse?  Could I really eat bread again without feeling guilty?  I thought long and hard and eventually, after much soul searching and a really strong carbohydrate craving, figured I may as well give in and see if her method worked.  At least if it didn’t I would know a) that I was right and she was wrong (always gratifying) and b) that I was not completely crackers, subconsciously creating psychosomatic illnesses to sabotage the career I had worked so hard to create.

So what am I eating now?  Anything.  Everything.  I had trialled gluten free, grain free and dairy free diets prior to GAPS to no avail, so felt no need to restrict my intake of those nutrients.  I attempted a low sulphur diet but after three days discovered I had inadvertently breached it anyway and decided to give up until my tooth had healed.  I am yet to experiment with reducing salicylates and FODMAPs but am now postposing any further “crazy diets” as we love to call them in my house (and the psychiatrist’s office) until after Christmas.

 

GAPS Boston Baked Beans

I must apologise for my prolonged absence, I’ve been a very busy girl of late.  Working full time, attending the gym, writing my finance column and cooking all my gosh darn GAPS compliant food really chews through a girl’s time!

To keep up with modern life, you need a lot of energy and I think I’ve found the perfect breakfast for that.  Ever heard the expression “full of beans”?  It means to be full of energy and vitality.  The reasoning behind this phrase, one can only assume, is that beans are a powerhouse of energy.  It’s true, beans and legumes are an excellent source of complex carbohydrates and that means sustained release energy.  They are also chock-a-block with fibre and are full of protein too.  Add to that, they’re actually a vegetable, so if you’re one of those people who doesn’t much like veggies, just eat some beans and that’s one less carrot you’ll have to face.

Of course, GAPS patients can’t just eat any old beans, in fact there are only two permitted by Dr Natasha Campbell-McBride: haricot (navy) beans or lima beans.  Fortunately, these are very adaptable little fellows, particularly the haricot bean, and work their way splendidly into a wide variety of dishes.  I love them tossed through a salad nicoise, mashed with lemon juice and served as a side dish with steak, added to chilli con carne, or in today’s dish, Boston Baked Beans.

GAPS Boston Baked Beans

Ingredients

  • 3 cups dried haricot beans
  • Water for soaking beans
  • 100g nitrite free, organic or free-range bacon, chopped
  • 170g tomato paste
  • 1 cup honey
  • 2Tbsp mustard powder
  • 2 cloves garlic, crushed
  • 1 onion, finely chopped
  • 2.5 cups water

Method

Day 1

  1. Pick over dried beans, discarding any foreign objects or dodgy looking beans, place in a bowl and cover with water.  Soak for at least 12 hours.

Day 2

  1. Rinse beans thoroughly, discard soaking water;
  2. Place bacon in a large pot and cook over medium hea;t until bacon fat has rendered
  3. Add onion and garlic and sautée until onion is clear;
  4. Add tomato paste, mustard powder and water, stir to combine and bring to boil;
  5. Add dried beans and reduce heat to simmer;
  6. Simmer for an hour or two, until beans are tender (alternately, you can put the lot in the slow cooker all day);
  7. Add honey and stir through just prior to serving.

Sensational!!

Unwanted Weight Gain on the GAPS Diet

If you’ve been following this blog, you’ll know the last major change I made to my diet was to try the GAPS Diet but with a high fibre spin.  So how did that go?

 

High fibre certainly made a difference, although I can’t say it was necessarily a positive one.   Things did seem to move through more quickly, if you know what I mean, but there was no real change to the symptoms I’m trying to heal.  My reflux was unaffected and my abdominal pain was unimproved.  I must say I feel better for having the Western standard “recommended” amount of dietary fibre but the benefit is minor and I suspect it may even partially be a placebo effect.

 

Increased Mass

I have been on the GAPS Diet for a couple of months now and I noticed something was happening to me… I wasn’t getting better, no… rather, I was getting bigger.  The GAPS Diet is supposedly the most healthy diet and considering how closely aligned it is with the Paleo Diet, I had naturally assumed I would lose weight on it.  No grains, no potatoes, no sugar… surely I would lose a few kilos, right?  Well, sort of. I did in fact lose exactly 3 kilograms in the first week of the GAPS Intro Diet.  This stayed off for the following week and right up until the point at which I introduced nuts and honey.  From there on in, I not only gained back the few kilos I’d lost, but gained a few extra to keep ‘em company.

