Fun with Portion Control!

Portion control is easy when your dishes are this pleasing!

Portion control is key when you have digestive issues.   We should all be eating more slowly, chewing each bite longer, and serving ourselves smaller portions for healthy motility.  In my case, these simple acts make a huge difference in reducing GERD (or eliminating it altogether).   Lately, I've been catching myself eating quickly, and eating beyond feeling full -- often, as I'm putting food away I eat a few extra bites, or I decide I want "just a little spoonful" more after finishing my plate.   Those few extra bites make an impact -- how many times have I felt great at the end of my meal, but then "bloated" and uncomfortable after not listening to my body?  (And, I seem to never learn!)

It is never too late to take a breath and re-train yourself to eat more slowly and mindfully.  Don't fret about past days or weeks.   Focus on today.   

SECRET WEAPON: MY JAPANESE CERAMIC BOWLS

I have been using 1 or 2 cup sized Pyrex glass containers for my lunches -- and the occasional mason jar.   A few months ago, my portable lunch container world shifted when I discovered these Japanese bowls at the inimitable NYC store, Pearl River:

Fantastic lidded bowls from Pearl River, NYC.

Microwavable, with lids, they are made from ceramic -- not lightweight to haul around, but I long gave up plastics, so I'm used to my lunch sack containing sturdy containers.   And, eating lunch in one of these is an aesthetic joy!   The craftsmanship of these bowls inspires me to take my time, enjoy my food, eat mindfully.

EATING OUT:  A FOOTNOTE

Often, eating out with GERD -- or any digestive/diet related concern -- is an ordeal.   J. and I usually dine out at "healthy" vegan or macrobiotic restaurants because we can choose most everything on the menu (a pleasure!), and the dishes are not overly spiced or too salty (though since our home cooking is mostly salt-free, anything remotely salted can be "too" salty for us). 

Restaurant portions are still too large, even in most vegan/macro places.   I wind up taking half home for lunch (not that bad an end).   One recent meal, however, was perfect.   At Blossom, a vegan bistro in Chelsea, NYC, I did not feel overwhelmed at the table by the portion size, and could simply enjoy and focus on the food, completely.  (Another effect of "too-large portions" in restaurants -- I get overwhelmed by the idea of having to finish it all, or the logistics of now having to take half home -- what if I don't feel like schlepping my half-eaten food across town?   Large portions become an emotional burden!)

At Blossom, we had the "tofu benedict" and an order of French toast with fruit.  We split each plate, and the amount was ideal:  about "two fistfuls" of food each.  (Maybe a bit more -- but we did not have busting guts and I had no nausea, regurgitation or other GERD calamities afterward.)   Here is what our breakfast looked like when it arrived:

Brunch at Blossom.

Report from my Gut: Getting GERD Flare-Up Under Control with a Counterattack!

Did too many tomatoes do it?

What happened??!

The past few weeks, all of a sudden, my GERD symptoms rallied and returned, five-fold.  This, after months of feeling much better, no "clenched throat," no reflux episodes, little or no nausea, even my constipation had been resolved for the most part.   Now, constipation has returned.  Bloating, nausea, consecutive days of acid reflux shooting up my esophagus, rare for me even in my GERD flare-ups -- a daily occurrence.  

What caused all of this?  I'm still trying to figure it out.  Too many tomatoes?  Exceptionally stressful (good and bad stress) weeks?  A few constipated days too many?

After a week of chewing on TUMS and feeling miserable and demoralized, I had to take action.  Several days into my "GERD Flare Up Counterattack," I am getting back on track, and the symptoms are subsiding.

Here's the strategy I used to get myself back on track:

• Eliminated my daily caffeinated tea and chocolate intake for a few days, choosing to drink chamomile-lavender and chamomile-vanilla, or lemon verbena, herbal teas.   When I resumed caffeinated tea, I selected pu-ehr and dark oolongs.
• Mindful eating, focusing on GERD-friendly foods (I tend to do this as a matter of course, but made a particularly strong effort to focus on stomach-friendly ingredients): lentils, sweet potato, kale, chard, pasta.  I also re-incorporated greenmarket (pastured) eggs as meals, having hard-boiled eggs and sauteed kale for breakfast and a scrambled egg for dinner.   For lunches, I brought soup or an Amy's frozen meal. I tried to eat slower and smaller meals, noticing I'd been lapsing about this.  
• Avoided tomatoes/tomato-based meals.  Was this the trigger for my reflux spell?  I bought two pints of sweet cherry tomatoes at the greenmarket -- the first of the season!! -- and gobbled them down, on their own, and in a salad.  I also had been increasing my tomato sauce intake, with more veg lasagnas and other dishes.  Usually, I'm lucky and can eat tomatoes without concern.  But maybe this was a case of too many, too soon, too fast.  I've also been eating a lot of strawberries, and tried honey with bee pollen -- a tiny taste that triggered an oral allergic reaction for 15 minutes.
• JUST SAY NO policy at work.   I refused birthday cupcakes, leftover pizza, free chocolate, and other office treats.   (Frankly, I should maintain this policy, which is, overall, the best way to manage my GERD, diet, health.)
• Tums.  Lots of Extra Strength TUMS.  I admit, they helped and I was determined to keep reflux away while I adjusted diet and other factors.
• Engaged in "self talk," trying to calm my mind and coach my body into relaxing, feeling better, getting back in control.  Reminding myself "the nausea will pass" and just don't worry about the constipation, this will resolve as well.  

Slowly but surely, returning to "my normal."

GERD and the Holidays -- My Latest Lessons

Leftovers, December 15, 2012

PREP

Several weeks ago, I had a revelation.  While cooking a healthy, GERD-friendly meal, I spent much of the prep time sampling, tasting, adjusting the seasoning and tasting it again.  By the time I served dinner, I realized I had probably eaten half of what would be my portion!  This is not as difficult to do as it sounds -- several small tastes that don't seem like very much can quickly add up to a small portion size, when your small portion consists of a half cup.  When I ate my usual modest plateful, it was to my downfall -- of course I was bloated and refluxy after what was actually too much food.

Lesson 1:  Feel free to taste and sample as you cook, but account for this later when you have your "meal."  (As for cooking and snacking -- I think it is essential to taste as you go.  To prevent over-eating, use smaller tastes, and recognize this will be part of your portion.)

POST

What happens after a meal is as important as what happens before it.  Along with acknowledging I needed to adjust my portions to account for food prep tastings, I also realized I was stealthily expanding my portion size while cleaning up.  How many times did I leave the table feeling perfect, satisfied, guts content, only to gobble down "a spoonful" of leftover potatoes and finish off the rest of the pasta because "there's just a few strands," replacing my gut bliss with bloat, clenched throat, and reflux?  How many times do I need to ignore listening to my body before changing my actions?   

Lesson 2:  Leftovers are left-overs -- don't eat them, snack on them, or otherwise put them into your mouth.   Because what goes into your mouth winds up in your guts.   Just put them into your cute Pyrex container, seal it up, and into the refrigerator it goes for a nice small-portion lunch.


RECIPE EXTRA:  BRAISED PARSNIPS AND CARROTS 

The photo at the top of this blog entry shows what was left of our recent vegetable side dish success- braised parsnips and carrots.   I usually roast root vegetables and the braising method was a happy revelation.  (Thank you, The Joy of Cooking!  And Seasonal Eating, another good locavore blog featuring the JoC's oven-braised roots recipe.)   Here is my version, which uses olive oil instead of butter.  Parsnips and carrots always digest well for me, with no GERD triggers, so I am happy to include them often in my meals.

Ingredients

3 parts parsnips to 1 part carrots (from the Greenmarket, if possible)
Water or vegetable broth
Olive oil
Salt

1. Preheat oven to 375 degrees.
2. Peel parsnips and carrots.  Trim ends, and cut on an angle into 1inch slices.  For parsnips with a thick core, cut slices off the core.  You can also slice carrots lengthwise if you prefer.
3. Place in one layer in roasting pan.  
4. Drizzle with olive oil and stir well.  I just use my hands to "massage" the oil in.
5. Sprinkle with salt to taste, if desired.
6. Pour water or vegetable broth over parnsip/carrot mixture so veggies are just barely sticking above the liquid. 
7. Braise in oven for 30-40 minutes until vegetables are soft, easily pierced with a fork.  Halfway through, stir/turn vegetables.  Stir once or twice throughout to evenly cook them.  You may need to add more water/broth if it evaporates; there should be enough liquid in the pan at all times to prevent roasting/burning.
8. Serve as side for practically anything!   We had this with red beans; pasta or other grains would be great, as would other kinds of beans, or veggie burgers/sausages.

