Elimination Diets & Disordered Eating

Cover of Zine 7 - Elimination DietsElimination diets are a helpful diagnostic tool for identifying food allergies and intolerances. I recommend them fairly often to clients for various health issues. To streamline the process of explaining an elimination diet, I have written a how-to zine which can be found in my educational resources, Issue #7. In the writing of this, I interviewed a number of friends who’ve gone through the process to hear about their outcomes. It was a common theme to hear about elimination diets leading to and/or triggering disordered eating, or full-blown eating disorders. So I wanted to highlight the connection in this blogpost.

My friend Audra Locicero, of Beautyberry Apothecary, shared her own experience, from which we can learn a lot…

Beginning in my early 20s, I started to experience a variety of health issues that felt oddly out of place for my age. These included a lyme disease infection, gut dysbiosis, and chronic inflammation, and manifested as fatigue, depression, anxiety, digestive issues, brain fog, headaches, and joint and muscle pain. Determined to live a life less encumbered by pain and illness, I decided to adopt a variety of healing diets as a way to address the source and the symptoms I was experiencing. My knowledge of herbs and nutrition and my general worldview, as well as the guidance from various health practitioners at the time, led me to look to food as both a root cause of imbalance and a source of healing.

The specifics of the way I ate transformed over time, but almost always included the elimination of gluten, processed sugar, and alcohol. I took those three ingredients out of my diet entirely for about four years. I also experimented a great deal with the GAPS diet*, abiding by it for long stretches of time intermittently. This included the addition of bone broth daily (which overall I think was very nourishing and am still fond of today). For some time, this way of eating felt really good – I felt that I was in control of a major factor in what was keeping me unwell. Overtime however, in an attempt to assuage the symptoms that were ever-increasingly plaguing me, digestive upset in particular, I began to eliminate more and more things from my diet, eventually removing all grains, dairy, fruit, starchy vegetables, legumes, raw vegetables, nuts, and certain fats. I was left with bone broth, and cooked meat and vegetables. I ate in this way for about four months before I crashed and burned, and eventually saw the light. This was a really dark time. All I could think about was the foods I was not allowed to eat, all day, everyday. I avoided things I previously loved like sharing meals with family and friends and going out to eat. I lost a ton of weight and my period, too. All the while, my digestion, the very thing I was eating to support, was suffering more and more.

Somehow, in a stroke of enlightenment, or more likely a deep survival instinct, I was able to see my situation for what it was: an eating disorder. I almost immediately began to eat whatever I wanted and all of my symptoms improved. I gained all my weight back and more, my menstrual cycle regulated, and my digestion improved, too. I often joke that I turned cheesy pasta into 20% of my body mass in 3 months (the weight I lost and then gained back), a glorious feat! It was an incredible turn of events and I’m so grateful my body eventually had the wisdom to override my mind and seek what was best for me. Orthorexia, or an obsession with “healthy” eating, is not officially recognized as an eating disorder by the Diagnostic and Statistical Manual of Mental Disorders, the international authoritative handbook for health care professionals on the diagnosis of mental health disorders, but it’s my best guess that it will be in the near future. My presentation and experience read orthorexia to the T, which was both shocking and empowering.

In sharing my story with friends and family, I’ve learned that so many people deal with this type of disordered eating, women especially. What I know now about myself (and the disorder, too) is that I don’t have the mental constitution to eat in such a rigorously restrictive way for such a long stretch of time. While I don’t have an official OCD diagnosis, I know that I’m someone who deals with obsessive thought patterns, anxiety, and perfectionism, and have for as long as I can remember. While some people may be able to maintain an elimination diet for a lifetime even, I believe that great care must be taken before suggesting such a diet to people with a known history of OCD, eating disorder, or anxiety, as it has the potential to do more harm than good. I do not wish to entirely discredit the practice of eating a prescribed healing diet, dabbling in elimination diets, etc, as I think they can have great value for many people; there is no one size fits all approach to healing. I simply hope that through experiences like mine we can become more well-informed, compassionate citizens of the world. This is the responsibility of health professionals especially – herbalists, in my case, but doctors, acupuncturists, and nutritionists, too.

