Rabbit Starvation

A few weeks ago, I was complaining (ok, I was full on whining) to my fiance — who is graciously and selflessly doing the diet with me — about how much I hated the endo diet, how hungry I am always am, how terrible I felt, and how badly I wanted a slice of pizza.

Fiance: I know it’s hard, and I’m sorry, but how do you feel terrible?
Me: I’m so cranky, and I’m constantly tired. My mind is foggy. I just feel bleh. And it’s really hard to be hungry all the time, no matter how much I’m eating.
Fiance: Maybe you should start keeping a food log so we can make sure you’re getting enough calories. What did you eat yesterday?
Me: A fruit and spinach smoothie with almond milk for breakfast, a huge bowl of eggplant and lentils for lunch, and the black bean quinoa thing we had for dinner.
Fiance: And the day before, do you remember?
Me: Another smoothie and some popcorn for breakfast, salad and two bean tacos for lunch, and the chicken stir-fry I made for dinner. See, I’m eating. I’m often stuffed after a meal, but then I’m hungry again in like an hour.
Fiance: I think you’re rabbit starving.
Me: ?????

Rabbit starving, it turns out, is a kind of malnutrition that early settlers faced when they tried to make it through the winter eating only rabbits. Rabbit is a very lean meat, and no matter how much of it you eat, it can’t sustain you because there isn’t enough fat.

The side effect of the endo diet is that you eat healthy. Take out dairy, red meat, eggs, animal fat, sugar, and gluten, and there’s very little left in terms of indulgences and junk food. So without even meaning to, I removed almost all of the fat from my diet, and it made me feel terrible.

Interestingly, it stopped me from losing weight too. The first few weeks, I lost weight quickly and easily, but then it just stopped, even though I was following the diet very strictly and had even added in some exercise. Then I went on vacation, and while I did adhere to the diet, I ate much less healthy. I ordered sandwiches on gluten-free bread with a side of french fries. I snacked on potato chips in the hotel at night. I had sorbet twice. I even had a snow cone and french fries for lunch one afternoon when we were at a county fair and my options were very limited. The strangest part (and what should have been a huge red flag) is that I lost about a pound and a half that week! In hindsight, we’ve decided that my body must have gone into some kind of starvation mode in those weeks when I wasn’t feeding it any fat, and when I went away on vacation, my metabolism revved back up.

If you’re wondering why this didn’t happen to my fiance as well, it’s because he loves nut butters. He puts a huge glob of peanut butter in his morning oatmeal, and often snacks on rice cakes with sunflower seed butter in the evening. He also has a jar of nuts on his desk at work and will sometimes grab a bag of chips from the vending machine. His higher intake of fat and his lack of hunger and symptoms is also what led us to conclude that I needed to eat more fat.

It’s kind of counter-intuitive, I know, I’ve been enjoying losing weight (the only perk I’ve found from endo!), so it seemed smart to eat healthy while I eat for my endo, but I guess there really is such a thing as eating too healthy. Anyway, I’ve now been eating a handful of nuts with my morning smoothie, am sauteing our veggies with olive oil and garlic instead of steaming them, have incorporated avocados into more of our meals, and have been more lax about using oils in my cooking. Since making this shift, I’ve felt much, much better and have continued to lose weight!

So, if you’re also following the endo diet, be careful about your fat consumption. It’s an important nutrient despite what the diet industry has drilled into our heads 🙂

Eating with Endo

Or, maybe that should say “Not Eating with Endo.”

The diet for endometriosis is quite restrictive, and honestly, pretty overwhelming. When Dr. X first said he thought my cyst was caused by endo, I immediately went home and started researching. The amount of information about what you should and shouldn’t eat is vast, and unfortunately, often conflicting. I ended up putting my trust in three sources:

1. Endometriosis Resolved – This is a great website which nicely spells out what to eat and why. It’s my go-to resource, and I often refer back to it when I’m craving something and desperately want to cheat. (Read: “Ok, but how bad is this piece of cheese actually…” And then I remind myself about all the ways it can cause me pain and regretfully put it down.)
2. Stop Endometriosis and Pelvic Pain by Andrew S. Cook – This book is a wonderful resource for anyone with endo. It covers everything from the mysteries and myths of the disease, to different surgery techniques, treatment plans, and other underlying health problems that can be associated. It also has a section on nutrition that I found very helpful.
3. Endometriosis: A Key to Healing Through Nutrition by Dian Shepperson Mills and Michael Vernon – Written by a nutritionist in England, this book is very in-depth and informative, almost too much so. It’s heavy on science and and gives lengthy explanations about how different parts of the body interact with various foods an chemicals, which is great, but it’s sometimes a bit over my head. Even so, it was incredibly helpful in shaping my diet.