Note:  This dish was so delicious -- it was hard to stop eating it!  I am pleased to report the leftovers in the pan in the above photo were all stored away -- I did not take one extra bite! -- and felt good all evening for it.  Small steps, small portions, stay mindful!  

Road Trip with GERD: Stop 5 -- Cape Canaveral

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Orange and grapefruit juice, free for travelers!

Throughout the trip, I would ask myself, "Is eating this a good idea?"  When you have a chronic issue involving your diet, no day is routine, especially when on the road.    You cannot abandon your eating plan without consequences, or consume something without a quick calculation of where it fits into the plan (I'm thinking about my GERD, but this applies to diabetes, food intolerances, and other issues).  So when we arrived at the Florida border, I could not drink the complimentary juice without first thinking, "Will this trigger my GERD?"  Is this a good idea?  I decided to give it a try, and had no concerns after my Dixie cup of orange juice.  Whew!   (Florida!  We made it!)

HOW NOT TO DINE OUT WITH GERD

On the way to Cape Canaveral -- our next stop -- we meandered our way along small roads lined with palms, oceanfront beach stores with fiberglass sharks and surfboards, and tiny, short hurricane-proof cement houses.  Before we knew it, the dinner hour arrived and we were not in sight of our hotel.  We had decided "no more late dinners!" and to stop around 5-6 PM to eat, wherever we were.   There were few choices, mostly seafood places and fast food, and it was Sunday evening so early closings were a concern.  When we spotted an Olive Garden, we were thrilled -- we knew the menu, we knew we could get reliable, decent food into our stomachs. 

Still, I knew I did not want a huge plate of pasta, and decided to split dishes with my travel party.  (They agreed, smaller portions for all would be best.)  I split the order of four lasagna roll-ups and a large salad.  MISTAKE #1:  After one roll up, I was full, but I decided to eat the other one because everyone else was still eating (ridiculous reason, but the roll-up was tasty, and I thought maybe I "needed" more food).  By half of the second roll up, my stomach was straining and I was unable to eat more.

My travel party decided to have dessert as well -- something I could not stuff into my body at that moment.   A slice of chocolate pie was ordered, an apple crisp with vanilla ice cream, and…what was I going to order?  I really wanted to get nothing at that point, but ordered a mini parfait -- the menu promised it was really small, a "taste."  I was happy to see it was manageable, and enjoyed a few bites of it.  MISTAKE #2:  I then "helped" my travel party finish up the vanilla ice cream from the crisp and had a few bites of the pie.  By then, I was so full my stomach felt like it would rupture.  I am not exaggerating.  I got panicky and went to the bathroom, doubled over in pain.  What did I do?  Why did I do that?!  Idiotic to not listen to my body (or reason -- why eat that much dessert anyhow??!).  I did some relaxed breathing, massaged my stomach, and "talked to my body," telling it we'll get through this, just relax, time will help the situation.

It did -- but I learned a lesson.

We spent the night at the Air Base on Cape Canaveral in little attached houses -- here is the front of mine!

Cape Canaveral and my overnight "house."

NEW DAY, NEW ENDEAVORS!

Beach at Cape Canaveral

I was thrilled to wake up with little ill effect from the Olive Garden gluttony.  TUMS helped, and just relaxing and eating minimally the next morning.   One of my favorite breakfasts while traveling is oatmeal (real oatmeal -- not the packaged instant, overly processed/sugared stuff).  We ate at the Air Force Base mess hall, where I was overjoyed to discover this thick oatmeal and a fruit/nut bar.  I added my berries, nuts and cinnamon -- to the horror of the cashier.  She chided me, "I'll let it go this time, but the nuts and fruit are for the yogurt.  Cinnamon and raisins are for the oatmeal."  I was mortified to be reprimanded but…the results are wonderful, aren't they?

My rogue oatmeal with berries and nuts!

