This article about water rights is a little dry, but it's interesting in a socialism vs capitalism kind of way. I'm still trying to figure out where I stand on this spectrum and I'm leaning toward the opinion that limited socialism (for the goods and services necessary for life, maintenance of society, and preservation of the planet: water, power, security, health care, education, infrastructure, national parks, etc.) should be at least somewhat socialized and run by the government, to what extent I'm not sure, but then we should layer WELL REGULATED capitalism on top of that for everything else. Going all the way to full blown communism, where the state owns everything, was never a good idea; it kills creativity and entrepreneurship which are vital to a thriving society. But then I also think everyone should have the basics it takes to survive- clean air, clean water, decent food, shelter, and healthcare, because we have the resources for that in the US. Then everyone goes from there. Some will take advantage, settle for the "basic package", and not contribute anything extra, content to just live off of their small share, and I'm OK with that; for some, the disabled, the elderly, the ill, it will make a difference between life and death, and that's vitally important because everyone has value. I think enough of us will work and contribute to make something like this successful, and now with automation there will be less need for all of us to work anyway....

I need to do more research on this. I'm guessing there are countries where this is working, especially in Europe, so I'm curious to learn more. I know socialism isn't working for other countries, because they went too far. Venezuela comes to mind. The state grabbed ownership of everything, corruption set in, and everything descended into chaos. It's got to be a lot more complicated than that, but that's my surface understanding of the issue.

So some political ramblings for you. Just trying to figure things out.

First "Challenge": Xylitol

Things were going well with my low FODMaP eating plan, I was feeling good with my symptoms reduced, oh, 80% or so. Then I went back on my supplements. I take B12 (when you get older you don't absorb it as well from food so a supplement is beneficial), vitamin D (I had blood work that said I was deficient), and pro-biotics. After a few days I started feeling a heaviness in my lower belly area, which wasn't a good sign. The next day I was back to pre-diet pain levels and almost didn't go to an event I was looking forward to. (I went anyway and I got through it!! I was distracted with the great people I was able to talk to so I didn't focus on the pain as much, and I was very thankful I wasn't gassy.) Later that night I was trying to figure out what I could be doing wrong, what was I eating that I shouldn't? Light bulb- check the B12! It's a chewable so they put sweeteners in it, and sure enough, xylitol, which is a polyol, was on the label. (The "P" part of FODMaP.)

That counts as my first "challenge"! I didn't do it on purpose, but at least I figured it out. So I was eating cherries and honey AND taking the supplement with xylitol in it every morning. Good grief. Now I'm wondering about the cherries and honey though, were they really the problem? Maybe they were, but I'll have to challenge with them later to find out. Right now I have to wait and get the xylitol out of my system and get my symptoms back under control again. Sigh...

What this points out, though, is how difficult it is to tease out what's causing symptoms. I took the B12 for four or five days before it started to bother me, and my worst day was when I had a late breakfast one day then an early breakfast the next. I take my supplements with my breakfast, so it was less than 24 hours between doses. Some triggers are OK in small amounts, or when they are spaced out far enough. They cause symptoms only after building up in your system.

I've posted about IBS and this low FODMaP eating plan on Facebook a few times and now so many people are talking to me about also having IBS, or telling me their loved ones have IBS. Statistics as to how many people have IBS vary from 10 to 25% of the population, and since so many people are undiagnosed, or wait years before getting diagnosed, the 25% is probably more accurate. That's a quarter of the population!! Of course lots of people have it or know someone who has it!! We need to talk about these things more. Eating a low FODMaP diet will be so much easier if more people are talking about it and looking for low FODMaP food; there are organizations that will certify processed food as low FODMaP. Look at the gluten free craze and how many gluten free products there are now! The thing is- for people with IBS and not celiac disease or gluten allergies specifically, going gluten free helps them by cutting out not the gluten but the fructans that are in wheat. So they feel better, and they think it's because they are gluten free, but really it's due to cutting out a FODMaP.

