Friday, October 23, 2009

For My Pumpkin, With Love

My Pumpkin has a head full of wild blonde curls and the roundest, fullest cheeks I’ve ever seen.  She has tiny hands and feet, and she likes to hold my hand when we walk down stairs together.  She loves raisins and watermelon, honey and strawberries, the latter of which she calls “gaw-bewies.”  Her favorite color is pink, and she likes us to coordinate so that we wear our pink tank tops or pink sweaters on the same days.  My Pumpkin enjoys watching the adventures of a pink pig named Olivia, which she pronounces “O-Lydia.”  While she watches Olivia, she tucks her thumb in her mouth and twirls a blonde curl around her finger.  She likes to help us cook, especially when the cap to the honey bottle needs to be cleaned out.  She’s our little honey bear.

My Pumpkin is my niece Lydia, and she is three years old.  Lydia cannot eat gluten or corn, and we don’t know why.  When she does eat these foods, she gets a rash on her bottom and complains that it hurts.  We do not know what these foods are doing to her body on the inside.

Lydia’s food sensitivities could be a result of any number of things.  She may have celiac disease.  She could be experiencing ulcerative colitis, irritable bowel syndrome, or Crohn’s disease.  She may have food allergies.  Whatever it is, it’s not good.  For about eighteen months of her life, Lydia didn’t gain any weight.  She was a huge baby at birth—a ten-pounder!—but from about eighteen months to three years old, she didn’t gain any weight.  Over the summer, Lydia and her mother drastically changed their eating habits, cutting out all grains, and after just two and half months on this new diet, Lydia has put on four pounds.  Her mother, my sister-in-law Amanda, is absolutely thrilled.

This decision to cut out grains completely was not a willy-nilly decision.  Nor are the food restrictions limited to grains.  At some point in her research, Amanda discovered a diet plan called the Specific Carbohydrate Diet that follows a simple plan for healing the gut: do not eat complex carbohydrates that cannot be digested by a damaged intestine.  Eat simple, whole foods, allow the body to heal itself through nutrition, and enjoy delicious, pain-free meals.

To be honest, I was shocked when Amanda told me about the Specific Carbohydrate Diet.  Cut out all grains?  WHAT?!?  Why on earth would you want to do that?  I could not imagine a life without grains.  No wheat, corn, oats, rice, or cereal.  I think a gluten-free life sounds hard enough, but no oatmeal, not even when it’s made with certified gluten-free oats?  No rice on which to ladle spicy stews?  No granola or cookies for snacks or desserts?  It sounded so awful that I wanted to hide in the pantry with a bag of oatmeal cookies to soothe myself.

Prior to starting the Specific Carbohydrate Diet, Amanda and Lydia had eliminated wheat and corn from their diets.  I had finally adjusted to this change when they started their new diet.  Why, I wondered, is it not enough to avoid wheat and corn?  The answer is that the Specific Carbohydrate Diet (SCD) offers the possibility of completely healing Lydia’s body of her food sensitivities.  Gluten-free diets offer no such hope.  For example, outside of SCD communities, celiacs are told that they will have to avoid gluten for the rest of their lives.  This prognosis is cheerful only if it relieves the symptoms of celiac disease.  But one study estimates that 18%—almost one in five—of celiac patients do not respond to the gluten-free diet.

One in five.  Count the fingers on your hand.  One of those fingers is a person with celiac disease for whom avoiding gluten is not enough.

Before gluten became the answer to celiac disease, a team of doctors had found that eliminating most carbohydrates, especially grains, helped celiac patients immensely.  The original SCD patients ate a diet rich in fruits and vegetables (with the exception of a few starchy ones like corn and potatoes), meat, fish, unrefined sweeteners such as honey, and cultured dairy products.  That last item was particularly important: the bacteria in yogurt could improve digestion by repopulating the intestines with so-called “good bacteria,” which could help reduce populations of “bad bacteria” that interfere with absorption of nutrients.  But what was really remarkable about the original SCD study was that of 561 children, 461 were able to return to a normal diet within three years of following the SCD.  That’s 82%, four in five kids.

