What I eat affects how I feel: consider an elimination diet for chronic pain

The Internet is full of dietary advice, much of which has as much basis in opinion as fact. I won’t try to define for you what constitutes healthy eating, but I can share an effective strategy for testing your own diet that could potentially improve your health and well-being.

You could feel healthier within weeks, and it is free

Twice in my life, I have undertaken “elimination diets.” I credit this process with measurably reducing symptoms that were severely impacting my quality of life. In my case, I was able to reduce migraine headache symptoms from daily to just a few episodes per year. More recently, I shifted constant, debilitating joint pain and fatigue associated with autoimmune disease to a still regular, but less incapacitating, condition.

In both cases, I was able to stop taking some preventative prescription drugs and take fewer pain relieving drugs (an objective and measurable result.) I also made myself feel better (a subjective improvement in my well-being.)

You don’t need to spend an extra penny to try it, and you should know within a month if it is going to work for you.

What is an elimination diet?

An elimination diet is not designed to eliminate weight and/or fat. This isn’t a weight loss diet. I think of it as a health gain diet; you could also consider it a symptom loss diet. I prefer to focus on the positive.

Reduce foods you eat to a “safe” list

Put simply, an elimination diet involves first reducing your diet to a limited list of foods known to be inoffensive. By inoffensive, I mean foods that are not commonly allergenic or irritating to the system. At this stage, you would eliminate any food you think might be triggering your own symptoms.

Re-introduce different foods one at a time

After a period (typically around three weeks) on the very restrictive diet, you re-introduce new foods one at a time into your meals and see if symptoms recur or increase. If you feel worse, you remove the offensive (or “trigger”) food again and go on to the next test food. Ideally, you wait a day or two after being “triggered”/negatively affected so your body can return to a neutral state.

Continue this process until you have tested the foods you prefer

You continue this process until your diet includes everything you prefer to eat (excluding trigger foods!) Speaking again from my own experience, it took me a few months to recover from almost daily migraines; I experienced profound relief on day four of my elimination diet for autoimmune disease symptoms.

Elimination Diet food picture - 1

I began with a low-fat, vegan diet of exclusively cooked foods, mostly vegetables. Olive oil was my only fat. I included rice, quinoa, and black beans. I avoided foods that I previously ate the most frequently.

What foods are safe to start an elimination diet?

The first time I did an elimination diet, my primary care doctor gave me a “migraine diet” that I used as a starting point. On my second go ’round, I consulted with a nutritionist recommended by my regular physician to compile a food list for myself based upon a website and a book I regarded as trustworthy.

I used the book, The Elimination Diet by Segersten and Malterre. I borrowed it from my library and read the whole thing, but you don’t need the book to try this technique. This couple does offer many useful resources as free printables on their website, however, and they do a nice job providing a thorough blueprint for those who don’t want to do a lot of planning for themselves.

The point of this intervention is to find out, for yourself, how specific foods affect you.

If you don’t know which foods to start with, begin with a recommended diet from a professional—either your own health provider, or a list from a book or website whose credentials you trust.

An elimination diet is a short-term experiment

Perhaps the most vital thing to know about this diet is that it is never meant to be permanent. I hate the experience of working through an elimination diet, especially those early, very limited weeks, but I like the results enough to commit to a few weeks of deprivation to feel much better.

If you undertake this process and finish up with a long list of foods you plan to permanently eliminate, I strongly encourage you to consult a dietician or doctor to ensure your nutritional needs will be met. In my case, only a few key foods seem to be responsible for a majority of my current symptoms.

Look beyond the usual suspects

Perhaps the most interesting thing I learned in my most recent elimination diet phase was that two common foods I’d barely suspected give me the most trouble. I won’t name them because it’s easy to label foods as “bad” and then proselytize for others to avoid them.

Please do your own experiment and find your own best diet. My two “bad foods” are not any of the foods so popularly demonized these days. (Hint: neither of them is a grain or gluten!)

