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Health burnout, diabetes, and gluten-free absurdity

June 7, 2012

OK, coming up with interesting titles really is not one of my talents. 😉 And this is a rambly one, also typed on the phone; again, please excuse any typos I may have missed.

Today, I had intended just to comment on gluten-free eating done badly, inspired by a post at a diabetes-related blog I ran across last night, looking for more info on false hypoglycemia. (Which I prefer to think of as relative hypoglycemia, since “false” seems to imply that it’s not a legitimate problem-and I’ve heard more than enough of that over the years about symptoms, totally inappropriately. It may not carry a risk of death, but it sure can be hard to deal with.) But, I will get back to the intended topic.

Another thing that struck me last night, looking through the archives there, is that one of the major difficulties I’ve been running up against lately is not just diabetes burnout, but a broader chronic health problem burnout, which is helping me feel depressed on top of health problems very directly causing some depression. Which kind of ties back in, because most of it traces straight back to the adult-diagnosed celiac, yes. Not just the osteomalacia, which at least half of people with adult-diagnosed celiac will develop, and the associated chronic pain and general neuromuscular weirdness. I suspect that was also a factor in triggering the type 2 diabetes; see also Vicious circles: Diabetes, and vitamin and mineral deficiencies.

Between one thing and another, I have been having serious problems coping lately. This shit gets old, and the complications from having multiple things going on at once are not anything like linear. I just don’t talk about the frustrations anud feeling like I’m in a perpetual game of catch-up (and failing miserably), even trying to cut back on responsibilities, that much, because I don’t want to come across as some kind of whiny drag. The combo of social isolation (which I mentioned recently, and do intend to get back to when I have spoons available)–with a lack of people to talk to about some subjects–and trying to carry on with a stiff upper lip also gets very, very wearing. I have hesitated to write much about this stuff, but it needs to come out somewhere. And, in general, people just don’t talk about these things much, for the reasons I’ve mentioned and more. It’s easy to feel very alone, and mindfulness only goes so far toward coping.

Back around to the originally intended topic, prompted by Bob Fenton’s Gluten-Free Foods – Watch Nutritional Value. IME, an awful lot of the stuff offered explicitly as GF versions of familiar wheaty Western foods are just dire. They’re made primarily from refined starches–not flours, other than white rice flour, but things like potato and corn starch. Most people would balk at sitting down and eating a big pile of corn starch, but that is basically what they’re selling. That’s an iffy enough proposition for heavy substitution of staple foods for metabolically healthy people, but a disaster for someone who has trouble handling carbohydrates anyway.

I, somewhat unusually, happened to have a loaf of commercial GF “brown” bread in the kitchen. The “brown” here, AFAICT, usually means some whole wheat content, but not 100%. The ingredients in this? Water, tapioca starch, (white) rice flour, potato starch, rapeseed (canola) oil, maize starch, psyllium husk powder, treacle (basically molasses syrup), humectant (vegetable glycerine), stabilizer (hydroxypropyl methyl cellulose), dried egg white, yeast, salt, millet flakes, flax seeds, sugar beet fibre, caramelised sugar syrup, rice starch, preservative (calcium propionate), flavouring.

Nutritionally comparable to the “regular” stuff it’s meant to replace? I think not. This can at least claim to be high in fiber, since they added some Metamucil to the starches. (The way psyllium irritates some people’s digestive systems, that does seem a poor choice of fiber for folks who are already prone to problems that way.) When I have to buy it, I try not to eat more than one or two slices a day, balanced somewhat with plenty of protein and fat. There’s lots of starch and sugar, but not much in the way of other nutrients. (And this style of baked goods is explicitly made for and traditionally marketed to folks who, pretty much by definition, already have multiple deficiencies going from malabsorption.) You can buy some GF wholegrain breads–the Ener-G brown rice stuff, imported from the US, comes to mind–but the texture leaves so much to be desired that I have only bought a couple of loaves. It is, at least, easier to find decent pastas made from actual grains, many brown rice or (whole) corn. Expensive as they are, I also ate a lot of quinoa pastas when I was back in the US; if you can even buy it here, I hate to think what it would cost.

I didn’t even know about the diabetes when I got the celiac diagnosis (though, at best guesstimate, it had been full-blown for years by then), but I knew enough to tell that baked goods made of pure starch probably aren’t that good to eat on a regular basis. And I started experimenting with the many, many flours not made from wheat, rye, or barley–mostly wholegrain–to make my own versions. In general, trying to replicate the flavor or texture of yeast-raised wheat breads with other grains is a losing proposition to begin with; not a surprise, really, even before factoring in the desired long shelf life. (Too many commercial ones remind me of a dry, crumbly, too often sandy version of what I imagine the 10-year shelf life Army bread would be like; I’ve never even seen it.) Fresh breads that I find tastier and better-textured are totally possible to make from all wholegrain and legume flours. Things like cakes which don’t rely on gluten for their texture can easily be made from any kind of flour (I like straight chickpea for many, and ground almonds are good to mix in)–yet the commercial versions are still made out of starches. It really is appalling.

I have also ended up having to do an awful lot of scratch cooking to avoid the wheat ingredients which are as ubiquitous in the UK as corn is in the US. (Which seems to be why I rather suddenly started having such disabling symptoms.) It’s the cheap staple here, in the same way, and very difficult to avoid. I mean, I had an obsessive label-reading lapse a while back, and found out the hard way that the main brand of frankfurters on the market here is using wheat fiber as a filler. (You may be engaging in sausage-making FAIL when…) That is another reason, besides price and generally high quality, that I buy a lot of things at Lidl; German (Dutch, etc.) manufactured foods are rarely gratuitously wheated up that way.

