The Happy Foods List (A Work in Progress)

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After my last post, The Well-Rounded Mama asked me in comments whether I had plans to do a post about what stuff I can eat without tummy trouble. Why, yes, in fact, I did. And here it is.

Now, bear in mind a few things:

One, I haven’t tested everything yet in isolation, particularly some fruits that are out of season. I’ll be marking a few items as subjects for future research.

Also, I’m still trying to figure out for how long a problem food is going to continue giving me problems; I’ve been known to have asplodey after one bite of an ostensibly safe food, or even after drinking water. Eating or drinking anything is bound to stimulate the gastrocolic reflex, especially if it’s feeling particularly sensitive (as mine does for the first few hours after I get up). But chances are pretty good that if asplodey happens immediately, it has a lot more to do with something I ate quite a while before that. Maybe even a few days before that, for all I know; transit time can be tough to pin down.

And I’m not going to discount stress — including the unbelievable amounts of stress I was subjected to pre-aspie-diagnosis — as a factor in stomach upset, either. Not to mention decades of ibuprofen and naproxen overuse for my killer cramps because my first GYN scared me by saying, “There’s a death rate on the Pill.” (Right, doc, and there’s no “death rate” on hurting so badly every three weeks that you want to yank your uterus out and flush it down the john?) Nor have I ruled out the possibility that my problems could be a harbinger of something more serious, and I’m actually strongly considering getting scoped in order to rule that out. But when I’ve eaten something my southern half disagrees with, I do start getting inklings of it pretty quickly.

So here goes:

Stuff I can eat when I first get up: Hoo boy, this has been the landmine for me. For a long time, I was getting up so late that my breakfast was my partner’s dinner. I’ve since realized that I can’t really do that; I have to acclimate my digestive tract to the fact that it’s expected to receive nutrition after being in a stupor for the last 9 (give or take) hours. Now I make sure there’s at least a few hours between the time I get up and the time I eat dinner-type foods, and I make sure to have something small first. I’ve tried high-protein breakfasts, mixed carbs and protein, just carbs, high fat, low fat, medium fat, big breakfasts, little breakfasts, medium-sized breakfasts, fruit-only breakfasts…you name it.

And this is what I’ve come up with: The best thing for me is a small bowl of gluten-free cereal and some hemp or soy milk, and if I handle that okay, follow it up half an hour later with some berries (frozen if off-season). My favorite is Mesa Sunrise Flakes, which I get in economy bags from the local hippie stores; they taste great, and I’ve never had any belly rebellion after eating them. If I have to dash and don’t have time for that, I carry some raw cashews and some Mary’s Gone Crackers with me, and eat either or both them when I get peckish. I may look for a different GF cracker besides MGC, though; they taste fine, but sometimes they make my teeth hurt. (If you have recommendations, feel free to share.)

Stuff I don’t know about because I haven’t had a chance to test it yet: Cherries, peaches, nectarines, plums, melons, grapefruits (who knows; oranges seem to be on the “no” list, but small amounts of lemon and lime juice don’t bother me), asparagus, artichokes, cauliflower, clarified/drawn butter (or ghee).

As long as I’m mindful of when I’m about to reach salicylate overload (I can tell if I’m starting to feel agitated apropos of nothing in particular), I can consume the following: Broccoli (must be careful of undercooked stems due to FODMAP issues), eggplant, olives, spices, herbs, coffee, tea, peppers (though I hate bell peppers and pimentos), yams, zucchini, cucumbers, spinach, water chestnuts, alfalfa sprouts, berries, dried apricots, grapes, almonds, avocados, olive oil, coconut oil, sesame oil, cornmeal, pine nuts, pistachios, macadamias, mint, pickles, popcorn, wine, rum, vinegar, mustard, Worcestershire sauce.

FODMAP-listed stuff I know I can work with are the following: Anything in the onion family as long as I don’t eat the white parts of the flesh (I can cook with it for flavoring), broccoli (beware undercooked stems), carrots if cooked or shredded and I have a little dextrose with it, tomato sauce or ketchup if I have a little dextrose with it, any legumes (including soy products and any flours or noodles made from legumes), brown rice as long as I don’t go too hog-wild with it, pomegranate juice (it’s tart, so I just use a little for flavoring fizzy water), small amounts of honey, fruit sweetener (including agave), or even HFCS (which I avoid for metabolic reasons, but if some sneaks past me on rare occasion it’s not going to kill me), coconut milk or cream, small amounts of sucrose (table sugar) or brown sugar (i.e. table sugar plus molasses). Gatorade, SweeTarts, and Smarties are my go-to sources for dextrose at the moment, though I’m considering getting some dextrose powder to see if it’s more effective.

