IN MY FIRST BOOK, Living with Crohn’s & Colitis: A Comprehensive Naturopathic Guide for Complete Digestive Wellness, Dr. Jessica Black and I argue that eating well is key in prevention and treatment of digestive diseases, including Crohn’s disease, ulcerative colitis, and other diseases of the gut. Why are autoimmune diseases on the rise across the board in the world today? Some theories include the advent of refrigeration and the overuse of antibiotics. However the basic fact that our bodies have trouble digesting over-refined foods is argument for a simple diet that is easy to cook, to chew, and to digest: for example, steamed or roasted veggies, rice, and some protein (tofu or chicken). Our first book advocated an anti-inflammation diet, joining a farmshare/CSA, slowing down, and de-stressing life. Now, with Living with Crohn’s & Colitis Cookbook, we will guide you step-by-step in integrating this simple and nutritious diet into your everyday life.
Why are people suffering from the debilitating effects of Inflammatory Bowel Disease (IBD) across the board in the United States, and in other developed countries?
It is no secret that ulcerative colitis and Crohn’s disease are on the rise, and a new study traces how a typical Western diet that is high in saturated fats (found in dairy products, baked goods, and processed foods) may increase the chance of an imbalance in the gut microbes. According to a recent article in Scientific American’s Health Blog by Katherine Harmon, Crohn’s and colitis (inflammation of the large intestine that can cause pain and diarrhea) seems to run in families, but not everyone with the genetic risk gets the disease. Because of this, scientists have presumed that an environmental trigger initiates the disease.
According to Eugene Chang, a professor of medicine at the University of Chicago and co-author of a new study published in Nature, “Moving from elevated risk to the development of the disease seems to require a second event, which may be encountered because of our changing lifestyle.”
Chang and his colleagues traced how saturated fats, particularly those from dairy, which are also present in many baked goods and processed foods, can change the composition of naturally harmless bacteria in the gut. As the balance of bacteria species shifts, it can trigger an immune response that results in inflammation and tissue damage.
The word “inflammatory” literally means relating to or causing inflammation of a part of the body. In Dr. Chang’s study, comparisons were studied between a group of mice with a genetic predisposition for intestinal disease which were fed a diet high in dairy and saturated fats, versus a group with the same genetic predisposition which were fed a diet low in saturated fats.
The mice that were genetically predisposed and fed a diet high in dairy and saturated fat developed a harmful bacteria (with an extremely poetic name), Bilophila wadsworthia, which is also found in patients with intestinal diseases. In fact, the team at the University of Chicago found that the mice with the increase in harmful bacteria went on to develop an immuno-activated response that created subsequent inflammation.
What can we learn from this study? First of all, I want to applaud Dr. Chang and his team, as well as the excellent reporting by Katherine Harmon and the publishers of Nature and Scientific American. Those of us who live daily with inflammatory bowel disease are anticipating that this knowledge will help us find a cure that doesn’t depend on drugs to suppress the entire immune system (a treatment that often creates other health problems).
As a layperson and author who struggles with Crohn’s-Colitis, I follow blogs and scientific journals with the zeal of a medical student doing a GI rotation. Call me crazy, but I am not going to sit around getting sicker and waiting for the doctors to complete long term trials and simulations. We can start by eating a simple, structured diet; what I like to refer to as a diet where we “eat food with one ingredient.”
Next, we can keep a food journal. Start by eliminating dairy for three days and see if that helps, then record what you eat—usually small frequent meals are best: oatmeal in the morning, followed by a hard-boiled egg at 10:30, lunch is a spinach salad with turkey and a rice cake, afternoon snack can be raisins and almonds or carrots and pure hummus with garlic and lemon, and dinner is beans and rice or baked chicken or fish with steamed broccoli. (All of these are just suggestions, if tolerated, as everyone is different!)
I have not eaten wheat for seven years, which has been of great benefit. Though I still love dairy products, like cheese and yogurt, I gave them up a year ago. I recommend cutting back on dairy, switching to lower fat cheeses like provolone, and making your own yogurt by following the Specific Carbohydrate Diet (SCD) book, Breaking the Vicious Cycle by Elaine Gottschall.
Adding probiotics to your diet with a daily supplement is also a great way to help balance the gut microbial balance. I use All-Flora Probiotics by Metangenics. When I am traveling, I use the great Jarrow product, Jarro-Dophilus EPS, which has 5 billion organisms per capsule.
Don’t forget to exercise, eat a balanced diet with small frequent meals, keep a food journal daily, get lots of sleep (eight hours is recommended), and add holistic and complementary treatments to your lifestyle, such as acupuncture, daily yoga, and meditation, as outlined in my previous book Living with Crohn’s & Colitis.
I love to travel and left home when I was eighteen to live in Europe by myself for a year. I settled in Vienna, Austria, and loved the culture and the people. The diet, however, was not the healthiest, and I gained twenty-five pounds by subsisting on Würst, bread, and of course, beer. I remember, when I came back from Europe, my father looked at me and said, “you’ve gained twice the Freshman 15, and you didn’t even go to college!”
