Shifting Gears

Earlier this week I had a meeting with my GI doc in preparation for surgery #7, which will happen on Wednesday of this week. Mostly I wanted to talk to him about managing my remicade infusions with all the surgeries, but I also had a couple of symptoms I had been noticing that I wanted to run by him. All in all he is happy with my progress and not making any changes to my treatment plan for now, except for one thing.

One of the things we talked about was diet and nutrition. I had been keeping a food journal for several weeks, and I was starting to notice some patterns. Some of my suspect foods (for example: dairy, even when properly fermented; tree nuts and peanuts in large quantities; fruit in large quantities) were some of the very same foods that are highly recommended on the SCD diet. Also, when I strayed from SCD, I noticed there were other foods that seemed to agree with me but that I wasn’t “supposed” to eat (for example: rice, sweet and white potatoes, oats). When I told him about some of the triggers I noticed, he told me he wanted me to try something called the low FODMAPs diet and gave me a brief explanation and some materials on how it works.

I have mixed feelings about this transition. On the one hand, I have spent so much time and energy doing my best to implement SCD. It also sort of fits in with my general view of what is good for our bodies (nothing processes, lots of fruit/veggies, nutrient-dense foods, and healthy fats). On the other hand, I wasn’t experiencing as much relief as I hoped while following it. To be fair, from the beginning I was told that to be effective you have to commit 100% to SCD, and I never was quite able to do this for more than a few weeks at a time. So I can’t say that the diet doesn’t work, I can only say that it doesn’t work for me. In my mind, if it is impossible to follow a diet and occasionally travel, go out to eat, or have a meal at someone else’s home, then it’s not a real option for me at this point in my life. Maybe it will be at some other time. Even  following the diet 90% of the time, I was starting to feel too deprived.

So, before I even talked to my doctor, I had thought about trying something else. He told me that the low FODMAPs diet is actually the diet with the most scientific evidence behind it for controlling symptoms of Crohn’s. I’m a scientist, too! I love scientific evidence!

I’m still learning about the low FODMAPs diet, but here is a quick summary of what I have learned so far. Like SCD, it works in part by altering the microbiome in the gut by restricting the type and amount of food available to gut bacteria. And, both diets limit foods that are thought to be difficult to digest. But, the specific foods that are identified as being hard to digest are different. SCD limits all simple sugars, grains, and starches, whereas low FODMAPs limits foods containing specific types of sugars that can lead to fermentation in the gut when too much of them is consumed (the acronym stands for “fermentable oligo- mono- di-saccharides and polyols). Also, whereas SCD requires the patient to completely eliminate these foods during a one-year introductory phase, low FODMAPs encourages patients to eliminate high FODMAPs foods completely for 2-6 weeks, then reintroduce them slowly to identify specific triggers. There are also quite a few foods that you can eat, even during this introductory phase, as long as you limit portion sizes. Best of all, the diet doesn’t depend on 100% adherence–just on reducing your overall FODMAPs load, because high FODMAPs foods are only considered problematic when you eat too much of them at once. In fact, except for the very short introductory period, 100% adherence is discouraged, mostly because many of the high FODMAPs foods are also important sources of prebiotics (compounds that encourage the growth and activity of beneficial gut bacteria).

I made a table comparing the types of foods that are allowed on the diet. This isn’t meant to be comprehensive, just a quick overview. As you can see, the main differences are that low FODMAPs allows gluten-free grains and a wider variety of sweeteners, but limits the type and quantity (usually to 1/2 cup per sitting) of fruits, vegetables, legumes, nuts, and seeds somewhat more than SCD.