Ok, so after reading through all of these, I came to learn that I need to avoid:

• Dioxins – An environmental toxin which may change the immune system’s response to unregulated growth of endometrial cells. It can also disrupt how hormones work. Amazingly, they did a study in 1992 with rhesus monkeys, and 79% of the monkeys who were exposed to dioxins developed endo, while those who weren’t exposed had very little or no disease!
  • To reduce your ingestion of dioxins, you need to avoid dairy, fatty meats especially red meat, egg yolks, and bleached paper products. That last one is really important. Tampons and pads are bleached and treated with tons of chemicals. Make the switch to organic, chlorine-free feminine products!
• Phytic Acid – Found naturally in wheat and soy, phytic acid can aggravate symptoms of endo and reduces the absorption of calcium and other minerals, which is especially important for endo ladies because we’re supposed to cut out dairy.
• Prostaglandins – These are very complicated, and I still don’t entirely understand them. The Endo Resolved website calls them fatty acids, the Mills and Vernon book refers to them as “oil-based hormones,” and the Cook book (ha, cookbook!) just says they’re “compounds found in tissues that stimulate nerve cells.” So, I don’t know, take from that what you will. Anyway, from what I can gather, prostaglandins cause inflammation, contractions, and pain; however, that’s really their job. Our bodies need prostaglandins to ovulate, menstruate, and give birth. They are also involved in immune responses where we need that inflammation to fight infection. The problem comes when we have too many bad prostaglandins — or prostaglandins that have escaped the uterus and are running rampant in our abdomens! — as they then cause too much cramping and inflammation.
  • So, we want to avoid these bad prostaglandins which are found in saturated fat, animal fat, dairy, red meat, and butter, while we increase our consumption of the goods ones, which are found in omega-3 oils and help to reduce inflammation.
•  Inflammatory foods – It’s pretty obvious why we don’t want more inflammation in our bodies when we’re already growing unexpected tissue all over.
  • To lower your overall inflammation, avoid wheat, red meat, refined sugars, and dairy.
• Caffeine  – I know, I know, I love coffee and chocolate too. But caffeine can increase cramping and more importantly, increase estrogen levels, which we definitely don’t want since endo feeds on estrogen. Sorry, Starbucks lovers.
• Alcohol – Alcohol robs the body of B vitamins, which are stored in the liver, and we need our livers in tip top shape so they can remove excess estrogen. The Mills and Vernon book states, “the risk of endometriosis was roughly 50% higher in women with any alcohol intake than in control subjects.”

And finally, the most controversial element, which I personally decided to avoid:

• Phytoestrogens – Phytoestrogens are naturally occurring estrogens in plants like soy, wheat, flax seed, sunflower seeds, and many others. Some researchers think that by consuming this extra estrogen, we are feeding the endo and making it worse. However, others say that these weak plant-based estrogens actually block estrogen receptors in our bodies and are therefore balancing or even lowering the amount circulating estrogen. No one can really decide, which is frustrating. The Endo Resolved site says to avoid high levels of phytoestrogens, while still eating them in balance to block the receptors. Cook’s book encourages ladies with endo to eat phytoestrogen-rich foods for that blocking benefit. The Mills and Vernon book admits that no one conclusively knows what is best and shares two studies. The first study looked at Japanese women who consume a lot of soy and have low rates of breast and uterine cancer, but high rates of endometriosis, leading them to conclude that it’s unclear what the phytoestrogens do in the body. How can they reduce these estrogen-associated cancers but increase estrogen-fueled endo? In another case, a zoo started feeding their exotic cats a diet of 50% soy protein, and they became infertile, but the fertility was restored when they were switched back to chicken!
  • So, it’s kind of a personal choice. I’ve decided to cut out all soy and wheat since they are inflammatory and contain phytic acid as well. However, I will occasionally use flax seed when I’m cooking as it’s a great binder to replace eggs in recipes, and I feel the phytoestrogen from the flax is probably going to hurt me less (and maybe even help) than the dioxins from the eggs. Obviously, make the decision that feels best for you.

TL;DR

Foods to Avoid
– Dairy: Very inflammatory, a primary food source of dioxins, contains growth factors and hormones, increases bad prostaglandins
– Wheat (Gluten): Contains phytic acid, promotes inflammation, and many ladies with endo also have a gluten sensitivity
– Red Meat: Contain growth hormones, bad prostaglandins, dioxins, and causes inflammation
– Sugar: Inflammation, inflammation, inflammation
– Coffee and Chocolate: both contain caffeine which can increase estrogen levels, interrupt liver functions, and is a phytoestrogen. Chocolate also has sugar, see above.
– Alcohol: Impedes the liver’s ability to remove excess estrogen
– Egg Yolks and Animal Fat: Dioxins are stored in the fat of animals
– Soy: Research goes either way on the phytoestrogen component of soy, but it also contains phytic acid. There’s a great article about why you should avoid soy on Endo Resolved, which you can read here.

Foods to Embrace
– Omega-3 Fatty Acids: Found in salmon, flax seed, walnuts, and leafy greens, they increase good prostaglandins which reduce inflammation
– Fiber: Good sources include oatmeal, legumes, brown rice, fruits and veggies. Fiber helps decrease circulating estrogen levels.
– Cruciferous Vegetables: Broccoli, brussels sprouts, kale, cabbage, mustard greens, etc. These vegetables help metabolize estrogen healthily.
– Immune Boosters: Garlic, ginger, onions, carrots, rhubarb, legumes, seeds, and green tea.

Good luck and happy eating! 🙂