We spent a few hours wandering around the beach and trying to get a good look at the launch pad of the Kennedy Space Station, which you can see in the distance (the white square on the horizon) in the photo below.  Note the grandstands -- these are just outside the non-public security zone of NASA.

NASA's launch pad!

We continued on, heading to our next stop -- Orlando and Disneyworld.  En route, more fiberglass animals and roadside kitsch…

Mini-golf on the Space Coast.

Before leaving Titusville (the town outside NASA's space station), we decided to have lunch at an old diner -- better here than somewhere en route, where options might be limited.  Plus, I could imagine the astronauts stopping in before their flights.  The place was old school and of course my meal of choice was my road-trip staple -- grilled cheese.  I shared fries and chips with my travel-mates, and -- amazingly -- had no ill effects from this rather greased-out meal.  (As I noted earlier in my Road Trip posts, for this trip, I decided I would eat cheese when it was an easy option -- I must admit I really enjoyed this melted mess.)

Next stop -- Disneyworld!

At a Space Coast diner.

Strip near Cape Canaveral.  Fiberglass sharks galore!

Linkage: Mindful Eating as Food for Thought

I was excited to learn the New York Times recently published an article on mindful eating.   As I've mentioned in various posts here, eating slowly is consistently one of the keys to keeping my GERD in check.

The Times piece is a good introduction to the idea, loaded with links and references to some of the leaders of this "new" trend.  (It isn't a trend, nor new, but -- hopefully -- it's getting new buzz.)   One thing I was not pleased by is the writer's emphasis on using mindful eating to achieve weight loss by avoiding binging -- an "anti-diet," something the Huffington Post picked up on in their response, as well.   Isn't this notion of our food intake as something we need to tame, dominate, control, put into "good" or "bad" boxes is contrary to the concept of food as nourishing, healthy, and pleasing?  Food is not the enemy!  Mindful eating is, to my mind, more about connecting your body and your food, allowing your body to go at its own pace, savoring the sensory experience -- improving the quality of your life and by extension, your health.

RELATED POINT:  I always roll my eyes when I read about strategies for weight control and how we need to stop eating with our emotions, replacing "real" needs with food, and so on -- has it ever occurred to these diet pundits that I just LIKE food?  It is not a substitute for anything missing in my life -- it is a sensory pleasure in itself.  My pecan-maple artisanal chocolate bars or slices of good bread dipped in superb olive oil or greenmarket roasted potatoes stand alone.   I've eaten food when stressed, sure -- but, mostly, I eat food because I enjoy it and to nourish myself -- not because it is a security blanket.  I really wish writers would recognize this.

In any case, I think bringing mindful eating into the consciousness of the "average household" is a positive thing!  After you read the Times article, don't miss the follow up piece, Mindful Eating: A Teacher Responds to Readers and the follow up to the follow up: Mindful Eating: More Questions for an Expert.

YET MORE:

Zenhabits' introduction and how-to regarding mindful eating.

A registered dietician at Brigham and Women's Hospital offers mindful eating tips.

FIT Me!

Have you seen those make-up ads with the woman challenging the brand to "Fit me?"  "Fit Me!"  "FIT ME!"   Well, I'm ready for my diet to FIT ME and not give me FIT -- my acronym for that "food in throat" feeling.  I'm tired of it!   I'm cranky!


WHERE I STAND NOW

• food in throat/lump in throat feeling (sometimes I wonder if I am imagining it…but there is always a subtle sensation of this)
• waking up and 5-10 minutes later experiencing acid reflux (rarely am I woken up by this; it happens shortly after waking)
• increased acid reflux throughout the day (it comes in the morning and stays, or goes away and returns; I am definitely seeing an increase in "reflux," something I haven't had in the past)
• constant belching
• the occasional heartburn
• feeling too full too soon
• feeling like everything I'm going to eat is going to be a trigger (let's not underestimate the psychological effects of dealing w/our chronic gastro issues!

WHAT IS WORKING?