Your long term diet should be healthy and sustainable

I’ve learned that other foods—some of which are commonly listed as likely triggers—affect my symptoms, too, but they do so in a more gradual, symptoms-building-up sort of way.

For example, I can include some dairy and some organic wheat in my diet and live pretty comfortably. I don’t eat freely of these foods, limiting them to special occasions, but I enjoy life a lot more. Allowing these, in moderation, means more excitement and variety in my meals, which is another factor in long term, emotional well-being.

The myth of “the” healthy diet

My two dietary interventions happened about 20 years apart and resulted in the adoption of somewhat different “ideal diets” each time. The biggest similarity between the two situations was the process.

Did I misinterpret my results the first time I did an elimination diet? Have my needs changed? Has food itself changed? All of these are possible.

It is really difficult to do great studies on human nutrition. To put it very simply, this is because:

  1. There’s no expensive product to market afterwards, so no one wants to pay for long term, well controlled studies of large groups, and
  2. People have really complex lives so it’s hard to design great studies that give straightforward results.

For this reason, I take every bit of nutrition advice with a grain of salt, and I try to stay very open-minded as new research is published. I think it is likely that different people have unique dietary needs based upon lifestyle and genetics, the same way we are susceptible to different injuries and diseases. I think we probably need different nutritional inputs at different stages of life.

I also believe that the adoption of modern, processed foods has likely affected human health in currently unknowable ways. After all, “traditional diets” sustained us for thousands of years, and they differed around the world. What are the odds that one very specific diet could optimize health for all individual human beings?

In the USA, our doctors typically receive little to no training in nutrition. They can advise us when we need to lose weight, or tell us to “eat a healthy diet,” but they aren’t necessarily in a better position than we are ourselves to create a specific blueprint for what we should feed ourselves.

I advocate this particular approach to health through nutrition experimentation because I have personally experienced success with it, twice. It is also free, costing more in time and commitment than financial outlay. You will have to do some planning to successfully undertake an elimination diet.

I don’t believe that we are responsible for every ailment that befalls us. Sometimes, we get hit with an unlucky break, in health as with the rest of life. But here is an opportunity to shift the odds back in our favor by putting in a bit of effort.

If you are suffering, consider trying an elimination diet. The most you have to lose is a little time—and the enjoyment of a few favorite meals—over a few weeks. What you stand to gain is good health.

Have you tried, or considered, an elimination diet? What were your results?

Capsule wardrobe for Hilton Head Island, under-seat carry on size

This won’t be as pretty as the Polyvore sets you’ll see on fashion-oriented blogs. I’m not a photographer or a fashionista. In spite of this, I want to post a capsule wardrobe as I packed it in an under-seat size carry on bag for a recent (early March) family trip to Hilton Head, SC.

Amtrak luggage on cart redacted

Train carry on luggage at Savannah, GA Amtrak station. For two travelers, we had three Tom Bihn bags: an Aeronaut45 (with our train compartment friendly Rolo inside for organization), Western Flyer, and a large Shop Bag full of snacks and bottled water.

Compact capsule wardrobe saves precious vacation time

Packing lists and capsule wardrobes—which is just a fancy way of describing a simplified wardrobe that can be mixed and matched to create many combinations— help me enjoy my trips more. My stress is reduced, I don’t waste precious vacation time deciding what to wear, and I can present myself the way I prefer to be seen when I’m meeting new people.

Rarely do I see a travel wardrobe capsule that reflects the reality of someone like me. Items of clothing on my petite yet plump and short-waisted body look nothing like the stock catalog photos on Polyvore. More importantly, my priorities begin with function before moving on to the more enjoyable considerations of color and form.

Dressing appropriately while maintaining health & function

I have an autoimmune condition that involves widespread joint pain. I suffer particularly from foot problems. My wardrobe is constrained by the limiting factors of shoes that accommodate bulky rigid orthotics and clothes that don’t squeeze or pinch even when inflamed joints swell.