Well, here I am, many years later—with college, marriage, and three wonderful children behind me—and I have to say that the one good thing that having Crohn’s disease has done is that I no longer worry about my weight, and I just eat what I can and make no apologies to anyone. My weight has stayed at around 140, which my gastroenterologist says is perfect because I eat healthy food all the time—hardly any sugar, no fried food, no wheat, and very low-fat dairy—and I exercise daily, and maintain a low-stress lifestyle.
The reason I was motivated to write this cookbook was not to talk about our American culture’s unhealthy obsession with being thin as a sign of success; I wrote it to talk about the opposite—I hope the recipes in this book will encourage you to learn to eat, cook (and even grow!) healthy food, love your body and cherish your family, and take responsibility for your own health and education.
I say this because for years, I wallowed in self-pitying behavior during my Crohn’s flares, which occurred monthly and had the nasty habit of coinciding with my menstrual period. I used to crawl into bed and sometimes cry quietly, so as not to disturb my kids. After driving the kids to school (during one of these flares), I would frequently pull over to the side of the road in my car, and just put my head on the steering wheel and sob. It took me years to ask for help, and by the time I was finally diagnosed, my disease had basically devoured my terminal ileum, for it was beyond repair due to repeated flares leading to scarring.
So having first had symptoms of ulcerative colitis (I have this, too!) after I returned from Vienna (remember my unhealthy lifestyle, horrible diet, and self-loathing attitude?), fast forward to 2006, to when I was admitted to the ER with a stomach the size of a basketball and a severely impacted bowel that was about to rupture. I finally admitted that I was one sick person and I needed help.
That was my first step toward getting well. In the past, I would constantly think about what I could or could not eat to stay thin and be attractive. I smoked cigarettes to curb my appetite and utilized the diuretic aid that nicotine provides; I also worked all the time and exercised in fits and starts, and tried to diet, off and on, but always gained the weight back.
Having my kids and going through childbirth helped me let go of inhibitions and was a great release for me. I always wanted to be trim and fit and “in control.” One thing I’ve learned from having Crohn’s is that sometimes when you lie on the cold and smelly bathroom floor with your arms wrapped around the toilet crying and in pain, you are clearly not in control!
After Jessica Black, N.D. and I came out with our Living with Crohn’s and Colitis book, I was interviewed by Linda Sparrowe, a writer from Yoga International, who wrote:
“A disordered body image isn’t always about weight, of course. Dede Cummings, a graphic designer from Vermont, remembers the time she was in a yoga class practicing handstand and her shirt came up, revealing a huge scar on her belly that she hated and felt ashamed of—a result of multiple surgeries. Her yoga teacher told her she was beautiful. ‘But my scar,’ she said. ‘Your scar is beautiful, too,’ he said. ‘It’s a part of who you are.’ ”
So for my fellow Crohn’s disease and ulcerative colitis readers, and people who love you who may also be reading, I urge you to let go, and by that I mean ask for help, but also study everything you can about your disease and admit you have a serious disease that can even lead to death. Don’t be polite at potluck dinner parties; at restaurants, ask for gluten-free pasta or rice, well-steamed fresh local veggies (especially available in summer), and baked fish specifically made for you if the menu doesn’t have easy-to-digest food you know you can tolerate. Don’t be afraid to take control of your health and get your life back on track—it is possible to enjoy an active fulfilling, healthy life with IBD!
In this book, I do not offer strict diet rules for “this or that digestive disease.” Instead, I offer up my own tried-and-true nutritional suggestions based on my interpretation of current medical research (remember, I follow gastroenterology papers, studies, and the like, with the zeal of a pre-medical student!), and personal stories that will, hopefully, help people cope, learn about their disease, and thrive!
The specific types of information you can expect to find in the following pages include tips for food shopping, a guide to keeping a food journal, and recipes for when you have a flare, plus recipes for typical daily life. I wrote this book to complement the work Jessica Black, N.D., and I presented in our first book, and I hope that you will be able to read that first or concurrently with this cookbook.
As you read, you will find recipes for making basic meals that are not complex and that use simple ingredients, plus staples that include how to make your own home-cooked chicken soup, rice, beans, guacamole, almond milk, and more.
I have also included some basic tips for food shopping along with information about how to avoid pesticide-tainted fruits and vegetables, joining a farmshare (CSA), and creating your own vegetable garden.
One of my basic premises in this cookbook is to help you plan and create an individualized diet just for you or for someone you love or care for who has inflammatory bowel disease. A daily food journal forms the foundation of the plan as do other holistic lifestyle activities including getting daily exercise and enough sleep, practicing yoga and meditation to calm your brain and relieve stress, and other health-promoting techniques you will learn about.
The recipes in this book are really unique and have been approved by many of my “Crohnie” and “UC-er” friends! There is a very strong community of IBD/IBS people out there (I honestly don’t like to use the word “sufferers” due to the negativity of the word), who share recipes, and I list many websites and places where you can get support.
It is my hope that those with Crohn’s or colitis, and variations of these diseases, and even those diagnosed with Irritable Bowel Syndrome (IBS), will be able to benefit from taking control of their own diet through using this cookbook.