 

Now, I want you to know I was not underweight to start with, this is not the GAPS Diet making a wan body healthy.  I wasn’t obese either, just a teensy bit overweight.  I had been a pretty healthy weight and size prior to getting sick but feeling like death all the time is not conducive to exercise nor even healthy eating.  I had tried to smother my nausea in starchy white crackers and breads, giving myself an energy boost with an array of gelatine based confectionaries.  Apart from, no doubt, making my gut health worse, this lead to an increase in physical mass of around 10 kilograms.  I really didn’t need to gain any more.

 

GAPS is a high fat diet, no doubt.  In fact, for patients who suffer from constipation based problems such as abdominal pain, Dr Natasha recommends high fat, suggesting half a cup of crème fraiche a day!  GAPS is not meant to be a high calorie diet though.  The energy you would normally have consumed by eating grains is supposed to be replaced by GAPS-legal fats, avocado, ghee, nuts and animal fat.  I wondered if maybe I had gone overboard and so I visited Calorie King, a website I used to utilise when I was younger, to figure out exactly how much energy I was consuming on an average day.  I was shocked at what I found.  What with all my crème fraiche, nuts, oils and fatty meats, I was wolfing down almost twice the calories a woman of my age and stature ought to be!  No wonder I was gaining weight… it was a miracle I wasn’t humungous!  There were only 2 things for it, I would resume exercising (properly this time, not just my casual strolls around the block when I felt so inclined) and I would need to make a meal plan with a reasonable amount of calories.  Say, around 1500 a day.

 

I began by joining my local gym.  I have actually been thinking about doing this for over a year now.  Ever since moving into the area I have been dissatisfied with the prospect of my local, looking for something better to replace the old gym I had frequented but had to leave when we relocated, to no avail.  I had toyed with the notion of taking up yoga again, resuming the belly dancing I had loved in my teens, or even starting a hip-hop dance class but discovered the cost of one dance class a week was nearly the same cost as an entire week’s worth of gym membership… a membership which entitled me to unlimited fitness classes including dance and yoga and all the other stuff too.  Even if it wasn’t the best gym in the world, it was the most sensible option, and I am all about sensible.

The Plan

To lose weight, get strong and fit again and to just generally feel well again, I was going to need to do a combination of workouts.  I have never liked running, I get bored really fast doing most cardio, and I lack the discipline to simply work out on my own.  I like classes.  Music is good, having an instructor is better and the best bit of all is if I stand up the front and convince myself people are judging me, I dare not slack off in front of them all!  I am very fond of the Les Mills fitness classes and have always enjoyed them, despite the epic legal saga which prevented them from using original music.  My favourites are:

 

BodyPump

An intense weights based class, the first of its kind!  Class members use a barbell with weights while an instructor leads them through a workout set to music incorporating squats, lunges, chest presses, tricep presses, bicep curls, the clean and press and more.

 

BodyBalance

A calming, strengthening workout which combines moves form tai chi, yoga, pilates and dance, all set to modern music and with a short, guided meditation at the end.

 

Sh-Bam!

Back in the day I used to take BodyJam classes and I loved them.  Awesome modern dance routines set to funky music (I was particularly fond of TV Rock vs Dukes of Windsor’s “The Others”), I would get so engrossed in the class I wouldn’t notice I was out of breath ‘til the hour was over.  The only problem was, not too many other people loved it.  There seem to be a lot of very self-conscious types out there who would stand awkwardly at the back of the room, watching the instructor’s feet, afraid to even try lest they get the move wrong and “embarrass” themselves (I need you to understand, I am not a good dancer.  I made heaps of mistakes and probably looked quite ridiculous but the point is, I choose not to be embarrassed because at least I’m having a go).  Anyway, the gym finally phased BodyJam out, despite my multiple objections and strongly worded letters and replaced it with an easier, more accessible dance based class.  Sh-Bam is easier to follow with simpler moves.  It’s a shame, because BodyJam was starting to make me feel a bit like the next Michael Jackson, but at least with Sh-Bam I get a good work out and any class that incorporates a bit of Skrillex is alright with me.

RPM

Ok, so I don’t actually love this class… it is really hard.  But, as my calf muscles rip off their tendons just thinking about high impact aerobics, it is the best cardio workout for me.  Members sit on stationary exercise bicycles and an instructor leads them through a guided workout to thumping music.  Guaranteed to get your heart racing!

