Episode 20: How can I cut out foods for health reasons, without it becoming disordered?
In this week’s episode, Jessica is discussing the question, “How can I cut out foods for health reasons, without it becoming disordered?” These topics can be quite complex in nature, and I would always recommend seeing a dietitian that specializes in healing from restrictive eating!
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Intro
Welcome to the art and science of eating. I’m Jessica Begg, registered dietician and clinical counsellor. I worked for fifteen years in programs for the treatment of eating disorders. I now help those that struggle with emotional eating and their relationship with their body. This podcast is where I answer questions to help people along this bumpy journey to creating peace with both food and their body.
Podcast
Hello my lovely listener. Thanks for joining me again. This week I have a question for you that was written into me, and I want to thank that person for sending it in but also to thank anybody that is thinking about sending in a question so please do keep them coming in. I can’t continue doing the podcast without you and we’ve got a small little group of listeners so if you’re sitting there and you’re thinking uhh I have something but I like to ask Jessica and I haven’t yet then I really love to hear from you. So let’s jump into this one. This one is from a listener that was on my email list that I had put out the call to my email list as well so please do join there. I send out little weekly notes but it’s from the listener that we’ll use her first initial C.
Hi Jessica,
I’ve been listening to your podcast and am enjoying them, thank you. Thanks C.
Everytime I hear you invite listeners to sending questions I think about how I would phrase mine so this email is irresist. I am doing a lot of reflecting on my relationship with food as I’m working to navigate my health and how it relates to my diet. I’ve had varying degrees of food sensitivities for decades from wheat and grains, dairy, sugar, all of the usual culprits. I’ve been tested for but not diagnosed with many conditions and diseases but I suffer from digestive discomfort, weight gain, joint soreness, and most recently gallstones and a fatty liver. As this has been a long road of restrictive eating for me and what I’m realizing is a lot of diet culture thinking is good and bad foods and behaviour. I have a lot of stress around what I should be eating and how it affects my body. This stress is compounded by my role as cook for our family. The best way I can phrase my question is this:
How do you navigate restrictive eating in a way that does not become disordered when it comes to managing digestive symptoms or ailments?
Ok, so that’s the question from C.
Gosh, this is a very medically complicated question that ultimately, I would say you should see a dietitian at minimum. And I would suggest you see a dietitian that understands healing from restrictive eating or disordered eating. Not that you’ve indicated in your question at all that you have an eating disorder, but they would be well versed — or should be — in helping with the understanding of what you’re thinking about around good and bad foods, behaviour, and diet culture.
But to answer your question, C, with the general information that you’ve given me here, and without your entire medical history, keep in mind that this is not medical advice, as with everything that goes on and is said in this podcast. My goal is to help you start thinking about other possibilities as you discuss this and bring it back to your own personal healthcare team.
So, I hear in your question that you’re concerned about health and you want to make sure you’re doing everything that you can do to protect your health, or at least maintain it as best you can.
So first things first, I want you to know that whatever you choose to do to care for your body is the best choice. You know how you feel. You know how to care for your body and what is important to you, and what decision you make with that in mind is the best for you in the context of your life. So that includes your family, your work life, whether you’re working from home, and any kind of activities that you do. You are your best knower or seer of what’s going on.
By the time people often come to see me, they’ve been shamed, or felt shamed, for something they might have thought they should have done better. My experience working with all sorts of clients is that they always made the best choice for them at the time. So please don’t feel like you’ve missed something or that you should’ve caught something earlier or anything to that degree.
But let’s dive into this a little bit more.
Where I would first start is making sure the food items that you’ve taken out — or think that you should take out — are actually needed to be removed from your diet. And this is where I would suggest going to your family doctor, like I had mentioned, or seeing a dietitian to figure out what actually needs to be taken out.
Because as you say, you have these food sensitivities that you’ve been tested for, but you haven’t been diagnosed with any conditions. There’s not enough concreteness in this comment to tell either you or me definitively whether you need to remove these foods for health reasons or not. And that’s really important.
What I also want you to know is that some tests that you may have done — I’m not sure if this was the case for you, but this is good information for other people and yourself — is that if you’ve had the IgG food sensitivity test that is often offered by alternative health providers, please know that this test does not have any actual evidence to support its use.
In fact, the Canadian Society of Allergy and Clinical Immunology, the CSACI, which is a group of doctors that specialize in allergy and immunology, has put out a position statement against the use of these tests. I’ll put a link in the show notes that has that paper.
But basically, what they say is that these tests show many false positives, so people think they should avoid all sorts of foods, making eating and preparing foods very difficult to do. And I’m hearing that in your email — that you might be getting frustrated or very stressed around what you should be eating, or also what you’re cooking for your family.
Cooking, thinking about what to eat, grocery shopping — all of these are already really big and difficult tasks. So if you throw on needless hurdles, like cutting out foods unnecessarily, it makes it nearly impossible to do.
And to add to that stress, people may choose to still eat these foods because it’s too hard to cut them out, and then feel guilty needlessly because they never had any issues with these foods to begin with.
So some of the foods you’ve listed as intolerances are admittedly common allergens, but you need to go back to talking to your dietitian about this because some of the things that you’ve said are kind of confusing to me.
You said you’ve had varying degrees of food sensitivities for decades from wheat, grains, dairy, and sugar. So dairy and wheat are common allergens, as common as food allergies are — which they actually aren’t as common as we think. But it is very rare to have a negative response to wheat and all grains.
