I am fascinated by food – what makes us eat the food we eat and how it affects our health. I’m especially interested when there is evidence to support the ideas.
As the American diet has changed in the past few decades, we have been gaining weight. It is also true that we are seeing more diseases – especially those that have an inflammatory component. Inflammation is when the body responds to things that shouldn’t be there – like an infection or a chemical – and the body sends cells to the area to fight them off. This can lead to pain and swelling, among other things. Some diseases caused by inflammation have “itis” at the end – arthritis, colitis, bronchitis, etc.
Is it possible that the food we eat is causing some of these diseases that are due to inflammation?
We know that people with celiac disease get pain in their bellies and diarrhea from eating foods that contain gluten, such as bread, pasta, cookies, etc. Gluten is a protein found in wheat, rye, and barley that has been found in research studies to cause inflammation in the gut in people with celiac disease. But can foods cause other diseases that are due to inflammation, even in other parts of the body?
A fascinating article in the NY Times Magazine a few weeks ago, The Boy With a Thorn in His Joints, is a mother’s account of how her 3 year old son, Shepherd, developed juvenile idiopathic arthritis (JIA). “Idiopathic” means we don’t know what caused it. JIA is very painful and can be cause problems with growth so is treated with powerful drugs that fight inflammation. Shepherd was put on methotrexate, a drug that treats inflammation (and can also be used to treat certain kinds of cancer).
While Shepherd was still in a lot of pain, the author learned of a social worker and massage therapist named Char Walker, who treated her child’s arthritis with diet and herbal remedies. This was based on an idea called “leaky-gut syndrome” – that inflammation in the gut caused by certain foods can cause proteins and bacteria to “leak” from the gut and cause inflammation in other parts of the body. The author was initially skeptical but when Shepherd’s arthritis continued to worsen she started thinking about this alternative therapy. She was also concerned about the possible long-term effects of the methotrexate.
Research shows that leaky gut syndrome exists but there is no proven connection to JIA. The author understood this but wanted to try the treatment plan that Char Walker had used and discussed it with Shepherd’s doctor who did not think it was likely to cause any harm (he didn’t really think it would help either). They worked out a plan to try the new treatment plan but also to continue the methotrexate for at least 6 weeks when it usually starts to take effect. After 6 weeks, Shepherd felt much better and was able to come off the methotrexate. The author states clearly that we don’t know for sure if the diet and supplements were the reason he got better.
The possibility of food causing (or triggering) disease is interesting and worth further research. But, the best thing about this story is that the doctor listened to the parents and worked with them to come up with a treatment plan that they could all live with.
Doctors need to be willing to think in innovative ways, communicate with patients and their families and work with them to make the best decision for the patient. That is the Care Triad at work.