Why Your Diet Isn’t Working & What You Need to Know About the Power of Personalized Nutrition

Weight loss is a challenge, especially when you have a chronic illness. Here’s how learning about the importance of personalized nutrition helped me and my family reach healthy weight goals.WHY YOUR DIET ISN'T WORKING

After a gluttonous Christmas one year, my husband and I looked at ourselves and decided we had to go on a diet. Things had been spiraling downward for a while. The primary factor was that I had been diagnosed with a chronic condition the year before (fibromyalgia). Pain and fatigue made cooking healthy or moving more just seem too difficult. In my husband’s case, catered meetings at work meant one too many many muffins. So we went on a plant-based, nutrient dense diet. I lost weight, about 20 lbs., and kept it off. My husband did not – even though he swore he only looked at the muffins. How does that work?

The answer lies in the fact we each have a unique physical and genetic makeup. A 2015 study investigated post-meal glucose levels in 800 individuals over the course of a week. They found significant individual variation among the participants in the blood glucose levels caused by different foods, even when they ate the exact same, standardized meals. For example, in one participant sushi caused their blood sugar to rise higher than ice cream, while another found that healthy tomatoes spiked her blood sugar.

Researchers attributed this variability to a combination of physical makeup (weight, blood pressure, etc.), lifestyle and gut microbiome (the unique gut bacteria in our digestive tract). In fact, an algorithm based on these factors was able to accurately predict personalized post-meal glucose reactions to specific foods. Using this information, researchers designed individual nutritional recommendations that eliminated the foods that caused high glycemic reactions, which led to overall lower blood sugar levels among study participants.  It is this individual variability that explains why one of your friends is trying to convince you to eat like a carnivorous caveman to lose weight (hello, Paleo), while another swears that rabbit-food veganism is a game-changer. Essenially, different people respond differently to different diets. My husband found a high protein, low(er) carb vegetarian diet worked for him. He needs high protein dairy options like greek yogurt and cottage cheese, while I don’t.

Another example of individual variability in nutrition is sensitivity to dietary cholesterol. For most of us, the liver produces 85% of our cholesterol and the rest is acquired from our dietary intake. If we eat a cholesterol-rich meal, our body responds by manufacturing less cholesterol to maintain healthy blood levels. However for about 30% of people, their sensitivity to blood cholesterol is blunted, leading to problems regulating healthy levels. For these individuals, if they eat cholesterol-high foods, their blood cholesterol goes up because their body fails to sufficiently reduce how much cholesterol is manufactured in the liver. These people are at an increased risk of having high cholesterol.

As you might expect, research into the relationship between our individual genetic makeup and our nutrition, called nutritional genomics, is a rapidly expanding field. Lactose intolerance is one example of how genes can affect your reaction to food – certain variations of specific genes confer lactose tolerance, while other variations cause intolerance. Many researchers argue that personalized diets are the future of nutrition, rather than broad dietary recommendations or one-size-fits-all diets. However, the application of these research insights are not yet widely available to enable people to develop an individual diet based on factors like genetics, physical makeup, and gut microbiome.

One step everyone can take to personalize their diet is to try an elimination diet, which will helps to identify food intolerances and sensitivities. A food intolerance is a nonallergic reaction that causes negative bodily symptoms like digestive problems, skin irritation and fatigue. Food intolerances can cause inflammation of the digestive lining. If one diet plan is not helpful, then consider trying another, until you find what works best for your body. Here is a list of the three best diets for fibromyalgia, according to science (vegetarian/vegan, gluten-free and FODMAP free), as well as helpful resources to get started.

The good news is that there is one diet plan that is always good for you. What is that diet? Eating whole foods. Not necessarily raw, organic, GMO-free or local foods (although there are lots of good reasons to choose some of those options too). Whole foods mean food as close to their natural state as possible – carrots in the earth, grapes on the vine, or fish in the sea. Real foods are not processed, refined, added to, fortified, or otherwise messed about with by a food chemist. This is the one diet you can’t go wrong following.

References:

Dr. William Sears. Prime-Time Health (2010): http://www.amazon.com/Prime-Time-Health-Scientifically-Proven-Feeling/dp/0316035394?ie=UTF8&*Version*=1&*entries*=0#

Nutritional Genomics and Lactose Intolerance http://nutrigenomics.ucdavis.edu/?page=information/Concepts_in_Nutrigenomics/Lactose_Intolerance

Zeevi, D. et al. (2015). Personalized Nutrition by Prediction of Glycemic Reactions.  Cell. 163(5), p. 1079-1094.

