Monday, May 30, 2011

Elimination


Several weeks after writing that last post, I’m thinking there might just be something to this FODMAPs thing. Not that it is an easy thing to do.

I’ve never restricted the food I eat before. I’ve never been on a diet. Although this isn’t a weight loss thing, the same principle applies: dieting messes with your head.

Despite all this, after the first week of the elimination phase of the diet, I start to feel better. Actually better than I have in a while; hardly any symptoms. This seems hopeful.

It’s tricky when you have to start thinking about food in terms of what you can’t have. Especially as a professional eater – I am used to eating a (sometimes wildly) varied diet from day to day.  I might attend a lunch of Malaysian food one week; a launch for a range of diet products the next; in between doing tastings of soups or crackers or noodles or any number of recipe testings. Not to mention the myriad of food products that get delivered to my desk each week, demanding tasting. Now I have to think about whether I can try them or not.

The range of fruits and vegetables that are OK during the elimination phase is quite limited. I’m getting very creative with carrots, courgettes, tomatoes, capsicums, lettuce and spinach. But also quite bored. After a short time I find I’m craving broccoli, caulifower and cabbage. Missing onions and garlic, too, although I’m making liberal use of the allowed garlic oil and the green bits on spring onions. Thank goodness I can have ginger and chillies, two of my favourite flavours; and spices are OK too, in moderation. And citrus, so I can use lemon and lime juice for flavour. Harissa has become my new best friend; because it’s made from chillies and peppers and tomato, and doesn’t have onion, it works to add an intense burst of flavour, especially to my work lunches. I’ve never been a sandwich girl, and sandwiches of gluten-free bread are pretty depressing. So I’ve been eating a lot of sort of warm rice salads, like the one below. I take the ingredients and make these up in the kitchen at work, but you could easily put it together at home the night before work.

Lunch rice salad
¾ cup cooked brown rice (I’m loving the Sun Rice quick cups – great for a desk drawer)
handful spinach or rocket leaves
1 small pepper (I’m using the little ‘vine sweet’ ones) or ½ red capsicum
1 small carrot, grated
piece ginger, grated
½ red chilli, chopped
1 small can tuna, salmon or sardines, drained
lemon or lime juice & olive oil, to dress

Heat rice if you like, or eat cold. Combine all the ingredients in a bowl, toss well, add dressing and enjoy.

VARIATIONS
Use your imagination – but some things I’ve added include:
Nuts – almonds, walnuts, cashews
Pesto
Harissa
Soy sauce (gluten-free)
Grated parmesan
Grated courgette
Chopped tomatoes
Lemon zest

Saturday, May 14, 2011

Tedious acronyms and inner workings


There’s a character in the Tom Robbins book Fierce Invalids Home from Hot Climates, who is so squeamish about the goings-on of his insides that he prefers to think of his digestive system as a ‘ball of white light’. I must say I can relate. I’d really prefer not to think about my inner workings; once my food has passed my lips I don’t think I should have to think about what happens to it.  You can keep your toilet humour; fart jokes do nothing for me; even the word colon makes me clench a little bit.

Unfortunately I’ve recently been forced to contemplate my bowel a lot more than I am comfortable with. It’s because of IBS. Irritable Bowel Syndrome (even the full name is a bit Too Much Information for my liking). But it can’t be helped. Because I’m embarking on something I’ve been putting off for about a year. It’s not cleaning out the garage. I wish it were that easy. It’s an elimination diet to finally get to the bottom (so to speak) of my IBS.

Anyone who’s suffered from IBS will have no need of an explanation of the symptoms (and the rest of you are probably switching off right now). It’s pretty much as the name suggests – I’ll leave it to your imagination. It’s something that’s been with me for years, on and off, and for years I’ve tried, half-heartedly, it must be said, to figure out what sets it off.

