FODMAP Sensitivity - The Most Annoying Food Restriction
(Originally posted by Michael on Pine Body + Mind’s website 2/15/24)
“What in the hell is a FODMAP?”
This was my question after hearing from a doctor that FODMAPs may be the cause of my mysterious, years-long digestive struggles.
Now seven years after my FODMAP awakening, I am here to proclaim that I think it is the most annoying and trickiest food restriction to manage. No disrespect to my lactose and gluten intolerant brothers and sisters out there, but at least most restaurants these days have alternate menus or symbols that signify what you can and can’t eat. When I ask waiters if they have any dishes without garlic or onions, they usually laugh or roll their eyes.
But let me start at the beginning…
My challenges started in my early twenties. I started to feel very bloated very often. This bloating was accompanied with pain and an urge to use the restroom but without results. The bloating and constipation would last for hours and even days. I was getting quite discouraged.
I didn’t get it. I was eating healthy - mostly fruits, vegetables and meats. Finally, after feeling generally shitty for a few years, I decided to see my primary care physician (PCP). This guy came to the conclusion, in under five minutes and without any testing, that I needed to use probiotics. So I started taking probiotics daily. This alleviated some symptoms for a while, but after a year of still feeling not great, I decided to go back to the same doctor. This time, he concluded, again in under five minutes with no tests, that I had too much acid in my stomach. So he told me to take Prilosec (an anti-acid, heartburn medication) every day. So I did that. For another year. Yet again, after some initial pain relief, my symptoms returned.
I decided to seek medical help again, but this time ditched the (former) PCP for a specialist - a gastroenterologist (GI). He first had me test for SIBO (small intestinal bacterial overgrowth) - finally someone willing to test for an issue rather than just throw a random “solution” at me. Unfortunately (fortunately?), I tested negative, so my issue remained a mystery. It was then that he concluded that I had Irritable Bowl Syndrome (IBS).
At last, someone had a diagnosis. Excited to finally be on the right track, or at least a track, I asked about the cause of IBS and how to cure it. Well…it turns out that there is no known cause or cure. Fantastic.
But, the nice enough GI doc recommended the low-FODMAP diet.
So…what in the hell is a FODMAP?
FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols) encompass a group of fermentable short-chain carbohydrates (sugars). They are classified into four main categories: oligosaccharides, disaccharides, monosaccharides, and polyols. Each category can be broken down into subgroups that consist of specific types of sugars and fibers that can be poorly absorbed in the small intestine by some people notoriously triggering digestive symptoms such as bloating, gas, and abdominal pain. These subgroups include (with some examples of foods where they’re found):
Oligosaccharides:
Fructans: Found in garlic, onions, wheat, rye, leeks, asparagus, artichokes, and some legumes.
Galacto-oligosaccharides (GOS): Present in legumes like chickpeas, lentils, and beans.
Disaccharides:
Lactose: Found in dairy products such as milk, yogurt, and soft cheeses.
Monosaccharides:
Fructose: Present in honey, apples, pears, mangoes, watermelon, and high-fructose corn syrup.
Excess Fructose: When the ratio of fructose to glucose is high, it can be problematic. Foods with excess fructose include certain fruits like apples, pears, and sweeteners like honey and agave nectar.
Polyols:
Sorbitol: Found in stone fruits like cherries, peaches, and plums, as well as some sugar-free gums and mints.
Mannitol: Present in mushrooms and cauliflower, and can also be used as a sweetener in some sugar-free products.
Some people, like yours truly, have a tougher time digesting a variety of these FODMAPs than others. The only way to figure out which of the FODMAPs you’re sensitive is to do a very restrictive elimination diet where you cut out all FODMAPs, then to start reintroducing potential trigger foods one FODMAP at a time. It sucks. But, it doesn’t suck nearly as a bad as being constantly bloated.
So after going through my elimination diet, I determined that I really only had an issue with one subgroup - fructans. That means I can eat lactose, fructose, sorbitol, mannitol and (some) galacto-oligosaccharides pain free! Great news, right?
Yes, but fructans are in a variety of fruits, vegetables, legumes and grains, and the main two villains in this category for me are onions and garlic. This was devastating news to my Greek tastebuds. Not only because I LOVE onions and garlic, but also because they are in EVERYTHING.
Most sauces and condiments contain one or both (this includes garlic and onion powder). Don’t believe me? Go to the grocery store and try to find a condiment, salad dressing, marinade, etc. without one or both. Good luck.
So that was challenge number one, but I’ve learned to cook at home without my former favorite staples (more on that later).
The second and much more difficult challenge is eating out. It is such a pain both physically and emotionally. As mentioned before, the look, laugh, or eye roll I get from waiters when I ask if they can make a dish without onions or garlic is tough enough, but the real soul crusher is when I finally receive that beautiful looking bowl of bolognese over pappardelle and find it to taste rather…bland.
