A Balanced Approach to Food Restriction & Nutrition Therapies

Hey Spoonful-ers! This is Audrey Inouye, one of the dietitians who helped create the app. I wanted to touch base with you on a difficult topic – food restriction. Over the past year, we’ve seen a growing amount of fear-based nutrition messages aimed at convincing people to unnecessarily cut healthy foods. While Spoonful, by design, helps you make and manage these cuts, we in no way want you to feel overly restricted or anxious about food.

I know how tempting it is to remove ingredients until your symptoms subside, but that can oftentimes be the wrong approach. In this article, I want to shed more light on food intolerances and give you a game plan for navigating your food journey in a safe, evidence-backed way.

Step 1: Follow the Science

Many types of nutrition therapies are known to improve symptoms, but some are not. When considering a dietary change, look for research supporting improvements in your specific symptoms or the condition you have been diagnosed with.  

There is an abundance of research for the low FODMAP protocol for people with IBS and/or certain digestive conditions. Likewise, a gluten-free diet is necessary for people diagnosed with celiac disease, and people with allergies will need to avoid the foods that they are allergic to.  Myself and the Spoonful team have and will always focus on making it easier for people to adhere to these types of nutrition therapies. We even make it possible to accomplish this in the context of a vegan, vegetarian, or pescatarian way of eating.   

Given the enormous amount of nutrition advice online, it is also important to weed out the diets that are not supported by an abundance of research or not applicable to you. The IgG food intolerance test is a classic example. There is no evidence for the use of these tests, but they continue to be used by practitioners. I often work with people who have unnecessarily avoided many foods (like wheat and dairy) for years because of these tests. What about nightshades?  I’m sorry to say that there’s no evidence on nightshades either. If you experience symptoms from eating nightshade vegetables, consider whether your symptoms are the result of a nocebo response, FODMAPs (like in green peppers), or capsaicin (like in hot chili peppers).   

Nutrition research is ongoing and there are many new therapies in the pipeline. The Spoonful team and their dietitians are waiting in the wings to launch new additions to Spoonful once nutrition therapies are ready for mainstream use.  

Be Mindful of Confirmation Bias

Perhaps you have read in a group about someone who experienced symptoms from a specific food, let’s say tomatoes. Maybe you had symptoms on a day that you had tomatoes. You also read that tomatoes are high in histamine. Our brains are always looking for connections, so this seems like an obvious hit. Tomatoes => Symptoms => Histamine Overload => Low Histamine Diet. This type of connection may be correct, but it also might not be. You may end up restricting more than is necessary for you.  Do your best to be objective about your symptoms.  

Step 2: Consider the Pros and Cons

Dietitians take food limits very seriously! We are trained to always consider the possible ups and downs of changing your diet and then we decide the best path forward.  

Pros: 

• Your symptoms may improve.
• You may find the answers you were looking for.
• Your quality of life may improve.

Cons: 

• Your symptoms may not improve.
• Dietary restrictions can be difficult.
• You may find it hard to get the nutrition your body needs.
• Social events are difficult.
• Your gut microorganisms LOVE diversity, so cutting foods out may have a downside for the gut.
• You may develop food fears and disordered eating habits.

Food May Not Be the Cause of Your Symptoms

It is important to stay open to the possibility that food may not be the cause, or only cause for your symptoms.  For example, a trial of the low FODMAP protocol is recommended for 2-6 weeks to improve symptoms of IBS.  It is very effective for many people.  However, what happens if your symptoms didn’t improve?  What next?  Rather than cutting anything else out, it is important to work with your health care team to continue looking for answers and be open to the possibility that your symptoms aren’t related to food.  

Step 3: Find Your Individual Threshold

With conditions like celiac disease and food allergies, certain foods need to be completely avoided. However, with food intolerances, it is important to find your own individual threshold.  You can find excellent advice on the FODMAP reintroduction phase here. If you have completely removed a food from your diet but you aren’t certain whether a complete restriction is necessary or not, then you may consider looking for your individual threshold by adding it back in increasing amounts. For example, if you stopped eating all dairy, you may consider trying lactose-free dairy such as cheese or lactose-free yogurt. You may be surprised with the result.   

Get Experienced Support

You don’t have to do this on your own.  Look for a dietitian who has skills in the nutrition therapy that you are considering. Some nutrition therapies are complex and must be adapted to help you find answers. Many dietitians offer virtual counseling, which increases your access to more specialized services. You should look for the right dietitian who will help you be the least restrictive necessary for symptom relief.  

If you are considering trying nutrition therapy or cutting something out of your diet, I hope this article has given you a common sense approach so that you can carefully weigh the pros and cons for yourself. The Spoonful team is always on the lookout for medical nutrition therapies that will fit with the app so stay tuned.