 

Here’s my weekly plan:

 

Monday

BodyPump

 

Tuesday

BodyBalance

 

Wednesday

Warm up + free weights

 

Thursday

RPM

 

Friday

Warm up + free weights

 

Saturday

Sh-Bam!

 

Sunday

Rest

 

In combination with my 1500 calorie diet, this should get me back to normal.  Yes it will be tough to begin with but I’m hoping some pain = no more gain!

Fibre: Friend or Foe?

Fibre.  It’s one of those modern holy words that promises infinite health and conjures mental images of healthy elderly folk, jogging on beaches and enjoying what I can only imagine must be the benefits of their perfectly functioning bowels.  Every doctor in Christendom and beyond touts fibre as the intestinal cure-all and the advertising industry has latched on to this, peddling an array of high-fibre “health” foods and supplements.  But what if fibre isn’t the answer?

Dr Natasha Campbell-McBride, creator of the Gut And Psychology Syndrome (GAPS) diet, claims fibre is in fact more trouble than it’s worth for some people.  Now, before all the critics start stomping their feet, let me clarify this.  No-one is saying fibre has been misjudged and is in fact an evil in society, cloaked in the shroud of health food (like, say, supermarket yoghurt).  No, what Dr Natasha points out is that fibre is fantabulous is you have healthy gut flora.  But if you don’t?  Then it’s downright wretched.

The reason fibre is so darned good for the digestive system is not just that it provides roughage, indigestible solids that slough along the intestinal wall, giving you an internal Spring-clean, but also because it provides a feast for intestinal flora.  They eat it, bathe in it, sleep in it, frolic in it and generally just adore being smothered in fibre.  As a result, the happy bacteria activate the fibre to absorb toxins, boost water and electrolyte metabolism, recycle bile acids and cholesterol and more.  So if you had, say, irritable bowel syndrome or gut dysbiosis, you would automatically think fibre would be the solution, right?  You wouldn’t be alone.  When I first began experiencing symptoms of digestive disorder I visited GP after GP, gastroenterologist and eventually psychiatrist and psychologist.  The first thing all of these medically trained practitioners wanted to know was how much fibre did I eat and had I tried a supplement?  It came to the point where I was so frustrated by answering the same insultingly obvious questions, that I typed up a chart of my diet, my supplements and what I had already tried.  Still, I can’t really be angry with the medical profession for asking about my fibre intake because, as we’ve seen above, it is actually really good for us if our gut is functioning properly.  It all goes horribly wrong you see if the gut is not working right.

Should you suffer from a disorder which causes your intestinal flora to be out of kilter, where the bad bacteria have overtaken the good, then fibre will not save you.  The problem is, funnily enough, the bad bacteria love fibre too.  The pathogenic strains will thrive in the high fibre environment but do not perform the same symbiotic functions.  Instead, the fibre is not processed properly and it further inflames and irritates the intestinal wall.

For these reasons, the GAPS Introduction diet dictates weeks of a virtually fibre-free diet in order to kick start the system, starving out the bad guys before repopulating with the good.  The problem with this is, no fibre often means no bowel movements and if you’re on GAPS due to symptoms of constipation or abdominal pain caused by distension, this is not going to heal your problems at first but initially make them worse.

To counter the unpleasant sensations that accompany the low-fibre diet, Dr Natasha recommends daily enemas but for many, this just isn’t a real possibility.  For those patients who have the courage to attempt what seems like a totally foreign act, they are time consuming, inconvenient, invasive and often painful.  Further, enemas, although widely used in Europe and the US, are not considered acceptable in Australia.  Enema kits are virtually unheard of and are associated with a stigma of something dirty, juvenile or perverse.  Requesting an enema kit in a pharmacy will be met with raised eyebrows and that’s if the staff actually even know what you’re asking for.  The only way to acquire a kit is to purchase online and for those who are have internet access, are techno-savvy enough and, let’s face it, are brave enough, this is a slow and expensive purchase.  Buying an enema kit from overseas can cost upwards of AUD$100 and the wait time on delivery can be weeks.  As such, many Australian GAPS patients struggle through the low fibre Intro Diet with no assistance to get things moving.