Advertisements

Why Whole Foods are the Only-One-Size-Fits-All Diet

4982162914_05be924839_m

Photo by viteez

Nutrition is critical for spoonies (people living with chronic illness). For anyone coping with chronic illness, sustained energy is a significant challenge. Balancing macronutrients – carbs, protein and fat – along with factors such as fiber and sugar, is important for preventing spikes in blood sugar that inevitably lead to energy crashes. Maximizing micronutrients (vitamins and minerals) is also key healthy eating. Adequate intake of nutrients like Iron and B vitamins have been linked to improved energy levels, while others like Vitamin D and Magnesium help reduce chronic pain. In addition, chronic illnesses like fibromyalgia have been linked to high rates of oxidation, so eating antioxidants is important to counteract these effects. Eating fish rich in omega-3 or certain phytonutrients in veggies can have powerful anti-inflammatory effects.

In a previous post, I wrote about why many researchers argue that personalized diets are the future of nutrition, rather than broad dietary recommendations or one-size-fits-all diets. Individual variability – genetics, physical makeup (weight, blood pressure, etc.), lifestyle and gut microbiome (unique gut bacteria in your digestive tract) – are all factors that can determine your unique response to different foods.

Here is why the whole food diet is the only one-size-fits-all diet. There are only benefits to eating whole foods. Whole foods are associated with a lower risk of disease, including cardiovascular, cancer and type II diabetes. They contain more fiber, which is important for lower blood sugar levels, low cholesterol, colon health, a healthy microbiome, and feeling full, among many other benefits. Whole plant foods contain vitamins and minerals, as well as phytonutrients, which are natural compounds that improve health by acting as antioxidants, anti-inflammatories, antimicrobial and anti-cancer agents. Whole foods enable your body to benefit from the synergy of all their nutrients acting together. Research shows that single vitamins and minerals are not as successful as the combination and interaction of multiple nutrients together.

In contrast, processed foods offer few health rewards and many drawbacks. Processed foods are stripped of their nutrients during refinement. Even if the product is fortified with vitamins or minerals, there is no way to manufacture the thousands of vitamins, minerals and phytonutrients in whole foods or reproduce the synergy effects they have in the body. Processed foods tend to be calorie dense and nutrient poor, which is not a good recipe for maintaining healthy weight. The lack of satiating whole grains, protein and fiber means you get hungrier sooner.

Food additives and preservatives potentially have a number of negative health impacts throughout the body, including on the brain, and digestive system. Other common ingredients like high fructose corn syrup, or hydrogenated oils and trans-fats are best avoided. High fructose corn syrup can lead to high blood sugar, while trans-fats lead to high cholesterol.

Salt, sugar and fat are the protagonists of the processed food industry.  They are addictive. They are added at just the right amounts to make you crave more processed products. And they are terrible for your health. Processed foods have high levels of unrefined carbohydrates that lead to high blood sugar. Over time, this can lead to insulin resistance and diabetes. Processed foods are often high in unhealthy fats (hydrogenated and excess saturated fats) that can raise cholesterol and lead to cardiovascular disease. Both sugar and unhealthy fats contribute to inflammation. Finally, high salt is the third unhealthy ingredient, which can raise blood pressure and contribute to heart disease.

Basically, it’s just better to just not go there.

Basically, it’s better to just eat real foods! Here are some resources to get started:

Digestively Challenged: Overcoming G.I. Tract Problems when you have a Chronic Illness

Digestively Challenged: Overcoming G.I. Tract Problems when you have a Chronic IllnessIs eating well with chronic illness a luxury? When I first got diagnosed, I thought so. The significant pain I was experiencing in the muscles around my shoulder blades made it impossible for me to chop, stir, or sauté a whole meal – basically, to cook. My partner was more than happy to help (as long as I showed him how!), but it felt unfair. After all, he was now supporting me financially and doing the majority of the housework – since laundry, vacuuming, scrubbing and dusting were similarly impossible for me. We tried to eat the healthiest convenient foods we could. Unfortunately, convenience isn’t healthy, at least when it comes to eating. In a previous post, I wrote about how my processed diet failed me, even though I was making supposedly healthy choices. In one year, I gained about 20 pounds, ate four times the daily recommended allowance for sugar, was woefully short on fruits and vegetables, ate too many servings of grain and too few servings of protein.

I also had hypoglycemic attacks if I did not eat on time. I remember that panicky feeling of being on transit, far away from a convenience store, and starting to feel shaky and sweaty.  I also developed a number of food intolerances.  I felt anxious about eating out or trying a new recipe for fear of having an ‘episode’.  Not only did I have unpleasant digestive symptoms but also strange neurological ones – sweating, pulse racing, excessive salivation, skin crawling, restless legs, and others.  It was these two problems that made me feel like I needed to understand what was going on in my body and to regain control over my eating. It’s important to begin with a good understanding of digestive problems that affect spoonies (people living with chronic illness).

