- Crystal Zaborowski Saltrelli, CHC
On October 31st I had the pleasure to talk with Crystal about her newly released, updated version of Eating for Gastroparesis. I have to say I was quite excited to read new tips and gluten, dairy-free and mostly low FODMAP recipes-something I hope might benefit others out there with digestive troubles or, at the very least, encourage experimentation. Due to my own multiple food sensitivities it was a relief to have some new ideas for navigating meals!
After reading the book in one sitting, I learned more about Crystal's own journey and at the same time, received additional tips and general information for eating well with GP. Not only this, her book goes beyond food and discusses some of the other aspects of our lives that fall into play when managing GP. I highly recommend anyone struggling or looking for some fresh ideas to read this book and give the suggestions a try.
This is quite a long post but goes over everything we talked about from her original diagnoses to experiments with food, working with clients, recipes, and her number 1...well perhaps 2 or 3 pieces of advice. Also, at the end I’ve included a yummy recipe from the book and a chance to register to win a free copy of Eating for Gastroparesis!
I have to admit I was a bit nervous to talk with Crystal (I feel much more comfortable writing over speaking) and began the conversation sort of stuttering my way from “hello,” directly to “I love your book!” I’ve had more of a chance to ask questions and get an understanding of her philosophies when it comes to living well with GP by participating in her current group program. She was incredibly easy to chat with, obviously coming from a place of understanding, compassion and being truly honest about her own experiences and where she is now. So, after thanking her for taking the time and asking about how her adorable daughter Lily is doing (who by the way is waking up early in the morning stating that the “sunshine is still sleeping!”), we began to discuss the book and so much more beyond diet for GP....
Stephanie - First I want to say that I was really excited for this book! This version does quite a bit of branching out from what was published before. How is the feedback so far?
Crystal - At first glance it may seem like it is restricting you more, especially when people are already following a limited diet and feeling boxed in by their choices. I personally feel like it really opens up choices compared to the standard GP diet most are used to seeing (I agree!). Positive feedback so far, people like the book and like the recipes. I think that today there is a general discussion in the nutrition world of more people going towards real food, which is great.
S - When I started reading the book I was surprised at the number of diagnoses you were given in the beginning, such as PCOS and raynoud’s.
C - It came in the years soon after the diagnosis of gastraparesis, which originally I just had the digestive issues. Years that followed I started getting more symptoms and more diagnoses.
I hadn’t written a lot or talked much about that because I’m very conscious of the fact that we can attach very closely to our diagnosis and make that into our identities, which can put some limits on us that don’t necessarily have to exist. There was a period when I thought, "Oh my gosh, I have GP, I have this and that and taking a dozen medications,"...at one point the specifics became unimportant and I began with the general idea of focusing on wellness.
Over the years of coaching I began to realize how others also experienced this so I also want people to understand that I get what they are going through, I have been there.
S - Yes I do think so. I rarely meet someone with just GP. There is usually subsequent health issues going on such as autoimmune, thyroid, anemia, lower GI, etc.
I can relate. It is comforting to know it's not just me and certainly think other people will feel the same way.
C- I think one of the reasons it’s so uncommon to see someone with just gastroparesis, and it’s a lot of things, but there's that the diet begins to break down the body, the stress that begins to break down the body and part of it is that you just start going to a lot of doctors and the more doctors the more diagnoses. For me, I was diagnosed at Mayo with PCOS, colonic inertia, raynaud's, (had anemia for a long time) and those things, none of them are an issue any more. I think partially it was the diet, partially the whole plan altogether with stress management. There was really a change, and I still struggle, but not in a way that I did before I had the tools and the information and resources that I do now.
S - You do talk a lot about diet not being the answer to everything, that it’s all a part of a bigger plan, and I like how you reiterate this in the book, despite it's title Eating for Gastroparesis! I agree, if you follow a diet and everything else in your life is crazy or stressful, then you probably won’t get feel much better.
C - I have a few reasons for trying to drive that home. There are some who won’t/can’t follow the real food diet and continuing with a typical GP diet, that it can be dangerous long term, but to eat a somewhat process diet and at least make some changes in other areas of your life.
Eating, for me, I got really wrapped up in that “if I can just do this right” it’s going to be the thing. But what’s right is going to vary from person to person. For example, if I try to go full out paleo then I’m going to have a lot of symptoms and I just can’t do that right now. But there was a time in the last year where that is what I was trying to do, "if I can just be super clean, super AIP (autoimmune protocol)," and that just wasn’t working for me. So finally I had to go back to my own advice, "Look - this isn’t the end all be all. Look at all the things you are not doing now. The diet was stressing me out so bad that it was offsetting my stress management, what am I doing?!”