So, what happened to the original symptoms I was hoping to address with these diets many years ago? Some have fallen away, some remain, and some new ones have taken their place. Now, three years later, I eat whatever I want, mostly. I limit gluten and processed sugar for the most part, and don’t have much interest in alcohol, but overall I am so much less restrictive. In some ways, I feel like I withstood the most rigorous elimination diet of all time, and came out the other end with real information about what is good for my body (for example: dairy and gluten-free grains are no issue; gluten and sugar make me feel inflamed in large, continuous doses). Unfortunately, even limiting certain things to a few times a week is still a slippery slope for me mentally, as I imagine is the case in most eating disorders. At this point, I still have to be very cautious about the way I frame the value of various foods in my mind (say, labeling something as healthy or unhealthy) and I can’t meddle in any prescribed diets. I stick to these boundaries as an act of kindness to my mental health. For now, it is a line I still cannot cross, but I hope that it eases in time. If I chose to eat something, regardless of what it may be, I have to trust that it’s nourishing me.

Through these personal experiences I’ve learned a lot. Being an herbalist, folks sometimes ask me for advice on what they should eat. These days I often say: eat whole foods, in variety; just about everything is ok in moderation; and please, eat with your loved ones, for health AND for joy.”

Thank you Audra, for sharing your experience.

*GAPS diet: “Gut and Psychology Syndrome”, by Natasha Campbell-McBride, 2010

Dosa and Uttapam; my staple food

I was recently asked how I eat healthy in the midst of a busy schedule.  I have been “blessed” with a weaker digestive system, so if I don’t stay on track with food that is appropriate for me, I feel it.  Thus, I have fairly high motivation for keeping my food consumption in check. Some tools I find helpful include planning ahead and batch cooking (preparing food in large amounts, so it can stretch throughout the week), and when all else fails, in good times and bad, I heavily depend on dosas (doe-sah) and uttapams (oo-tah-pom).

I am often sharing my love of dosa and uttapam, so I thought I would post the preparation process, and you might find that you love it too…

What are dosas and uttapams?

Dosas and uttapams are South Indian fried bread, made with a simple fermentation process of rice and lentils. Both are made with the same recipe, but dosas are crepe-like, while uttapams are pancake-like. They are delicious alone, and serve as a wonderful base for endless meal possibilities.

Yes, they are gluten-free and optionally vegan.  For folks who are giving up bread, they may satisfy that craving, and the fermentation process makes the grains and legumes easier to digest.  And did I mention they are frugal-friendly?

How to make the batter…

Ingredients for 1 quart of batter:

1 cup rice (white basmati is considered traditional, though I’ve used many kinds: brown, white, wild, basmati, long grain, etc. All work fine.)

1/2 cup lentils (Urad daal, white lentils, are traditional.  I usually use red lentils because it is easily found and makes a lovely pink batter.  I have also used green lentils, black lentils, and mung beans)

3 Tbsp Fenugreek seeds (optional, does fine without)

1/2 cup yogurt or kefir (optional, does fine without)

2 Tbsp apple cider vinegar or lemon juice

1/2 tsp salt

cooking oil (I usually use coconut)

 

Preparing the batter…

Step 1. Put rice, lentils, and fenugreek seeds into a quart jar or bowl.  Cover with twice as much water, a dash of vinegar or lemon juice, and let soak 8-12 hours.  It will swell.

Step 2. Strain out the water.

Step 3. Blend the rice, lentils, and fenugreek with 1 cup water and yogurt or kefir (optional). Blend into a batter the consistency of pancake batter.  It should be pourable and fine (not chunky). Add more water if you’d like. I use a Nutrabullet and let it blend for a long minute to make it as fine as possible.  Sometimes I get impatient and cut the blending time short, but then I always regret having chunky batter at mealtime.

