There Are Diets, And Then There Are DIETS

posted by meowser

Fillyjonk’s tremendous post yesterday on intuitive eating and how it doesn’t always mean eating everything you’re “allowed” to eat — and the ensuing discussion that climaxed in the question, “What if you can’t stop eating things you know are bad for you?” — got me thinking. (Ooh, dangerous.)

There’s no universally “bad for you” food unless it’s food that has been tainted in some way that will make everyone who eats it deathly ill. We’ve established that. But teetering on the precipice of codgerhood, and having created more medical records than I can count where people are put on restrictive diets for one medical condition or another, serves to remind me once again that there’s also no universally “good for you” food either, and that some food encounters that are benign for some people are less so for others. C. has had kidney stones and isn’t supposed to have spinach (or at least not very much of it). My XH has hereditary hemochromatosis and is told to avoid leafy greens. Similarly, people on blood thinners like Coumadin (a very common medication for people over 70) are told that if they do eat greens, they must eat the same amount every day or not eat them at all, so that their medication can be adjusted accordingly. But the rest of us are told that there’s no such thing as too many greens, we can knock ourselves out, and can actually be given a hard time for not eating enough of them, especially if we’re fatasses.

Some people with diabetes can eat sugar and other carbs and as long as they don’t go bonkers, it’s not a problem for them, they just adjust their insulin dosages or tweak their diets in some other way and they don’t have blood sugar spikes. Some others with diabetes find that even eating one or two bites of candy made with sugar will make their fasting glucoses soar into the 300s and beyond, or even put them in a coma. Some people with diabetes need to have sugar at a particular moment in time if they are experiencing hypoglycemia; others never get hypoglycemia at all.

People with kidney failure are told to avoid all but minimal protein. People with dysphagia (trouble swallowing) have to have pureed diets. People who are treated for heart disease in the hospital are given “heart healthy” diets which are low in saturated fat. People with dental problems need soft foods only and probably have to pass up that pizza unless someone puts it in the blender first. (Pizza shake, yummm.)

And of course, some people have food allergies or intolerances ranging from severe anaphylactic reactions to vomiting and diarrhea if they have wheat, dairy, mushrooms, shellfish, peanuts, soy, or any number of other things they don’t feel well after (or can actually die from) eating.

Me, I have PCOS. If my eating is too heavily carb-weighted, I will get foggy and sleepy. I don’t avoid any particular food entirely unless I just don’t care for it, but I do consider how certain foods will make me feel and function after I eat them. The combination of pizza and beer, for example, is restricted by me to times when I don’t have to do anything at all after I eat, because it will make me stuporous. Sometimes stuporous is nice, but not when you still have four more hours of work ahead of you. And if I haven’t been having a lot of fiber, my digestive tract pays the price and my energy can go out of whack. So I sometimes do push myself to eat more of it even if it’s not what I’m craving. It isn’t so much, “Get the brown rice, white rice is bad for you,” it’s more like, “I’d rather have white rice, but brown will be more filling, and I’ll be able to sit in my chair afterwards without bouncing up and down in it.” And sometimes I’ll get the white rice anyway and take my chances, and sometimes that will be the right decision, too, especially if I’m going to be active immediately afterwards.

The older you get, the more the odds go up that there’s going to be something you used to love to eat which you can’t chew, swallow, digest, or process the way you used to. And even a lot of younger people have health conditions for which their eating is limited by something other than personal predilection. So if that’s true for you, does that mean you have to throw IE out the window? Of course not. Whatever particular food restrictions or requirements you have, you just incorporate into your fund of knowledge about how to feed yourself.

If you have a food restriction that will cause an acute reaction if you violate it, of course, it’s a lot easier to follow that; if you know you get hives the size of NBA basketballs after eating strawberries, you’re probably not going to want to touch them no matter how tasty they look. But it gets trickier when there are no immediate sequelae to eating something your body has trouble processing, at least in the amounts you’re giving it, but the sequelae show up later in the form of impaired insulin response or sluggishness or constipation or some other decidedly non-salubrious effect. What then? Does that mean you can’t be trusted to feed yourself and need a “don’t eat” sheet?

Not hardly, say I. I don’t think there’s anything wrong with allowing the part of your brain that knows your particular body well to have final say over what goes in your mouth. For most people, that takes the form of, “You don’t want to be fat, do you? You’d better not, piggy.” But over here, where we practice earth logic rather than superstition, nobody voluntarily goes hungry to fit a certain pants size, not least because that will completely mess up your hunger responses and make you crave things (and amounts of things) you might not otherwise want. I’ve seen women on diets completely helpless in the face of a tray of day-old Costco muffins: “Get those carbs away from me!” And me, I look at the day-old Costco muffins and see…day-old Costco muffins, gag, no thanks.

The thing is, those it’s-bad/I-shouldn’t/I-want-it-even-more effects can persist for years — decades — after you cease trying to lose weight. (Remember the Ancel Keys semistarvation study? It doesn’t take much calorie restriction, or too long a period of time doing it, to potentially screw your head up but good.) That’s why not everyone can practice IE out of a book, or a blog post, without outside support (and why people with full-blown eating disorders can especially find it problematic). And that’s also why your particular brand of IE can involve your left brain as much as your right. Only it’s a matter of training your left brain not to make this about your looks or about your food choices as caste markers, so much as saying, “Is there something my body could use more of? What do I have access to right now that could satisfy that?”

It gets dicey, of course, when your access to foods your body wants is limited by finances. Sometimes I really, really want those white anchovies, but my bank account says, “Forget it.” That’s when my left brain steps in and says, “Here’s some canned sardines, you like those, too, and they’re a lot cheaper.” Maybe I won’t like them quite as much as the white anchovies, but it’s at least in the ballpark. Similarly, your life circumstances may not allow you (or whoever you live with) to do much cooking or food preparation or shopping, and sit-down restaurant meals may be a rare treat. It’s admittedly much more difficult to get a lot of dietary variety under those circumstances. In which case, I say screw it, you can only do what you can do, and you don’t owe anybody the last of your health and energy to find and chop cauliflower.

The last thing I would ever want to see is for intuitive eating principles to be something people think they’re “failing.” The whole point of doing this is to quit punishing yourself already! You don’t have to eat the exact thing that pops into your head, and that thing that pops into your head doesn’t have to be something “healthy,” or you flunk. Nobody flunks, okay? It’s perfectly understandable that some people will have to go about things a little differently for one reason or another; when you’ve had shit pounded into your head about right and wrong food from the time you were a little kid, those idees fixe can be pretty damn difficult to dispense with, especially if they’re mixed with genuinely appropriate reasons for you to avoid or restrict certain foods that your particular body has trouble with.

But maybe you can gently nudge yourself to start thinking in terms of addition rather than subtraction. C. isn’t supposed to have peanut butter either, which he loves, at least not as often as he used to have it. But he doesn’t clobber himself when he gives in and buys it and eats it more often than his doctors would approve of. Instead, he says, “What can we get next time that I can spread on bread, so I won’t automatically go to the peanut butter?” That’s the kind of thing I’m talking about here. Not forcing yourself to eat stuff you really don’t like, because as we know, you don’t get as much nutrition out of food you don’t care for. But I think you’re allowed to feel “meh” about what you’re eating and have it anyway, because that’s what’s there or because you genuinely need it for the sake of balance. If this is about loving every single bite you eat, and always picking the “perfect” thing and the “perfect” amount of it, I flunk too, believe me.