A summary of dietary options for people with chronic health issues, some pros and cons, as well as my personal journey are outlined.
Gluten-free diet– likely helpful for most people with chronic conditions involving the gut. For more information on this, see http://www.edibleangela.com.
Dairy-free will also likely help, dairy and gluten intolerance usually coexists and may cause neurochemical, hormonal, blood sugar, and digestive issues.
Low FODMAP– limited usefulness beyond managing levels indigestible sugars in foods such as broccoli, caulifolwer, garlic, onion, and high fructose fruit such as apples. Created by Peter Gibson at Monash Universirty, with funding from the bread industry. Controversially in 2004 it was found that the FODMAP diet may reduce ‘good’ bacteria levels- though later studies found this reduction did not correlate with symptoms, leading to questions around definitions and requirements for ‘good’ and ‘bad’ bacteria. It was then suggested that this diet is for short term elimination only, which makes it basically useless. My personal experience is that the gas and bloating from FODMAPS is not painful, as it doesn’t involve the immune system- unlike the bloating associated with dairy and gluten, which can be excrutiating.
Vegan diet– may be helpful in weight-loss, metabolic disease, and hormone imbalances such as PCOS. Positives: if wholefood, ample antioxidants. Limitations: fat-soluable nutrients such as vitamin d, and EPA/DHAs found in oily fish are not found in any plant based foods. /flax and chia likely have low conversion from AA plant-based omegas to EPA/DHA (5%). For more information see http://www.ediblethebook.com or edibleangela.com.
Low oxalate diet has been found by some to assist with managing pain levels in fibromyalgic conditions. Mechanism unknown, effect documented by doctor (link). Foods include kale and almonds.
Similarly, histamine intolerance is theorised to be problematic in some people with methylation issues. This is related to allergies as well, which produce endogenous histamine. Amine and salcilyate sensitivities are an issue for some people with progressive gut issues. These may be improved on a gut healing diet as they are often secondary to other issues. Amine and saliclyate issues are often seen as behavioural problems in children after consumption of older or slow cooked beef. The problem is worse with beef as compared to lamb, for example, and with 3-4 day old ‘fresh’ meat as compared to 1-2 day old meat.
Low carb diet/autoimmune protocol/paleo– found to be helpful for many people with autoimmune conditions. Also useful in yeast overgrowth or dysbiosis, as limiting starch may slow or reverse the growth of yeast and pathogenic bacteria. For an example, see LINK (journal article referenced). Paradoxically, complex sugars may be more problematic when they feed pathogenic bacteria, than quickly absorbed sugars absorbed much earlier in the digestive system. This diet is similar to the fad candida diet which was designed to ‘starve’ bacteria, however may have a noticable effect on pain levels and symptoms of chronic conditions such as lupus, thyroid problems, fibromyalgia and ME/CFS.
Similarly to the above, the GAPS (gut and psychology syndrome) diet uses bone broth and a temporarily limited diet, with gradual reintroduction, to assist in gut healing and heavy metal detoxification. This is used in ADD, schizophrenia, autism, depression and many other health conditions which stem from poor gut health and nutrient deficiency. For more information, see the book of the same name by Natasha Campbell-Mcbride.
A milder version of GAPS is the Body Ecology diet, which advoctes for fermented foods, such as probiotic ‘juice’ from fermented veggies, coconut water kefir, fermented vegetables and kefir starter (on dairy) with every meal. While it is true that fermented foods are an essential element of long and health civilisations, they are now adjunct from any cultural roots and often feature a limited range of cultured beneficial bacteria. On the other hand, kombucha ‘scobies’ which are cow stomach bacteria passed between generations and communities may become contaminated by modern or rogue bacteria which can then propogate. These may also be problematic for individuals with yeast infections, and fermented foods may also exacerbate SIBO.
Personally, I have been dairy-free for nine years, gluten-free for 7 years and off cane and refined sugar for 6. I was a strict vegan for 4 years, but struggled to eat regularly and well for the final year due to financial stress, work pressure and lifestyle upheaval (primarily a lack of time for food prep). I found a vegan diet assisted in clearing my skin, balancing my menstruation and reducing my allergies, though I was also experiencing less stress during that time, which may explain the allergies. I was ethically most comfortable as a vegetarian and have since been very careful with choice of meat (I don’t eat pig, buy organic and free range and locally where possible). Stores of B12 tend to last 3-4 years, and although I supplemented, this was the time period the lifestyle worked for me.
Since the onset of my severe chronic fatigue, potentially CIRS due to mould exposure (see here) which was/is accompanied by persistent diarrhea, I have been intro GAPS/full GAPS/autoimmune paleo/low carb/moderate FODMAP.
I have found that eliminating all grains and starches, as well as complex sugars, has controlled my abdominal pain, diarrhea and fibromyalgia. It has also allowed me to stabilise my weight. This includes eating: bone broth, lamb shanks (slow cooked), lamb chops, pumpkin (jap & kent, not butternut), chicken (whole, organic, slow cooked), almonds (organic, as homemade butter or ground as pancakes), smoked/baked salmon (wild caught), smoked trout, avocado (FODMAPS, 1/2 per serve), zucchini (oxalates,peeled), buk choy/pok sum (daily, unlimited), local raw honey, kale (oxalates, DINO lowest, dehydrated as kale chips only), coconut oil, olive oil, ample celtic sea salt. I also have on occasion: lemon & ginger tea, homemade herbal jellies (gelatin and herbs), cocoa (very high oxalate, with milk or avocado), coconut wraps, coconut chips, beetroot chips (high FODMAP), mashed carrot, brazil nuts, tahini (nuts and seeds high oxalate), pecans, walnuts, pepitas, soft cooked broccoli (FODMAPS), paleo sausages. I also occasionally supplement with herbs, glutamine, mag etc: see supplements.