My advice from everything I've researched- if you are having intestinal issues, stomach pain, not-normal bowel habits, gas, bloating, etc., go to your doctor. If your doctor rules out Crohn's, colitis, cancer, celiac disease, etc., and gives you a diagnosis of IBS, then try the low FODMaP eating plan. If the doctor gives you the same print out mine gave me, don't despair!! The "good" list and the "bad" list on that print out are very short. You can eat a lot more than it says, and there are lots of resources on-line to help you out. It helps to eat whole foods and cook for yourself, but you have to know which whole foods to eat and which to avoid. Eating out and processed foods will be difficult- I haven't faced that yet, but I'll learn as I go! (Eating out is something I'll have to talk to a dietitian about.) It's possible to get through this, and 80% of people with IBS feel better when they know what to eat and what to avoid. Sometimes it will be "damn the torpedoes", I'll eat what I want and suffer the consequences, but at least I'll know why I'm hurting and will keep it to a once in a while splurge when I can recuperate the next day.

PS: I mentioned that the doctor recommended daily Zantac in my last post. I only took it for a day or two then I was feeling so much better I stopped taking it!! :) I'm taking the pro-biotics she suggested every day.

Time to Fire Up the Blog Again!! Low FODMaP Reports

It's been almost two years!! Hello again! A lot has happened in the intervening time, but what I want to write about now is my experience going on a low FODMaP elimination diet. I first heard about the low FODMaP diet on an episode of "The Food Hospital" several years ago. (Go to about 25:20 to get to the IBS part, the follow up is at about 36:30). I don't know why I didn't try it then, maybe my symptoms weren't too bad at that point? I was definitely diagnosed as having IBS by then. I forgot about it and went along with life, but then I've recently experienced some severe flare ups. I thought it must be something else, maybe I have an ulcer from taking an NSAID every day for arthritis and fibromyalgia, or gallstones, or whatever, since this was so much worse than flare ups in the past. I had a bout of food poisoning (??) back in late December and just never felt right in my stomach since then, so maybe it was from that. I had my suspicions, but no definite answers, and my stomach was hurting all the time. I went to my GP and she referred me to a gastro doctor (and getting in to see her was a whole different story for another time- it was quite an ordeal). While waiting months for that appointment I had such bad diarrhea (sorry, when talking about IBS these things come up) that I wound up at urgent care, then they sent me to the ER for a CT scan and IV fluids. Fortunately my gastro appointment was within a week and a half of all of that. When I went in to see her she immediately zeroed in on the IBS as a source of the pain, no mention of an ulcer or gallstones, and came up with a treatment plan. She told me to go on a low FODMaP diet, take Zantac twice a day, and take pro-biotics. She gave me a print out with a list of OK foods and a list of high FODMaP foods to avoid. A very short list. A very limited list. A very discouraging list.

Luckily we have the internet!!! I immediately started researching and found longer lists of things to eat, although there is some conflicting information out there, but whatever, I had a place to start. I ordered a couple of e-books, and found that the research for the low FODMaP diet originated at Monash University in Australia. I've been watching You Tube videos as well, anything I can find on following the low FODMaP eating plan. Here's what I've learned, some of my experiences, and some things I'm eating!

1. FODMaP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols. These are foods that don't digest properly for a large number of people with IBS. These carbohydrate chains are supposed to break down in your small intestines but they don't, so they move into your large intestines where two things happen. Due to osmosis and your body trying to balance out the liquids in your bowels, excess water is drawn in to compensate for all of the extra molecules of these carbs floating around where they aren't supposed to be. In addition, the bacteria that live in your large intestine party on all of the extra food, and when they party they produce gas. Lots and lots of gas. The combination of the extra water and the extra gas cause bloating, diarrhea, distention, and, just for fun, lots of stinky farts. Oh, joy!