My symptoms flare when I’m tired. Travel, no matter how wonderful, comes with physical and sometimes mental stress. Traveling light is one way to reduce symptoms from my condition: I’m less likely to wear myself out, physically, with a lighter weight bag.

And yet! I’m a colorful person who enjoys attractive clothes. I don’t obsess over fashion, but I accessorize daily. When time is ample, I willingly spend some of it on my appearance. I rarely wear black, which I find both boring and depressing, and my neutrals are often dark red or dark plum instead of sedate grey, navy, or taupe. I express myself sartorially.

Wardrobe and sleepwear

Every stitch of clothing (minus my raincoat) for five days with 40 degree (F) temperature variations in the forecast. It was COLD when we left; STEAMY arriving in Savannah.

Wardrobe considerations—climate and events

Our trip was for four nights and five days. We flew to Savannah, stayed three nights in a Villa at Sea Pines Resort, then DS1 and I rode the train (Amtrak, overnight) back home. We left and returned to temperatures in the 40’s; it was 60-79°F in Georgia and South Carolina. Because DH was traveling for work, we needed dressy clothes suitable for socializing with professional colleagues in a resort environment.

With a rental car and apartment style accommodations, I could have easily packed everything plus the kitchen sink. Aside from enjoying the planning exercise of creating a packing list for this trip, I wanted to travel light on Amtrak. There was no baggage car on our Northeast Regional train after connecting in New York City. The train’s carry on restrictions are much more generous than found on airplanes, but handling luggage remains one of my least favorite aspects of travel.

I used my smaller travel pack for this trip, a Tom Bihn Western Flyer. Even fully packed, I can typically manage this bag myself. It’s better when I don’t bring a laptop, which I didn’t need for this quick getaway.

Packing lists — never forget a vital item

Here’s my clothing packing list, adapted from this one at LadyLightTravel.com:

Packing List for Hilton Head

Outerwear

teal raincoatFor early spring travel, outerwear choice is pretty critical. We had occasional light rain in the forecast. Even a week or two earlier, I would have gone with my purple, lightweight down coat, but water resistance is my bottom line in spring. All five pockets on this coat zip securely closed—a travel essential!

  • Teal Duluth Trading soft shell coat (thin gloves, not shown, in a pocket)
  • Purple down vest
  • Purple thin knit cap (not shown, in coat pocket)
  • Teal waterproof sneakers
  • Grey Propet Women’s Travelactiv Mary Jane (dressiest shoe I could consider)

 

Ahnu shoes sneakers

Ahnu Sugarpine shoe rainbow! Podiatrist approved, and colorful enough for me. Front row: airier mesh; Back row: waterproof styles.

I had to make sure everything I brought worked with my comfortable, supportive Ahnu Sugarpine sneakers in teal. These are my go to shoes for reducing the likelihood of crippling pain from too much walking. I opted for the waterproof pair that coordinates nicely with my raincoat and capsule color scheme of teal-magenta-grey.

Bottoms

I started my fashion choices by selecting the bottoms. As a fairly modest dresser, there are some pants I won’t wear with more revealing tops. I wanted the freedom to remove layers as necessary in case the temperature was hotter than forecast while still literally covering my bum.Bottoms1

To layer underneath on the colder, northern ends of the trip, I had pieces ranging from long johns, to silk pettipants, to pantyhose (which violate the comfort doctrine, but I do wear them as needed to add discreet warmth when dressed formally.)

I’m counting my soft, stretchy Angelrox Goddess dress as “bottoms” because it layers well and stands in for a skirt. These dresses (I also own a full-length Goddess Gown) are body conscious so I usually wear a wrap or otherwise layer on top. Tight is not my style. The Goddess dresses are so soft and so comfortable, though, I can forget to be self-conscious about the snug fit. Wearing one, I feel as glamorous as an old time movie star with the comfort of pajamas!

Tops

This is where I cut back from my usual policy of having one or two extras, just in case. The weather was forecast to be moderate enough, and I knew I could go shopping if necessary. I usually do bring more pieces than this, but I absolutely did not need additional tops to wear fresh, interesting outfits every day.

