Why I Don't Rate the IC Diet
Reading around interstitial cystitis forums as I occasionally do, I am often frustrated to see posts from people who follow the IC diet, yet continue to experience symptoms. While the IC diet may work as an emergency short term strategy for a minority of people, I have absolutely no time for it as a long term strategy for the majority of IC sufferers and I am going to use this blog post to outline why. If you are unfamiliar with the diet but are interested in why I don’t like it, you might want to Google it and have a look at the list of safe foods and unsafe foods before you continue with this article. If you have been following the diet without much success, or with limited success but without a sense that you’re actually healing, this post is for you.
It should be noted at this point that I am not a doctor and the views expressed here are purely my own personal ones. Do your own further investigations, consult with professionals and don’t take my word for anything! There will inevitably be people for whom the IC diet has been a roaring success, so if you’ve never tried it and want to give it a whirl, by all means have a go and if it works for you, hurrah! If it doesn’t you can always come back later, have another read of this and see if you find it helpful further down the line. In the meantime, this post is likely to be most useful for those who already follow the IC diet, continue to experience symptoms and have no idea why this might be the case.
I’d like to stress at the outset that I am NOT disputing the link between what we eat and our bladder health. On the contrary, I am going to argue that there is a massive link between what we eat and our bladder health and that THIS is the reason I am not a fan of the IC diet. I’d also like to highlight the fact that most IC sufferers do not experience bladder problems in isolation. The vast majority seem to have some combination of:
- Irritable bowel syndrome (IBS) or other digestive problems – most every customer I’ve directly spoken with since Tiny Pioneer was born has mentioned also suffering from IBS.
- Allergies or sensitivities
- Anxiety, depression or panic attacks
- Autoimmune disorders, such as rheumatoid arthritis
These associated conditions are known to be strongly linked to gut health and can be very well managed with long term dietary changes. It is therefore reasonable to suppose that interstitial cystitis appears more commonly in individuals with these disorders either because it too is directly tied into gut health, or because the urinary system has a similar structure and population of microflora to the digestive system, aided and damaged by similar factors. The fact that IC is so strongly associated with the above disorders is frequently overlooked or disregarded as insignificant. However, I believe the link is of crucial importance in recovering from IC and this brings me on to my concerns regarding the IC diet.
1) The IC diet has on its safe list numerous gluten-containing products.
Breads, cereals, pasta, cakes, pastries, pies and muffins are all listed as being safe for IC sufferers to eat. These are typically made with wheat flour, meaning they also typically contain gluten. Though oats do not naturally contain gluten, they are often contaminated with it, and rye flour contains it, meaning that most baked goods and pasta contain gluten grains. I’m of the opinion that excessive consumption of gluten does nobody any good, but that said there is probably no reason for people with robust digestion and no chronic health problems to avoid it completely. However, people with IC are not perfectly healthy with robust digestion – in fact as mentioned they often have other chronic health disorders that have been shown to be affected by gut health. In particular, it is thought that a ‘leaky gut’ is responsible for many of these disorders. A leaky gut occurs when the small intestine becomes more permeable than it should be and allows things to pass through into the bloodstream that should not. These then circulate around the body, causing inflammation that manifests as a wide variety of chronic health problems. Various factors can contribute to leaky gut, but the number one culprit is thought to be gluten. I could do a whole blog on gluten alone, and perhaps I will at some stage, but suffice it to say that in my opinion gluten is not a good thing for people with chronic health problems to be eating and therefore should not be considered a safe food for IC sufferers. Indeed, many people have found that by eliminating gluten and following a leaky gut treatment protocol, they have recovered from their IC symptoms.
2) The IC diet safe list contains many dairy products.
As with the above point, dairy products can be very irritating to the intestinal lining and can be a factor in the leaky gut syndrome that predisposes individuals to numerous inflammatory disorders. Additionally, many people are lactose intolerant. Lactose is a kind of sugar found in dairy products and the body is supposed to break it down into two simpler sugars, glucose and galactose, which are then absorbed into the bloodstream. People with lactose intolerance lack the necessary enzyme to achieve this break down, meaning that lactose molecules remain intact in the small intestine. Here, they draw in an inappropriate balance of fluid and electrolytes, upsetting the digestive process. Later, in the large intestine, the free lactose is fermented by bacteria, leading to excess gas, diarrhoea and other digestive symptoms. As with gluten, there is probably no need for healthy, resilient people to avoid dairy entirely and indeed organic, unpasteurised dairy can be extremely nutritious. However, for those with IC and other chronic inflammatory disorders, it is my firm opinion that dairy should be eliminated while gut health is addressed. I therefore find it incredibly disturbing to see foods like ice cream, milk and cream listed as IC safe and especially to see ice cream and milk marked as potentially soothing foods.
3) The IC diet safe list contains many foods that are not conducive with good health for anyone.
Ice cream, cakes, sherbet, milkshakes, cookies and sugar(!!) listed as safe foods – in some cases even listed as soothing foods?!?! I find this incredible and deeply worrying. Sugar is as addictive as cocaine and it has been said that were it to be discovered afresh in modern times, it would not be approved for usage, such is its detrimental effect on health. Aside from its adverse effects on weight, insulin resistance, heart health and tooth health, sugar promotes overgrowth of pathogenic bacteria in the gut and thus reduces the amount of health promoting good bacteria therein. This takes us back to leaky gut and its connection with chronic health problems. Furthermore, if sugar disrupts the balance of bacteria in the gut, it is certain to do the same in the urinary tract, meaning that IC sufferers should definitely aim to reduce their overall sugar consumption and eliminate consumption of sugary junk foods entirely. The fact that ‘everyone’ eats cakes, ice creams, doughnuts, milkshakes and sweets does not mean it is wise or safe to do so. Eat them if you like, but don’t do so under the illusion that they are helpful to your IC or your health in general. They are junk foods, not even worthy of the name ‘treat’, and if you have the willpower to cut them out of your life permanently and entirely then you will surely reap the rewards in more areas than just your bladder health.
