Category Archives: NYT

Lessons from the Whole30 Challenge (Or, the importance of mindfulness)

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Somehow, it’s already August. I always think summer will mean extra time, but with freelancing, summer classes, and adventures with my two-year-old, the weeks have flown by, and the hours are full.

If you read my interview with Dr. T. Colin Campbell, author of Whole, over at WBUR’s Commonhealth, you know nutrition has been on my mind lately. For the past few months, I’ve incorporated a lot more vegetarian meals, eliminated dairy, and really examined what we buy and what our habits are.

And then my husband started doing the Whole30 Challenge—you know, the one that’s all over the Internet these days and often invites comparison to the Paleo diet. In case you’re not familiar, here’s a quick summary: for thirty days, eliminate dairy, gluten, all grains, legumes, sugar (including honey, agave, and alcohol), seed oils, etc. to calm down the inflammation in your body. Basically, you should eat plenty of clean, whole foods–plenty of vegetables, along with protein, fruit, and healthy fats like olive oil, coconut oil, avocado, etc. After the thirty days, can you assess what you’d like to try and introduce back into your diet, and what you’re better off avoiding.

The changes in him were immediate, and not just in terms of weight loss. His congestion and joint pain decreased, and his energy levels increased. We’ve never been huge consumers of processed food (being gluten-free and then also dairy-free makes that hard, anyway) but watching him, I began to see how our choices could be even cleaner and healthier.

With celiac disease and other autoimmune conditions, I am all too familiar with how inflammation can wreak havoc in your life so I jumped on board and did my own Whole30 Challenge, and it’s been a great experience. I’ve lost weight, yes, but more than that, I’ve gained so much energy (I used to drink 6-7 cups of coffee daily, and now, even with the same lack of sleep, I drink one) and I am much more conscious of what foods make me feel good, and which ones simply aren’t worth it.

For example, I know I won’t be re-introducing dairy since I don’t miss it and am less congested without it. I don’t plan on re-introducing rice or corn, but I do think quinoa has an occasional place in the rotation. I’ve discovered nightshade vegetables like tomatoes and eggplant really bother me and aren’t worth it, and gluten makes my husband feel truly horrible.

Kale is our favorite new food, and we some days we have it with all three meals. Since we never bought sweets or desserts I thought I was doing pretty well avoiding sugar, but I now see the many small ways it crept into my diet, like the cane sugar in in my almond milk and in vegetarian soups I often had for lunch. We are both amazed at how much more we enjoy fresh fruit, and crave it in a way we never did. (Interestingly, I just came across this NYT article that makes the case for eating fruit.) Olive oil and a squeeze of fresh lemon taste better than any salad dressing, which usually have some sort of sweetener.

Honestly, the hardest part for me was getting used to drinking black coffee, and while I will try it out with completely unsweetened almond milk, I now know I can drink black coffee and be okay—it took me a long time to acquire that particular taste, admittedly, but I did it, and I feel so much better without adding chemicals or sugar to it. I am not a huge red meat eater (remember, I’ve been vegan for breakfast and lunch and eating mainly vegetarian for dinner), but I’ve been getting a lot of my protein from eggs and fish, and since it’s summer, we’re throwing so much on the grill.

It’s been a great exercise in thinking thoughtfully about choices and paying close attention to what makes our individual bodies run best, and we plan to keep with it.

Have you tried the Whole30 Challenge? What benefits did you notice? Are you doing some sort of modified Paleo diet? What recipes or resources are most helpful?

The Flexitarian (or, Nutrition and Chronic Illness, Part 1)

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In the wake of the book’s release, I’ve talked a lot about gender and pain. In a social history of chronic illness, gender and pain is indeed important to the storyline, but it is just one of many themes.

One question I’ve gotten is, what about the role of nutrition and lifestyle?

The short answer is that you simply can’t talk about how changes in the way we work, live, and spend our time—a recurring theme of industrialization and innovation—without looking at the influence of nutrition and diet. Some of the most common and costly chronic diseases, like cardiovascular disease and type 2 diabetes, are so closely linked to lifestyle. In many ways, this can be empowering, because it means there are concrete things we can do to prevent or mitigate conditions that don’t involve medication and intervention.