You might think, “Well yeah, Michael, you were ordering food at an Italian restaurant. Surely there are other types of cuisines that aren’t known for heavy garlic and onion use.”
Oh yeah? Which ones?
Mexican - sure, easy enough to ask sin cebollas, but good luck finding a pico de gallo sin cebollas. Or a salsa. Or any meat that hasn’t been marinated with garlic.
American - sandwiches, salads, and burgers are sometimes ok. Just don’t count on that tasty dressing, or the cold cuts, or that crunchy onion on top of the burger. And this is assuming the burger is prepared without using onions/garlic.
Japanese - sushi is doable, just make sure to ask no onions/garlic. Forget about ramen.
Mediterranean/Indian/Chinese/Thai/Middle Eastern - lol
You get the point. It’s hard. But I’m not here just to complain.
If you determine that you are also fructan sensitive, there is a way forward!
First, with cooking at home - learn how to flavor dishes without onions and garlic. It might seem tough at first, but here are two cheat codes for you:
Fructans don’t transfer in oil, so if you sauté onions/garlic in oil but then remove the onions/garlic, your oil will retain the flavor without the fructans. Enjoy! If you are trying to save time, you can buy oil that is pre-infused with the flavor. My favorite is Garlic Gold.
The green part of green onions, chives and leeks are safe to eat, but do not use the white and bulb parts. This way you can infuse some onion flavor into your dishes without the pain.
Second, with eating out - don’t be discouraged by the reactions of the wait staff. Be confident and steadfast about what you can’t eat. I know it’s tough, and I know you think you can just suck up the pain, but don’t do it! My hope is that if more of us start to vocalize our sensitivity then restaurants and society will begin to take notice. One day we might have our own symbols on the menu to signify what’s safe for us to eat. (If you find yourself out and simply unable to avoid eating trigger foods, you can try this digestive enzyme powder. I use it every once in a while when in a pinch. It’s not perfect, but it definitely helps)
I’ve learned that with my particular sensitivities, if I avoid onions and garlic, I feel pretty great about 95% of the time. While that’s about way better than I used to feel, it’s not 100%.
I am still on the hunt for a cure. I’ve tried probiotics, prebiotics, sporebiotics, celery juice, hot lemon water, apple cider vinegar, just to name a few.
I haven’t found the magic bullet yet, but I will. Until then, my slightly restricted diet will have to do.
If you’re having similar struggles and haven’t found a solution, please reach out. I’d love to share more of what I’ve learned and hopefully help find you some relief.
The Real Secret to Getting Fit
(Originally posted by Michael on Pine Body + Mind’s website 1/10/24)
The real secret to getting fit is…
DRUM ROLL PLEASE!
….that there is no secret.
“Exercise might be the most potent “drug” we have for extending the quality and perhaps quantity of our years of life.”
— Peter Attia, MD, author of Outlive: The Science & Art of Longevity
Exercise. Is. Necessary. This doesn’t mean you have to go to a gym or lift weights or run on the treadmill, but you do need to do a combination of resistance, cardio, and stability training. What this exactly looks like should be based on what you enjoy so you consistently do it. That’s the most important thing. Secondarily, ensure you’re doing a combination of resistance training (building strength), cardio (improving heart and lung health), and stability training (preventing injury and increasing performance).
“Eat food, not too much, mostly plants.”
— Michael Pollan, In Defense of Food
Eating healthy really isn’t hard. But breaking the habit of unhealthy eating can be. And that’s by design. Junk food is specifically made to be highly palatable so that you eat a lot of it, and processed food is often cheap and convenient. So breaking the habit of choosing these foods definitely can be challenging. But once you do, once you start eating a primarily whole foods diet and are able to stick with it for a period of time, you will see how easy it is. You will start to be grossed out by some of the processed food you used to eat - you’ll start to see it for the junk that it really is. In the words of one of my favorite authors, Michael Pollan, “Eat food, not too much, mostly plants.” (By “food” he means real, whole food. Ya know, animals and the stuff that grows out of the ground.)
“The shorter your sleep, the shorter your life. The leading causes of disease and death in developed nations—diseases that are crippling health-care systems, such as heart disease, obesity, dementia, diabetes, and cancer—all have recognized causal links to a lack of sleep.”