S - I’ve been there for sure. There was a time when I went strict SCD (specific carbohydrate diet) thinking it would be the answer, I was so stuck on that. I had all of my friends on board helping me out, cooking and supporting me. In the end it ended up making me so sick which in turn brought on more stress. These days there is just so much information out there on diets being the cure to everything in life, I think that is hard to break through and why some people may look for the “right diet” to cure the gastroparesis. And like you said, there is not one diet that works for everyone with this.
C - I think that one of the reasons we become so diet focused is that it feels easier to control what we eat vs. our stress levels or lifestyle choices. "Just tell me what to eat and I can do that, but don’t tell me to manage my stress and rearrange my priorities!" Backing off commitments, that is really hard.
S - I never thought about that, being easier to control however, with our society today we tend to praise being busy and productive, how much we can handle.
What advice do you have when it comes to not losing touch with family and our support community during meal time, something that can be hard to avoid?
C- That is something that can be really tough. You have to figure out what works best for you, but again not always the easiest answer. For the longest time I just ate when it was my time with my meal. When it came to thinking about having a family, it takes work to make a meal for everyone and how could I make this enjoyable? Now we prepare the meal together, and even if we don’t eat the exact same dinner, we sit down together. I think it’s important to work to include yourself. It does take effort but I think there are ways to include yourself. It’s not easy, everything about this can be difficult, but it’s all a choice and you have to make the best choice for you. This may not always be putting in the extra effort, to have a mealtime together. But I think, like you mentioned earlier, that awareness is the crucial piece, the way this is affecting your life and what you can do to reverse that.
S - In your new book, you have a lot of recipes that can be shared, that others will enjoy as well, as opposed to a cup of broth or saltine crackers that may feel like the only things we can have at times.
C - This is one of the differences in this book from the first version of Eating for GP. In this book, my family, we really do eat most of our meals from this book. When people come over to our house that’s what they eat to, it’s real food. I’m all about step by step, one step at a time. If that means once a week people start to make a meal for their family that they can also eat then great, that’s better than no times a week. Some of us who have GP, especially those with a type A personality, we think, "Okay, that’s what I can do and I’m going to do it all right now." I can almost promise you that won’t work. Small changes can up to really big things in the long term.
S - Yes, I can get anxious about trying new things! However, I really like what you are sharing in the group program, reminding everyone that there is a reason the diet classes are further down in the program. Taking the other steps will help you get there and feel better when it’s time to experiment and incorporate food.
C - When I used to work with clients one-on-one I would always start with diet and that just didn’t work. The more I learned and the more I experienced and recognized, it is so variable from person to person. What’s not variable are stress management, self-care and lifestyle. Nobody is going to get sick by reducing stress. And as long as people are doing appropriate physical activity, things like lifestyle changes, they are going to help most everyone. It’s not just diet!
S - I had the same experience working with clients in the past, even on my own journey with GP. For the past 6-7 years that has been my first question, ‘What do I eat?!’ I think I’m finally coming to the point in the last 6 months that it’s not the question or the answer to focus on.
C - Yes, there is so much information out there that you can quickly take yourself down the rabbit hole.
S - You talk about in the book really tailoring it to yourself. I like how you called it, instead of the “GP friendly diet,” it’s actually the “(insert your name hear) friendly diet.” So one of the suggestions you include to make this happen, for example, is to experiment with meal sizes, compositions and schedules to see which combination works best for you. Perhaps start with 1 1/2 cups every 3 hrs and record your symptoms for a week. That is such a step-by-step slow process which can really take time, something that I know for myself is really intimidating. How did this work for you?
C - It actually took me a lot longer because in the beginning I didn’t go step by step, I did pretty much everything I read immediately, sometimes in conjunction with a bunch of other things. I really felt like the Tasmanian devil, I was spinning in circles faster and faster, getting nowhere. It was almost, in hindsight, how it eventually happened, but not in weeks, more like months. Once I started to get it, then I went back and used that, start from scratch, look at what has worked. After my daughter was born when hormones were fluctuating and the GP got worse, that’s the system that I use. When I was working with individual clients, this is how we worked with diet, slowly over a 12 week period. Slow and steady is really the way to go.
