Now that the unofficial ‘diet month’ has passed, I thought I’d give some of my thoughts on what diet works best for people with MCAS. The short answer is ‘yours’. If only one thing is true, it’s that people with MCAS are different. What works for one will do another one in. People like to start diets with yes and no lists. Elimination diets are a challenge to do while having a life, and sometimes a food that is fine one day isn’t the next day. There are several popular approaches, particularly the Paleo diet and Low Histamine diet. I think we can do better.
The paleo diet makes no sense to me logically or for how my body works. I know people who swear by it, but I’m not sure why. Much of the genetic diversity we see in humans today developed long after the Paleolithic time period, based on where they lived (skin colour, height, hair growth patterns, etc.), so it would be surprising if climate and diet linked digestion changes didn’t also occur. As well, my safest foods in the last seven years have been wheat and dairy… the antithesis of a paleo diet. That said, if it works for you, go for it.
The Low Histamine Diet
The Low Histamine Diet makes a lot more sense to me, again both logically and personally. They’re fraught with challenges, but those who follow them do usually find some relief. Except every list is different… and frankly, most people I know on it say ‘I do low Histamine, but I’m actually fine with xyz, and even though abc is high in histamine, I can tolerate it fine.”. So why does it work? I think that Histamine is one factor to consider when looking at trigger foods, but it’s only one factor. We know that cooking, exposure, cross-reactions, freshness etc. all factor in. Moreover, once you start looking at foods and your diet that way, you’ll figure out what could be triggers. I think the Low Histamine Diet gives a place to start, without it, figuring out food triggers is such a huge task! The strength of the low Histamine Diet is that it changes how you think about food, which helps you figure out what works better for your body.
So, What Does Work?
Listening to your body. Careful consideration of foods and reactions. A way of looking at food that most people aren’t used to. It’s not easy, especially with prepared foods, knowing ingredients and processing is very difficult, adding in personal factors and it becomes a huge logic problem. Remember those old standardized tests that have “Mary is sitting next to Ken, but Steve is twirling a basketball. Why is Jane crying?”. Picture one of those from hell…
So…? What Should I do?
Well, I don’t know, but I might be able to help you figure it out. I’m not a dietician or a physician, I’m just me. I flatter myself that I’m smart, but really, it’s an isolated skill- I’m really good at logic. I seek out logic puzzles like those for entertainment. If you could make a living being a philosopher, I would have done it in a heartbeat.
While I can’t tell you what to do, I can give you some ideas to think about as you tackle this. My entire life I’ve been told that allergies were binary- you’re either allergic to a food, or you aren’t. The practice is slowly changing, but a lot of allergists still use that thinking. It simply doesn’t work for MCAS.
We are so used to diets being prescriptive, what we can and can’t eat, how much of something we should have, etc. Just like with medications for MCAD, they are some safer bets’ and ‘less likely’ options. Figuring out what works means starting somewhere, and going from there. So where should we start? Stay tuned for my Trigger Identification Series. First installment should be up today or tomorrow, so stay tuned!