Last July, I wrote my first post for Eat + Run – and there have been 50-odd pieces since. My goal is to share practical, evidence-based nutrition information that cuts through the myths, half-truths and generic nutrition advice that's too vague to be useful. But in trying to educate others, I've been schooled by my readers as well.
1. When discussing Diabetes, ALWAYS distinguish between Type 1 (autoimmune) and Type 2 (acquired).
My most humbling moment as a blogger followed an article I wrote about prediabetes, in which I discussed its alarming prevalence and possible ways to prevent its progression to diabetes. In referring to "diabetes," I neglected to specify that I meant Type 2 diabetes – a metabolic condition that can be brought on by controllable factors such as weight or diet in addition to uncontrollable factors like genetics.
An outpouring of e-mails followed from people affected by Type 1 diabetes – formerly called "juvenile diabetes" – an autoimmune condition in which the body attacks its own insulin-producing cells, resulting in lifelong dependence on insulin injections to manage blood sugar levels. This type of diabetes represents the minority of all cases (about 5 percent) and is not currently treatable or reversible by medications, diet changes, exercise or weight loss.
These readers explained that they and their children are confronted with misunderstandings and harsh judgments daily. Some kids with Type 1 diabetes are scolded by strangers for causing their disease by "eating too much candy." Parents described needing to shield their kids from online articles about scary "diabetes-related" complications that actually refer to Type 2 diabetes. They were understandably frustrated by my article – another example of the media confounding rather than clarifying. They also directed my attention to an online petition to the American Diabetes Association and the National Institutes of Health requesting that they change the names of Type 1 and Type 2 diabetes to "better reflect the nature of each disease."
Needless to say, I signed the petition. Lesson learned.
2. There are a lot of gassy, bloated folks out there suffering in silence.
I write about bloating and gas quite a bit, and these articles are far and away the most trafficked pieces I've written for Eat + Run. While they generate no online comments or Facebook likes, I receive tons of e-mails from shy readers desperate for relief from the gas that plagues them. Why are we all so uncomfortable?
Interestingly, patients from cultures in which the traditional diet is consistently high in gassy foods like beans, cabbage or cauliflower virtually never complain to me about gas and bloating. It's not that they don't produce gas; it's just that it tends not to bother them. Sensations of discomfort tend to diminish over time in healthy people who produce a high level of intestinal gas resulting from consistently high fiber intake. It's a type of acclimation that results from sensory nerves becoming saturated with stimuli; after a while, they stop sensing. Think about how you stop smelling your perfume as the day wears on – it's the same phenomenon.
By contrast, the typical American diet is quite low in fiber and, by extrapolation, the average American gut may be less accustomed to the sensation of distension that may result from the sporadic bowl of lentil soup or occasional salad.
Of course, this doesn't preclude the possibility that our collective bloat is more than just out-of-practice sensory nerves. America's highly processed food supply hosts ever-growing doses of highly fermentable carbs like fructose, inulin (chicory root fiber) and sugar alcohols like sorbitol and xylitol. Fermented by gut bacteria, these ingredients can produce a substantial amount of gas. And the prevalence of Irritable Bowel Syndrome (IBS) is estimated at 10 percent of the population.
[Read: IBS? Could be the FODMAPs.]
People with IBS tend to be hypersensitive to even minor distension of the intestinal passageways, meaning that they can experience substantial pain even from "normal" amounts of gas. The bottom line: If gas and bloat plague you, don't suffer in silence! Seek help from a gastroenterologist or gut-savvy dietitian to help pinpoint the source of your woes.
3. Nothing provokes a spirited online debate better than childhood feeding and nutrition topics!
Whether the topic is infant feeding, how to introduce solids, giving candy to kids or getting kids to love their veggies, the "live and let live" philosophy seems not to apply to online dialogues about childhood nutrition. Why can't we all just get along?
There seems to be a lot of fear around childhood nutrition, with an underlying concern that there's only one chance to get it right (so we'd better not screw it up.) In this context, whether that first bite is rice cereal or sweet potato takes on epic significance – when in reality, it probably matters very little. Complicating matters is the substantial variation in feeding philosophies among pediatricians, in which parents routinely receive advice from "experts" that conflicts with what others in their circle have been told.
I suspect also that critiques of how we feed our kids can feel like critiques of us as parents – and by extension, as individuals. In this regard, it's understandable why we can become so defensive about our choices when these topics arise.
I wonder if this emphasis on specific foods we feed our kids overshadows an equally (or more?) important focus on the eating habits we instill in our kids. New (healthy) foods can be introduced at any time, and old (junky) ones can stop appearing in the pantry. Tastes change and mature. Children acclimate to their family's diet, learning to love strong flavors, spicy flavors and veggies in direct proportion to their exposure.
Habits, however, are much less flexible. Learning to stop eating when full; using food to feed actual hunger, not boredom or sadness; eating most calories at nutrient-dense meals rather than in empty-calorie snacks; accepting what's served at family meals rather than expecting a catered "kid's meal" … these are the foundations of a healthy, well-nourished life. How these habits are actualized with specific food leaves much room for personal choice, cultural traditions and "expert" interpretation.
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Tamara Duker Freuman, MS, RD, CDN, is a NYC-based registered dietitian whose clinical practice specializes in digestive disorders, Celiac Disease, and food intolerances. Her personal blog, www.tamaraduker.com, focuses on healthy eating and gluten-free living.