Throw in the added diabetes factor, and it is a real problem sometimes. As you probably saw coming, all of this requires spoons I don’t always have available. There’s the fatigue and brain fog. Especially with the slow-healing sacral and rib fractures now, standing up to cook (and wash dishes, etc.) is often a problem. I know I keep reinjuring the pelvis enough to further slow healing, but the alternative there is bed rest. Besides feeling guilty, I am just too hyper to manage that; I did try briefly.

Going out and getting ingredients is also a major one these days. (Then I often can’t cook them afterward.) Thankfully, we have a smallish Iceland store about 300 yards up the street, and a couple of choices for online supermarket orders when I can remember to do it, along with regular vegbox and milk deliveries. Mr. U picks up a lot of items on his way home from work. (And has offered to do all the cooking, but I would feel bad about that. Besides wanting specific foods prepared in specific ways.)

Also throw in the problems I have written about before with getting adequately fed, and what happens? I feel like my life is centered around the kitchen these days, with few spoons left for anything else–and am still having problems with (a) getting adequately fed, and (b) making changes to ways of eating which should help me manage my blood glucose levels better. Avoiding triggering disordered eating behavior and related OCD patterns is sill something I want to write about–common a problem as this seems to be, with so many people in our society having no personal frame of reference for lifestyle changes other than weight loss–but, the major problem at this point is sheer lack of spoons.

Then I sometimes kick myself over continuing to rely more heavily than I would like on things like rice, GF pastas, oatcakes, snack foods like tortilla chips and Bombay mix–and, yes, sometimes the nutritionally lousy commercial GF baked goods–to meet energy requirements. I’m not eating as much starchy stuff as most people, but it is still more than my system wants to handle.

To further complicate things, the relative hypos from trying to cut back much on the carbs send my muscles right back into painful spasm, with a side order of migraine-type headache. I had problems again yesterday with that–besides other low blood sugar symptoms–and got very frustrated/exasperated indeed. Looks like I need to recover longer from the D deficiency/osteomalacia and cut back more gradually. Also, the pain itself–not to mention stressing over what I’m eating!–is no doubt also screwing with my blood sugar, to a degree I have tended not even to take into account. The beatings will continue until morale improves? 😉

The upshot? There are no easy answers in complicated situations, and it is far too easy to get overwhelmed and burn out without even necessarily realizing how far that’s progressed.

A good food-related post from Sue Marsh, which touches on some similar themes: Poverty Cooking. Some of the comments, in particular, tie in disability-related issues (beyond, erm, poverty); if she has gotten around to writing the follow-up around that, I haven’t seen it. Even more relevant in my particular case, since while I am luckily not poor ATM, lingering ghost poverty still influences my habits. But, a lot of the same points apply just considering spoons issues. I grew up with the second, labor-intensive approach to low-budget cooking, and am just not able to do that now. Unfortunately, the celiac also keeps the first strategy of buying a bunch of lower-quality prepared stuff off the table. (Haha.) Remember the Iceland up the street? Yeah. I have a choice of their limited fresh and dry/canned stuff without gluten, frozen veggies and meats (some added convenience), or a couple of prepared potato-based frozen items. Which are occasionally handy, but still fairly heavy on the carbs. The tradeoffs can be difficult and complex, but, as she points out, we still blame people regardless. Including ourselves, at times. 😦

But, at least with the celiac diagnosis, I wasn’t thrown into the disconcerting tailspin that a lot of people seem to be. I may have needed to back-engineer a number of dishes to get the wheat out–a continuing process, yeah–but I was well aware that there were plenty of options within my own cuisine which didn’t involve gluten at all. Back home, I never got to hear the classic “but, what do you eat?!”; people probably just assume it involves a lot of corn and potatoes. (And rice, these days, but…) I was also able and willing to cook, with a decent bit of experience already.

When people feel deprived of familiar and comfortable foods, and when they feel intimidated by the prospect of coming up with their own alternative versions and/or have trouble cooking, for whatever reason–then, they’re likely to try to fill the gap with commercial GF mimics. That is unlikely to end well with heavy use, motivated by celiac or other gluten intolerance or no.

Which leads me to the “gluten is the new poison” meme, among some who don’t have any obvious medical reason to avoid it. I’ve been aware of that one for some time, and bemused, even given the variety of other foodstuffs people have felt a need to scapegoat and demonize. The idea of using a GF diet for weight loss was something I only ran across a few months ago, and am still wondering WTF. Yes, that is the only context many people have for dietary changes, but WTF? Then bring in the “what do you eat?!” factor, and you get (a) the ones who assume it must be synonymous with very low carb, and (b) the ones who load up on low-nutrient commercial GF crap, without learning more about nutrition and how to get their needs met, and expect to turn healthier and thinner.

Not well thought out and potentially dangerous, indeed. Especially if it involves the common meme that thinness and health are exactly the same thing.

One Comment leave one →
  1. PlentyOTea permalink
    June 7, 2012 6:38 pm

    I had the same reaction when I heard about gluten-free for weight loss. WTF? I think most people who have a real problem with wheat sometimes gain weight when they give it up, because their bodies are able to be properly nourished once again.

    One way the “GF as weight loss, or a fad” has played out here in the States is that you get some really nasty looks in restaurants when you tell people you can’t have gluten. Because everyone thinks you’re trying to make their lives difficult with your weird weight loss fad.

    Although, in a way, it has been good because good GF stuff is available. I’m sad to hear you don’t have that experience across the pond. Feel better soon!

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