Are you frustrated by how many different gluten free diets there are out there that might help you feel better? While I wish that going gluten free was enough to fix everything, that’s certainly not the case (do not believe anyone who says gluten free is “the” fix to every health problem there is). I should know… I went gluten free and was sicker a year later than where I’d began pre-gluten-free. What you’re really looking for is the most healing gluten free diet that will address your unique symptoms (rather than just blindly following what someone else has done).
But there’s no easy way to pick which way to go… AIP, SCD, GAPS, FODMAPs. So many darn acronyms, but no clarity on what will actually work for you!
I know a lot of women who’ve given almost all of them a try and are still sick. That’s a lot of wasted time experimenting for a couple of months trying out each of these different healing gluten free diets. The question arises about how one should go about picking a dietary path that will 1) work and 2) be efficient in healing.
If you’re at one of these health crossroads yourself or at the beginning of your own journey wondering where you should even start, today’s podcast is perfect for you.
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How to Choose the Most Healing Gluten Free Diet with Andrea Nakayama
Complete Transcription
Jennifer: Welcome back to the Gluten Free School Podcast. I’m your host, Jennifer Fugo. And today, we’re going to talk about that moment in time when you find out that you’ve got some sort of health problem and you’ve got to be gluten-free.
And all of a sudden, as you’re researching on the internet, you discover that gluten-free doesn’t mean just one way of eating. In fact, there are several different types of diets that fall under the category of being healing gluten free diets. And you think to yourself, “Which way do I go?” It’s like staring at a sign post that sits before five different roads in front of you, and you have no idea which way to go.
We are going to break down the question today and give you some idea of what might be the best way to move forward if you’re at that highly confusing, frustrating crossroads that sometimes might make you want to throw in the towel before you even start.
I have a really wonderful guest with me today. This has been months in the making to get her here to her speak with all of you about this topic. Her name is Andrea Nakayama. Andrea is a functional nutritionist, educator and speaker. Her passion to redefine the health industry came as a result of a personal family tragedy. Her young husband was diagnosed with a fatal brain tumor while she was pregnant with their only child.
It was in defeating his prognosis of six months and prolonging his life for another two years that Andrea’s expanding interest in food as personalized medicine blossomed and met its first testing ground.
That concept has since grown into a thriving clinical practice encompassing a team of four nutritionists and a naturopathic doctor, as well as guidance for thousands of students worldwide through the programs of Replenish PDX and Holistic Nutrition Lab.
In addition to teaching every week in her programs, Andrea is the co-founder of the Hashimoto’s Institute, on the Board of–Directors for the Center of Integral Wisdom, has been featured in O Magazine, and Martha Stewart’s Whole Living, and is frequent contributor at the Epic Times.
Her work is regularly featured in a variety of health, nutrition and wellness blogs, online summits, radio shows and publications nationwide, particularly on the topics of thyroid, autoimmune and digestive health issues.
Andrea, thank you so much for joining me today!
Andrea: Oh, Jennifer, I’m so excited to be here with you and your whole community at Gluten Free School. And thank you for that introduction!
Jennifer: So many of us have had this feeling of going to the doctor’s, we don’t feel right and many times the doctors don’t know what’s wrong. So it could take, in the case of Celiac, for example, up to 10 years to get a diagnosis.
Andrea: Right.
Jennifer: Some still don’t have clarity on that. Even after years they’ve been tested for Celiac or Hashimoto’s, and a number of things, still without a clear answer.
You decided to take the reins into your own hands. You got on Google, you start looking around for some answers. Maybe some of your friends have given you suggestions. Gluten-free seems one of the things that pops up, “Oh, maybe gluten-free can help. Maybe FODMAPs can help, because, oh, FODMAPs, that would be gluten-free for the most part.” Then you’ve got, “Oh, SCD, the Specific Carbohydrate Diet. Oh, that could be gluten-free too.” Then, “Oh, you’ve got GAPS and then the Autoimmune Paleo Protocol.”
I mean, there are so many different avenues down which you could go and you find yourself thinking, “Where do I even begin?”
