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Intuitive Eating + Food Allergy

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Proper nutrition, much like medicine, does not have a one-size-fits-all approach. In fact, what works for one person may not work for another. This is also why fad diets often don’t work. 

One of the more recent nutrition concepts that extends into counseling practices is Intuitive Eating, which encourages us to steer away from the diet mentality, and instead embrace positive lifestyle behaviors. The authors and dietitians behind Intuitive Eating, Evelyn Tribole and Elyse Resch, first wrote about the concept in 1995, publishing what is today the best-known book for helping rebuild healthy body images and restoring normal healthy eating behaviors. 

When I hear diet talk from friends, family, and clients, I’m often conflicted. On the one hand, I applaud the perceived need to change. On the other hand, I know scientifically that diets don’t often work; behavior and lifestyle changes are what stick. There is an overwhelming body of scientific literature that offers insight as to why our bodies fight diets. So if diets don’t work, then how do we make healthier, long lasting, and positive lifestyle changes? Here’s where Intuitive Eating comes into play. 

I like to compare Intuitive Eating to your best self-care day—it’s listening exactly to what your body needs, accepting it, nourishing it, and moving on. It’s giving your body the nutrients it needs while listening to your internal cues. 

The following are the 10 main ideas behind Intuitive Eating: 

1.   Reject the diet mentality. Get rid of the ideas and materials (books, magazines, etc.) that encourage and offer false hope of quick weight loss. 

2.   Honor your hunger. Physically and biologically feed your body the adequate energy it needs to function properly. Build trust in yourself that your body will tell you exactly what it needs. 

3.   Make peace with food. Give yourself permission to eat and abolish food rules. No foods are forbidden (unless you have a food allergy, that is). More on that later!

4.   Challenge the food police. Don’t applaud yourself for only eating x number of calories or feel guilty for eating that piece of birthday cake. 

5.   Respect your fullness. Really listen to the body signals that tell you you’re full. 

6.   Discover the satisfaction factor. Savor the foods that bring you joy and pleasure. You’ll typically find you end up eating less of that “forbidden” food because you took the time to savor it. 

7.   Honor your feelings without using food. Stress, anxiety, and boredom are some of the feelings that are often responsible for triggering emotional eating. Instead, pay attention to your emotional responses. 

8.   Respect your body. Accept your genes. You would never force your feet into the wrong shoes. Give your body the respect it deserves. 

9.   Exercise. Focus on how you feel while working out. If you hate it, try something new. Look at the true motivation behind your workout—is it to lose weight? Feel an endorphin high? Reduce stress?

10.  Honor your health. Make food choices that honor your health, but that also make you feel good. You don’t have to have a perfect diet. Remember, it’s progress over time that matters, not any one meal or one day that will make the difference. 

Over time, I’ve grown curious as to how food allergies, intolerances, and other medical conditions might apply to a philosophy like Intuitive Eating, which challenges us to actively listen to our bodies’ dietary needs. Initially it seemed counterintuitive to combine the two: one teaches us that we should intuitively feed our body what it needs/wants, while the other requires us to avoid certain foods for medical purposes. 

But what if Intuitive Eating could unlock greater freedom, patience, and kindness towards their bodies for those with food allergies?

Intrigued? Let’s dig into the details. 

Diets don’t work for a variety of reasons. Scientifically, when you restrict food or are on a diet, your brain produces something called neuropeptide Y, which triggers your brain to crave carbohydrates. Familiar with that feeling you get at 11am because you skipped breakfast? Pay a little thank you to your brain. It’s physically reminding you that you haven’t eaten and that you need to feed it carbohydrates because they are our body’s primary and preferred source of energy. When the body is in a deficit, we are physically depriving it of the calories and nutrients it needs to function. 

This isn’t to say all diets are bad. In particular, medically-prescribed diets are often extremely helpful and medically necessary for those suffering from food allergies, intolerances, and other medical conditions. However, many diets end up depriving your body of the vital nutrients it needs to function properly. The more you deny your hunger and fight your natural biology, the stronger and more intense these food cravings can become. 

If you’re reading this, there’s a good chance you either suffer from a food allergy or intolerance, or care for someone who does. Food allergies force us to eliminate foods or food groups to keep us safe. Intuitive Eating encourages us to ditch all food-related rules. How do you reconcile the two? What about challenging the idea that food allergies are a limitation, and instead, thinking of your food allergy as part of your body’s intuition? By reframing the way you think about your food allergy, you acknowledge your food cravings and indulge in the foods that your body CAN tolerate. Craving ice cream but have a dairy allergy? Search out dairy-free ice cream alternatives—there are a lot of comparable ones out there that are delicious and will do the trick. This way you honor your cravings, while respecting your body’s intuitive dietary boundaries. 

If you’re curious to learn more about Intuitive Eating, here are a few resources:

1.     https://www.intuitiveeating.org

2.     10 principles explained in depth: https://www.intuitiveeating.org/10-principles-of-intuitive-eating/

3.    Additional resources: https://www.intuitiveeating.org/resources/articles/

Rebecca Noren is on the Allergy Amulet health advisory board and works with chef Ming Tsai. Rebecca holds a master's degree in nutrition and is a registered dietitian. She is dedicated to bringing her expertise in public relations, marketing, and culinary production to the intersection of food, health, and food allergies. 