2. I recently switched up my morning breakfast. I typically eat the same breakfast every single day of the world, just because it's easy and I don't have to think about it. I mix things up once in a blue moon, and I recently switched from packets of oatmeal to quick oats. I would have two packets, one plain and one sweetened with maple syrup. When I switched to plain quick oats I started using honey as my sweetener. I also pile on fruit and a few months ago I changed from frozen strawberries to frozen cherries. (I like the frozen fruit because it keeps so much longer, plus it makes a nice contrast between the hot oatmeal and the cold fruit.) Now that I'm learning about FODMaPs, I realized I was hitting my tummy with a double whammy first thing in the morning. Both honey AND cherries are high in FODMaPs!! So all of that misery was self inflicted. I did try to switch things up- I was adding walnuts but I thought the nuts were too harsh so I stopped that, I thought maybe the supplements I was taking were the problem so I stopped those, I stopped my daily NSAID, I tried eating mild foods the rest of the day, (although the "mild" food I was eating was also high in FODMaPs), but my stomach still hurt. I kind of thought maybe the cherries, but I never suspected the honey until I got the list of high FODMaP food. Both cherries and honey!! Sheese. Also the mild foods I was trying? Yep, high FODMaPs. Pasta, toast, crackers, etc. I was doing it wrong.

3. When the doctor gave me the print out for the low FODMaP eating plan, it didn't come with much explanation. There is a list of food on the front, half low FODMaP allowed foods, half high FODMaP foods to avoid, and a couple of short paragraphs of explanation on the back. It just isn't enough information to radically change your eating habits, but it was a start. I googled other FODMaP lists and went to the grocery because I wanted to start right away. I'm sick and tired of being in pain all the time, and if this was going to help I wanted to go for it! It's been less than a week so far and I think I've done quite well, if I do say so myself. I have a few things going for me, though. I've taken coursework in nutrition and I'm certified to teach health so I have the background to implement this eating plan without consulting a nutritionist, at least not to start out with. (I may do that later because I think it's a good idea, I just don't need to rush it.) I also cook my own food most of the time, even in a family of 5. We all eat so differently! My oldest is vegan, my husband is vegetarian, my son is super picky, and my middle child has a completely different schedule than the rest of us. My kitchen is always a disaster with 5 people in there preparing meals every day, but it means I'm used to cooking for myself. I also have some food sensitivities that I've known about for a while (soy and sulfates) so I'm used to reading labels and working around common ingredients, and I hate most processed food. I can't stand microwave meals, for instance, so giving up that type of food is not an issue for me at all. I cook with whole foods as much as possible, so this eating plan just means switching up the high FODMaP whole foods for low FODMaP whole foods. Not a big deal. My breakfast, for instance- I went back to frozen strawberries instead of frozen cherries (I also throw on some fresh blueberries every day since they're in season now and they're low FODMaP) and use plain sugar (just a little bit) as my sweetener. I also throw on some raisins (the FODMaP lists say up to a tablespoon of raisins is OK) and I've added back my walnuts, but only 10, because any more might cause some FODMaP issues. (Portion size affects the FODMaP load too- there are some foods that are OK in small amounts.)

4. The low FODMaP eating plan (which is actually a more accurate description that "diet", because the goal isn't weight loss, the goal is to feel better) is a temporary elimination food plan. You go on it and let your body heal from the damage you've been doing with high FODMaP foods, then the goal is to slowly "challenge" with various categories of high FODMaP foods to determine which ones you are OK with and which ones are a problem for you. From my research, the elimination phase can last anywhere from 2 to 8 weeks, depending on how you react to it. I'm already feeling so much better (I think from just giving up the cherries and honey!!) so I may be able to start challenging pretty quickly. I'll write more about the challenge stage when I get there.

5. I've started eating tomatoes and salad again- hooray!! When my stomach started hurting all the time I gave up salads because maybe roughage was the problem? I can enjoy them again because tomatoes and lettuce are low FODMaP foods, which makes me very happy, because I was eating salads as a meal several times every week. I did have to rethink my salad dressing, but I found a recipe for a homemade version that's OK. I had to give up avocados, which is a favorite food for me (but they are OK in very small quantities so I think I'll try that and see how I do), but other than that my salads are pretty much the same. I even found some fantastic gluten free crackers that I can crumble up and use as croutons. (Gluten isn't the problem for IBS sufferers, it's the wheat itself which contains fructans, an oligosaccharide, so gluten free products are sometimes accidentally low in FODMaPs, but you have to read the label. They could also be sweetened with honey, for instance, or contain other problem ingredients.)

