Food can be medicine too: the power and danger of special diets

One of the things you’ll find if you start researching medical conditions is that there are often dietary suggestions made—things to add (or remove) from your diet, suggestions for what you should (or shouldn’t) eat, and suggestions for when and how to eat.

It can easily become overwhelming, and it can also put your health at risk. What you put in your body is important, and your eating patterns can have a huge impact on your health.

The sometimes-miraculous power of food can be real, but that makes it all the more important to treat major dietary changes with the same respect as medication, and to do your best to deeply understand the risks and rewards involved with your decision.

If you are considering a massive dietary change for yourself, it’s really important to understand what you are selecting, how it’s supposed to work, and how much quality scientific information is behind it.

Defining “healthy”, when your food can be medicine

You hear “healthier” and “health benefits” a lot when looking into diets and dietary changes. But what is “healthy” when you’re talking about food?

This process of defining things as “healthy” and “unhealthy” is much more about comparisons than it is about absolutes. This is why I wrote a post focused on healthier eating. Generally, your goal should be to eat better options, not necessarily to eat “the healthiest” foods.

Healthy is too often associated with these images of perfection—thin, young, beautiful, and abled.

The reality is that we all have different body types, ages, and appearances—and while many people might benefit from losing weight (there is an obesity epidemic in the US) it’s not really about dropping poundage.

It’s also generally healthier to have a consistent weight (and/or slow but steady weight loss) than to lose and regain the weight.

When managing a disabling condition, we often face extra challenges to both exercise and diet, and that needs to be recognized.

The standard dietary recommendation for most people is to focus on fruits, vegetables, and whole-grain foods.

Anti-inflammatory diets generally match these recommendations and are especially likely to be helpful for people with chronic conditions, as inflammation is often associated with many chronic illnesses.

We can choose to adjust our diets to be healthier and better help us manage our conditions.

A healthier diet should give you more energy, encourage weight stability(reduction for most people), and provide for all of your nutritional needs.

However, it’s extremely important that we be aware of the costs, benefits, and risks surrounding any major dietary change—and be able to evaluate if it’s really going to help improve our quality of life enough to be worth the effort involved.

Diets can help with diagnosis

We’ve talked about understanding symptoms before and the importance of symptom tracking.

If you have symptoms associated with inflammation and/or more standard allergies, you can temporarily change your diet to test for food allergies and sensitivities.

This testing process is referred to as an “elimination diet.” It’s best done under a doctor’s supervision, since if you do have allergies, you run a risk of a more extreme allergic reaction during the reintroduction phase.

When done correctly, an elimination diet can help you identify the food categories that you are allergic or sensitive to so that you can create a long-term dietary plan for yourself that doesn’t include triggering foods.

These categories sometimes are individual foods(like blueberries) or categories of foods(like nightshades), and other times are components of certain foods(like gluten or histamines)

Diets free of food we are allergic or sensitive to makes all the sense in the world—improving our quality of life, minimizing gastronomic discomfort, and otherwise eliminating the bodily stress that goes with your allergies.

Dietary changes can replace or reduce the need for medication

The ketogenic diet has a reputation for helping with a variety of conditions, including epilepsy, traumatic brain injuries, dementia, cancer, and certain metabolic disorders. It also is sometimes recognized for helping people think more clearly.

It was initially created in the 1920s as a treatment for epilepsy but fell out of favor as anticonvulsant medications were developed. It’s reemerging now, and research is indicating that it can help treat multiple additional conditions. Basically, a ketogenic diet mimics fasting in some ways and causes your body to process fat rather than carbs for fuel.

It’s an effective cause of weight loss (which often improves health) and strict adherence to it has allowed not only folks with epilepsy to go without or reduce medications (or helped those who couldn’t find a helpful medication) but also many people with diabetes and prediabetes to delay their need for insulin by years, sometimes indefinitely.

A friend of mine followed the ketogenic diet after being diagnosed with diabetes. Her doctor thought she’d start needing insulin within a year of her diagnosis.

Instead, she committed wholeheartedly to the ketogenic diet and not only lost a lot of weight, but currently shows no indicators of diabetes when tested.

People with high blood pressure can also reduce or eliminate their need for medication by following a low-salt, heart-healthy diet (a specific form is the DASH diet).

Another condition, Mast cell activation syndrome(MCAS), is an autoimmune condition, where the body overproduces histamines, the part of our immune system that clears the body of allergens.

For people with MCAS, they experience all the symptoms of allergies without actually being allergic to any particular food.

One of the more powerful tools for treatment is going on a low-histamine diet, which reduces the likelihood of symptom flares by avoiding the histamines that naturally occur in many of the foods we eat.

Whatever condition or conditions you have, it’s possible that there’s a diet out there that could improve your quality of life and may reduce your need for medication. While some conditions are best treated with dietary adjustments, this change usually comes with an associated cost.

Recognize the costs

For those of us with chronic conditions, “cost” is a relatively broad concept.

There are financial costs (many of us are relatively poor), time costs (reading labels, understanding diets, and planning meal adjustments takes extra time), energy costs (all of that is extra work, and there also may be additional effort involved in food preparation too), and the cost inherent to the dietary change (in most cases, the hope is for more energy/fat loss, but many diets can also have side effects or unintended consequences).

Nothing in life is free, and too many diets, especially fad diets, promise way more than you will actually experience.

