Tag: gluten free diet

Said Differently

Sometimes we understand something we couldn’t before when it’s said differently. If a doctor says avoid all foods that contain gluten, we may only hear the AVOID ALL and fail to understand that this may not be as restrictive as we imagine.

teeth biting lip with red lipstick

Said differently, she could begin by saying, “enjoy all meat, poultry, eggs, fish, and seafood that you are not allergic to. Eat any nuts, seeds, fruit, and vegetables that agree with you. And enjoy any baked goods made without wheat, rye, barley, or malt.” This second presentation sounds like we’ll be swimming in food. And that is the reality.

Of course, further education will be required regarding breading, thickening, and recognizing products that contain wheat, rye, barley, and malt, but additional details are required no matter where you begin. The finer details are not a reason for starting with a statement that can be regarded as negative or taking something away.

As we have experienced in the worldwide community the past few years, communication of health messages is key to adaptation and compliance. It may be more efficient to state restrictions first. It may seem clearer to only mention what must be avoided. This may be true, but we must deal with the lower brain when we’re asking folks to change something as essential as food.

The lower brain registers the message avoid all and goes on alert to protect us. It is likely to respond to the unstated threat: this doctor is asking me to give up food I need to live. We probably won’t experience this response as a conscious thought. Instead, our body will brace and we may begin to feel anxious, annoyed, angry, or resistant.

Why physicians don’t receive training by marketing professionals is beyond me. Marketers know how to present information to motivate people.

Communication is the easiest loop to design and complete in healthcare. And yet it’s the loop that is most often neglected or broken. Lacking and/or poor communication creates problems that would not otherwise exist.

I recently attended a birthday party with a child who was gluten-free. His father brought a piece of cake and slipped it in front of him as the cake was served. I talked to some other attendees later. No one had even noticed his cake was different.

The whole event was handled so smoothly, there was no awkwardness at all. When the venue placed pizza on everyone’s plate, the child let them put pizza on his. He just didn’t eat it. Most likely, he had already eaten something substantial before coming to the party.

While I wasn’t present when this child was informed his eating choices must be different, the family seemed so positive and matter of fact, I have to believe the parents were thoughtful and mindful with their communication. If the boy didn’t understand, I feel sure they were willing to say things differently until he absorbed the information and felt comfortable. It is evident that over time he has become a confident participant in normal childhood events.

I’ve seen adults who were way less adept. It’s not a stretch to think that if they had been communicated with differently at diagnosis, adherence to a gluten-free diet would be less problematic.

With the weird dichotomy of overly permissive and overly rigid that permeates many systems right now, it may be more difficult than ever to find a balanced approach for disseminating information in the most helpful, productive way.

That doesn’t mean it shouldn’t be a goal or that we shouldn’t try. Said differently, we can create better attitudes, higher rates of adherence to restricted diets, and a healthier population if we learn to communicate more effectively.

Multiple Overlapping Diet Restrictions

How can you navigate multiple overlapping diet restrictions? It’s hard enough to follow one regimen! Having to cross-reference, combine, then personalize more than one is challenging. It can leave you feeling like there’s nothing you can eat.

bread wrapped with caution tape

I’ve speculated before that my mother may have had MCAS. Her symptoms were compatible with that diagnosis. And her reactions to food could be so dramatic that she eventually limited what she consumed to lettuce with a squeeze of lemon juice, pasta with butter, and an occasional bite of pie. She augmented that with about 30 supplement pills per day.

To say that she was starving her body of nutrition is to put it mildly. But at the time, beyond allergy tests and shots, there wasn’t much in the medical knowledge base that would explain what was happening. Left to her own devices, Mom opted to restrict herself to a tiny number of well-tolerated items and avoid the misery of adverse reactions.

Even with the additional information we have now, it can be tempting to simply stop eating if a plan seems too daunting. And even if you choose to eat, it can sometimes be hard to get yourself fed a nutritious variety of foods that you tolerate well.