Food Group Specific Carbohydrate Diet Low FODMAPs Diet
Grains None All except for wheat, barley, or rye
Meat, Fish, and Poultry All (unprocessed) All, unless processed with high FODMAPs foods
Dairy Hard cheeses and homemade yogurt Lactose-free dairy, low-lactose dairy, all in limited quantities
Fruit All fruit (except canned) Bananas, blueberries, melons (except watermelon), grapes, kiwi, citrus (orange, lemon, lime, pineapple, mandarin, tangerine), passion fruit, raspberries, strawberries, rhubarb, avocado, cherries, grapefruit, longon, lychee, pomegranate, rambutan, coconut, in limited quantities at a time. Also, no canned fruit permitted
Vegetables All except for starchy vegetables (white and sweet potatoes, yams, parsnips, yucca, taro, jicama, corn), seaweed and seaweed products, canned vegetables, artichokes, bean sprouts, okra, chicory, cucumber All types of leafy greens (kale, spinach, lettuce), red bell peppers, bok choy, cucumbers, eggplant, green beans, cabbage, parsnips, pumpkin, all types of potatoes, radishes, seaweed, winter and summer squash (butternut, zucchini, yellow squash, spaghetti squash, etc.), tomatoes, turnips, water chestnuts, carrots,  bamboo shoots, canned artichoke hearts, asparagus, beet, broccoli, brussels sprouts, celery, peas, snow peas, corn, all in limited quantities at a time
Legumes No legumes permitted, except for peanuts and properly soaked lentils, navy beans, adzuki beans, peas, and lima beans No legumes permitted, except for peanuts
Nuts and Seeds All, depending on form (flour, whole, milk) and stage of diet, in limited quantity All except for cashews and pistachios, in any form, in limited quantity
Nutritive Sweeteners Honey, aspartame, and saccharine (occasionally) Sugar (white, brown, cane, etc.), maple syrup, glucose, stevia, regular corn syrup (but NOT HFCS), brown rice syrup, all in limited quantity
Cooking Oils All except for soybean All
Herbs, Spices, and Seasonings All except for mucilaginous herbs and vegetables (aloe vera, marshmallow, slippery elm, etc.), spice blends, balsamic vinegar, and various additives All salsas, jams, chutneys, pickles, sauces, etc. made with permitted fruits and vegetables, mustard, mayonnaise, green onion (green part only), soy sauce, vinegar, most spices and herbs, homemade broth, butter
Beverages Most fruit and vegetable juices, weak coffee, weak tea made with permitted foods, dry wine, spirits, nut milks Juices and smoothies made with permitted fruits and vegetables, coffee, tea, beer, wine, nut milks, all in limited quantities

The hardest thing for me, for sure, will be cutting out garlic and onion (even for 2-6 weeks, assuming the reintroduction goes well!). If you’ve ever looked at any of my recipes, you can see they all start with cutting up lots of garlic and onion! On the other hand, it feels like such a huge relief to have permission to eat some gluten-free grains here and there that it might make up for it. Not that I plan on going nuts–I still fully believe that eating unprocessed foods and focusing on eating fruits, vegetables, and protein rather than filling up on grains is healthier for almost everybody–but it’s nice to have a little bit more flexibility. To me, this diet seems much more manageable in the long term. And, while I won’t go into any gory details, in the 6 days or so that have passed since my doctor’s appointment, as I’ve tried reducing my overall FODMAPs load without yet jumping in on the elimination part, I’ve experienced more symptomatic relief than I ever did on the SCD. 

So, yeah, I think I’m going to give this a shot. Before I try the elimination part, I think I have a bit more research to do. I’m also not going to try the elimination phase until after I’m (mostly) recovered from my next surgery, since it seems like a lot to ask others to manage when I am unable to help at all with cooking or shopping. In the meantime, I might take a bit of a break from writing as well while I scope out this new territory, but I will be back, hopefully armed with a whole new set of recipes!

Advertisements

Reflections on my 1-Year Crohn’s Diagnostiversary

I never expected that on my first Valentine’s Day as a married lady, I would be sitting in a gastroenterologist’s office being diagnosed with an incurable, lifelong autoimmune disorder. But, that’s what happened! So, on my second Valentine’s Day as a married lady, I thought I would take a little time to reflect on my first year as an official crohnie, to share some of the things Chris and I have learned and felt along the way.