I need to step back and assess the past few months, during which I've tried:

1) a GERD Elimination Diet for 7 days (really helpful and I felt empowered afterwards!  this felt like a "cleanse" to me -- to just jumpstart good habits overall)

2) slow mindful chewing (also helpful; I haven't been practicing this for a few weeks due to guests, busy schedule, forgetting to be mindful)

3) reducing/changing my tea consumption overall (some days I don't have any tea!  most days, I start with low-caffeine teas like twig tea or herbals and may have black or green tea later in the day -- this does help and many times I don't feel tea is a trigger when I stagger it like that)

4) small portions (breakfast and lunch are set but dinner remains problematic…how to divide into two meals?  I'm not sure…)

4) trying to de-stress with more exercise, more efforts at "relaxing," more tai-chi (yes, yes and yes)  

TRIGGERS FOR MY REFLUX?

• eating too much at a sitting
• tea (ugh!  I hate to admit it.   But I do see a difference in drinking tea after having eaten something, or later in the day.  It does not bother me as much, or at all.)
• sweets (sometimes they can trigger heartburn)
• constipation (this is a definite correlation and problem…when it happens, it's a major issue for me; one preventative is a cup of tea in the morning, but this is also a trigger!)

Note that I have NOT been experiencing much nausea lately...

NEXT STEPS?

Carry on but listen to my positive experiences?

Should I again try a GERD Elimination Diet, this time being even more rigid about certain foods?  (I "cheated" once or twice on the last one.)    In any case, this might make me feel better, even psychologically.    

Should I go on a Food Elimination Diet?   I recently spoke with a woman who tried this and discovered her gluten reaction; she ate some of one type of trigger food each day for a week, then gauged her body's response when she eliminated the food.  A different tactic than the "don't eat it for weeks and then introduce it."  Hmmm.

Should I blog/log another food diary for a week with a focus on this morning reflux?   I don't think I tracked my moods and activities as well as I should have in the past entries, and this is something that I would do this time with more precision.

Am I sure I am experiencing GERD and not something else?  (Gallbladder issues?  Hernia?)   What about slow motility issues?  Could this be a factor?   Do I need to swallow those radioactive eggs?!!

Thinking about all of this -- and already feeling more empowered.  :)

Secret Weapon: Chewing Your Food (REALLY Chewing Your Food)

I experimented yesterday with this "chewing until liquified" business and am very impressed. I feel a difference, enough to inspire me to try this mindful chewing for a week.  (And beyond, if it works.)

Yesterday, I deliberately chewed my way through breakfast, lunch out, and a dinner party.   I "forgot" twice -- when I snacked on a banana and while mingling at the get-together over a bowl of popcorn.   I am not chewing 100, 50, or even 30 times -- more like 15 times,  I am chewing about 50-70 times (I counted!) or until the food is pulverized into a slurry.

My GERD symptoms were dramatically reduced all day, even into the night after a late dinner.  This morning, I experienced some belching, but that's it.   Hurrah!

I am fascinated by this idea.  Why does excessive chewing help?  Is it because more saliva is being sent down with each bite?  Or chewing gives the stomach time to receive signals that "food is coming" and set the digestive tract in motion?   Does breaking down food help the stomach get a "head start?"   Health professionals agree that chewing gum can relieve GERD, so it appears something in the chewing action is responsible for relieving GERD symptoms.

So, I'll chronicle my week(s) of "mindful eating" here and let you know if this makes a difference!  

Smaller Portions, Less GERD

Rainy days coinciding with a busy week ahead.  In the next seven days I will:

• attend Fashion's Night Out
• see Moby at a Barnes & Noble appearance
• coordinate a booth at a street fair
• coordinate a booth at a Mets game health fair
• volunteer at the animal shelter
• run "on all four cylinders" at work to meet deadlines and prep for the aforementioned fairs

I'm already pacing myself, getting nutritious foods ready, and planning for extra sleep.   (How is it that we don't take sleep seriously?  That it's the first thing to go when we're super-busy?  How did sleep deprivation become so glamorous and a mark of success?   I wonder if I got more sleep than my usual 6-7 hours if my GERD symptoms would decrease.)

SMALL PORTIONS -- ONE STEP TO HEALING

Progress!  I can definitely see a difference in my day when I have a "half breakfast" followed by a second half breakfast a few hours later.  

This usually involves a half portion of cereal (though I have a full serving of almond milk, since I like it for my calcium, Vitamin D, and other nutrients) around 5:30 AM - 6:00 AM and a homemade oat-flax-raisin-apple muffin (these are tiny, made in a vintage tin!  not your usual bowling ball sized muffins!) around 9:30 AM.   Or I'll have a hard boiled egg (from my pastured eggs at home), or a quarter sesame bagel, plain.   I have been experimenting with nut butters for a second breakfast, as well.   I usually have some fruit as well -- berries, applesauce, or a stone fruit.  