For me, the key is to have food available before I get hungry. Once I hit a certain point, it becomes impossible to make a decision, much less execute a plan. I accomplish this in a variety of ways, some more successful than others.

The first step is always determining which foods affect me most and which I can tolerate in small amounts. My NEVER VIOLATE list includes gluten, shrimp, bacon, sausage, canned fish, deli meats, and tonic. That becomes a lengthier list if I list everything that contains gluten, but let’s keep it simple.

My EXTREME CAUTION list includes sunflower oil, lecithin, and seeds; yogurt; spinach; eggplant; avocado and avocado oil; bananas; strawberries; oranges; dried fruit; sundried tomatoes; mushrooms; red wine; lentils; black-eyed peas; and sauerkraut.

My LIMIT AMOUNT list includes tomatoes; cheddar cheese; parmesan cheese; chickpeas; peanut butter; chocolate; pork; vinegar and pickled foods; fresh pineapple; lemon; lime; Bing cherries; cinnamon; white wine.

While I rarely consume something on the EXTREME CAUTION list, I don’t freak out if some guacamole ends up on my enchilada and I would consider trying a bite of gluten-free banana bread. And having a list in which I limit amounts without totally avoiding a food allows me to balance mild symptoms with social ease when eating at a restaurant.

The more regimens you must combine, the more time it may take to create similar categories. Begin with the lists provided by your doctor and/or nutritionist. Create a spreadsheet or visual grid. If a food falls in the problem list for all diets you’re following, it probably should be on the NEVER VIOLATE list. Gluten will always fall here for anyone with celiac disease due to the autoimmune damage created by consuming even small amounts whether or not symptoms are mild.

Because everyone’s system reacts differently to foods and combinations of foods, the items on your EXTREME CAUTION and LIMIT AMOUNT list may stray a bit from the recommended. Sunflower oil may or may not be hurting my health if I ingest it, but the reaction affects my day immensely so I exercise extreme caution when choosing foods that may contain or have been fried in it. As you observe your reactions to food, you may need to update these lists from time to time.

With your lists in mind, the next step is to cook multiple meals at one time. This can be as simple as making one entrée that will last for several meals – roast beef, meatloaf, chicken & rice, or chicken curry. As long as I have an entrée that lasts for more than one day, I can add an apple and have a meal. It may not be the best meal, but it will suffice.

Sometimes, I may cook more than one entrée at the same time to ensure variety for a few days. Sometimes, I cook multiple vegetables at the same time as the entrée. Sometimes, I add a veggie to a one pot entrée. I don’t spend hours and hours planning. I just wing it.

When I don’t have time to prep fresh vegetables, I rely on the frozen English peas, edamame, and sugar snap peas I keep on hand. These allow me to add a vegetable to a meal in a matter of minutes.

On days when I fall behind, I often choose rotisserie chicken, eggs, or a restaurant meal. I’m lucky to live in a city with many farm-to-table options. This allows me to find fresh ingredients even when I don’t prepare them. All I need are my lists as a guide in order to choose well.

I realize this makes it sound like I’m on top of things and never have a moment when I stand in the kitchen tired, dazed, and confused. That’s not the case. I sometimes feel overwhelmed and struggle to feed myself.

Remembering that a meal doesn’t have to be pretty or go together perfectly helps in those moments. As long as your diet is balanced overall, the occasional meal of scrambled eggs and toast with honey or rotisserie chicken over mashed potatoes won’t hurt you.

While these steps cover most of my meals, there can be broader issues when family is involved. We’ll deal with those in an upcoming post.

In the meantime, you can begin to compile lists of prohibited (or allowed, if you prefer) foods to help you keep things straight when shopping and cooking. It may not be easy. It may take away some of the pleasure of a meal. But facilitating your health is possible even when you have overlapping dietary restrictions.

The added bonus is you will feel better. And feeling better makes it easier to exert energy toward feeding yourself in a way that’s not harmful.

Here’s to feeling better!

https://my.clevelandclinic.org/health/diseases/mast-cell-activation-syndrome