For every complex problem, there is an answer that is clear, simple, and wrong. — H.L. Mencken
My study on nonalcoholic fatty liver disease continues. In an earlier post, I introduce you to Johanna where I also note she currently follows a FODMAP* diet.
I’m interested to see how you integrate not only food but also genetics, Johanna says to me. More and more, I think that there is a link between genetic variation and modern food. I have an interesting story I inadvertently discovered about my genome last week. About 18-24 months ago, my skin took on a definitely orange yellow hue. Understandably, my PCP thought I might have jaundice, but my bilirubin levels were within normal range. I asked her to check my beta-carotene levels and reluctantly she did, and those came back sky high. Being a vegan, I ate lots of vegetable and I took a multivitamin but those things didn’t really explain beta-carotene. The PCP didn’t speculate at all and to be honest, wasn’t even concerned. Last week I was reviewing a manuscript where I learned about a gene that metabolizes beta-carotene to vitamin A. There are variants in the gene that render it inefficient or useless and out of curiosity, I checked my DNA sequence on 23andme, and was perhaps not surprised to discover that I had all of the mutations. So not only was beta-carotene building up in my body because of the significant vegetable consumption but it also meant that I was deficient in vitamin A, which has been associated with liver disease. I think that there are a lot of factors that on their own might not be sufficient to cause liver disease, but in combination, are deleterious. For me, the combination of genetic susceptibility affecting multiple biological pathways and a strictly vegan diet for decades contributed to a host of factors (chronic choline deficiency, vitamin A deficiency, gut dysbiosis) that made me susceptible to storing fat in my liver.
I ask Johanna to tell me what she used to eat before the FODMAP diet and what she currently eats. I make a list and begin to consider placing the foods into the composition. I cannot help but think this is like a game of Chess where each move is strategic. I settle on a basic black and white Chess board-like grounding. White squares hold food Johanna eats while black squares are the food she is not eating (at this time). I have my own feelings about some of the foods and place a few onto both squares. Now, as I write this post, I wish I had not done this.
Curious, I say, I don’t understand why you gave up cashews and almonds. And why green bananas and not ones almost ripe? Why give up grains?
Johanna responds, ...cashews and almonds have compounds in them (FODMAPs) that create inflammation in the large intestine. Same with the apple, but I won’t mind if you leave the apple on a white square because it looks pretty there.
The apple is in the no foods column in my notes. Still, I assume the apple goes onto a white square. (…an apple a day keeps…you know the rest…) The act of taking out the apple makes something clear; I’d be bummed if I had to erase apples out of my diet. I feel for Johanna. #Choices #CostsBenefits
Johanna explains: I have been on a low FODMAP diet (prescribed by a gastroenterologist) since February and for the most part, it has mitigated a lot of the IBS symptoms. The low FODMAP diet is supposed to be a three-part process: 1) elimination of high FODMAP foods, 2) reintroduction of these foods one at a time, and 3) maintenance. Sadly, every time I try to introduce a high FODMAP food back into my diet, the IBS symptoms come roaring back. I am trying garbanzo beans today. Wish me luck!
As I paint, I think about a true whole food, a food that has not been processed. I am reminded of how sugar and salt come into the picture and how they eventually may contribute to chronic disease.
I bring in walnuts (white), cabbage (white), pasta (black), lettuce (white), salmon (white), wine (black), grains (black), tomatoes (white), berries (white), oatmeal (white) and soy (black). I forget how much I enjoy drawing and painting food.
I introduce images referencing genetics: human cell, chromosomes, DNA, mDNA and pedigree chart.
Johanna ends our conversation with good news, I just had blood work done in March and all my values are within normal range for the first time since I started this hepatic journey!
*I explain FODMAPs and IBS complications in → introduction post.
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