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To be honest with you, I’ve avoided speaking directly on this subject; I’ve avoided questions on it, and I’ve just straight up kept my own views to myself.
I’ve done this for several reasons.
Firstly, in the “health world”, and to a similar extent in the “IBD/chronic condition world”, there doesn’t seem to be a more polarizing, charging or emotional subject than diet. This is because of both the health and ethical concerns of the subject at hand.
Secondly, the science, the case reports, and everyone’s opinions are all over the map. There is NOT a consensus here, and there is way more we do not know about the long term consequences of certain dietary strategies than what we do know.
Thirdly, I’ve wanted my own views to mature, resonate, and evolve. I’ve wanted to deeply study others’ viewpoints and the science, and test out things on myself. It’s been hard not to just shout my mind to the world or call out some of the absolutely ridiculous things I’ve witnessed on all sides, but here I’ve tried to calmly and carefully write something of substance, of nuance, with hopefully limited dogma. However, I accept that I can be wrong, and I welcome anyone’s feedback: acclaim or criticism.
I do, however, hope that this post will help you and will challenge you no matter your belief or your lifestyle. I hope you will take just one moment to think and perhaps even entertain the possibility of trying something new – if only for a minute (in coordination with your amazing health and medical team of course!). A logical fallacy sometimes referred to as “appealing to tradition” is perhaps something we are all guilty of. It means sticking hard on something just because we’ve done in it the past. This I think we can all agree is not always the best way to proceed.
So let’s get to it:
The question that is being debated as I understand it is this:
Is the optimum diet for a person with a gut and/or an inflammatory condition like IBD a plant-based diet, a carnivorous-based diet, or an omnivorous-based diet?
Open the flood gates!
I’d like to share with you my major takeaways, but before I begin I must preface…
I’m not going to get into the weeds here: I won’t be discussing what we are “evolutionarily” adapted to, I won’t be discussing Trimethylamine N-oxide (TMAO) and whether it’s inflammatory or not. I’m not going to speak of plant toxins like lectins or phytic acid. I’m not even going to use terms like “nutrient density,” “omega-3,” or “B-12” in reference to the benefits of animal products. We won’t talk about specific carbs or “FODMAPs”, and I won’t even think of mentioning how some fish like tuna are loaded with toxic mercury. Heck, I’m literally not even going to tell you that a diversity of plant foods contain soluble fiber and resistant starch which totally feed a robust, healthy microbiome.
See? Some of you got a little worked up inside, but that was the point. In short, I won’t be citing a single scientific article. On purpose.
This, my friends, is a “zoomed out” 30,000-foot subjective opinion piece. What follows is my view and no one else’s. And my opinion is allowed to evolve, just as yours is too.
I would like to remind everyone that there is an endless stream of more-qualified-people-than-me shouting science at one another all over the internet. You can Google, you can PubMed, you can watch the polished and polarizing “Game Changers” on Netflix and its many “debunkings” on Youtube, you can scrutinize the highly studied and articulate scientists, doctors, and other experts on both sides of this issue. You’ll learn a lot. And there’s plenty of material that’s specifically IBD related too (but still the path forward to me is more unknown than certain).
Right now, I’d like to just give you a piece of my mind, so sit back, buckle up and enjoy (or don’t) what I hope is a unique perspective:
– Point One –
We are totally debating the wrong question, and to ask it is akin to mindlessly throwing a blanket over a complex issue, when what we need is a skilled tailor to measure and sew to spec.
Here is one way the question can be re-written:
Is the optimum diet for an individual person with a unique gut and/or inflammatory condition like (the up to 500 possible distinctive subtypes of) IBD a plant-based diet, a carnivorous-based diet, or an omnivorous-based diet?
Yes, you and I may share 99.9% of our DNA, but several other factors are vastly different between us. Here are just a few:
Our “epigenome” – which genes are turned on or off at a given time? (quite different from person to person, even between identical twins)
Our “microbiome,” “mycobiome,” and “virome” – what respective bacterial, fungal, and/or viral species uniquely inhabit our gut and skin? (depends on so many factors)
Our “connectome” – what is the unique way our brain cells connect to form our mind, personalities, behavior, and beliefs? (changes every time you learn something or feel something)
Our “environment” – where do we live? what do we have access to financially or geographically? How do our careers, family, school and other stressors impact this?
What I am saying is to lump everyone in one category and ask about THE “optimum” IBD diet or even the optimum human diet is utter nonsense. And I didn’t even mention other obvious differences like gender, age, ethnicities, etc. Do you see? We are all so different, thus require different things.
However, I lied. There is one optimum diet… wanna know what it is?
…its YOUR diet! And in the end, it will be YOU who figures that out and makes final decisions based on the plethora of contradictory advice and information you receive.
– Point Two –
Common ground: diet matters. There is more that connects us than divides us.
Firstly, all three parties here can agree on one thing: the Standard American Diet (SAD) is hugely problematic, and cutting out processed high sugar and artificial foods is paramount.
If we just did this, I suspect most non-dieting IBDers would be 95% there. We are now venturing into the remaining 5%, which I will admit for many people is also a very critical (even vital) 5%.
I think here it’s important to find camaraderie with each other even if our dietary strategies are vastly different. It’s important for us to hold our judgments and not to deny someone’s reality. It’s important for us to respect and believe one another.
And here I will make an anticipated defense. Some omnivores and vegans will protest that I have even included carnivores given your belief this diet is based “totally outside the scope of reality.” Well, I have news for you, the carnivore diet is here, and it’s growing and it really doesn’t appear to be going anywhere. Whether it’s harmful or helpful, there are thousands upon thousands of people practicing it. And yes, the long term consequences are unknown but right now there are real people thriving on this diet. Will they continue to thrive? Time will tell, but I’m not gonna lie to you, it seems to work for quite a few of them.