If a diet claims to be easy or requires minimal effort, I would tend to question its validity.

Most dietary changes require focused attention and some additional energy expenditure.

Many diets are accompanied by promises of increased energy, weight loss, clearer thinking, and, within the disabled community, a decrease in symptoms.

If you look into an alternative diet, make sure it makes sense and is safe for your to try.

For example, ketogenic diets can be very helpful for certain conditions, but they only work if you follow them faithfully—any “cheating” can ruin the effects for up to a week.

If you follow the diet, the health benefits can be high, but part of why its popularity nose-dived once there were medications was because it is hard to maintain without vigilance and commitment.

The side effects of your diet

Just like medications have side effects, major dietary changes come with risks.

Now, if the diet will actually improve your quality of life, it may well be worth the price you pay—but you need to understand what the costs are so that you can truly evaluate the diet’s value.

You need to ensure that you’re getting all the vitamins and nutrients you need while on these diets and do your research to make sure that you know about the risks involved and have plans to manage them.

As an example, vegetarian or vegan diets naturally reduce how accessible certain nutrients are, so often it’s necessary to take certain supplements while on these diets and to ensure a wide variety of vegetables are eaten to cover the spectrum of necessary nutrients. Most people get plenty of protein through eating meat, so vegetarians often need to put more effort and thought into getting enough protein each day.

Low-B12 is one of many conditions that can occur for vegetarians who don’t take the appropriate supplements or aren’t careful to eat a wide enough variety of vegetables.

All dietary changes will have some form of risks associated with them, with the general rule being that the less restrictive the diet is, the fewer negative repercussions you need to worry about.

Also, be aware that your habitual diet also has its own side effects as well. I’ve seen references to the Standard American Diet (SAD) and the acronym is quite apt. For some of us, at least part of the reason we are ill or disabled is the food we have habitually eaten.

Another rule of thumb is that the more restrictive a diet is, the higher the risks involved. Cutting out food groups or large categories of food types greatly increases the chance of missing key vitamins, and heavily restricting the amount or type of food you can eat can permanently slow your metabolism and leave you low on energy, on top of the potential for malnutrition.

I personally haven’t needed a specific diet, so just have been focused on shifting toward the anti-inflammatory diet. I tend to refer to my efforts as healthier eating.

Evaluating your options

The most basic part of the evaluation, though, is if you need or want to do it.

The biggest issue most dieters face is, very simply, compliance to the diet.

If you don’t want to adjust your eating habits, if you aren’t willing to put in the time and energy required to research, understand, follow, and maintain the diet, then it’s not going to work.

Also, the more abrupt and extreme any change you try to make is, the harder it often is to maintain it.

If you’ve decided that you’re willing and able to develop the plan and stick to it, then it’s time to figure out what dietary adjustments will make sense for you.

A friend of mine has been adjusting her diet based on research into her condition. She has fibromyalgia and has been slowly incorporating suggestions into her diet and evaluating their helpfulness.

She’s modeling great habits with this. She makes the point of doing research ahead of time, understanding the risks and benefits, and then giving herself enough time on each step to make sure she knows how effective the change really is.

If you start reading about a particular diet potentially helping with a condition you have, it’s worth learning more about it and its history so that you can determine if it might work for you.

Discussing dietary change with your doctor

If you are considering a major dietary adjustment, it’s important to discuss it with your doctor.

Since these adjustments can have a large impact on your life, and can have unintended consequences, you want to be sure that you are protecting yourself and that your understanding is correct.

Which doctor should you talk to?

Well, if it’s to treat or manage a specific condition you have, talk to the doctor managing it. That may be your Primary Care Physician (PCP) or you may have a specialist.

Using the ketogenic diet as an example again, if you have epilepsy and are having a hard time with your medications (either tried several that were ineffective or the side effects are overwhelming) then you’d want to discuss it with your neurologist.

Why?

Because they are managing the medications you are taking, and the two of you can discuss how to ease you into the diet, when, if, and how to reduce your medication, and the possible side effects you’ll need to look out for.

You also need to understand the risks specific to your dietary change so that you are prepared and on the lookout for those impacts.

Once you are prepared for your new diet, then you need to follow it and give yourself time to feel if it’s effective.

Dietary change, even an extreme one, will take time for you to see its effects—the more extreme the change, the more quickly you may see the impact, but generally the harder it is to maintain.

This isn’t fast-acting treatment like aspirin or an antacid; it’s likely to be a slower, more deliberate process, like adjusting to a new antidepressant or taking a new maintenance-type medication.

However, if you are going to have negative side effects, those may occur more quickly. Apparently, some people who try the ketogenic diet go through an adjustment period, which can be severe enough to be referred to as the “keto flu.”

Conclusion: Your diet can hugely impact your health

When you consider a diet, make sure you understand how it works, what it’s supposed to do, and what the risks are.

If you think your diet may be part of your health issues, it may make sense to explore an elimination diet or to shift towards healthier antiinflammatory diet.

If you are specifically changing your diet because of your diagnosis (or symptoms) you should discuss it with your doctor ahead of time to confirm that it is appropriate in your case.

Know what vitamins and minerals you may be short on, and how to make up for that, as well as how quickly you should notice impacts from the dietary change.

Don’t forget that any major changes in your diet will have an impact on you—and if you are going to make a concerted effort to change your food habits, it’s good to be prepared for all the possible consequences.