  1. Crohn’s taught me it’s ok to ask for help. Before I got sick, Chris and I had both had some pretty minor struggles with anxiety. What I mean by that is we both worried, a little more than we thought was normal, but we could manage it and continue to function without outside help. My siblings and I all have a history of worrying excessively about our health (ironic, isn’t it?), and looking back I now know that I would have saved myself a lot of unnecessary suffering if I had talked to someone earlier about that, but I was too stoic to do so. When I got sick, the borderline anxiety that we both experienced spiraled completely out of control; I was so depressed and anxious that I struggled to even function normally. Eventually, Chris and I both realized we needed to see someone about what we were experiencing, and we did. We learned coping strategies individually, that helped us each feel better, and we also learned ways to avoid making each other feel worse. Sometimes it’s easy to get into a sadness spiral as a couple, where you share things that are upsetting you, and because your partner loves you, those things in turn stress him/her out more. I think it’s important to learn to be honest and open without overburdening your partner, and this is one of the most valuable things that came out of therapy for both of us. I read some books and blogs–the most helpful of which was probably How to be Sick by Toni Bernhard. I learned about meditation and breathing exercises and embraced yoga again. Oh and by the way, my psychiatrist prescribed a low dose of an SSRI medication and supplements for me (although Chris’s did not). I feel exactly zero shame in sharing that, especially knowing a little about how gut and psychological health are connected. After a few months of medication, I remember Chris telling me, “I felt like you were gone. For the first time in forever, I feel like I have you back.” I felt that way too. And we both agree that we are stronger individually and as a couple than we were before Crohn’s.
  2. Crohn’s has changed my interests. I used to run a lot–I ran two half marathons (very, very slowly) in the two years before I got really sick. I also used to ride my bicycle all over town, and stay out all night listening to live music and dancing and sipping on beer. I can’t do those things anymore–or at least, I can’t depend on doing them. Last summer, Chris took me to a Neko Case concert and I had a few glasses of wine and a burger on a gluten-free bun and I sang and danced my heart out and it was one of the best nights ever. And on days when I feel well enough, sometimes my greyhound and I jog instead of just walking. He usually even wimps out before me, too! But I kind of have to accept that I can’t drink wine and dance and eat burgers every weekend anymore, and I might need to consider specializing in 5Ks rather than half marathons. BUT! I’ve found new things to do. I know so much more about cooking and nutrition than I used to (just ask Chris about the shrimp quesadilla incident if you don’t believe me). I’ve learned to crochet. I have a whole shelf of novels that I’ve read–FOR FUN–in the last 18 months. I’ve fully joined my husband in his appreciation of TV and movies. What seemed before like wasted time at worst, or a guilty pleasure at best, is now an opportunity for us to relax and spend time together. Last but definitely not least, because I’m at home a lot more we finally adopted a dog, which is something we had talked about for a long time, and we are currently fostering another. I know it might sound silly, but having these sweet canine creatures has brought so much joy and love into our house. Now I can’t imagine life without a fur child, but before I got sick we never felt like we had time for one.

See, here is a recent project:

IMG_20150128_094839051

Here I am cooking in the awesome apron my sister sent me!

11092_718406321606_2022458919462141682_n

Chris with our dog (laying with his paws on daddy) and our foster (demanding attention):

1780694_735301244046_1222283224692736583_n

Yeah, the dog situation is pretty serious…here is our greyhound dressed up for a Christmas parade, along with my niece and me:

10474814_725359113156_2320590208860208530_o

  1. Crohn’s has changed my priorities. I used to be very career-oriented, and I’ve worked very hard to have a prestigious and lucrative career. Now I live every day knowing that I might not be able to have a career. Or, I might be able to have a career, but only if I give up…like…pretty much everything else. Even before I got sick, I was beginning to realize how much more important family, love, and relationships are to me than my job. My illness has only confirmed this. My mom flew out to be with me after surgeries, to help us cook and clean and keep me company. Eventually, my parents actually moved across several states to be closer to us. My in-laws have cleaned the house when I’ve been too sick to do it. My nieces have colored beautiful pictures to help me feel better. One of my best friends flew across the country to spend a weekend watching reality TV and getting massages with me. My boss and advisers have been really great, offering excellent advice and putting up with me when I’m flaky and distracted and crying and in general being less than a perfect professional, but this encouragement and understanding is not the same as the support of a loving family. I still don’t think I could stay at home full time, but I am at peace with working part-time, or working in a less prestigious (and less demanding) job than I am qualified for if that’s the way things have to be. I am open to all kinds of possibilities that I never would have considered before, and that ambiguity is actually kind of awesome.
  2. Crohn’s has changed the way I interact with people. I am not as much fun as I used to be. I go to bed early almost all the time. I hardly drink and I have weird dietary restrictions (that I follow…like…90% of the time). I can barely be convinced to drive more than 10 minutes at a time, especially if it’s after dark and I’m already wearing yoga pants. So, I don’t spend as much time with a lot of my friends, and I totally get why some of us have grown apart. It would be easy to feel bitter about this, but I really don’t. Friendships change over time even in perfect circumstances. While some of my friendships have faded, some of them have grown stronger. One of my best friends (the one who flew out to visit me) is also chronically ill, and I think, if anything, we’ve grown closer over time in spite of the geographical distance separating us, because we totally get what the other person is going through. I have another friend who actually has Crohn’s, and we might have eventually lost contact after she moved away from the desert, but because of our shared circumstances we are in frequent contact. I’m so grateful to have that support. In general, I’ve just become so much more compassionate than I used to be. Probably at least 80% of the people I interact with day-to-day have absolutely no idea what I am experiencing; they just see a girl wearing leggings as pants, breaking all the fashion rules, and walking way too slowly across the street. They don’t know I just had a surgery last week; they can’t see the gigantic scars and drains sticking out every direction like porcupine quills; they don’t know that I probably just used all the energy I have for the day making myself look not sick and getting out of the house. So now, whenever I come across someone who is annoying me or seems a little strange, I think of all the things that might be going on in their life that I don’t know about. The result is a kinder, gentler, less irritable version of me, and I think that’s definitely a good thing.
  3. I’ve learned the real meaning of carpe diem, and it doesn’t mean what I thought it did. One of the hardest things that has happened to us because of my illness–at least for me–was having to cancel our honeymoon. I have always had this absolutely insatiable wanderlust. I haven’t often had the time or finances to travel internationally, but I dream about it, all the time, and for as long as I can remember. So when my husband and I agreed that it was really time to cancel our flights and reservations in 4-star boutique hotels in Istanbul and Antalya, it really almost killed me. For real. It had been all I’d thought about for months. I cried for days. I felt really, really sorry for myself. I’ve finally had to accept that I can’t go to Turkey today or tomorrow. Today I have to find all the joy I can in watching 5 episodes of Friends with my husband, in squishing my greyhound, and in reading a really creepy book in the bathtub during my third bath of the day. Maybe next year we can go to Turkey. Or maybe we have to change our plans and go somewhere with fewer potential barriers to communication and reliable emergency healthcare. We’ll see. I’m getting better at recognizing that life doesn’t owe me anything, and being grateful for what I do have already. Life doesn’t owe me a two-week long honeymoon on the Mediterranean. But, in fact, in the scope of human existence, I’ve really lived a pretty extraordinary life already. I mean, I have air conditioning. I can afford to eat meat and fresh vegetables and chocolate every single day if I want to. I don’t have to worry about the Bubonic plague or cholera or anything. Do you know how lucky that makes me already?!

I don’t mean for this to sound preachy, or like I’ve got it all figured out. Some days I still totally feel sorry for myself and curl up in a ball and cry. Sometimes I have to save a difficult conversation for a day when I’m feeling especially optimistic. But the bottom line, to anyone who has just been diagnosed with Crohn’s or another chronic illness, is that it gets so much better. It takes a lot of work, time, and support, but having an autoimmune disorder does not mean your life is over–in fact, it can be even better than you hope.

Christmas Treats and an Update

My husband is a web developing genius, so he moved my site here. He also suggested maybe it’s time to give an update on how I’m doing.

I’ve had kind of a rough six weeks or so. I mentioned in a previous post that back in August or September my GI doc had been very impressed overall with my progress, but wanted me back on antibiotics briefly before removing my final drain. When I went to my follow-up appointment (when my last drain was supposed to be removed) and reported that I still felt some swelling and occasional fever, he ordered an MRI. The results were a little disappointing. No new abscesses or fistula tracts were found (which is the good news), but the bad news was that the main fistula tract was still pretty giant. So, I had another surgery (#6!) and this time my surgeon opened the fistula all the way so that it could drain and hopefully close up with healthy tissue.