Firstly, we need to avoid food intolerances (also known as food sensitivities). Food intolerances are defined as a physical reaction to eating certain foods, such as digestive symptoms like bloating, gas, diarrhea or constipation, or stomach cramps.[i] These reactions do not occur because of an immune response to a particular food – that would be defined as a food allergy. In the case of a food intolerance, some people may be able to eat a small amount of the trigger food without having a physical reaction, up until they reach a threshold level. Food intolerances may occur because of the absence of a necessary enzyme (such as lactase to break down lactose sugar in dairy), having irritable bowel syndrome, having a sensitivity to food additives, having a problem digesting certain carbohydrates (acronym FODMAPS), or for no known reason. Food sensitivities may be more common among people living with fibromyalgia and CFS/ME because of the overall sensitization of the central nervous system associated with these conditions. Research indicates that at least half of people with FM or CFS/ME experience significant relief by eliminating certain foods.

How can you figure out what foods you are sensitive to? Naturopathic doctors, integrative doctors and nutritionists can offer tests that pinpoint sensitivities. However, the least expensive way is to do an elimnation diet. You begin by cutting out the most common foods that cause intolerances and any foods that you are suspicious of for a period of time, usually 2 to 4 weeks. These foods may include: dairy, gluten, eggs, soy, corn, sugar, citrus, peanuts, shellfish, and coffee. Then you gradually reintroduce one food type at a time to notice your physical reaction. If your symptoms reappear, then you know you are sensitive to that type of food. In my case, I am intolerant of eggs, red meat, and to a lesser extent, wheat. I am also sensitive to high concentrations of fiber or resistant starch. The elimination diet is best done with the guidance of your healthcare professional.

A second problem associated with the digestive system and chronic illness is the development of Leaky Gut Syndrome. Essentially, leaky gut occurs when the lining of the intestines becomes more permeable, which allows particles of partially digested food or waste to leak into the bloodstream.[ii] Increased permeability occurs because of damage to the tight junctions between intestinal cells. When the immune system encounters foreign particles in the bloodstream, it launches a response, including inflammation. Symptoms of leaky gut syndrome include digestive symptoms, gas, bloating, diarrhea, fatigue, joint pain and rashes. In addition to chronic inflammation, leaky gut syndrome affects the ability to digest food and to absorb nutrients. Furthermore, it compromises the immune system by tying it up responding to foreign particles in the blood, which leaves it less able to respond to actual pathogens. The intestinal lining actually is a significant site of immune activity, but when it is damaged, overall immune function is impaired. How does the intestinal lining become damaged? Through food intolerance, stress, medication, flora imbalance and autoimmune disease. Emerging research shows that several autoimmune diseases share increased intestinal permeability as a characteristic[iii].

In terms of diet, the usual recommendations include treating Leaky Gut Syndrome through clean eating; in other words, avoiding commonly allergenic/intolerant foods, inflammatory foods, pesticides, herbicides, additives, or sugar and rebalancing intestinal flora by consuming probiotics. For autoimmune diseases in particular, some experts recommend the paleo diet, which emphasizes protein and vegetables, while cutting out grains and legumes. For example, Dr. Terry Wahls has written a book on how she reversed her MS through a nutrient dense paleo diet. Supplements that can help to repair the damaged intestinal lining and reduce inflammation include l-glutamine and DGL.

When it comes to diet recommendations, I think the most important thing to remember is that we are all genetically diverse. We will all have unique responses to different foods and there is no one-size-fits-all diet. For example, I feel terrible after eating eggs or after eating a large portion of cruciferous veggies (broccoli, cauliflower, etc) because I have a food intolerance to eggs and  am sensitive to large portions of insoluble fiber. The paleo diet isn’t for me. However, a high-protein vegetarian diet keeps my digestion happy, hypoglycemia at bay, and generally gives me more energy. The only universal truth when it comes to nutrition is that nobody benefits from eating a diet high in processed foods, sugar, sodium or fat. We all feel better on a whole foods diet. It can seem overwhelming to change your diet when you are dealing with the multiple, uncertain symptoms of chronic illness. The potential to improve your quality of life is worth the effort in experimenting to find what works. Here are a few resources to help you get started:

  • 100 Days of Real Food is a resource for transitioning to a diet free from processed foods (includes blog, meal plans, challenge, cookbook) http://www.100daysofrealfood.com/

Read other great blog posts by writers with FMS on the Fibro Blogger Directory http://www.fibrobloggerdirectory.com/

[i] http://www.mayoclinic.org/diseases-conditions/food-allergy/expert-answers/food-allergy/faq-20058538

[ii] https://www.womentowomen.com/digestive-health/healing-leaky-gut-syndrome-open-the-door-to-good-health-2/

[iii] http://www.todaysdietitian.com/newarchives/021313p38.shtml