For lunch, I have a regular portion, which is already reasonable, and for dinner, I've reduced my intake altogether by about one-fourth of my usual portion.   I allow a couple of snacks throughout the day as well (granola bars, fruit, nut butters on crackers or half slice bread).  

Immediately, I feel better, and really feel the positive effect during the morning into the afternoon.  No bloating.  There may be some "food in throat" feeling after breakfast, but I suspect this may coincide with my caffeine intake, if I'm drinking black or green tea that day.  I will have to log this!   I'm still playing around with alternating days of tea in finding a way to still consume it, even if it is a trigger.   

A PUZZLE...

One thing puzzling me -- why do I have GERD symptoms (slight heartburn, FIT) after a few moments of waking up in the morning?  I don't wake up from symptoms, and don't have them right upon waking -- they kick in 5-10 minutes afterward.  Hmmm.  

BONUS LINK: To help pace myself and generally de-stress, I'm trying to incorporate more mindfulness in my days.  Here is a useful piece on mindful breathing.

GERD Progress Report: One Week Later

It's been about a week since the last day of my GERD Elimination Diet and…

I still feel good.  I have had caffeine on a steady basis in the form of black and green teas and dark chocolate, and did not feel "gerdy" afterwards.   (This was a pleasant surprise; I was expecting problems.)   I am still feeling the FIT (food in throat) feeling, and a few days ago I had more belching than I'd deem "normal."     Overall, I am experiencing less GERD symptoms.  No morning GERD either, which is a relief.

What am I doing differently?  For one thing, I've increased my daily exercise dramatically:

• More walking!  I'm briskly walking nearly 20 blocks to work each morning.  This is on top of the 20 blocks I walk after work every day.   This routine requires me to leave the house earlier -- which means more organization, and fortitude to stay "on target" in the mornings.  I love seeing the city waking up, my fellow commuters whooshing along, doormen polishing the brass fixtures, smelling the bakeries along the way.  
• I'm re-committing to climbing stairs (six flights) when possible during the day.  To distract myself from the tedium and challenge, I experimented playing an effective ball-dropping game on my smartphone while hiking up the stairs.  
• I've added an "abs" workout series to my morning strength routine that I do every other day.  I got the latest one from Real Simple, which has a good "15 minute workout" section online too, so you can just go there and craft a lovely series for yourself.

I've felt less stress throughout the day.  No night guard needed, either!

Can exercise really make this much of a difference?

Secret Weapon: Mindfulness and Movement

I am feeling good!  Despite having a minor procedure today (removal of that sebaceous cyst), I am thrilled to be focused and completing projects and feeling, overall, pretty normal GI-wise.    It is interesting to note I also have not been grinding my teeth the past few days.  Less stress equals a happy gut?!

After reincorporating caffeine (tea and chocolate) and other GERD diet triggers, I feel okay, with one exception:  an increase in belching.   This occurs during or after eating, so I suspect I may be eating too fast, or eating too much.

I greatly enjoyed my morning cups of green tea the past days but have to admit now, after my GERD diet detox:

My body feels different.

Good.

Energized.

Strong.

Looks good.

Since recent tea and chocolate did not "trigger" symptoms, I think the healthfulness I am feeling is related to a mindfulness and level of movement I embraced this past week.

I avoided gratuitous chocolate snacks, I drank a lot more water, and I really thought about my body and how it was feeling.  Focused on it.   And I cleared my head of tiresome nagging chores during my days off -- it was liberating to haul those sacks of books to the Salvation Army, clean the stove down to the knobs, and scour the shower.

I greatly increased my movement:  first with an extreme 14 mile bike ride, but then I walked extra blocks, took the stairs after lunch, added a new set of morning exercises and stretches to my routine.  This level of mindfulness and movement is something I would like to continue.

 P.S.  Blog finds:   Check out this gem of a well-written blog.    And then check this stunning berry layer cake -- breathtaking photo, cake, concept.  (I'll bet someone I know could veganize that…)