The mini controversy caused by Dr Giles Yeo’s recent Horizon programme ‘Clean Eating – the Dirty Truth’ was a welcome distraction from the world melt down documented daily.
The programme focused on the new Instagram driven trend of ‘clean eating’ and explored the work of women who advocate healthy eating: Ella Mills (Deliciously Ella), The Hemsley Sisters (Melissa & Jasmine) and Natasha Corrett (Honestly Healthy). Dr Yeo expressed concern that there is no evidence base for encouraging consumption of real food (over processed food).
This was interesting viewing for me because diet is an essential part of managing gastroparesis. After my virus in 2014, eating anything was problematic for me. Even water caused me fullness, pain and reflux. Before my diagnosis, I initially thought that eating more roughage would help my body process food. I ate bowels of granola and fruit for breakfast, salads for lunch and lots of vegetables at dinner. Ironically, I was doing the worse thing possible because those with gastroparesis should follow a low fibre diet to ease digestion. Then, following my diagnosis, I followed the specialist’s advice for a typical low fat/low fibre ‘white carbohydrate’ gastroparesis diet: lots of potatoes, white bread, steamed puddings. But this did not help either. It meant my body was getting minimal nutrition, it was boring and not satisfying to eat, it exacerbated some symptoms such as fullness, hunger (yes, you can feel full and ravenous simultaneously with gastroparesis) and nausea.
After reading Crystal Saltrelli’s 2014 edition of Eating for Gastroparesis, I started to review my diet. This edition differs quite dramatically from Crystal’s earlier version of the book by stepping away from a typical gastroparesis diet towards a nutrient rich diet. Whilst it is tailored for those with gastroparesis (low-FODMAP, gluten-free, and dairy-free), it is based on whole food nutrition: that is avoiding processed food.
Reflecting on my journey with food from that moment until now, I can divide it into three distinct phases:
2015 – changing what I ate completely to follow a gastroparesis friendly, nutrient rich diet. Minimising my consumption of processed food. Having a food and drink allergy test: as a result, minimising my dairy intake. Eating low-gluten bread (sourdough and spelt) and cooking with low-gluten flour (sprouted spelt flour and oat flour). Identifying food that is soft, easy to digest but nutritious: bone broth, soup, smoothies, purees, dips. This was an overwhelming year, the list of what I couldn’t eat was very long, I lost a further half stone in weight (I had already lost a stone by that point). However, along with the other changes to my lifestyle, I noticed a definite improvement in my symptoms. I believe this year lessened the stress being placed on my digestive system and gave my body the opportunity to heal.
2016 – changing my approach towards food: viewing how I eat not as a diet (to be ditched once I recover) but as a way of eating that will be with me for life. This helps me to be consistent but experimental: I started focusing on what I can eat rather than what I cannot. I also ate ‘outside the box but within the boundaries’ when travelling. As a result, the list of what I could eat expanded. I believe my food choices support my body to heal.
2017 – introducing a lot more foods that are not gastroparesis friendly. I have put on half a stone in weight. I stick to a fairly limited diet 80% of the time which allows me to be quite flexible when I need to eat out. However, the guiding principle of nutritious whole food is always a deciding factor now in what I choose to eat. I enjoy my food and love what I eat. I rarely worry now about whether something is high fat or high fibre. This does not mean that I eat without consequence: I notice an increase in symptoms if I consistently eat outside the boundaries of what my body is happy with but this does not prevent me from experimenting or widening those boundaries.
Over the last three years, I became aware of the ‘clean eating’ movement gaining rapid momentum. In some respects this was helpful. Restaurants are more accommodating of my dietary needs, without considering me a ‘fussy’ eater, and I can source whole food products more easily. However, as the Horizon programme showed there is a negative flip-side to clean eating. Most concerning is the rise in Orthorexia: a condition that includes symptoms of obsessive behaviour in pursuit of a healthy diet.
My response to Dr. Yeo’s investigation is conflicted. I applaud him for trying to address a lot of the misinformation that has grown around the clean eating concept. One such example is that gluten free is healthy. Many gluten free products are packed with sugar and other ingredients that are far from healthy and are often very expensive. Why, for instance, would you choose to buy expensive gluten free oats or avoid eating oats unless you are celiac or have a severe allergy to gluten?
The programme also importantly stressed that there is no scientific evidence that any particular diet or way of eating can solely cure you of being ill or prevent you from becoming sick. A common, and completely understandable, response for those diagnosed with gastroparesis is to assume that the elusive magic bullet lies in what you eat. Not so. Diet is an important part of managing symptoms but it is only one part: exercise, sleep, stress management, and appropriate medical treatment are all equally as important.
However, there were aspects of the Horizon programme that annoyed me. Firstly, why was Dr. Yeo’s focus on women? Why did he not include, Dale Pinnock, for example, who is a mainstream chef that often appears on television and advocates healthy eating? Secondly, Dr. Yeo made no attempt to disentangle healthy eating from clean eating. When we have a diabetes and obesity epidemic in the Western world, this was negligent. Eating more nutritious, unprocessed food does have health benefits. Thirdly, the Horizon investigation seemed, at times, to prioritise sensationalist reporting: Dr. Yeo appeared to dismiss, for example, without any explanation, the consumption of bone broth as a modern fad. Bone broth, with its high levels of gelatin, is a nourishing meal that is often easily digestible for those with sensitive stomachs. Gelatin has definitely helped soothe my gut. Far from being a modern fad, it has been used for many centuries as a nourishing meal for the sick.
So where do I stand in this debate? I stand with enjoying healthy, delicious, nutritious, nourishing unprocessed food. I stand with moderation, flexibility, diversity and abundance. In 2014, I went from someone who would eat anything to someone who could eat almost nothing. Not a day passes, when I am not thankful – truly grateful – for being able to now eat with pleasure, with enjoyment, with love.