— Matthew Walker, Why We Sleep
Sleep is truly the most underrated and neglected aspect of our health. I believe our attitudes towards sleep and the “I’ll sleep when I’m dead” hustle culture of our modern western world will be something we look back on in the not-too-distant future with genuine regret. Poor sleep has been linked to a higher risk of dementia, cancer, heart disease, diabetes, and obesity just to name a few. But I’m not going to list all of the ways that sleep improves health or reference the countless studies that show the impact of good vs. bad sleep because you need an entire book to convey all of this information. Thankfully, this book exists, and it’s written by one of the leading sleep scientists in the world. Why We Sleep by Matthew Walker should be a must read for everyone. I mean that literally. I highly recommend you check it out.
“Almost all our suffering is the product of our thoughts. We spend nearly every moment of our lives lost in thought, and hostage to the character of those thoughts. You can break this spell, but it takes training just like it takes training to defend yourself against a physical assault.”
— Sam Harris
Last, but definitely not least, is the mind. Actually, this is the most important aspect of your health and often times the root cause for everything you currently have or want to change. I’m not going to pretend that I have my mind figured out, I definitely don’t. Unpacking the mind, processing trauma and old wounds, detaching your mind from your thoughts, and freeing yourself from the struggles of stress, depression, and anxiety is a life-long journey. It’s one that I didn’t start taking seriously until just a few years ago, and I can’t believe I neglected something so important for so long. I know I’m going to sound like a broken record, but what you do for your mind has to work for you. You don’t have to meditate, or journal, or do yoga, or pray, or read, or see a therapist, etc., but you do have to do something. If you let your thoughts control your mind and/or shove your emotions down deep, not only are you hurting yourself but also those closest to you. You can have the nicest body in the world, but if you are deeply unhappy, sad, or anxious, what’s the point?
I say all of this to you not as someone who has it all figured out. I don’t have a perfect body, or eat a 100% healthy diet, or get my eight hours of sleep every night, and I’m certainly not “enlightened” or free of stress and anxiety. But I do pretty well, and I know all of these “secrets to getting fit” - the fad diets, weight-loss drugs, sleeping pills, and “don’t be soft” mindsets - are a bunch of bullshit. There is no secret. You have to do the work. The key is finding the the exercises and foods you like, creating a schedule that gives you ample sleep opportunity, and taking care of yourself mentally so that none of this feels like work.
New Year’s Resolutions
(Originally posted on by Michael on Pine Body + Mind’s website 1/1/24)
It’s that time of year again! The time for new beginnings, new goals, a new year.
I’ve always known health and fitness goals were popular New Year resolutions, but after doing some research it surprised me just how popular they are. According to the most recent Forbes Health/OnePoll survey, the top five New Year’s Resolutions for 2024 are:
Improved fitness
Improved finances
Improved mental health
Lose weight
Improved diet
Four of the top five center around health! But crucially, only 20% of people said they believe they can keep themselves accountable to these goals. This is exactly the statistic that I was looking for. I’ve had numerous health related resolutions over the years, and I’m pretty happy to say that I’ve stuck with many of them, but they are tough! Changing habits is a difficult task and all health related changes take time. That said, there are things you can do to help set yourself up for success. Having the proper support system in place is a surefire way to do this, and health coaching is a great option to help you set achievable goals and stick to your plan.
Whether you choose to work with a coach or not, keep these tips in mind for your health related resolutions (really any resolution):
CHANGE TAKES TIME. Be patient and compassionate with yourself. There are no overnight successes in health. Quick fixes in health are often fleeting and unsustainable.
SET REALISTIC GOALS. Unless you have hours and hours every day to train and cook, you aren’t going to look like Thor or Wonder Woman. (I (embarrassingly) know this from experience. I tried to put myself on the Chris Hemsworth workout plan for the movie Thor. Truthfully, the workouts were tough but doable. It was the eating that was ridiculous and unsustainable. Chris would eat 6-10 meals and around 4,000-5,000 calories per day. I neither have the appetite nor bank account for that kind of diet!)
START SMALL. Incremental change is much easier than doing everything at once. Let your successes snowball into the change you want to see. You can always increase the amount of time you workout, the intensity of the workout, your caloric deficit for weight loss, etc. It’s much harder to start with an unrealistic goal that will be too difficult to reach and leave you feeling disappointed and/or lead to self judgement.
FIND WHAT YOU ENJOY. I cannot emphasize this enough. You will never adhere to a plan that you hate, even if it’s “good” for you. I didn’t do cardio for years because I thought that meant running, and I HATE running (future blog post coming discussing why running is the worst). There are other options out there - you need to find what excites you. I’ve rediscovered my childhood love of biking. I cycle 3-4 times a week or basically every other day. My love of “cardio” is now at the point where on my days off I’m disappointed that it’s not a bike day. Find your love and cardio becomes something you look forward to.
BELIEVE IN YOURSELF. You are choosing to get healthy for you. Be your biggest cheerleader and supporter. You deserve it.
Happy New Year Everyone! Let 2024 be a healthy, productive, and prosperous year for us all!