  • Grey cotton/spandex Duluth Trading No-Yank Tank (not shown)
  • White ExOfficio crinkle kimono tunic
  • Floral sheer silk poncho
  • Magenta faux twinset (sheer silk turtleneck & cotton/nylon cardigan)

Accessories

This is where the magic happens! Wow, no, not really that exciting, but… this is where a bunch of clothing pieces that I like turn into full-fledged outfits like those I wear at home when my full closet is available.

I don’t bother with makeup very often, and my hairstyle is almost as minimal as wash-comb-go, but I didn’t realize how much my accessories matter to my sense of being “fully dressed” until after our home was burglarized a few years ago. Mostly, I was grateful that we weren’t at home or hurt and that nothing more than “stuff” had been stolen, but every morning for weeks, I would turn to the shelf in my bedroom where my costume jewelry had been and feel my heart sink at the empty space dusted with police fingerprint powder.

The thieves took most of my deceased grandmother’s costume jewelry and a little velvet box full of Post-it sized love notes my husband left me every Sunday morning before his karate class during our first few years of marriage. It’s ironic that they missed our hidden safe where my few expensive pieces of “real” jewelry  were hidden, but they stole slips of paper many times more valuable to me and lots of $20 jewelry that gave me joy but probably earned them virtually no cash.

  • Pashmina in grey/magenta/teal
  • Scarf in teal/white rayon
  • Angelrox teal “sleeves” (arm warmers or fingerless gloves)
  • Earrings (silver dangles)
  • Earrings (colorful stone dangles by Shayla Lynn Jewelry)
  • Necklace (silver with moonstone by Shayla Lynn Jewelry)

Unmentionables

Here I am mentioning the unmentionable, but I have to specify these details for completeness if you’re wondering how a capsule wardrobe really packs into a case as small as the Western Flyer.

  • Floral silk caftan
  • White rayon tank/tunic for sleeping (also works as a top in hot weather)
  • 5 pair underpants
  • 2 brassieres
  • 7 pair socks (one wool, 2 thin ankle socks, 4 no show footies)

These don’t factor into the wardrobe as far as style goes, though I’ll admit to a touch of smugness that my travel caftan color coordinates in teal blue.

Underwear and socks pack so small, I do usually bring enough to avoid hand-washing because I don’t enjoy it. I could get by with two pairs of each by sink washing every night, but I’ve never felt the weight loss was worth the time spent from my vacation day.

Remember that the outfit you wear on travel day doesn’t go into the carry on. Here’s what I wore onto the plane along with my water resistant teal jacket.travel outfit

Everything else

This is where I confess to everything else I stuff into my carry on bag… except there isn’t very much. First of all, my full confession includes the fact that I prefer to carry my everyday purse (a Tom Bihn medium Cafe Bag) aboard as a personal item. I don’t have to cram all my daily distractors into my Western Flyer!

I have a Tom Bihn Packing Cube Shoulder Bag that is always packed with my carry on comfort kit. This is where my inflatable neck pillow, silk sleep sack (we call it the sleestak, a la “Land of the Lost”), ear plugs, eye mask, and lip balm live. During a flight, it is big enough to temporarily house my Kindle or iPad, too, if it is easier to reach than my purse.

Aside from the Packing Cube Shoulder Bag, my Tom Bihn 3D Clear Organizer Cube 3-1-1 toiletry kit, and my electric toothbrush, I stash a water bottle in the front pocket of my Western Flyer, and I always carry at least a small personal PackTowl with the water. I’ve read my Hitchhiker’s Guide to the Galaxy! Also, my little guy is prone to motion sickness. And playground swings are often wet. A towel always comes in handy for moms as well as hitchhikers.

Putting it all together

When you’ve packed it all, the Western Flyer looks like this.

It zips closed without a fight. The Western Flyer isn’t over packed, and the bag weighs in at 9 lbs (just over 4 kg.)