So there’s this level of frustration. Like you said, there’s this moment where you have to stop and take pause at this crossroad, this situation that you’re in and say, “Well, do I take a big, deep gulp and plow ahead down one of this paths or do I stop and ask for help?”
I think a lot of people get stuck in the overwhelm, so can you talk about why somebody might get stuck in not knowing which way to take and how we can use nutrition from a functional perspective to start going down one of those paths?
Andrea: Yeah, absolutely. That’s a great question. To touch on the point that you spoke to, taking the reins in your own hands, I want to really commend that because in order for the patient and the practitioner to be in a therapeutic partnership, the patient needs to be an equal playing partner. And that’s not the culture that we’re in in medicine these days.
Jennifer: No, not all.
Andrea: Right? We hand ourselves over and we expect the practitioner to have all the answers. So, fantastic that you’re educating yourself, that you know what you need to go in and ask for. And if your practitioner isn’t serving you, you know to find one that is.
I want to remind people not to do that with expectation, but with allowance for a partnership to evolve. So, invite your practitioner to come into a partnership with you instead of challenging them or feeling like you know more than they do or they don’t know anything or they’re not helping you. Look to create partnerships.
Towards that end to what you were asking, Jennifer, I think it’s hard to do this alone, which doesn’t mean you can’t take one, two, three, four, five steps on your own without involving a practitioner. But when we get to some of these more hardcore dietary theories, that’s where it may be difficult to make a decision on your own. We can back that up and talk about why a little bit.
I went off topic a little bit just to set the stage.
Jennifer: No, that’s okay. And as you were talking, the thing that came up for me was this idea that a lot of times we’d like to think that the diagnosis to what’s going wrong is a straight path…
Andrea: Exactly!
Jennifer: …which is not the case many times. With that said, I want to shift gears to some of these various gluten free diets. Some people I’ve interviewed are very pro-FODMAP, or very pro-Specific Carbohydrate Diet. I’ve actually never had anyone talk about the GAPS diet yet on the podcast, but I have had guests talk about AIP.
Why don’t you tell me a little bit, before we go into a quick overview of all of these, so that people who may not have heard those other podcasts or just might not be familiar with them, we can all get on the same page, what is your take on dietary theory?
Andrea: As a functional nutritionist, I think dietary theory is just that, it’s theory. and that, as individuals, we each need to find what works best for us. There are positives and negatives to going down any one of these paths. Each of them is a healing protocol, not meant to be a way of life.
Now, we back that up a little bit. There are aspects of all of them that they share that are meant to be a way of life like being gluten-free and removing high allergen foods and processed foods and inflammatory foods. But beyond that, they can be very restrictive.
And so, I will incorporate each one of them, at times, for a healing period, during a healing protocol, depending on the person, and what I find to be true for them. And I will also try to move from them.
So again, dietary theory is just that, it’s theory. It’s a theory that works on paper. And you, Jennifer, me and my body with Hashimoto’s, all the people that I’ve worked with with various autoimmune conditions, chronic illnesses of all sorts, they are each unique. And I’m going to stair-step that, so that we can find a protocol that works for the person in a long term way.
We want to go for a sustainable healing diet, not just a restrictive diet where there are certain nutrients not included and over a long period of time, can be difficult.
That said, I know people tend to stick with diets that are restrictive when they’re not feeling better. So we should definitely touch on that and where you might go if that’s the case for you.
Jennifer: So why don’t we talk about FODMAPs real quick. Can you tell us what the FODMAP diet is and who might want to give that a try?
Andrea: Yeah. I’m going to back it up just a tiny bit if that’s okay…
Jennifer: Sure.
Andrea: Again, I just want to stress, for most of us who are looking to heal, as everyone here knows, the commonality all these diets have is that they’re gluten-free and low carb and that they remove the high allergens to some extent while also removing processed foods. And in this situation, you may experience the alleviation of symptoms within a few weeks to a few months.
I’m going to start often with an anti-inflammatory protocol just to see how we are doing in terms of talking about where we started the conversation. If you looking around online, where do you start? This persons says FODMAPs. This person says AIP.