We hope that Lydia will be one of those four kids.  But we don’t know if Lydia has celiac disease.  A positive diagnosis for celiac is not trivial to obtain.  False negative results are a concern.  The Gluten-Free Girl, Shauna James Ahern, has written quite movingly about how she finally got her celiac diagnosis.  The blood test that finally confirmed what Shauna believed in her gut to be true requires that a patient include gluten in her diet at the time of the test.  Lydia does not eat gluten, and frankly, I can’t say that I want her to, knowing how she reacts to it.

The beautiful thing about SCD is that it offers help for people who have not just celiac disease but all of the bowel disorders that I listed earlier.  Many of its followers have reported great improvement, and I can’t blame Amanda for being hopeful that the SCD might cure Lydia’s body so that one day she can eat pizza and cake at a friend’s birthday party.  Every parent wants their child to have a childhood filled with fun and adventures, and that includes all the edible treats of childhood.  There are lots of things Lydia can eat, but it would be amazing if there were nothing at all that she couldn’t eat.  I would make thumbprint cookies with her, and she could do the thumbprinting and fill each well with gaw-bewie jam.  We would pop popcorn and watch O-Lydia together while wearing our pink pajamas.  I want the SCD to work for her.  But there are no guarantees here.  The SCD fell out of favor with medical practitioners when the gluten-causes-celiac hypothesis caught everyone’s attention.  Certainly, the evidence for this hypothesis is strong—Shauna says she felt better almost immediately after she stopped eating gluten—but the gluten-free diet does not offer the hope of curing the disease in children.  It’s easy to understand the appeal of the gluten-free diet from an eater’s perspective.  Rice!  Corn!  Gluten-free oats!  But the gluten-free diet does not emphasize the importance of intestinal bacteria like SCD does, nor does it emphasize whole foods like SCD does.  SCD is more restrictive, but it’s also a more comprehensive plan for healing.  I like that.

October is Celiac Awareness Month.  Lydia and Amanda have inspired me to celebrate digestive health in a most unusual way: for one week, I will be following the Specific Carbohydrate Diet.  I don’t have a digestive disorder, but I want to increase awareness of the SCD as an option for those who do have digestive issues.  During the final week in October, I will be eating and blogging my way through a gorgeous new cookbook, Everyday Grain-Free Gourmet by Jodi Bager and Jenny Lass.  The only way I can follow the SCD is if I have a good cookbook to guide me around the kitchen.  I first spied this book while staying with Lydia and her family last month.  It looked so tempting to me that I asked Amanda to buy it for me as a birthday gift.  She sent it to me two months early as part of a very awesome and very generous graduation/housewarming/birthday gift.  Tomorrow I’ll tell you a little more about the book and why I like it so much.  Then on Sunday, I’ll shift into food-diary mode and tell you what I’m eating and how I’m feeling while following the SCD.  To be honest, I’m both excited and scared of this plan.  I love my grains and I know I am going to miss them.  But I think it will be an interesting adventure, and my kitchen will be filled with new recipes and inspiring dishes.

See you tomorrow, friends!

* * *

Two more things.  One, please note that I am neither a medical professional nor a nutritionist.  I am a skeptical scientist who would like to see the SCD undergo clinical evaluation to test its efficacy.  All of the information I’ve described here is excerpted from Everyday Grain-Free Gourmet.  My goal in describing SCD and the anecdotal results of SCD treatment is to raise awareness, not to single-handedly convince anyone who is suffering from a digestive disorder that they, too, should jump on the SCD bandwagon.  But if you are interested in the SCD, educate yourself about its benefits and risks before making a decision.  Be skeptical.  Ask the hard questions.  Google Specific Carbohydrate Diet, look at Pubmed articles, and most importantly, talk to a medical professional.  Knowledge is power.

Finally, did you enter Shannon’s ice cream maker giveaway?  There’s still time!  To enter, hop on over to Tri to Cook and tell everyone what you’d ask the kitchen fairies to bring you from csn  I’d ask the fairies to bring me this gorgeous All-Clad skillet.  Hubba hubba!


Nicole said...