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FOMO: Fear of Missing Out… On Nutrients

Part I: Milk, Eggs, Fish, and Shellfish

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FOMO, or the fear of missing out, is a source of anxiety for many. For some, it means missing out on social engagements with friends. For others (likely many of our Allergy Amulet followers), it means missing out on certain foods. If you’re in the latter category, this post is for you.

There are many reasons people avoid certain foods: elimination diets, food allergies, or food intolerances, to name a few. In these cases, you’re not only removing the food from your diet, you’re also removing important nutrients (especially if we are talking about growing children!). As a pediatric dietitian, my job is to identify the foods that need to be eliminated, and then figure out how to ensure those lost nutrients remain in my client's diet.

This two-part series will focus on the nutrient implications of eliminating one or more of the top eight most common food allergens from your diet. Whether because of a food allergy or intolerance, or for diet or religious reasons, we’ve got you covered. This first part will focus on milk, eggs, fish, and shellfish. Next month, we’ll cover wheat, soy, peanuts, and tree nuts. Let’s get started.

Personally, I find it helpful to first look at each food and its corresponding nutrients side by side. This approach can make it less intimidating to then find other food sources for those lost nutrients.

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As you can see, some of the foods listed above have overlapping nutrients, vitamins, and minerals. For example, if you are eliminating eggs from your diet, you can find substitutes for protein and vitamin B12 in fish and shellfish.

Where can you find these nutrients and how do they affect your health? Let’s take a closer look.

Protein: Is my child getting enough protein? This question comes up frequently in my practice. First, it’s important to keep in mind that the majority of Americans eat plenty of protein! To see how much daily protein you should be consuming, these Dietary Reference Intake standards provide helpful guidelines. On average, a child should consume approximately .8 - 1.2 gram/kg of protein per day, depending on their age. For example, a 4-year-old child who weighs 35 pounds would need about 16 grams of protein per day. For perspective, a glass of soy milk at breakfast and a turkey sandwich at lunch would be about 24 grams.  

Of course, protein doesn’t just come from animals. There are many plant-based sources that can help you meet your daily protein needs. Most non-dairy milks and yogurts are rich in plant-based protein, for example, as well as beans, legumes, seeds, and nuts.

Has anyone noticed the ever-growing number of milk substitutes hitting grocery aisles? I certainly have! If you’re wondering which one might be best for you, the below table shows common milk substitutes and their approximate nutritional values.

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Calcium: Most parents worry about protein, but I find I’m more focused on calcium intake - especially for those that don’t eat dairy! Calcium is important because it helps maintain the strength of our bones and teeth. It also supports our body structure and helps our muscles, heart, and nervous system function properly. Calcium can be found in vegetables like bok choy, broccoli, Chinese cabbage and collards, beans (black, garbanzo, pinto), and almonds. Several milk substitutes and some orange juices and cereals are also fortified with calcium. Calcium needs range from 700mg - 1300mg/day, depending on a person’s age.

Vitamin D: Vitamin D also plays a role in bone health and the absorption of calcium. Your vitamin D intake depends mostly on sunlight exposure. That said, if you’re not getting much sunlight (read: grey winter weather), it helps to supplement your diet with this important nutrient. You may also routinely have your blood checked to determine whether you’re deficient in this vitamin, as you may need more than the recommended daily dose. If you can’t eat dairy or eggs (a major source of vitamin D), you should look to foods enriched with vitamin D as substitutes.

B Vitamins (B12, B2/Riboflavin, and B5/Pantothenic acid): B vitamins are important multitaskers. They are involved in everything from cognitive function and mood, to energy production and heart health.

B12: The best sources of vitamin B12 are eggs, milk, meat, fish, and poultry. I most often worry about B12 intake in my patients that are vegetarian or vegan. If you fall in either of those camps, plant-based milk substitutes and fortified beverages are great ways to help you meet your daily B12 needs while avoiding animal products.

B2/Riboflavin: Foods high in riboflavin include eggs, dairy, lean meats, green vegetables, and fortified grains (think cereals and breads).

B5/Pantothenic acid: Vitamin B5 (pantothenic acid in scientific terms) plays an important role in turning carbohydrates, fats, and proteins into energy. It removes strain, or stress on the body. Good sources of B5 include mushrooms, cheese, fish, avocados, eggs, lean meats, sunflower seeds, and sweet potatoes.

Expert tip: focus on the foods that you CAN eat. If certain foods are off limits, create a list of the foods you can safely eat, and separate them into different categories (see below).

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Ultimately, the more variety in your diet, the more likely you are to meet your nutritional needs. Plus, it makes eating that much more interesting! Nobody should have FOMO when it comes to food—even if cutting out certain foods is a necessary part of your diet. The solution, in my opinion, is expanding your palate.

 

Tara McCarthy is a Registered Dietitian Nutritionist who has a passion for pediatrics. She has worked at Boston Children’s Hospital for over 15 years as well as a private practice, and specializes in nutrition for children with special dietary needs such as food allergies, celiac disease, FPIES, EoE, allergic colitis, and sucrose isomaltose deficiency. 

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