I really like to start with an anti-inflammatory, gluten-free protocol where we’re going lower carb, really bringing in high-nutrient dense foods and seeing how we do. In that place, your body is going to tell you a) if you have to take it further to a more restricted or specialized diet and b) what you’re still reactive to. So, how do you start to track, and see if you’re still reactive?
If we jump from 0 to 80, then we may be going too restrictive too soon and really not finding what does and doesn’t work for us.
So, because it’s a journey and because it takes time, we might as well learn more about ourselves in the process. So, I just wanted to stipulate that before we go to FODMAPs, which is more restrictive.
Jennifer: It is. It is. I’ve looked at the diet. I interviewed Patsy Catsos last year who’s a dietician and she work with clients around that diet. I’ve had people come to me and say, “I was thinking of giving the FODMAP diet a try especially since there has been research that has come out that gluten-free diets don’t work. That it might be the FODMAPs instead.” And so FODMAPs are now becoming a popular approach, but when you look at the list of what you can eat, it’s not that extensive.
Andrea: Exactly! And it’s not necessarily an issue for everybody. It is getting a lot more play, so to speak in Australia, and that’s starting to trickle over in some big ways. So, we are more aware of FODMAPs.
And FODMAPs have to do with how we absorb fructose. And honestly, everybody has fructose malabsorption. None of us absorb fructose very well. That makes it difficult because if we have compromised digestion, then we are likely compromised in that way.
Fructose malabsorption occurs when the amount of fructose consumed is more than the person’s small intestine can metabolize and absorb. So, again, we all have a little bit of a challenge there, but it’s going to be very individual in terms of what the dose is that that person is going to experience where they have signs and symptoms.
And what I would do is look at a combination there of FODMAPs and SCDs, so what’s going to be “legal” in the cross-over.
Jennifer: Well, I want to add to FODMAPs because you did mention for a time, it is important that people know that you should not be on the FODMAP diet for a very long period of time. It’s not a diet for life because it can actually cause an alteration to gut bacteria not typically in your favor.
Andrea: Exactly!
Jennifer: People say, “I’m going to do FODMAP!” Just know that you should not be on that for a very long period of time because that can cause issues down the road.
Since you mentioned SCD or the Specific Carbohydrate Diet, why don’t you tell us quickly about that?
Andrea: The Specific Carbohydrate Diet is, like it says, limiting carbohydrates and that’s really a good baseline. It’s a good umbrella term for us to think about the diets that are grain-free and low carb and removing some high allergens.
On the Specific Carbohydrate Diet, you are allowed some dairy, and you’re allowed some egg. And that’s why people might go SCD. You’re allowed honey, which is higher glycemic. They might go on an SCD diet and feel somewhat better or feel better for a time depending on where they’re coming from and then start to feel sick again or start to feel increased symptoms. I know, I can’t eat dairy, eggs or honey. So, if I were to say, “I followed an SCD diet,” it wouldn’t work for my body. But it’s a great umbrella term.
And in terms of understanding that all of these healing diets and what they fall under, there’s some really great research and writings in the realm of Specific Carbohydrate Diet.
I think it’s a great place to start educating yourself in terms of healing the gut with a dietary approach. So it’s a starting place. Again, I would take it further because there are certain permissible foods that, in my opinion, aren’t often part of a healing protocol.
Jennifer: Well then, why don’t we move to the GAPS diet? Tell us about GAPS. I’ve never had anyone speak about the GAPS diet before and I’m sure that everyone would love to learn about it who’s not familiar with it as well as why you might want to give GAPS a try?
Andrea: So GAPS, it’s funny, it was in so much favor when I started to practice about six or seven years ago. There were a lot of people following the GAPS diet.
GAPS stands for the Gut and Psychology diet and it is the baby of Dr. Natasha Campbell-McBride who is a UK nutritionist and therapist. She combined her interests and really put together this diet, which is a form of SCD. It just takes it much further and it’s much more restrictive.
So when we’re looking at a GAPS diet, we’re looking at higher fats and higher proteins. There are different phases of the GAPS diet and it goes very slowly. People stay in the different phases for a long time.
I saw a lot of people struggling with the GAPS protocol. It depends what the issues are. If they are mental health issues, which is really what Dr. Natasha was working with – autism in her son, in particular and what she was then known for — it really could do justice. So, there’s a lot because you’re going through this restrictive route and then you’re building up from there.