Out of curiosity, will you be adding meat and fish to your diet during this week, as seems to be part of the SCD? It seems like it would be hard to achieve balanced meals without any grains and meat. If you do add meat for this week, I would be interested to hear about your experience with preparing, cooking, and eating meat after being a nearly full-time vegetarian for so long. Good luck!

Rosiecat said...

Nicole, that is a great question! I don't plan to add meat or fish this week because I think I can get my protein from nuts, eggs, cultured dairy, and lentils, all of which are "allowed" by SCD. I really love all those foods, too! The hard part for me will be finding delicious things to fill the space where grain usually sits. Grain (whole or not) helps fill me up at mealtime and it is the centerpiece of breakfast, usually in the form of cold cereal or hot oatmeal.

I've had great results with some grain-free recipes already, especially a recipe for pizza crust made out of almond flour. It is so good and so easy--a perfect weeknight dinner! I'll share the recipe soon. And tonight I'll be making a batch of grain-free granola, which I'm really excited to try.

I'll mention here that I'm letting myself off the hook for any work functions next week that involve food. I'm not sure that mainstream science and SCD mix well since SCD fell off the radar of most medical professionals.

By the way, Nicole, the SCD cookbook I'm using has a recipe for lactose-free yogurt, which is basically milk or cream that you culture for 24 hours to allow the bacteria to digest all the lactose. Isn't that cool?

Nicole said...

That IS cool. But, it does befuddle me a bit. Yogurt, while not usually lactose-free, contains active cultures that eat up the lactose so that it doesn't bother people with lactose intolerance. Andy and I eat a lot of yogurt, both as a snack or sweet treat and as a savory substitute for sour cream (which is NOT friendly to lactose intolerance). I'm not sure yogurt needs any more treatments to be lactose free. Perhaps, some people are SO lactose intolerant that regular yogurt still bothers them? Or, maybe some people have have an allergy to lactose that isn't lactose intolerance, so they can't have any lactose in their system at all? Interesting. By the way, most cheddar and jack cheese are both processed in a way (don't ask me how!) that result in either having no lactose or having the same situation as yogurt (where the lactose is counterbalanced by live cultures). Andy and I also eat tons of cheese!

Of course you'll get protein from the sources you listed! Clearly, my brain simply does not work like a vegetarian's. I'm sure it will be a fascinating, and delicious, experience! :)

Rosiecat said...

Hmm, a mystery! Apparently we are not the only ones who are confused about this. Also, Elaine Gottschall sounds awfully cranky in her response:

"Dr. Sidney Haas instructed us to make our own yoghurt. I DID!!! When I studied, I had to learn manufacturing techniques and I did to the best of my ability. I never dreamed that people who are sick as those with IBD would challenge and question and balk at this. It is beyond my ability to understand."

Come on, Elaine! You don't really want all these patients blindly following the SCD without asking the hard questions, do you? IBD doesn't make you a dumb-ass, does it?

Ahem. I mean no disrespect to Elaine Gottschall, but I am appalled at her response in that letter.

Nicole, it must be a question of lactose levels. I checked my current container of organic, whole-milk yogurt and indeed, the second ingredient is organic nonfat milk powder, followed by several bacterial species. Perhaps for people with lactose intolerance, the threshold for irritation is higher than it is for someone with an irritable bowel disorder? In other words, maybe it takes more lactose to bother someone who is lactose intolerant but otherwise healthy? I'm not sure.

The other important point about the homemade yogurt is that because it is cultured for a longer period of time than commercial yogurts, the bacterial count is higher. That logic makes perfect sense to me.

And about the cheese: hurray hurray hurray! I think you are right about the lactose being consumed by cheese-making bacteria. I adore cheese. I think it would be easier for me to give up grains (like this week) than it would be to give up cheese.

Shannon said...

thanks for the link love! i'm so sorry to hear about your little pumpkin and how she suffers when eating wheat :( i do look forward to your journey this month, though!

Rosiecat said...

Shannon, I hope you have a great reader turn-out for your giveaway! It's my pleasure to direct people your way...even if it does decrease my chance of winning ;-)

The journey has begun. I just hope I can keep it up this week! It's harder to write a food diary than I thought.