QUESTION: I am in the process of introducing food back into my body and am having some trouble. I am finding that I get sick when I eat. Even crackers upset my stomach. I was wondering if you might have any suggestions on foods to start with or was to reduce my body’s reaction. Thank you in advance. Blessings.

ANSWER: I am so glad you asked such a valuable question – to begin with, be sure to ask for support from your MD and your treatment team. Use their experience to make this process as productive as possible for you.

In addition, I have discovered (after far too many years struggling with all kinds of unpleasant re-feeding side effects) that daily drinking a probiotic yogurt drink first thing in the a.m. and also taking a simple digestive supplement that I get at the health food store (we have Whole Foods market where I am from but I am sure you can find a similar market in your area) has reduced the symptoms by 80 percent or more.

I suggest DanActive - the caloric intake is minimal, there are several flavors, and it tastes like a mini-smoothie - I actually look forward to mine every day and miss it when I run out! I also agree with limiting dairy intake, with the exception of yogurt. Yogurt is pre-digested before you ever take one bite, so your body has minimal work to take in maximum nutrients. Make SURE you choose a yogurt with 'active yogurt cultures' and try to stay away from any artificial sweeteners which make your body work MUCH harder and are basically toxic to your system. I personally like DanActive because you get the most active cultures for your money, but you can also look for a drink called 'Kefir' that serves the same purpose and comes in many flavors as well.

Why is this so important? Active yogurt cultures aid your immune system in taking in and using nutrients from your food choices. When you have been taking antibiotics, or have not been requiring your body to digest and absorb nutrients on a regular basis, your digestive system stalls or shuts down entirely. Hence the re-feeding syndrome. Active cultures aid in re-establishing the 'good' bacteria that are normally present in your digestive tract that help your body obtain maximum nutrient value from any food you consume.

If you are not fond of smoothies for some reason, or are unable to consume any dairy, then Jarrow Labs (and probably other brands as well) make a probiotic pill that you can take. I actually take both - the probiotic pill and the DanActive drink - each day.

The digestive aid I take has different digestive enzymes condensed into a pill form. The enzymes assist my stomach and digestive tract with breaking down, digesting and absorbing nutrients. What does this mean? Much less IBS, gas, bloating, and other side effects too unpleasant to go into detail about. To give you some perspective - when I first started trying to eat again, plain white rice was too much for my stomach to handle. Juices - forget it. Nothing raw, nothing spicy, nothing too hot, nothing too cold - it was almost impossible to get through the day without hours spent enduring the after-effects of breakfast, snack, lunch or dinner. I dreaded mealtimes like a daily outbreak of chicken pox.

Today, I rarely struggle, and can eat all KINDS of foods I thought were off-limits forever! I attribute this to the DanActive, probiotic pill, and digestive aid I take. I also make SURE to take a multi-vitamin daily, and I try whenever possible to avoid taking antibiotics, which in the end leave you more vulnerable to illness in the future because they kill off the good bacteria in your digestive system. Without the aid (at least in the beginning) of nutritional supplements like probiotics and digestive enzymes, you can re-feed to your heart's content, but your body may not be able to utilize what you take in, which defeats the purpose of the process you are going through. Make it as easy on yourself and your body as you possibly can!

Another suggestion is to separate out your foods - for instance, if you eat fruit, wait at least 20 minutes before consuming anything else. Melon in particular you should either plan to eat alone (even apart from any other fruit) or leave alone. When you eat protein, don't combine it with carbohydrates, because your body uses two different digestive processes to break down carbs and protein. A good rule of thumb, again, is to consume foods that take less energy to digest before foods that are more complex. Fruits first. Then vegetables. Then carbs. Finally proteins. Wait at least 20-30 minutes in between each for maximum ease of digestion, but if that is not possible at least try to consume each group in the proper order.

Most adults have trouble with dairy, and soy tends to be hard to digest as well, especially if you consume more than the equivalent of two or more cups per day. You can buy fortified rice milk, however, which is both easy for your body to absorb and contains 1/3 of your daily calcium requirements. Be sure to check labels on any foods or dairy/dairy replacement drinks you buy to see what their nutrient contribution will be - they can differ widely between brands.

Also keep in mind as you choose foods each day what your climate is. When it is wet and humid, and cooler, it is not a good idea to eat cool, wet foods like milk and ice cream. Go for hot foods with a little spice and stay away from dairy. This helps your body maximize its digestive energy. Eating foods that mimic climactic conditions forces your body to use more energy to digest them. Similarly, when it is hot and dry, stay away from foods that mimic environmental conditions - this is a better time to eat cooler, wet foods and dairy.

One more bit of advice - be sure to consume enough water and electrolytes during this process. I suggest Propel or the powder packets of Emergenc, either of which both re-hydrate your body and re-balance your electrolytes if you've had bouts of digestive upset. One per day is usually more than enough. Emergenc also helps strengthen your immune system. Be careful not to overuse electrolyte replacements as well. Too much of even a good thing is still too much. Moderation, trial and error are key (for each of you there will be foods that will probably remain off-limits for quite some time, or forever, and there will be other foods you re-incorporate into your diet with ease).

Last but not least, be patient and tune in CLOSELY to your body's signals. For instance, now there are days when I crave bananas (potassium), grapefruit (antioxidants/immune strengthening), papaya (digestive enzymes), etc - you get the idea. I never used to be able to consume any of these fruits and now I eat them regularly when my body requests them. There are other days when I might put a bite of something in my mouth, like an apple for instance, and spit it right back out and choose something else instead, because my body just said to me 'swallow it and you'll be sorry'. I don't worry when I get this message - I have learned to obey without questioning. You will be surprised at how good your body is at communicating with you once you learn to listen in the language in which it speaks!

I am very proud of you for your dedication to the re-feeding process - that takes guts and you are an inspiration to us all!

Warmly,

Shannon

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