When somebody has an impaired digestive system, let’s say, an impaired small intestine, which is where most fat absorption happens and digestion (so we’re breaking down our fats and we’re absorbing them mostly in the small intestine), if that small intestine is impaired, then all that fat that you eat in GAPS can be really difficult on the system.
And I ended up getting a lot of people in my practice who had gone the distance, which is what exactly what we’re talking about. They took the reins, they went to the most restrictive healing protocol they could find and they were sicker because they had problems digesting fats.
And this is the problem with dietary theory. We are all unique. And even if you have the same organs as everybody in your family, they function differently.
This is where it’s not just about diet. Healing isn’t just about diet. You need to look inside and understand what’s true for you. And it’s exciting! You get to learn more about yourself, you get to really play with the edges of what works and what doesn’t.
GAPS is a high fat, high protein – that’s a very minimalist way to say it, but it’s a lot of broth, fats and meats.
Jennifer: It’s interesting. So, we’re going to even head to more restrictive and go to the AIP. What is the AIP and how does that compare with the other three?
Andrea: Again, SCD is a good umbrella, GAPS fall under that. Maybe GAPS becomes the most restrictive. Everything is very well-cooked in the GAPS diet so that it can be easily digested, so you’re really going light on the digestive system as long as your body can break down those proteins and fats.
AIP is a Paleo diet, which means it’s grain-free and low carbohydrate. The processed foods are removed. It’s also anti-inflammatory, but it goes a step further, removing all dairy, all nuts and seeds, fruits are even brought in at a minimum, yeasts, eggs, shellfish, peppers, spices, no nightshades involved.
So, basically, an AIP diet is fats like olive oil, lard and coconut oil if you can tolerate that, meats and fishes and organ meats, veggies and seaweeds.
Jennifer: It is a restrictive diet. I interviewed Mickey Trescott recently all about how to make AIP doable.
Andrea: Yeah.
Jennifer: And she acknowledged to me that without planning, this diet is pretty much impossible. You have to plan for it. It is not easy to eat out doing it and it’s not something that’s meant to be a long-term way to approach your health. That’s not what it’s for. You’re not going to be on AIP for the rest of your life. It’s there to help you figure out what does work for your diet and what doesn’t.
Andrea: Yes. None of these diets that are that restrictive are meant to be part of your protocol for more than two months. It might mean you have to go back to it once in a while and go there for 30 to 60 days if you’re flaring, but we don’t want to stay there.
Jennifer: If you are in a state of autoimmunity and you know for sure you’ve got Celiac disease, Hashimoto’s, rheumatoid arthritis, or something like that… or even if you don’t have clear answers… Do you find that these are helpful or are they best for people that don’t really have a clear answer as far as what is going on with their health?
Where do you even start?
Andrea: Start walking is what I want to say. I think that you want to embrace the overarching principles that I’ve been talking about where you’re removing all the inflammatory foods.
What you’re talking about are inflammatory conditions. On some level, the immune system is overactive. It’s doing what it’s supposed to do, producing inflammatory chemicals to try to heal, but those chemicals aren’t turning off. So, for some reason somewhere, there’s extra inflammation.
And that’s what autoimmunity is, that’s what most chronic illnesses at the core. If we go upstream, we’re looking at inflammation.
The way to tame inflammation is by taking out the inflammatory foods. Again, always start with doing a full-on anti-inflammatory elimination protocol. And by that, I mean, you can start basic. No gluten, no sugar, no dairy. Those are your most inflammatory foods. You’re on a whole foods diet. You’re certainly getting rid of any processed foods and anything that you know you’re sensitive to.
First step for me is just an anti-inflammatory protocol. No gluten, no dairy, no sugar. If you’ve gone there and you’re still finding you’re not getting better or you’re reactive, then you might want to actually do some testing and see what’s true for you.
So this is where we’re working with a practitioner, we do this testing in practice, food sensitivity testing, looking at how your body is responding to certain foods because you may be looking for categories with one of these specific, very restrictive diets when, actually, what you need is just to remove one food.
