By Maia Nagle, Mental Health PHE
“Mmmm, ice cream,” Emma murmurs as she spoons a large heap of Jeni’s into her mouth. Amy and I exchange looks—we know what’s coming. Emma spots us. “Stop it! I won’t complain, I promise. I’m responsible for my own actions.” This exact scenario has played out a hundred times. Now, I would normally never discourage anyone from eating ice cream, but Emma is an exception: she’s lactose-intolerant, in a bad way—as in, on the floor, can’t move, moaning. Lucky for this ice cream lover, with the help of Lactaid pills, Emma gets the enzyme she needs to break down the lactose (a type of sugar) in dairy products, so she doesn’t have to completely eliminate dairy from her diet. But elimination of a problem food is sometimes the easiest way to go for an intolerance, and especially for an allergy (like Celiac disease).
These days, you can find thousands of blogs boasting recipes that are vegan, gluten-free, dairy-free, or some combination of those and other things that I don’t quite understand enough to write about. “Elimination diets” are all the rage, whereby a person, experiencing some sort of mystery ailment—such as headaches, stomach aches, fatigue, joint aches, frequent allergies, dry skin, itching, and others—eliminates the foods they think could be the cause of their health problems. After a week, two weeks, a month, two months, or however long, this person then adds one food at a time back into their diet, leaving a break of a few days in between each food, to see if any adverse symptoms return. If the health problem resurfaces after consuming a particular food, then the person knows they are sensitive to or intolerant of that food.
But is it a good idea to try elimination diets without the guidance of a doctor or dietician? Some elimination diets are hailed as life savers, but do elimination diets actually help if you’re just shooting in the dark and don’t have a diagnosed intolerance or allergy?
To answer these questions and more, I reached out to Washington University’s dietitian, Rebecca Miller, MPH, RDN, LDN. Rebecca has an interest in nutrition and a passion for helping people manage their weight in a mentally and physically healthy way. At Washington University, she works with the dining team, investigating how we can get more variety and more nutritious food on the menu, using her Public Health degree to help the student population at large.
Rebecca explained to me that because of the fad diet industry, people think they need to eliminate foods such as gluten and dairy when they really don’t. Maybe they have some bloating, maybe some diarrhea—a general feeling of something funky going on in the gut region—and exposure to all the media hype makes them think they might have an intolerance. There are, obviously, some legitimate reasons to eliminate certain foods (actual allergies and medical needs, like celiac disease), but it otherwise isn’t necessarily essential to try an elimination diet.
“Some people just don’t eat all that well or don’t know how [to eat well], so that’s probably kind of merged with the elimination diet,” she observed, noting how it is important to pay attention to the foods we do put in our body, not just the ones we try to keep out. Rebecca clarified that if someone is having some intolerances or what they think is a food sensitivity, they can go through an elimination type diet. But a lot of people do fad diets such as Whole 30 and then just stop after the 30 days without doing the second, equally important part: adding the foods back in, slowly, one-at-a-time, so you can identify what’s actually causing the problem. In this way, diets such as Whole 30, which eliminates dairy, soy, grains, legumes, and any added sugar, are taken in an off-target way—as a quick weight loss solution. Not all diets work for everyone—any time we go extreme is bad, and it’s important to be careful about the way we educate, talk about, and promote nutrition.
I asked Rebecca if diet has any sort of effect on mental health, to which she quickly responded, “Yep!” If someone binges on unhealthier foods, that can send them into what Rebecca called an “eating disorder mindset,” which can definitely have an effect on mental health, and people can become too restrictive regarding their food because of these fad diets. Also, if someone just has carbs at a meal or snack—instead of a nice balance of whole grains, proteins, veggies, and the like—they tend to have a spike in blood sugar followed by a plummet in that blood sugar and energy. Carbs are the most easily digested nutrients in our body, so they are quickly broken down into glucose and processed, leading to that quick up and down that often leads to a roller coaster of sugar highs and crashes. Our brains are, obviously, part of our bodies, so feeding our bodies well includes feeding our brains. Our gastrointestinal system is linked to our brains through the vagus nerve, so the healthier our GI, the healthier our brain! Some things our brains love to munch on: fatty salmon, Omega 3s, the fats in nuts, the antioxidants in blueberries and other dark berries. Some things our guts love and need to turn that food into mulch: probiotics. Probiotics can be found in kombucha, Greek yogurt, fermented cheeses, and cottage cheese, to name a few examples.
So, where does that leave all the people with GI issues and inflammation and headaches and fatigue that may or may not be food related? Rebecca suggests keeping a food journal. Note when the pain or indigestion starts in relation to when you ate—maybe it’s a quantity issue, maybe it’s a pairing of foods. Rebecca says the ideal way to eat is to have smaller but more frequent meals throughout the day; this helps maintain appetite, focus, and energy, and goes against the intermittent fasting trend. A balance of complex nutrients is important at each meal—lean proteins, fiber, good fats, and non-starchy veggies. If you cut something out, make sure you find another way to get those nutrients because otherwise you’re still not treating your body right. Not everyone needs to be gluten-free; there is no rule that says the cause of everyone’s health issues has to be the same thing. And, if you are trying to find a healthy and nourishing relationship with food, it’s probably best to talk to a dietitian or other doctor to make sure you have a plan you can stick to that’ll keep you healthy. Now, if you’ll excuse me, I have a bagel to eat.