Recently I polled my Facebook friends about rich people’s complaints. It was for a novel I’m working on, but one answer felt uncomfortably close to real life: “obscure dietary restrictions.”
This displeased me. As a person suddenly forced to abide by obscure dietary restrictions — my stomach abruptly started objecting to most foods that fall under the category of “delicious” eight months ago — it pains me that people view the concept of nutritional medicine as akin to Gwyneth Paltrow Kegel-ing jade eggs.
I am, well, fed up — both with our cultural attitudes about food and health and with our medical system’s stubborn refusal to embrace their connections. Make no mistake: The disdain for those connections is as prevalent among some doctors as it is the public.
Yet those connections are becoming clearer every day. Some 70 million Americans suffer from gastrointestinal troubles, notes the National Institute of Health, a number that is on the rise. According to a study in the Journal of Gastroenterology and Hepatology, functional gastrointestinal disorders, like constipation and bloating, “rank second in the causes of absence from work or school.”
In some ways, I have the ultimate first world problem, both in the figurative sense — I’m not living in a war zone — and the literal: Research reveals that the American sugar- and fat-filled diet, overuse of antibiotics, painkillers and anti-bacterial everything could be leading to a kind of gastrointestinal crisis. The Centers for Disease Control and Prevention notes that the prevalence of food allergies among adults in the U.S. increased by 50 percent between 1997 and 2011. Meanwhile the age of onset for food allergies, Type 2 diabetes and Crohn’s disease is decreasing every year, and the childhood obesity rate is nearing 20 percent.
Say what you will about the alt-science of trendy (and high-priced) health movements, but something really is awry with the American stomach.
Say what you will about the alt-science of trendy (and high-priced) health movements, but something really is awry with the American stomach.
Justin Sonnenburg, associate professor of microbiology and immunology at Stanford University and co-author of “The Good Gut: Taking Control of Your Weight, Your Mood, and Your Long Term Health,” has been studying what’s going wrong, and has a few hypotheses. “C–sections, antibiotics, baby formula, overuse of sanitizers,” are wreaking havoc on our insides, Sonnenburg told me. “And of course, diet.” He calls them the “insults of industrialization,” working together to diminish the microbial community in our guts.
Again, science is on our side, here. Significant research shows the connection between restricting certain categories of foods and improving your stomach bacteria, or microbiome. There is a developing body of research showing that replenishing your microbiome can directly affect your mental health.
So why the disdain for people trying to cure their ailments nutritionally? One reason is the rise of lifestyle wellness media, the Goop.com-style websites that position real scientific research on the same plane as jade eggs, face yoga and “brain dust”— “an enlightening edible formula alchemized to align you with the mighty cosmic flow needed for great achievement.” These are things with no proven efficacy that are available only to those with disposable income (that jade egg, for instance, will run you $66 and may actually be bad for you. Meanwhile, 1.5 ounces of brain dust costs $38).
Such sites make “wellness” a commodity, obtainable by only the elite. And as a result wellness, we seem to have collectively agreed, is for the wealthy. Even articles debunking such sites make fun of those who might argue the merits of dietary restrictions generally.
But just because gluten-free food is a fad and a billion-dollar global industry doesn’t mean there isn’t real scientific and medical merit in investigating the steep rise of celiac disease, among other GI disorders. And related, just because celebrities are avoiding soy and wheat and downing chia-flax-açai concoctions doesn’t mean that the rest of us shouldn’t be following in their footsteps, at least part of the time.
The problem is, it’s incredibly hard to do so unless you can afford their shoes. Take my experience. For eight months I tried every Western medical test and intervention — everything covered by insurance — I could. I tried endoscopies, prescription drugs, allergy tests, breath tests, sonograms and blood tests, all of which showed or did nothing. (If you’re wondering about poop tests: Not a single doctor asked for one.)
At each stop, the doctors — GIs, internists, allergists — would dismiss the connection I’d discerned between certain foods and severe bloating and stomach pain, often snidely. Some outright scoffed at the notion of food sensitivities or intolerances. If the world of commerce is all too ready to embrace the microbiome path, the medical world remains all too resistant to it. While game to treat the symptoms, no doctor I saw was keen to discern their cause.
If the world of commerce is all too ready to embrace the microbiome path, the medical world remains all too resistant to it.
“You should go see a functional medicine person,” one doctor, at a boutique medical firm requiring a yearly $200 membership fee, told me. “Their focus is the root cause of the problem.”
“Shouldn't that always be the focus?” I asked. She didn’t answer.
None of the people she referred me to took insurance, so I steered clear until I was almost completely out of energy, my face had aged five years and I hadn’t successfully digested a meal in weeks. Only then did I begin to see functional medicine experts. These practitioners tested various foods’ affect on my muscles and nervous system and handed me a list of foods they said my body was reacting negatively to: gluten, dairy, sugar, soy, corn, fruit (excluding limes, lemons and berries but including tomatoes), nuts and, weirdly, millet.
Out of desperation, even though I was suspicious of their methods, I heeded their nutritional warnings and restricted my diet, among other negligible activities like drinking an apple cider vinegar cocktail and swishing raw sesame oil in my mouth for 20 minutes each morning.
Here’s what happened: I started getting better. It seems those foods were indeed making me sick. My body is starting to heal without them.
But that healing is a function of privilege. While not rich, I can splurge for a $125 functional medicine appointment, and I live in New York City, near a food co-op that gives me affordable access to a lifetime’s worth of organic kale and quinoa.
People who suffer from GI ailments and live in food deserts may not have the option of restricting their diets — rich people get to complain about dietary restrictions because they are the ones with the privilege of embracing them.
So in some ways, my Facebook friend was correct. People who suffer from GI ailments and live in food deserts may not have the option of restricting their diets — rich people get to complain about dietary restrictions because they are the ones with the privilege of embracing them. I saw this reflected recently at an eatery called Dr. Smood’s, which bills itself as “the healthiest café in Manhattan” and proclaims: “Our food is the new health care.”
They could be right. But who can afford their $10.95 detox kale juice and $14.95 wild-caught salmon sandwich on “power bread?”
Rather than dismissing attempts to solve medical problems nutritionally, we should make that part of the standard of care. My health insurance company, if it’s truly interested in my health, should be as willing to pay for zucchini-beet patties as it is to prescribe me Prilosec.
We are under the impression that it costs more to prescribe a diet than a pill. But a 2013 report by the Union of Concerned Scientists found that it could cost $17 billion less a year if Americans ate the daily amount of fruits and vegetables recommended by the USDA.
“Gastroenterologists are the ones giving advice and they know surprisingly little about the gut microbiome, because it’s not what they learn,” says Sonnenburg. Meanwhile, he notes, the world of wellness lifestyle media and products “can play off this hype,” he said, “and fill a void.”
We need to see changing our diets as part of a larger health plan, and not as the insincere whims of navel-gazing Goop.com readers with endlessly deep pockets. Yes, I am saying, “Please don't make fun of me for asking which menu items are gluten-free.” But I’m asking on behalf of every broken tummy person who is trying to heal. In order for a shift in the medical establishment to occur, we need a shift in our cultural attitude first. Wellness should be a right, not a fad.
Lisa Selin Davis is the author of two novels, "BELLY," and "LOST STARS." She has written about a variety of topics including urban planning, the environment and parenting.