Testing is the next step. “Test, don’t guess” is what I’m always going to say. Find out what’s going on for you. See if there’s any food sensitivities.
If you’re on your own, take it the next step further. Do an elimination protocol where you look at what you’re suspicious about and you remove foods and you play with it in a way where you take something out for three weeks and then you add it back in, wait three days, see how you feel.
I’m really a fan of eating as expansively as we can, so we’re getting a variety of nutrients while understanding what our restrictions are. Does that make sense?
Jennifer: It absolutely does! I think that’s a great response. And I also liked that you’re reminding people as well that they should look at this from a place of testing, of exploration as opposed to, “Well, I’m sick, I can’t eat this and I have to give up that.”
That cycle becomes so depressing because you feel so limited by your experience, as opposed to what you’re suggesting where it’s like, “Well, I’m just testing, I’m in an experiment mode. I’m going to figure out what doesn’t work instead of giving everything up” and trying to stick with it as long as you possibly can and then burning out.
Andrea: Yeah, absolutely. And we see so many people that come into our practice eating like three foods. So, they’ve gone down this road where they can tell, “I don’t feel good. I don’t feel good. I don’t feel good.” And as a result, they limit their diet further.
Now, because that becomes nutrient-restrictive, it also is brain-limiting. We don’t have what we need to function. It is depressing, not merely by its deprivation mode, but also, you’re not getting what you need to survive and to thrive.
So, it’s really important to find help on that journey, to find the root cause.
Jennifer: Well, I really want to just appreciate you for joining us, because I think this conversation is one that many of us have been having, especially in our own head, as you’re looking at the internet, and reading all these things. It’s like, “Which way do I go? What do I do? Can I trust my body? Do I feel well enough?”
I think you’ve provided us with a lot of clarity that many walking into this conversation and listening might not have had before. So, I want to thank you so much for being willing to join us on the podcast. You’ve also got a really great newsletter that you have recipes and all sorts of things. What can everybody expect if they’d like to join you in your newsletter? And you’ve got a great eBook called Stick With It, as well, what can they expect to hear from you when they join you?
Andrea: I thank you again for having me here. I think that the one thing I just want to say in leaving before telling people about the ebook is that it really is a mind shift. It’s more about how we approach our health than about any one dietary theory.
Know you are you. You are unique and your journey in all of these is going to be unique. And that it will carry you through and lead you to the right answers, the right practitioners, and really, the best support for you.
You can get my free eBook, Stick With It, that speaks specifically to this concept that I was talking about so we can live even when we’re following a restrictive diet of some sort, whether it’s just gluten-free or it’s Autoimmune Paleo for a 2-month period of time, how do you live with that and stick with it.
Live and stick with it, that’s really what that’s playing with.
And then I mail my audiences once a week, usually on Thursdays. It’s very much in keeping with the discussion we’ve been having. So, how do we shift our mindset? It must be something specific like looking at our poop or tracking our food mood poop or thinking about our liver during this spring time. It’s very much contextualizing our relationship to our bodies and to our diets and how we think about nutrition in a different way.
Jennifer: I love it. Thank you again so much for joining us.
Andrea: Thank you!
Jennifer: Her website is ReplenishPDX.com. I will post up Andrea’s links for Facebook and Twitter, as well as her URL for her website and the ebook all below in the show notes.
And I have to tell you again, this was months in the making, getting Andrea here, and I’m so glad we were able to make this happen. Please stay in touch with her.
And then remember, if you love the information that you’ve heard today, please subscribe, rate and review this podcast. And then leave any questions and comments below. Andrea and I will hopefully have some answers for you and I hope that we’ll be able to have her back sometime soon.
Thank you so much for joining me. I wish you all the best on your journeys. I’ll see you the next time. Bye bye.
IMPORTANT LINKS
Andrea’s website – ReplenishPDX.com
CLICK HERE to get a free copy of Andrea’s eBook Stick With It!
Practitioners looking to understand how to help their clients better, CLICK HERE to check out Andrea’s Holistic Nutrition Lab.
Facebook: http://www.facebook.com/replenishpdx
Twitter: https://twitter.com/AndreaNakayama