The longer, more complex answer is that of course, it isn’t always as simple and easy as that. Health literacy, socioeconomics, and many other factors go into it. (There is a much more eloquent discussion of all of this in the book, thanks to some insightful interviewees.)

People are incredibly passionate about nutrition and diet, whether it’s Atkins or Paleo or WFPB (whole foods, plant-based). I have celiac disease, so I know firsthand the power what we eat has in terms of improving our health. I’ve also routinely gone dairy-free; I am not lactose intolerant but cutting out dairy helps reduce mucus production. I know that eliminating certain foods can be incredibly liberating, and that even if you don’t have an allergy or food intolerance, choosing to eat a particular way can absolutely make you feel better.

To that end, I’ve been loosely following Mark Bittman’s “vegan until 6pm” mantra for a few years now, and over the past several months, I’ve slowly been adding in more vegetarian family dinners: butternut squash chili, peppers stuffed with quinoa and vegetables, garlic, cumin, and chili pepper roasted chickpeas (a toddler favorite—she has an eclectic palate), etc.

I don’t envision a point where all my protein sources will be plant-based, for pragmatic reasons. For example, my daughter loves salmon and we usually share a serving, so I wouldn’t want to cut that out, and I don’t always have the time to make separate meals. Sometimes, after a day of working, running around with a toddler, chest PT, then working all night again, it’s just easier to eat some (healthfully prepared) chicken, you know?

But still, I am definitely increasing my plant-based proteins and while I don’t eat a lot of processed foods (remember, I have celiac, and I don’t buy into packaged foods that are originally made with gluten and then are reformulated with GF ingredients), I am more conscious of selecting whole foods.

You can imagine my pleasure this week, when I stumbled upon Mark Bittman’s new column, The Flexitarian, and his measured approach towards a diet high in plant-based protein. While I am sure there are critics of the name itself, the philosophy here resonates since it’s what I’ve been gradually working towards on my own.

Interestingly enough, I read the column the same week I had the chance to interview Dr. T. Colin Campbell, author of The China Study and the forthcoming Whole. If you’ve heard of his work, then you know Dr. Campbell’s research suggests many chronic diseases can be either prevented or reversed through eating a whole food, plant-based diet. Keep an eye out for interview material and my thoughts on Whole–so far, it is engrossing.

I recently read an extreme comment on an article that said something to the effect of, nutrition is at the heart of everything and there is simply no reason for anyone to live with chronic illness. My gut response to that was, well, what about people with genetic or autoimmune disease? Would a change in nutrition suddenly grow working cilia for me? Or, isn’t it problematic to place the “blame” for lupus or multiple sclerosis solely on nutrition?

So as a preview of this discussion, I think you can acknowledge the enormous impact of diet on costly and preventable chronic disease without putting unattainable expectations on whole populations of patients. I also think that no matter what conditions you have or what causes them, the better you eat, the better you will feel, and I also think that conscious nutrition choices can do a lot to improve symptoms of existing disease.

What’s your gut reaction? More soon!

Doctors, Patients and Health Care Reform

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There’s been a lot of talk about the economic stimulus plan, comparative effectiveness and health care reform lately. And with good reason—health care reform is integral for our physical as well as our fiscal health.

But in today’s Well column, Tara Parker-Pope raises an important point: in all this talk of methods and outcomes, where is the doctor-patient relationship?

The column touches on a core critique of our medical system, one that right now is better equipped for acute care then prevention and wellness. Specifically, it explores our propensity to want prescriptions that might be unnecessary, or to favor newer or more expensive treatments or procedures when older or less expensive ones might suffice:

“Whether it’s invasive back surgery, medical scans or expensive drugs, patients and doctors alike often refuse to believe that costly treatments aren’t worth it.”

What I find interesting about this column is that it doesn’t posit the blame on just the patients who ask for drugs or the doctors who write the scripts—rather, it points towards the need for both parties to work together to achieve the best outcome.

I’ve written a lot about the doctor-patient relationship, and while I have much more to say about this particular manifestation, I can’t help but feel so much remains true—in the end, mutual trust and respect is fundamental to a healthy relationship and thus a healthier outcome.

The medical education our providers have and the experiential wisdom we have about our own bodies are not at odds with each other. If we combine them and ask the right questions of each other, hopefully we can filter out the unnecessary treatments and tests.

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Another great edition of Grand Rounds is up at Health Business Blog. Check it out!