Foods that are generally no problem for me at all (see above for caveat about breakfast): All nuts not listed above, any kind of fish, meat, or poultry, all non-gluten-containing grains not listed above (oats can be okay depending on processing), tamari/liquid aminos, all vegetables and tubers not listed above, bananas if they’re not underripe or overripe, mangoes, small amounts of dark chocolate if not made with milk fats, garlic, salt, eggs, all oils not listed above, Earth Balance spread (indispensible in baking), vanilla extract, gluten-free beer, sparkling water, fish sauce, liquid smoke, hemp milk.

I just got an Imperia pasta maker and am starting to make my own GF pastas (flour blend is 1/3 garbanzo, 1/3 cornstarch, 1/3 tapioca — it doesn’t taste beany at all once it’s cooked). YUM! I also ordered some Better Batter flour mix to try out, so that my partner can (I hope!) go back to doing the baking he used to do before I started tinkering. (He’s not doing the same restrictions I am, but he also doesn’t want to bake things I can’t eat.)

I’m sure I’m going to forget some things and have to add them in later.

With that in mind…got any good recipes for me?

2011 Resovolutions, Part 2: The FODMAP Not Taken

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I used to fantasize writing a universal cookbook for eating theorists. Each food would come complete with a citation from one system or authority claiming it the most divine edible ever created, and another, from an opposing view, damning it as the worst pestilence one human being ever fed to another.

Steven Bratman, MD, Original Orthorexia Essay

So for all the operetta involved in this dietary change, how much did it benefit me? Well, let’s just put it this way; it helped quiet down my noisy belleh, and I actually got a surprising brain boost out of it. I had thought all that stuff about leaky guts and opiate peptides was woo, and maybe it is, but the fact of the matter is that it made a difference in functionality for me. When I adhere to GFCF, I don’t feel like a totally uncoordinated stumbledrunk (most of the time), and I have markedly less agitation and anxiety and don’t stim as much as I used to. It could be that only a small percentage of autistic folks actually do get this benefit, but I do seem to be one, though a “cure” it ain’t.

As it were, though, I was just scratching the surface. Sure, I’m “sensitive” to food. I’m sensitive to air and water, why the hell wouldn’t I be sensitive to food? But the question nagging me was, was it really going to be every food that was going to give me problems? Do they even make diapers in my size? Yeah, I know a certain tiny percentage of post-chole patients do have issues with bile salts (warning: grody stuff in link) and have to go on something like Questran, but my patterns didn’t seem to fit that. Some foods really have been okay. But here’s the thing: When they diagnose you with IBS, what’s the first thing they tell you to do? Eat a high-fiber diet. Which usually means lots of things like whole wheat bread, brown rice, lots of veggies and fruit. And these are undoubtedly wonderful things for people without major intolerances to have a lot more of, if they can.

But after I ate an apple and a pear from that Zabar’s basket, I knew there had to be more going on than just gluten and dairy stuff. Apples! Apples are health food, right? Keep the doctor away, right? Yeah. I had a childhood that was more or less one long stomachache, and do you think anyone would have taken me seriously if I’d complained that apples made me feel yucky? But they do, and the shrink sez it’s a common thing for autistic folks to have problems digesting. Along with pears. And tomatoes. And onions, which I’ve never liked much anyway but are undeniably useful for cooking.

So then I did some poking around and discovered the mostly-unknown-in-the-U.S. disorder called fructose malabsorption. Apparently, about 30% of the population in Western nations has it to one degree or another. Thirty percent! With rare exceptions, that usually doesn’t mean we can’t eat any fruit sugars, but that we have to know what our limits and triggers are. This covers not just fruits or their derivatives (including everyone’s favorite chewtoy, HFCS), but also many veggies and beans. (Does Michael Pollan know about this?) And in some cases, it can lead to problems digesting wheat and dairy, too.

Meanwhile, I’ve discovered that small amounts of Gatorade (which changed its formula in 2010), along with SweeTarts and Smarties, can help me digest things like tomato sauce and carrots, because the dextrose in them helps balance out the slight overbalance of fructose to glucose in the veggies. (These are the hard-candy Smarties known as Rockets in Canada, not the chocolate-based candy by that name sold outside the U.S.) Doesn’t do squat for me with apples and pears, though, or with any savory veggies or grains…oh well. But Gatorade! It keeps the doctor away! For reals now!