When I went into this last surgery, I thought it would be like my previous ones–three or four days down and then a slow return to normal. But the incision was much bigger than any of my previous ones. Poor Chris (who might as well be a nurse in addition to a web developer by now) had to pack the incision with clean gauze several times a day for a few weeks. It was not fun for either of us. After two weeks I was still very uncomfortable and unable to move around too much. Now it’s been almost three weeks and I’m finally starting to feel well enough (and painkiller free enough!) to get out of the house a little.

I’m going to start a new medication to see if it gives me better results and gets that last bit of healing under way. I also started some new supplements–a probiotic, vitamin D, and folic acid–at the suggestion of another doctor after she ran some blood tests and found that I was extremely deficient in some vitamins, in spite of all that I do to eat a really nutrient-dense diet that should provide plenty of these and other vitamins. Needless to say, all this news was not what I had been hoping for. But, my surgeon and GI doc both said that we are still moving in the right direction, just maybe not as quickly as we might hope. So I’m doing my best to focus on that.

Anyway, this has given me a good excuse to watch Every. Single. Christmas. Movie. Ever. I’ve also gotten to spend lots of time admiring our tree and cuddling our greyhound. And finally this weekend I felt well enough to do a little Christmas baking! This way I can bring my own desserts to share to Christmas festivities and that might help me keep my paws out of all the goodies I shouldn’t be eating right now. I thought I would share a couple of recipes so that you can treat yourself or a loved one with dietary restrictions as well.

The orange ginger spice cookies are fragrant, soft, and chewy, even after they cool down. The peanut butter cups are rich–just as they should be. Also pictured are the thumbprint cookies from Danielle Walker’s ebook Joyful, which you can get as a Kindle version for only $1.99. I made them just as instructed and they are both pretty and tasty! The ginger cookies and thumbprint cookies are both paleo and SCD legal. The peanut butter cups are all around a little illegal. But all three are grain-free (and by default gluten-free) as well as free of refined sugars. The peanut butter cups are egg free and dairy free. Both the peanut butter cups and the ginger cookies can be made nut-free if you substitute sunflower seed butter for the nut butters.

Here is the process for assembling the peanut butter cups: a little chocolate, a little peanut butter, a little more chocolate!

P1000931 P1000933 P1000935

Here is the finished product. Yummmm.

P1000937

Santa could appreciate this plate, even if he has IBD or has gone paleo since last year!

P1000938 P1000940

Orange Ginger Spice Cookies Ingredients (yield 1.5 dozen)

  • 2 tablespoons butter
  • 1/4 cup plain, smooth almond butter
  • 1/2 cup honey
  • 1 egg
  • 2 teaspoons vanilla extract
  • juice of 1 orange
  • 1/2 cup coconut flour
  • 1 teaspoon ground cinnamon
  • 1/2 teaspoon ground ginger
  • 1/2 teaspoon ground nutmeg
  • 1/4 teaspoon baking soda
  • 1/4 teaspoon orange zest

Orange Ginger Spice Cookies Method

  • Preheat oven to 350 degrees Fahrenheit and line a cookie sheet with parchment paper.
  • Combine butter, almond butter, honey, egg, vanilla extract, and orange zest in a large bowl. Use a hand or stand mixer and mix until smooth.
  • Add all remaining ingredients and mix well.
  • Drop batter by spoonfuls onto parchment paper. Bake 12-14 minutes. Cool on cooling rack.

Homemade Peanut Butter Cups Ingredients* (yield 10-12 cups, depending on chocolate to pb ratio)

  • 4 ounces 100% cacao chocolate (unsweetened; the only ingredient listed should be cacao)
  • 1/3 cup organic, smooth peanut butter (the only ingredient listed should be peanuts)
  • 1/8 cup coconut flour
  • 6 tablespoons honey, divided
  • 3 teaspoons palm or coconut oil
  • 3/4 teaspoons vanilla
  • 1/4 teaspoon sea salt, plus a dash more

Homemade Peanut Butter Cups Method

  • First make the peanut butter filling. Combine the peanut butter, 2 tablespoons honey, coconut flour, and sea salt. Use a hand mixer to stir until well combined. Divide into 10-12 balls by rolling between your palms, and then flatten a little into discs.
  • To make the chocolate, combine chocolate and oil in a heatproof bowl. Set on top of a saucepan with about 1 inch of simmering water in it. Stir until melted.
  • Remove from heat and add in remaining 4 tablespoons honey and vanilla. Stir until smooth.
  • Spoon a little chocolate in the bottom of a silicone cupcake liner and swirl to coat the bottom and up the sides just a bit. Then drop in one disc of peanut butter. Top with more chocolate to cover and a pinch of sea salt.
  • Refrigerate several hours, until set. Gently peel off the silicone liner. Store in the fridge.