I would know: I am part of both carnivore and vegan FB groups, and their numbers are in the tens of thousands.
My question for you is this: if someone who only eats meat or only eats plants (possibly with IBD) reports to you they feel the best they have ever felt, are you going to respect them? I’m not saying don’t challenge, but will you accept that this is a reality for this person? Will you be open that you might actually be wrong?
The same here goes for anyone on a very restricted diet.
Let us support one another and build one another up, not break each other down. And lastly, let us remember the pure and good intentions of (most) people on either side. It’s natural to want to promote what worked for us personally in order to help other people, but that can’t be at the expense of hearing and respecting other perspectives.
– Point Three –
Human beings and people with IBD can thrive and suffer eating only plants, eating only animals, or eating both.
Wait…what? Yes, there are IBDers thriving on an omnivorous-based diet, on a plant-based diet, and yes, on a carnivorous-based diet. And yes, there are people who are very sick on either three of these dietary strategies as well.
How do I know? I see it almost every day. I’ve spoken with thousands of you, and you tell me what you’re eating. Highly scientific? No, but remember, this is an opinion piece in which the science seems to polarize us.
Again, the conclusion? Is it possible there is NO one perfect diet for all humans? You bet.
– Point Four –
The following is the most underrated factor that will determine if a dietary strategy will work for you – perhaps the number one factor.
It’s not your DNA. It’s not your microbiome. It’s not your disease.
It is… your brain. Your belief. Your bias.
Every medical intervention, no matter if it’s a drug, a surgery, a supplement, or yes, even a diet, is dependent on placebo in addition to the targeted and intended mechanisms of action.
It has been demonstrated that when we believe something, there are physiological changes that occur in our body and brain. Not only this but we begin to shape the environment around us and change the very inputs to our brain.
This is a concept known as confirmation bias. If you’re a carnivore, everything in your environment like your friends, your Youtube suggestions, and your news feed will start to look like: steak, hunting, a lot of dead animals, and Dr. Shawn Baker telling you how toxic plants can be detrimental to your health. If you’re a vegan, your inputs will probably be telling you about the dangers of animal products and be filled with Dr. Michael Greger reviewing the literature and making some banana ice cream. If you’re like me, then you’ll have it all coming at you at once. It’s enough to make anyone’s head spin.
Do you see the feedback loop?
What you believe matters, and what you believe starts to be fed back at you. And honestly, if you can’t even entertain changing your belief, then don’t bother changing your diet.
If you believe in what you are doing, and it’s working, then awesome! Keep going. Why fix what’s not broken? But if you are struggling, perhaps make the uncomfortable move to change your belief – be brave enough to admit that, yes, you might actually be wrong.
– Point Five –
Relax – there are more right decisions than there are wrong ones.
Just like there is no one diet for all humans or IBDers, there is probably no one diet for you either.
There are probably multiple strategies that will help you accomplish your goal of health and wellness.
This is the approach that I have taken with my own diet. And given that I receive multiple inquires per day about what I eat, sometimes followed with, “OMG I can’t believe you are not plant-based?” or “You really might want to try carnivore, its changed my life,” statements thrown in there, here it goes:
I personally eat a full spectrum, whole food, omnivore diet with both high quality animal products (no cow dairy, limited goat and sheep yogurts and cheeses, lots of bone broth, some organ meats, lots of salmon, no other high mercury fish) and an enormous diversity of plants (emphasis on soluble fiber – blueberries, banana, avocado, papaya, sometimes oats in granola). I try not to villainize any type of food and I pay more attention to what I am eating than what I am not eating. And guess what? I’m in remission. I believe for me personally that both animals and plants robustly contribute to my health and my state of remission. Every time I eat an animal, or on occasion I may accidentally eat a non-sustainably farmed plant (yes, large scale agriculture kills animals too) I acknowledge that an animal’s life was sacrificed for my health. I honor that animal – and I use the energy to go out and better human life, human health, and work for a better world for all living things.
I realize that my diet works for me, and that the isolation of plants or animals in another’s tailored IBD diet is a personal decision that should be honored, respected, and even celebrated. And if you can believe it, I am open to changing my diet in either a more plant-based or even more carnivore direction, should my health indicate this. What gives me security and confidence is that I know my mind can change and that I can adapt to what my body needs as I age and as my environment changes.
I would like to close with this:
In diet and nutrition, in general, try not to kick yourself or be hard on yourself about something you did “wrong,” regardless of whether you think you’ve been dieting wrong for years or if you just slipped up and ate something you should not have.
Try and move forward and use hiccups as information.
How can you decipher the many voices around you, and integrate them into knowledge about how different foods affect you? How can you better learn to sense yourself and what your body needs?
As I tell my clients, sticking to a certain diet that you know may help you is less about perfection and more about persistence and adaptability. Always be ready to change, but also be disciplined with what is working for you and be honest with yourself.
And in closing, remember, I’m just another voice in the sea of many. I have biases too. I have IBD, I know what works for me, and also my training is in neuroscience and psychology. It’s natural I look at this issue from the perspective of studying the actions, behaviors, and opinions of the humans at the center of this discussion.
I know one thing. We can heal IBD, and diet seems to be an absolutely critical part of this equation. It certainly was for me. Food is medicine, and each of us requires an individualized protocol, regardless of the inclusion or exclusion of animals and plants.
So ask yourself… what’s for lunch?
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