Wednesday, March 28, 2018

Paleo titles

I've been pretty sick on and off for about a year, although not with anything that has a particular name.  Just sort of high "food intolerances" with overflowing "generalized inflammation" of multiple systems.  My doctor suggested an anti-inflammatory diet which has given me good results so far.

The Wahls protocol: How I beat progressive MS using Paleo principles and functional medicine, by Tery Wahls.  It will be hard to cover absolutely everything about this book, because there's so much going on-- the diet, the health information, how it applies to my heath, and also the writing technique and style.  I'm counting this as a "read" book, although, to be truthful, there were parts I skimmed (and a few non-relevant-to-me parts I totally skipped).

First, this is a useful book, for me and for other people with chronic autoimmune disorders.  I don't have MS but I do have multiple body systems suffering from general inflammation.  Although many sections in the book talk specifically about MS and/or brain-related disorders (Parkinson's comes up most frequently), most sections are applicable to a number of other autoimmune disorders.  It's clear why MS is the subject of the most specificity: that is the author's personal experience, and it's also the disease being targeted in her clinical trials.  Other immune/autoimmune disorders that share obviously similar body processes make sense to include and to treat similarly.  Less relevant or believable are the author's assertions that this diet would necessarily have profound impacts for people suffering from a wider variety of problems-- she suggests everything from depression and autism to diabetes and hormone disorders.  That strikes me as unsubstantiated.  While that ascertion makes me question the credibility, I can't see the harm in anyone trying a diet like this; unless you have very specific food problems, it is, at its base, a diet focused on fruits, vegetables, healthy fats, and lean meats.  It might not be the perfect help for someone with a mood disorder or thyroid problems, but it hardly seems likely to make it worse.  (I am not a doctor.  Ask yours.)

I have been on the "first level" of the proposed diet plan since 3/25, and I immediately saw an improvement in my symptoms.  I can't at this time say whether that means the book is mostly or entirely "right" about everything, but it's hard to argue with my results.  Caveat: I did have to modify the protocol to allow for my additional food allergies.  The base plan is to consume 9 cups daily of different types of fruits and vegetables, 3 each of leafy greens, sulfur-rich vegetables, and colorful fruits and vegetables.  Because I am allergic to (the high nickel content in) all leafy greens, I'm instead getting 4 cups, aiming for 6 cups, of other types of produce.  Between some gentle easing-in, modifications to level 1, and trying to incorporate what I can manage from level 2, I'm definitely in a class by myself.

In terms of some of the other science content, I'm not in the best position to judge.  I have seen more about Functional Medicine in the last few years, and a lot of what the author talks about seems to make sense, at least to me: all the body systems are interrelated and a problem in one area can cause inflammation in another system.  Stress, toxins, allergies, and illness all push on each other and on our bodies.  My experience the last year has been a bad domino effect: I struggled with a food allergy for several years but after a bone fracture last summer, things stacked up against me.  My food allergy became more sensitive, limiting even more what I could eat.  I developed secondary lactose intolerance.  I was unable to exercise effectively because of my recovery, then I was unable to exercise at all because of constant fatigue.  The sicker I felt, the fewer foods I could eat without issue.  These things all increased the stress at home; stress at home is always up and down because of kids, school, family, etc.  I was physically uncomfortable at best, feeling sick and miserable at worst, daily for more than 6 months.

Science-wise, I'm not in a position to say if the Functional Medicine approach behind the protocol is right, only that it seems to make sense.  It reassures me that the author is a clinically-trained physician from a "real" medical school and working in a "real" hospital.  The protocol is undergoing legitimate clinical trials (at least as a treatment for MS) so it does not strike me as faddish, hippy, or fringe.

The book is understandable for beginners without much formal science education.  I am new to reading about autoimmune problems and Functional Medicine, but I felt like I understood very well.  I do wish the tone was a little less informal-- the author uses exclamation marks all over the place; she's probably aiming for friendly and reassuring, which must be comforting to readers who are ill.  The writing doesn't *quite* feel dumbed-down, although it could maybe be described as hokey.  Although there are end notes, there isn't nearly enough in-text information: she tends to say "studies show" instead of saying "in a 2009 study which appeared in the peer reviewed [Journal]," which I felt would have added substantially to her credibility.