*The cocoa makes these not 100% SCD legal but in my estimation these are still much better than most standard treats. To make them paleo compliant, just switch out the peanut butter with sunflower seed butter or your favorite nut butter.

The Fat Conundrum

I was inspired to do this post because a very dear friend and former roommate recently visited me, and we had several conversations about how strange it was that back when I lived with her I just found it impossible to lose weight, in spite of the “healthy” lifestyle I was living. She saw me exercising regularly, trying to follow a relatively low-fat, heart-healthy, mostly vegetarian diet–the kind of diet doctors often recommend to the overweight and obese–and still gaining weight. Now she witnessed me shoveling nuts and mayonnaise in my mouth every day and still dropping pounds.

Here are pictures of me from about four years apart.  The picture of me on the right, in the blue dress, was taken just this week. The picture on the left, in the black dress and red belt, is from about four years ago. Today I want to talk about the idea that dietary fat is what makes you fat, present some evidence that this is misguided, and do a little compare and contrast with my diet, lifestyle, and weight four years ago and now.

164311_10100105993001072_4650608_n cam00084_2

Mimi 2010

BMI: 34.2 (obese, nearly 60 pounds overweight)

Exercise: nearly daily, at least 1 hour. This picture was taken not long after running a 10k for which I trained religiously. I also regularly did yoga, went on walks, took spinning and zumba classes, swam laps, and worked out on gym equipment.

Dietary Staples: whole-wheat bagels, whole-grain cereal, skim lactose-free milk, vanilla soymilk, nonfat fruit-flavored yogurts, tofu and soy meat substitutes, all kinds of fruits and vegetables, salads with store-bought light vinaigrette, peanut butter, whole-wheat sandwich bread, whole-wheat flour and corn tortillas, sweet potatoes, occasional (less than once a week) fish or chicken, pasta with homemade sauces or store-bought pesto, brown rice, homemade fruit smoothies, ice cream, frozen diet dinners, olive oil, vegan butter substitute, egg whites, soft cheeses, diet soda, coffee, beer, wine, cocktails.

Mimi 2014

BMI: 27.6 (about 15 pounds above ideal weight for my height) yes, that means I’ve lost 45ish pounds, which I think gives me a right to talk about some of this stuff. I’m still hoping to lose these last 15 pounds, but I want to make sure that it’s because I’m trying to lose it, not because I’m sick and my body isn’t absorbing nutrients.

Exercise: basically none. This is not by choice, but I’ve only recently been able to start walking (2 miles at a time, a few times per week). I hope to increase walking and start yoga again soon as well.

Dietary Staples: full-fat plain kefir and yogurt, all kinds of peeled fruits and cooked vegetables, lots of nuts and nut butters and flours, homemade almond and coconut milk, hard cheeses, poultry, fish and shellfish, beef, lamb, bacon, eggs, butter, coconut oil, olive oil, homemade mayonnaise, honey, lentils, homemade fruit smoothies, tea, coffee, coconut water, occasional glass of wine or cocktail, very occasional (typically less than once a week) serving of white or wild rice, oatmeal, or white bread or tortillas, dark chocolate.

It is important to note that even though we eat dairy and/or meat at most meals, we usually: a) choose grass-fed, organic meat and dairy when possible because it has a better fat profile b) limit the serving size of animal products and incorporate plenty of veggies, fruits, and nuts (we also try to have one or two vegetarian meals most weeks) and c) choose seafood, eggs, and poultry more often than beef, lamb, and pork. That is to say, we are not following an Atkins-style eat all the bacon diet. I’m also not eating coconut oil by the spoonful, btw.

Conclusions and Caveats

I am unable to say how much of the weight loss I have experienced is due to diet, how much is due to a suppressed appetite, and how much is due to my body just not absorbing nutrients as well. But, my husband is sort of the control in this experiment, and he has pretty much stayed at the same weight since starting SCD in spite of rather more frequent indulgences and generally larger portions. And, as I mentioned before, prior to being diagnosed with Crohn’s or showing any symptoms my husband and I both did lose a significant amount of weight when on the paleo diet, which is very similar to SCD.

