Therapeutic diets (gluten-free, autoimmune protocol, anti-inflammatory diet, etc) are super trendy in the media right now. But they’re also under fire from the intuitive eating community because of what they are — diets. This creates a lot of confusion for individuals looking to manage their health in the most non-invasive way possible while at the same time embracing food freedom. In today’s post, I hope to clarify some of the discussion surrounding therapeutic diets and help calm the conversation on both ends of the spectrum.
Lets start at the beginning…
What Is a Therapeutic Diet?
Therapeutic diets are modifications made to a person’s eating habits for the purpose of restoring or supporting a person’s health. They often are restrictive in nature, with stringent rules about the types of foods a person eats. Sometimes these dietary modifications manage allergies, but they also are used in treating infectious, inflammatory, or other types of autoimmune conditions. In contrast to weight-loss diets (which I don’t find useful or advisable), the purpose of therapeutic diets is not to change the size or shape of a person’s body, but rather to influence that person’s physiology. As a clinician, I never use therapeutic diets in my patients’ treatment plans without a full understanding of the risks/benefits to the person’s health. I also generally give them in conjunction with other lifestyle interventions. Another important distinction to understand is that between therapeutic diets and elimination diets. While the former usually involves some degree of the latter (avoiding certain foods), elimination diets are a tool used to uncover food-related symptoms. In contrast, therapeutic diets are typically given based off of existing clinical diagnoses made by a healthcare provider. Elimination diets, though often useful, are not sufficient for diagnostic purposes; therapeutic diets, however, are effective as part of a treatment plan for managing clinically diagnosed illnesses.
Therapeutic Diets Should Be Monitored by a Physician
Just like drugs and surgery come with risks and adverse reactions, therapeutic diets come with the potential for side effects, some of which are not readily apparent to the patient based off how their body “feels.” For this reason, it’s extremely important that individuals using therapeutic diets do so under the care of a health professional. As a patient’s health improves, the patient will then ideally be able to resume eating many of the foods that are “off limits” on the diet to maximize the patient’s quality of life. Resuming the diet at the wrong time (or prolonging it too much) can nullify the positive effects of the diet, lead to unwanted side effects, or even worsen the initial condition.
Therapeutic Diets Should Not Be Used Long-Term (In Most Cases)
Therapeutic diets often create abnormal physiologic environments in the body. By preventing the body from accessing certain nutrients or natural food components, metabolic/hormonal pathways in the body can be either “turned up” or “turned down” depending on the therapeutic goal. For example, someone with a higher than normal immune response (i.e. an autoimmune disease) would benefit from an autoimmune protocol (the AIP diet) to temporarily reduce the reactivity of the immune system. By reducing the exposure to triggers for some time, we can create more margin in the patient’s reactive threshold, helping them to react less frequently and with less severity. Once that threshold has been normalized, however, there’s no need to keep suppressing the immune system. Doing so may even be harmful.
With the exception of extreme cases, muting or shutting down body systems for too long can end up being harmful. Therapeutic diets help return the body to a more normalized state and once there, the goal is to then return to normal, baseline lifestyle behaviors.
Many individuals who co-opt therapeutic diets for themselves outside of clinically supervised environments are unaware of the risks of long-term use of therapeutic diets. Without full knowledge of their blood chemistry, many individuals also start new therapeutic diets unnecessarily and receive no benefit from them. In doing so, they can end up harming themselves! When used appropriately in a clinical setting, therapeutic diets offer enormous value in managing various conditions in a minimally invasive way. However, the key is that they are used appropriately.
Therapeutic Diets Are Not for Everybody
As a healthy woman, there’s no need for me to follow a restrictive diet. Doing so would offer no benefit to my well-being, and actually would likely create significant problems in my health. The same is true for most other individuals. I’ve seen countless patients who follow extremely restrictive dietary protocols become ill from them, though I’ve also seen those same dietary protocols facilitate healing in sick patients. With nutrition, integrative medicine, and therapeutic diets, context is everything.