4) The IC diet has lemons in the unsafe category.
Lemons are extremely helpful to many cystitis sufferers, as in spite of being acid on the way in (and incidentally helpful for digestion and liver function, with antimicrobial properties) they alkalise the urine, which can reduce the pain associated with cystitis and inhibit bacteria growth in the bladder. Obviously there will always be someone who can’t tolerate them, but the fact that Sweet Cures recently brought out a new lemon flavoured Waterfall D-Mannose makes nonsense of the idea that lemons are irritating to delicate bladders. Indeed during my last cystitis flare up, I found the addition of lemon juice to bicarbonate of soda to be an excellent short term way of reducing my pain and getting a good night’s sleep, as discussed in this early blog post!
5) The IC diet has herbal teas in the unsafe category.
A sweeping statement of all herbal teas. Lots of herbs are extremely safe – and even very helpful – to drink in tea form during cystitis flares. If I go into that now, this blog post will become unmanageably long, but a quick Google should throw up plenty of suggestions! For those seriously interested in herbal approaches to managing cystitis or IC, a consultation with a qualified medical herbalist will throw up plenty more ideas and should pour boiling water all over the teabag of rubbish that suggests herbal teas are detrimental to bladder health! Of all the hundreds of herbs that exist, there must indeed be a few that really are aggravating to IC, but plenty more have been used for centuries as traditional medicines for this painful and stubborn condition! (Don’t start dabbling in herbal remedies without the supervision of a qualified herbalist though – ‘natural’ does not mean safe for everything all of the time and if you’re on existing medications or have other health problems, there may be herbs that you should not take.)
6) The IC diet does not talk about managing urine pH.
Though there are some exceptions, in general meat, fish, eggs, nuts and grains lead to acidic urine, while fruit and vegetables lead to alkaline urine. I personally find this quite important in keeping my PGAD (which I believe is just an unusual manifestation of IC) comfortable and non-problematic. While meat, fish and eggs are very nutritious, I would never have a breakfast of something like salmon and eggs on their own. This would make my urine feel a bit too acidic for comfort a couple of hours later. However, I regularly consume salmon with plenty of vegetables – usually as an evening meal with something like sweet potato, shallots and mushrooms. Similarly, though beef is listed as a safe and potentially soothing food, I’d never eat beef without a large salad or helping of mixed vegetables to offset the acidifying effect it would have on my urine. I often start my day with some lemon water, or a freshly squeezed fruit and vegetable juice to alkalise my urine a bit before I eat breakfast (since breakfast is the meal where I’m least likely to consume lots of vegetables) and I’m mindful when serving up my meals that well over half my plate is vegetable based. If I’m dining out, I usually ask for my meal to be served with a portion of extra mixed veg, partly to ensure I can still achieve this balance and partly because for me one of the joys of eating out is getting loads of my five a day in without having to mess about preparing them myself! Too often in the Western world we make half of our plate the tasty meat/fish portion, stick some potato or pasta with it, and congratulate ourselves on having a couple of spoonfuls of peas to green it up a bit. Really, at least half of your plate should be mixed vegetables, while the meat/fish part should account for only about a quarter. By all means meat, fish and eggs can be enjoyed by people with IC – indeed organic, outdoor reared animal products are highly nutritious for most people and not everyone fares well on a vegetarian diet – but in my opinion, care should be taken to ensure more of the plate has an alkalising effect on the urine than an acidifying one. It is worth stressing that what goes in as an acid does not necessarily come out as an acid and vice versa, so if you’re not sure what foods do what, print yourself off a table from the internet and use that to help you!
There are things the IC diet gets very right. Most IC sufferers don’t fare well with coffee, alcohol, orange juice and tomatoes, for example. Indeed, in the throes of a flare up, I can see that several of the ‘caution’ foods could well exacerbate symptoms. However, lots of foods in the ‘caution’ section really ought not to be a problem for the majority of sufferers even during a flare up, while plenty in the safe column are frankly ridiculous for even the healthiest of people to be routinely eating. Even if every food in the caution section were to cause someone a problem during a flare up, I still don’t think that means they are going to experience a full recovery and a healthy life if their daily diet looks like:
- Breakfast: cereal and milk
- Morning snack: an apple
- Lunch: meat sandwich with a bit of salad between the bread
- Afternoon snack: a cake
- Dinner: chicken and a big plate of pasta with a token bit of veg mixed in
This is exactly the kind of thing I see people on IC forums saying they eat, being careful to stipulate that they’re avoiding all the fruits and drinks that are not IC safe. However, most people are going to see only the bits of the ‘safe’ list that they want to see – in other words it’s a rare individual who loads up their plate with the bladder friendly vegetables and holds on the convenience of bread and pasta or the deliciousness of cakes and biscuits. It’s too easy for people to consult the IC diet, look for all their favourite foods and continue to eat a daily diet of absolute junk, loaded with gut damaging sugars, served with excessive amounts of wheat and dairy, and then wonder why they’re not feeling any better.
In coming blog posts, I will talk about some alternative ways of eating and discuss some specific diets that people with chronic health problems typically find helpful. However, regardless of the finer details, what all ‘good’ diets have in common is an emphasis on real foods, cooked from scratch – meat, fish, eggs, vegetables and fruits, nuts and seeds – and the need to avoid convenience foods, processed foods and excess sugar. What the IC diet fails to stress is that everything you put into your body should serve a nutritional purpose and be of benefit to you, for this is the route to optimum health.
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