Beware of the fermentation explosion!

Step 4.  Allow this batter to sit out for 12-48 hours, or longer. The batter will rise.  In warm weather (like Florida summer), the process will move fast and I feel satisfied with the batter after 12 hours.  You can even leave it out for a couple days and the sour, cheesy flavor intensifies…the magic of fermentation at work!

Step 5.  After you’ve allowed it to ferment, add salt to the batter.  Cap the jar and store in the fridge.  It can last for a few weeks, and will continue to ferment at a slower pace, cultivating a cheesy and savory flavor.

Cooking the batter…

*Please note: Dosas are crepe-like preparations, while uttapams are pancake-like preparations.  The recipe above sets you up to make uttapams, so if you’d like to try dosas, simply add more water to the batter to thin it out. (My fickle stovetop only allows for the thicker pancake-style uttapams.)

Step 6.  OPTIONAL: Herbs such as chopped garlic, basil, cilantro, parsley, grated ginger, and spice powders (try turmeric, cumin, coriander, etc.) can be stirred into the batter.

Step 7. Heat a well-seasoned frying pan, preferably cast iron, with a touch of oil.

Step 8.  Once it is nice and hot, use a ladle to pour batter onto the pan.  I like to make them small, about 4-5 inches in diameter. Use the ladle to spread the batter out in a spiral-like fashion.

Step 9.  Watch for little bubbles to appear on the surface, just like a pancake.  Once the bottom has thoroughly cooked, flip it with a spatula and cook the other side.  Lightly oil the pan between uttapams. If this doesn’t go perfectly on the first try, don’t give up! If they are sticking to the pan, then it is probably not seasoned enough. I have a cast iron that never gets rinsed or washed and it works well.

Preparing your meal…

Once you’ve cooked your uttapams, the possibilities really are endless.  I often top them with the following layers…

Layer 1: A spread.  This can be butter, pesto, dairy cheese, cashew cheese, guacamole, pâté, etc.

Layer 2: Stir fry.  Nothing beats simple sautéed onions, peppers, garlic, with some diced potatoes and tempe.

Layer 3: A sauce.  I often make a tahini sauce, or a spicy salsa drizzle.

Layer 4: Gomasio.  Nearly everything I make gets topped with gomasio, which is roasted sesame seeds freshly ground onto the dish. Definitely not necessary; I just really like it.

Here are some examples of meals I’ve prepared that center around uttapams…

 

 

Breakfast: My breakfast uttapam is topped with avocado, a spinach-bidens-garlic omelette, and gomasio.

 

 

 

Lunch: This lunch uttapam is topped with an asian-inspired stir fry, in which the carrots, asparagus, onions, and mushrooms are sautéed in a little coconut oil,  peanut butter and a lot of Tamari.  Topped with gomasio, of course.

 

 

 

Dinner: These uttapams are topped with a spread of cashew-cheese, a stir fry of onions, garlic, potatoes, carrots, and tempe.  Tahini sauce is drizzled on top.

 

 

 

 

Dessert: Yep, they can even be made into a sweet!  Simply add 1 Tbsp sweetener to 1 cup batter. I like to use maple syrup.  It turns out very similar to a pancake.  This one is topped with Elderberry syrup and a dollop of ice cream. Oh yeah.

 

 

Late night snack: Sometimes my favorite way to enjoy uttapams are plain, with a little butter and a lot of gomasio ground on top.  On this particular night, I paired them with fried plantains and it hit the spot 🙂

So there you have it…the dosa/uttapam fix! I start my week by making a batch of batter, and then my toppings are dictated by whatever else I find in my kitchen. On days when I haven’t planned squat, I can usually scrounge uttapams, onions, and potatoes, and that in and of itself is not a bad meal to whip up on the fly!