Finally, although many of the food rules and other life modifications (exercise, stress maintenance, etc.) seem reasonable, there were a few things here and there that struck me as the author not really being in touch with reality.  She talks about how normal people doing the clinical trials are able to do such and such or to make modifications to x, y, and z in their lives, but then she gives what she prefers, is able to do, or would highly suggest.  Ones that stuck out most to me were:
1.  For her exercise, the author swims every day in her home lap pool.  Then, for detoxification, she spends at least 30 minutes in her home sauna.  She mentions how this "probably" isn't an option for most people and that local fitness centers could be used.  Let's recognize, though, that there is a huge difference between being able to exercise at/around home and having to go out/elsewhere-- the difference is way bigger than the time spent in transit.
2.  The author suggests lunch menus, but admonishes people not to use microwaves.  It's not really clear where she is day-to-day or how she manages lunch, but a freshly-made hot lunch every day is out of the possibility at my work place's staff room.  Does your staff room have a cook top?  And cold lunch every single day?  I guess the suggested foods could be eaten cold but that doesn't seem very satisfying.  The mechanics of managing this were missing.
2.b. Although diet level 1 allows non-gluten carbs (corn, rice, potatoes), these aren't included in the example recipes.  She also doesn't talk at all about gluten-free prepared products (pasta, cereals, etc.).  With the emphasis on whole foods, they obviously aren't ideal, but quicker, convenient foods in the amount allowed (up to 1 serving per day) seem important to add variety, convenience, and comfort.

Overall, I'm impressed with my health results.  I'll be staying on this diet for at least a few weeks, until other tests or information suggest another course.  Book content: 4; book quality: 3.

Since the diets in The Wahl's protoco are Paleo, or at least kind of Paleo-ish, I checked out a stack of some of the more "normal" seeming Pale-type cookbooks from my library.  I have no opinion on whether Paleo is the "right" diet or if "everyone" should try it; this food modification is working for me right now, and here's how well these cookbooks stack up against my normal criteria for useful and accessible.

Well fed: Paleo recipes for people who love to eat by Melissa Joulwan.  The forward and introduction are warm and down to earth-- focusing on fresh foods that make you feel good, recognizing that people have work and commitments that take time.  The author is honest about occasionally cheating, and some other comments make it clear that this is a book for people who are going Paleo as a health optional choice, not a health requirement.  She also talks a bit about CrossFit; those two seem to pop up together a lot.

The book is also obviously for people for whom cooking from scratch will be a big change-- there are many pages of introduction to spices, kitchen gear, and meal planning, which seem informative but not daunting.  Despite that, some of the recipes seemed like they woud be a bit of a stretch for true novices: she gives a formula for "hot plate" fry-ups (3-6 oz protein of choice, 2 c veggies of choice, spices as desired) and gives some suggested combinations but it seemed maybe scary to have this in the front of the cooking section if people really don' know how to approach this type of cooking.

The recipes are all international flavors but definitely seem reasonable: nothing I couldn't find at my supermarket, and not a spiralizer in sight.  I wrote down a few recipes-- I was nearly salivating over some of the dressings-- and I will definitey be checking this out again if/once I get a possible-coconut-problem figured out.  (If I'm ok to eat coconut, I might even buy this for myself!)  Recommended for libraries and for Paleo eaters who like Asian and Middle Eastern foods.

Paleo comfort foods: Homestyle cooking for a gluten-free kitchen by Julie and Charles Mayfield.  This book seemed to suffer a bit of an identity crisis: most interpretations of "Paleo" equate to more than just guten-free but the authors are a little laissez faire about how they define things.  There is a lengthy introduction about each co-author (which I totally skipped), plus a short paragraph before every singe recipe about how it was made, which family member requests it, etc.; these added unnecessary clutter to what is a pretty thick book.  Readers are here for recipes, people.

Despite the title, this cookbook is pretty comprehensive, going far beyond "comfort foods"-- sides, main dishes, salads, soups-- although comforts like biscuits, fried chicken, and desserts do get some space.  However, most of these recipes seem a bit unnecessary; surely anyone embarking on Paleo recognizes they can have salsa, deviled eggs, and roasts-- things which seem too simple to have to include.  It felt like the authors were trying to bulk up the page count.  For a longer book, I wrote down fewer recipes than I did for Well fed.  Not recommended.

More Paleo cookbook reviews to come once my holds arrive!

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