And more poking around still uncovered a condition called salicylate sensitivity, which we auties (among others) can also be subject to, and which covers the triggers I have that aren’t accounted for above. Guess which foods are highest in salicylates? Yes, that’s right — pretty much every produce item that’s not on the FODMAP list. (And Donna Williams, an autistic author based in Australia, says documentation exists that veggies are being bred these days with extra salicylates, which are supposed to protect against cancer.) Not to mention tons of nonfood stuff like aspirin and ibuprofen, and most commercially available shampoos and soaps. Holy frigging gluten-free donut holes, Batman. Maybe there’s a good reason some people resist chowing down on ten-foot piles of produce — we don’t just get a little farty eating undercooked broccoli stems, we turn our tummies into skin-covered Cuisinarts doing it, no matter how many times we try over and over again to “get used to it.”

Oddly enough, though, beans don’t bother me at all. Not even if I eat them with pickled cabbage slaw. I’m weird, I know.

I’ll probably keep thumping away on this drum until I die or get a knuckle-ache, but one more time for old times’ sake: Insisting that everyone “eat healthy” (or be thin) is a form of ableism. All of us can’t fucking do it. Oh, they think they’re not talking about people who have Medically Documented Problems eating fiber by the yard, but when we’re potentially talking about almost a third of the population, most of whom have no idea why they can’t “learn to like” stuff that’s allegedly good for them, something is getting lost in the conversation.

Dr. Bratman published his orthorexia article in 1997, but most of what he wrote still applies. Like him, I can’t help but be flummoxed by the fact that, after all this time, after all this study, after billions of human volunteers happily and unhappily offering their bodies up for the cause, nobody can come up with a unifying theory of nutritional medicine. Instead, what we have are handfuls of theories about what’s “good for us,” all of which cancel each other out. Is it possible that some people thrive as veg*ns? Sure. Is it possible that some of us really do have metabolic issues requiring a relatively high consumption of animal proteins? Sure. (Remind me to go on for about six weeks about low-carbing sometime, but for now I’ll just say that going to the grocery store and seeing apples marked with skulls and crossbones would make me snortlaugh to the point of hiccups.) And is it possible that some people have to be every bit as careful consuming “healthy” food as they do eating “junk”? Sure. But that seems to be too much complexity for all the eat-like-I-do gasbags out there to process, just like they can’t process that being fat doesn’t cause diabetes any more than male-pattern baldness causes prostate cancer, and that as much as we might like to prevent prostate cancer, we’re not gonna cure it with hair transplants.

The dietary changes I’ve made pretty much require me to learn to cook all over again, learn to grocery-shop all over again, learn to eat out all over again — in other words, all the things they tell us we have to do if we want serious weight loss. (Fifteen pounds is not serious weight loss for someone my size.) So yeah, I’m capable of doing that, if there’s a clear and imminent benefit to doing so. But here’s why it usually doesn’t work (especially in people who don’t binge) for losing and keeping off any more than minor amounts of weight, if that: people get hungry. Very few people are capable of ignoring constant, gnawing hunger for decades, and very few people can endure the disorientation of forcing themselves into ketosis for years at a time, either. If I pass a pizza place, I might lament the fact that I can’t have a slice without giving myself a terrible tsura, but I don’t have to keep telling myself you’re not hungry you’re not hungry nobody your size can be hungry you just think you’re hungry don’t eat don’t eat don’t eat don’t you want to be liked? Instead, if I’m hungry, I can reach in my bag and pull out some almonds or GF crackers and a portable squeezy tube of hummus, and have something else.

And if I want the pizza bad enough that I’m willing to endure the attending asplodey, I’ll have it. This is where “intuitive eating” becomes a process that incorporates left-brain knowledge about what I can physically handle and what I can’t (as opposed to “demand feeding,” which basically means giving the right brain whatever it’s clamoring for and trusting that I can handle it, whether true or not). I can have what all of me wants (and can afford, of course). And so can you, whatever that is.

2011 Resovolutions, Part 1: GFCF, Meet HAES

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So. In the interests of turning over a new leaf, I’m going to try to be as un-grody about this as I can. Today is my four-month gallbladderversary. Yep, I celebrated last Labor Day by emergently having my gallbladder out. I had intractable stomach pains that weren’t going away no matter what remedies I gave them, called the advice nurse, who told me I’d better see a doctor pronto. Since my regular doctor was off that day, I went to urgent care, described my symptoms and history, and it took them about ten minutes to figure out that my gallbladder was on fire and it needed to come out right away.