What I've been eating:
Breakfast:
I follow package directions to cook half a cup of oatmeal in the microwave with a pinch of salt. Once that's cooked, I sprinkle on some cinnamon to taste and maybe a teaspoon of sugar, if that, and mix that in. I add a tablespoon of raisins, 10 walnut halves broken up, and about half a cup of berries. Lately it's been the frozen strawberries, some blueberries, and for the past few days I even included some raspberries since I found a nice package of them at the grocery.

Lunches and Dinners:
I have to pair these up because lunch one day is dinner the next, or vice versa- dinner one day is lunch the next! *See note below regarding pairing up meals; not the best idea for the elimination phase!

I like to pre-prep chicken so I have a quick protein ready to go. I saute about a pound and a half of boneless skinless breast or tenders in a frying pan with a small amount of olive oil and season it with salt, pepper, sage, thyme, and marjoram. (I used to use poultry seasoning but that's a no-no because of onion and garlic powder.) I pair that with a carb of some sort. I made up a batch of quinoa (switching from high FODMaP pasta) and used that as my carb a couple of times, once with just the chicken and some glazed carrots, once on a salad. Literally. I had quinoa with chicken and a side of glazed carrots for dinner, then the next day I put the leftover chicken, quinoa, and carrots over lettuce with tomatoes, cucumbers, and orange bits for a salad. Delicious both ways. I found a chicken stock base that doesn't have any garlic or onion listed in the ingredients and used a bit of that to flavor the quinoa when it was cooking, and I almost forgot- I put in a glob when I was cooking the chicken then added water slowly while stirring it into the chicken stock base. I like to do this when the chicken is just about cooked through and let it finish up with some liquid in the pan, which makes it moist and yummy.

Another lunch/dinner combo from today:
I made a baked potato and I wanted beef instead of chicken to top it with, just to mix things up a bit. I always use either 90% or 95% lean ground beef and saute it in a frying pan with olive oil. Today I seasoned it with salt and pepper to taste, then I was going for kind of a chili feel but I'm not big on heat in my food (heat always upsets my tummy) so I just threw in about a third of a can of diced tomatoes at the end of cooking time. The potato was giant so I halved it and added a little bit of cheddar (acceptably low FODMaP since it's a hard cheese) then topped it with half of the beef and tomato mixture. I did the same to the other half and put that away for dinner. It turned out just the way I wanted it!

Snacks:
I absolutely love fruit and I'm pleased that oranges, grapes, and not-super-ripe bananas are low in FODMaPs, so I'm eating those. I have to watch portion sizes though- from what I've read about half a cup or one serving of any kind of fruit is the max that's advisable at any one time. You can have more during the day but it just needs to be spaced out by a few hours to give your body time to digest everything. Popcorn is also OK so that's been a good snack. Corn tortilla chips are OK. I found some allergy friendly cookies that are pretty good too, and they come in individual packets so already portion controlled. I had a small piece of dark chocolate today too- yum. Those gluten free crackers (linked above) are great as well. Today I even had bread! According to Monash University, sourdough bread is acceptable in small quantities, depending on the ingredients it's made with. Whole Foods had a great sourdough loaf in the bakery today with very few ingredients, including whole grain flour. Apparently the fermentation process sourdough goes through breaks down the problem carbs in wheat so it's low in FODMaPs- hooray!!

Shopping:
I scoured the three grocery stores I shop at (Costco, Whole Foods, and Publix) for ingredients. I read a lot of labels, as is my habit anyway. I took a picture of the food lists I was using (from the doctor and one I found on-line) with my phone and referred to those often. Before I went shopping I combed through the lists and starred ingredients I like and crossed out things I don't like, and made sure I was familiar with the list of foods to avoid. I Googled a few items I was unsure of in the store. I am most likely going to get the Monash University app one of these days- it's $9.00 so that's reasonable, and it's apparently invaluable when shopping for low FODMap foods.

I have enough low FODMaP food for a good, varied diet for the next few days so I feel I've made a good start, and I'm only a few days in so I'd say so far, so good!!

*Today, of course, I ran across a video that says it's not good to eat the same thing for two meals in a row because you're getting the same FODMaPs without enough time in between. The suggestion is to wait 24 hours before eating leftovers for a second meal.

Pinterest link: I'm pinning lots of FODMaP info on my Food: Low FODMaP Recipes and Info Board