I was one of these unlucky patients and as such, I was thrilled when I finished the Intro Diet and was able to add foods like dried fruits and, praise be, beans!  Grains provide the majority of fibre in the “ideal” modern Western diet, closely followed by vegetables, then fruit and legumes after that.  Once the patient has re-introduced GAPS-legal vegetables and fruits, she can begin to introduce lima beans, haricot beans and lentils.  Of course, being the GAPS diet, nothing is ever simple.  You can’t just use any old beans, oh no.  The list of legal legumes must be properly prepared, involving soaking in water and whey overnight before cooking until soft.  Nonetheless, I was thrilled.  Having been a vegetarian by choice for many years, legumes form the basis of many of my favourite meals and I had sorely missed them whilst living on meaty meals.

The question is, once all the introductions are over, can a person on the full GAPS Diet actually get enough fibre without supplements?  According to the Mayo Clinic, adult humans need between 21 and 38 grams of fibre each day in order to maintain healthy digestive functions[i].  That’s a lot of fibre!  Fortunately, as a female, I need much less than the 38g and can settle for a reasonable 21g.  So what GAPS-legal foods are fibre rich?  I began constructing a list and it turns out it’s not that hard.

Dried figs

I love figs.  I am a fig pig.  When figs are in season I will gorge on them, finding a way to incorporate them into every meal and snack until they disappear from the farmers’ market again for another 11 months.  Dried figs are available all year around and as such not nearly as exciting, but they are nearly as delicious.  Just three dried figs for morning tea packs 10g fibre, that’s nearly half the day’s requirement!

Coconut flour

Coconut flour is the saviour of the GAPS and paleo diets, allowing almost traditional baked goods to be enjoyed once more.  It also just so happens to be extremely high in fibre!  A quarter of a cup of coconut flour has 12g of fibre compared to 0.8g for the same quantity of wheat flour.  Make yourself some coconut banana bread for brekkie and you’re well on your way to a high fibre diet for the day.

Avocado

I wouldn’t have thought of avocado as being a naturally high fibre food, being as creamy and soft as it is, but it turns out half an average avo’ contains 5g of dietary fibre.  It’s also a fantastic way to get more of those healthy fats in to your diet which are necessary to replace the calories we would normally get from grains.  Avocado is a great addition to salads, makes a great snack on its own and pairs beautifully with Mexican dishes.  I’m actually eating some chilli con carne with avo’ right now.  So tasty!

Beans/Lentils

Look, they’re called the musical fruit for a reason, ok?  But don’t worry, when soaked and prepared properly, legumes shouldn’t give you any excess gas or digestive problems.  Dr Natasha recommends soaking your legumes overnight in cold water and whey to activate them and to wash away all those nasty lectins (a naturally occurring protein that causes intestinal irritation for many people).  Some people swear by soaking beans in water with lemon juice and I personally find I can handle just plain old water.  100g of dried haricot beans will give you 7g fibre and a quarter of a cup of dried lentils provides about 15g of fibre.  Legumes are also marvellously versatile, good for breakfast lunch and dinner.  Remember that chilli I was eating?  Full of beans!

Nuts & Seeds

Nuts are a powerhouse of nutrition.  Full of good fats, protein and fibre, it seems impossible to conceive that nature might not have intended us to eat them (except of course if you are allergic, then definitely don’t).  30g of mixed nuts yields 2g fibre so tuck in.

Nut breads and nut butters add extra fibre to the table.  A wedge of almond bread for breakfast is a great way to boost your fibre intake.  Want more?  Try mixing dried figs into the batter before baking and serve with lashings of melting butter for a super-fibrous gourmet breakfast treat.

Berries

The only fruit, possibly even food, I love more than figs is raspberries.  There’s something about that sweet, tart, spongey little berry that tingles my palate in just the right way.  Serendipitously, they also happen to have about 4g of fibre per a lahf-cup and other varieties of berries have comparible fibre levels too.

Pre-GAPS I would scoff down berries with mascarpone, meringue and powdered sugar but they also make a delicious accompaniment to yoghurt or crème fraiche, drizzled with a delicately flavoured honey.  You can mix them into your coconut flour banana muffins or enjoy them dried with some nuts just as our ancient ancestors would have done.  And really, that’s what this whole GAPS thing is all about, isn’t it?


[i] Mayo Clinic, n.d., Dietary fiber: Essential for a healthy diet [sic], online, available 14/09/2012, URL: http://www.mayoclinic.com/health/fiber/NU00033.

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