And I have to tell you, these folks should get some kind of medal for treating a fat chick decently. They weighed me, because they had to for general anesthesia, but never gave me any crap about it; the closest was when the surgeon told me that my gallbladder might be hard to get to because of my “build” (which could have referred to my splendiferous hooters as much as anything else). But they didn’t have to cut me all the way open, thank the elves and faeries, and this doctor had pretty obviously done this operation enough times that he could do it in his sleep, so really, everything went down like guacamole.

Until I had to start eating solid food again. And then, as ever, I started to discover that many of the foods most enjoyed by the northern half of my body made my southern half threaten secession.

As you know if you’ve been reading here a while, I’ve had stomach problems pretty much my whole life, and they only got worse after the surgery and never seemed to get any better. About 16 months ago, I wrote about possibly changing my diet to figure out if I could isolate potential triggers. I got great comments on that post, and a couple of folks suggested I try an “elimination diet” — that is, for a few days only eat a few things I know for sure are safe, then gradually re-introduce the questionable ones until I zeroed in on the culprits. I finally tried that, and sure enough, I found that the old autistic bugaboos gluten and casein were giving me the lion’s share of the trouble, so I cut those out.

Yeah, that’s right, MY INSURANCE BLAAARGH folks, I actually did give up most of my favorite foods (soy sauce! I practically swam in that!) for better health, so I don’t want to hear any puling from the VIP seats that I’m self-destructive and don’t take care of my fat self. Pizza, pasta, cheese, butter, milk chocolate, ice cream, yogurt, bread — all of it went, or at least the gluten-and-casein-full versions of them. I told myself that I could eat anything I wanted; I just had to be prepared for what might happen if I did, which was basically going to be the Disneyland fireworks display, only not in color.

You see, I’ve pretty much had to plan my entire life around proximity to an unoccupied toilet. It’s terrible. I have IBS-A (anybody wanna cure that already?), which means I alternate too fast and too slow, and that gives me very little margin for error when it comes to what I eat, and also limits the kind of medication I can take for it. I just had enough. My goal was, no more having to drop my library book or my cooking or my browsing in a store to race to the crapper, no more dirty looks from salespeople when I stunk up their bathrooms and didn’t buy anything because nothing looked appetizing anymore, no more stomach cramps, no more straining, no more uncontrollable fart attacks in public, no more sweating and praying while on the bus or train or in a car that I would make it to the next bathroom on time. And when I say “no more,” I mean no more than the average person; everyone has that stuff happen a few times a year, but not a few times a week (or sometimes, a few times a day).

Gluten-free, by itself, is a pain in the butt, but it can be worked around. I got wheat-free tamari (including little packets to take to sushi bars), found some cool new recipes, including one for red velvet cake that my wheat-eating partner said he liked better than the kind I used to make with wheat and dairy, and he doesn’t blow smoke up my nethers about things like that; he actually ate more of the stuff than of my prior recipe. For me, no dairy is the real pisser. So I didn’t tell my mom I was doing this, and she has never in her life sent me food (other than tea), and what did she send us for the holidays this year? A fruit and cheese basket from Zabar’s. OH MY FREAKING GOD. You can find (or make) gluten-free baked goods that taste great, but I’m sorry, nobody is ever going to find a decent casein-free substitute for luscious Camembert and extra-sharp cheddar. I actually ate a slice of Tofutti mozzarella and some Daiya cheddar after trying that stuff, and I wanted to cry — but alas, even with Lactaid, real cheese goes down like spackling paste.

And yeah, I knew all about orthorexia and nocebo/placebo effect and the dangers of restricting too much for no good reason, and I really wanted to make sure that I wasn’t just doing a number on myself about this, because eliminating entire categories of food really is a big deal. It’s expensive and a pain in the ass to eat this way, and don’t let anyone tell you it isn’t. No longer can I just “grab something” just anywhere — convenience store, fast-food, pizza — and eat on the run. I must have contingency grub with me everywhere I go, lest I be somewhere the treyf ain’t safe. Most restaurants are now off limits for me if I want to avoid the possibility of asplodey, and the asplodey-proof places are more expensive. (Hawthorne Fish House, I love you to death, but really, $16 for a small basket of oysters and chips?). And make no mistake about it; with GF and CF products, there is price-gouging, and I pretty much have to prepare every meal from scratch now. There’s no way in the world I would do this without getting something — or several somethings — out of it.

Did I? Tune in tomorrow and find out.