More concerning is that you’ve listed sugar as one of your sensitivities. And this may have just been confusion in the wording of the email, because saying you have a sensitivity to sugar is kind of like saying you have a sensitivity to water.
Just like water, sugar is an integral and necessary part of every cell in our body. And yes, we can operate on ketones if people out there have done or are considering the keto diet, if it is absolutely necessary and the optimal fuel source — sugar — is not around. But our brain really prioritizes sugar as its primary fuel source because it works and functions much better on sugar.
Sugar as a compound gets inappropriately confused with added sugar, where there was a public health push for people to decrease — not cut out — the amount of added sugar they ate. But what’s unfortunate is that at some point in this telephone game of disseminating information, someone — and I’ll say “hint hint,” someone selling bogus health products — heard “sugar is bad” and decided people should cut it out entirely. And that’s not the case.
The problem with thinking that sugar is bad is that we need it as a primary fuel source. If we don’t have it, we will then crave it and often sometimes binge or feel out of control with food, particularly sugar. So this fuels the thought that sugar is addictive because people now feel out of control when they eat it, but really it’s that your body desperately needs it, so it’s pushing you to get it whenever it can.
But this phenomenon also cuts out super healthy foods that break down into sugar, like fruits and all grains. In these foods, we get the most important thing — sugar that our body needs — but also things like antioxidants in fruit, B vitamins, fibre, and nutrients from grains.
So this is why I suspect someone may have made this mistake with you.
Ok, so that’s a little bit of a roundabout way to answer your question. But after that, we can kind of get to it.
So your question is how to navigate restrictive eating in a way that does not become disordered when it comes to managing digestive symptoms or ailments.
In light of what I’ve said here, it sounds to me like you may be thinking that you need to cut out more things than you actually do. So that will dramatically ease the amount of possible restriction that you might have to do — if any restriction is even necessary.
But once you sort that out, there still may be some foods or ways of eating that align better with your digestion. So if that’s what you’re asking me, then with your dietitian you can start figuring out what is actually upsetting your stomach or what might be needed for any ailments that could improve with changes in the way that you eat.
So in light of that, you or anyone else listening may have gotten suggestions from healthcare professionals on ways to eat or things to cut out to improve your health. The next thing I would suggest you consider is that food restrictions are only suggestions — merely things to consider.
If you don’t do them in the exact way they were suggested, you can implement them into your life in the way that best fits you. And that’s how you should do it.
Even speaking as a dietitian, it’s not that I’m expecting these restrictions or suggestions to be implemented rigidly. Restrictions become particularly triggering when they’re implemented rigidly, especially when we don’t make them our own.
These suggestions become disordered when they’re turned into rigid rules followed out of fear that something bad will happen if the rule isn’t followed perfectly.
We can try to care for our body in ways that protect us as best as we can from getting sick, from aches and pains, or from having to take medication. However, even after our best efforts, we will likely still experience all of these things.
We’re going to get sick no matter what we do. We will get things within our body that we need to manage with medication. We’ll get aches, we’ll get pains. Something is going to happen to our body that we will have to manage.
And while I’m not saying to just throw up your hands and say, “Forget it, I can’t do anything, I have no control over my body, I’m going to get sick regardless,” I do need to say that not everything you do will make you sick, and therefore not everything you do will keep you healthy.
This is not a burden that you necessarily need to carry with such a heavy load.
Knowing that, you can decide how much time and effort you want to put into whatever suggestion you’re offered, while understanding what kind of impact that may or may not have on your body.
So with that in mind, you can be a little more gentle with these “food restrictions” — and honestly, I don’t even usually like that word because it’s kind of harsh — but you can be more gentle around these food restrictions that you’ve talked about. You can consider how much effort you want to put in for the level of impact you’re likely to get.
And obviously, this isn’t the case for food allergies or situations where you specifically cannot eat something. Usually those are one or two specific items and tend to be more straightforward to manage. But again, I would suggest going back to your healthcare team.
Ok, so lastly, C, I would also suggest going back to your team to determine whether the food restrictions are even needed for some of the concerns you’ve listed, because they may not actually be correlated.
So as an example, let’s take the joint pain concern that you mentioned. Likely you, or someone listening, has been told or thought that joint pain would improve if they lost weight.
Actually, research has shown that movement or activity — and it doesn’t have to be a crazy amount, just walking or swimming to keep the joints moving and strong — has better outcomes on joint pain than weight loss itself.
Joint pain is neither lessened nor increased by any one particular food.
Same thing with gallstones. Just because it’s related to the gut, we may unconsciously think that we can prevent gallstones through food. But really, gallstones are largely genetic.
Now, we may need to redistribute fat intake or make sure we don’t have too much fat at one time because when you have a fatty meal, your gallbladder contracts and a gallstone can move and block the pathway. However, you can also get that same blockage after eating something like your morning oatmeal because we’re going to use bile acids at any point of digestion.
So even that kind of recommendation isn’t necessarily going to fully protect you from gallstone issues.
I say this to lessen your mental burden around all of this, not to tell you to shut off and ignore your body and say, “Well, there’s nothing I can do.” But rather to make thoughtful choices depending on how much control you realistically have in each situation.
And this can all be done through open discussion with a caring healthcare team, C.
If you don’t have a caring healthcare team, dump the ones you have and ask around until you find people who are.
Ok, C, I hope that answers your question and gets you thinking about how you can be more compassionate with yourself and how you choose to care for your body.
Let me know how that goes.
Take care, everyone.
Disclaimer
This podcast is for education and information purposes only. Please consult your own healthcare team to discuss what is right for you and your care.