In addition to losing weight, other indicators of my health have improved. While I was still mostly vegetarian, some bloodwork showed that I was anemic; very recent bloodwork has shown that I am not anemic anymore, even though it is a very common problem with IBD. My cholesterol is currently slightly lower than it was while a mostly vegetarian.

I’m not suggesting my weight loss can be explained by diet alone; in fact, I’m not even recommending SCD as a weight loss diet because that’s not what it is meant for. Still, the question remains, why is it that I am the thinnest I’ve been in my adult life while on a high-fat diet, and the heaviest I’ve ever been while on a low-fat, low-calorie, “heart healthy” diet? Here are my thoughts.

  • Processed food is a thing of the past. SCD-legal processed food does not exist, so by default you have to make pretty much everything you will consume from scratch. Say goodbye to giving in to a frozen pizza after a hard day at work, or accidentally eating half a box of Annie’s white cheddar bunnies snack crackers because you were bored!
  • A corollary to the first point: you can’t just pick something up. My husband and I do go out to eat occasionally or eat at other people’s homes, and in these situations, I try to make decent decisions based on what’s available, and enjoy my food. But, on a day-in, day-out basis, I know picking up a meal or a snack is a very bad idea for me, so I just don’t do it. Ever. This takes a whole lot of temptations out of the picture altogether.
  • Food with fat in it tastes better. To make “low fat” food palatable, fat is often replaced with all kinds of sugar, sodium, and other questionable artificial flavors that are likely more harmful than the fat they are meant to replace. Just eat real food, people, even if it has butter in it.
  • Fat makes meals more satiating and reduces cravings. My husband and I were both struck by the fact that, when we eat paleo or SCD style, the food we eat leaves us feeling so satisfied but not bloated. We do much better at recognizing “full” signals earlier, and when we do stop eating we feel good, not stuffed and miserable. Since the smaller amounts of carbohydrates and sugars don’t cause major spikes and crashes in blood sugar, we have fewer cravings and we feel satisfied for much longer.
  • Eating real food changes your tastes. Food that I know I would have enjoyed previously now tastes a little too sweet, or a little too salty, or just plain “off.” It might not seem like it at first but you will eventually reach a point where fresh, simple, whole food tastes the best, and it is more enjoyable because you know it will make you feel good, too.
  • Even WebMD, that stalwart of conventional medical advice, agrees that combining fat with other foods helps our bodies absorb nutrients better. Mostly eliminating grains and replacing them with veggies, fruits, and healthy fats from sources like fish, nuts, and plant oils means that you are getting more of the nutrients your body needs, period. And when your body is struggling with a chronic condition and not absorbing nutrients properly, this is really important. Being kind and supportive to your body means that it can do all of its jobs–including metabolizing food and putting it to good use–better.
  • Your microbiome matters. Check out this article for a really good and accessible summary of the amazing scientific advances being made in the link between gut health and overall health. In short, highly processed junk food containing starches and sugars, antibiotics, and stress (among other things) can cause an overgrowth of bad bacteria and die-off of good bacteria, which is associated with inflammation in general, metabolic syndrome, weight gain, IBD, and numerous other health problems. Eating probiotic foods like fermented dairy and cultured vegetables, as well as food containing prebiotics (some whole grains, vegetables, fruits, and nuts are good sources) can actually rapidly change the microbiome in your gut by colonizing it with more diverse, good bugs. So, this is yet another argument for eating whole, real, unprocessed food if weight loss and healing is a goal.

The bottom line, is that the whole is more than the sum of its parts. I’m not advocating giving up bananas for sausage if you want to lose weight. I’m not suggesting you can cure IBD with enough kefir. And I’m not even close to saying I’ll never eat another greasy cheeseburger in my life. My point is just that I think counting calories, and especially restricting healthy fats, is not the whole answer to losing weight. Eat traditional, real, nutrient-dense foods you make you from scratch in your own kitchen 90% of the time, stop eating when you are satisfied, get plenty of rest, and exercise if you are able. I trust that more than any fad diet you can throw at me!