IBS is a diagnosis of elimination: other possible causes of the symptoms (some of which are serious) need to be eliminated first. So over the years I’ve had a series of delightful tests including but not limited to: a colonography, a colonoscopy, tests for Coeliac disease and ultrasound scans for ovarian cancer. What all this has shown is that I don’t have any serious conditions, fortunately; so what I’m left with is IBS. It’s not debilitating, but it is inconvenient, uncomfortably painful and occasionally embarrassing.  And in this I am not alone; a surprisingly large percentage of women, particularly, experience IBS in varying degrees.

It’s not all the time, for me. Sometimes I’m good, and other times I’m not. I know that stress is a trigger; so not ideal for someone in a business with constant deadlines. I know that too much alcohol isn’t good, and too much coffee can be disastrous. I know a lot of onions are not a good idea, likewise beans. But beyond that I can’t explain why one day I have the runs, the next nothing’s going anywhere, and the next I wake up with such a bloated stomach it causes a re-think on what I was planning to wear that day. When my gut started to get in the way of my wardrobe choices, I knew I had to do something.

I’ve been privy to much of the research into IBS due to my job at Healthy Food Guide. For several years now it all seems to be honing in on foods: specific foods that people who suffer from IBS have trouble with. I’ve been putting all this off because I know that the standard way to find out which foods are the problem ones, is to embark on a scientific process known as ‘elimination and challenge’. It’s how food allergies and intolerances are diagnosed. It involves, as the name suggests, first the elimination of all possibly problematic foods, followed by individual food ‘challenges’. It’s a tedious and long-winded process, not to mention anti-social. It would turn me into one of those whiny people of whom I have been myself, quite intolerant: the people who ‘can’t’ eat things. Get over yourself, I usually want to shout. Just eat the damn bread.

However, the ball of white light theory just wasn’t working for me any more. Something had to be done. So, I find the blueplan for an elimination diet, formulated by American dietitian Patsy Catsos, and outlined in her book  IBS  - free at last (terrible name; even worse cover, trust me, but actually very scientifically sound and rigorous within). After running it past our HFG nutritionist, I’m ready to give the IBS elimination diet a go. It involves, first, eliminating all the FODMAPs.

FODMAPs – like many things in nutrition - is a very un-catchy acronym. It stands for Fermentable Oligo-, Di- and Mono-saccharides and Polyols. What they actually are, are different types of carbohydrates: lactose, fructose, fructans, polyols and galactans. (I know, it gets no better with the names). These are found in groups of foods which are the subject of emerging research, much of it coming out of Australia, and much of it focussed on IBS. Some people (possibly me) can’t fully digest one or more of these FODMAPs in food, leading to the symptoms we know as IBS. The diet is a process to try and figure out which, if any, are causing problems for me. It’s not something to stick to long term; rather a learning exercise. Which is good, because I’ve never been on a diet in my life, and I’m not sure how I’ll do on one now. Plus, I really really don’t want to be one of the intolerant people.

Before I start the diet, I psyche myself up. During my ‘baseline’ week I binge on things I won’t be able to eat for a few weeks: I make sourdough bread; braised lentils; broccoli and blue cheese soup; apple pie. Quite a lot of the FODMAPs foods are ones I’m pretty fond of: onions, garlic, broccoli, beans, chickpeas, bread, pasta, honey, yoghurt, milk and quite a few different fruits. How will I cope? I try and time it so I can start during a week without potentially problematic eating out occasions. I buy lots of the things I can still have and make a bit of a menu plan, promising my husband he won’t feel deprived (he’s worried I’ll turn into a whiny person, too).

On the plus side, there are quite a few foods that are fine on the elimination diet; I won’t be surviving on a diet of rice milk and bean sprouts. One bright spot is that I can still have wine – a couple of small glasses a day. Thank goodness for small mercies.

And so I start. I am hoping that, at the end of this, I’ll have a better idea of what upsets my rebellious bowels, and I’ll be able to take it from there. I can’t see myself ever eliminating whole food groups. How could I, as a professional eater? It depresses me more than words to think of myself ever saying “Oh no, I can’t eat that,” when faced with some new delicious thing. But at least if I know what it is that makes my insides grumbly, I can choose what to do about it – limit, eliminate or compensate. Fingers crossed. I will keep you posted.