It may seem like it will take forever but in the context of how long have you been doing and how has that worked or not worked for you? It really can help put it in perspective.
S - What would be your advice for people who feel stuck with the typical GP diet that may lack essential nutrients, where to start? What advice can I give to the people I care about that may benefit from dietary changes suggested in your book?
C - I think the best approach is to ask them what is working for them right now, "Are you feeling good, is your quality of life good, do you have other health issues?" I think the fear of stepping outside of whats known, that's totally understandable, I was stuck there for many, many years. But it was the realization that this is really not working for me. Help them recognize that what they are doing maybe is not giving them the outcome they want.
S - I hope to see more dietitians get on board with what can help and use the type of suggestions from Eating with GP. I’ve personally shared it with my team of GI doctors and dietitians who were open to learning more from a patient perspective.
S - What are some of the major updates in the new version of Eating for GP?
C - It’s much more in line with the comprehensive wellness plan philosophy, what most of my work is now based on. When I wrote the first edition of this book I had only been coaching for a year and it really reflected my coaching style at the time which was very diet focused. When you are mostly diet focused or diet and drug focused your diet is typically a more restricted and not health promoting. When it comes to GP, this ends up being really refined, not nutrient rich food. This version is more in line with nourishing the body and an idea of wellness vs. symptom management. In 2010 that was the best I knew and now this is the best I know and it’s only appropriate that I share that knowledge. I think this book is not only going to reduce symptoms but will help nourish the body and contribute to overall wellness in the long term. Also I think the recipes are better! The first time around it was recipes I came up with over a few months of working with clients and experimenting, and this is literally years worth of recipe work.
S - So with this, what differences have you noticed in your own health?
C - Well the biggest one is that I have a baby now! When I was following the typical diet and drugs approach and the way I was eating when I wrote the first version of my book I was maintaining a very low weight, not eating enough, I wasn’t menstruating and wasn’t sure this would be possible. When I changed my diet I was able to gain weight, start menstruating again, get pregnant, carry and have a healthy baby. To me that is the biggest, number one change.
Going back to what we talked about in the beginning and the several other diagnoses, with colonic inertia it had been suggested that my colon be removed through surgery. And now, I don’t even struggle with constipation anymore. Part of that started to improve when I was pregnant so maybe part of that was hormonal, I don’t know, but my diet has really expanded and gone significantly more towards whole foods in the last 3 years since I was pregnant and following my daughter being born. I’m generally healthier than I’ver been in a decade. I don’t attribute it all to diet. Like I said before, I think it’s also stress and lifestyle, but I attribute a lot of it to diet.
S - That is so inspiring, I feel like I’m going to cry. Reading about your journey during and after pregnancy gave me some hope, after thinking it might be impossible. And not being constipated is HUGE!
C - I know, there was such a long time where that was a bigger problem for me than the gastroparesis. The only thing that had worked for me was prucalipride from the UK but it was so expensive and it stopped working after awhile and then taking up to 12 dulcolax a day. Not to be dealing with this anymore is amazing!
S - I agree and I know a lot of others who can relate to this. For myself once the constipation comes into play then everything else goes downhill. Last spring when I went through a period of where I was doing so well that I thought the GP was gone, over time I became constipated again and I was back to square 1. If this comes up is there anything you change with your diet to help with this?
C - It seems kind of counter intuitive but I back off any raw fruits and vegetables and smoothies and go back to bone broth soups, cooked foods, basically what you and I consider gut-nourishing, easy to digest foods. Well cooked veggies, soups, juicing still works for me. I decrease in general the bulk of food I consume while still trying to get in my nutrients, so for example juicing in place of a smoothie. I think its different for everyone. For me, even still, there is little bit of a frantic-ness that comes with “this isn’t working!” so I try to be aware of this and address it. I know from the past that can mess me up even more. So I address the diet but also to be really aware of where my heads at.
S - Yes, you actually address that in your book about the stress response, under the 10 Guidelines of a Gastroparesis-Friendly Diet. For me, the most significant of those is #8, “Eat slowly, calmly, and in a relaxed environment.” That’s not generally recommended with diet. It can be hard when we want to sit down in front of the computer, watch TV, or on the run multitasking. That’s a big one.
Another piece that I found interesting to read is under the section on fats: “Most sources of fat are considered GP-friendly.” I don’t think this is something people hear often, usually more on the lines of "fat is bad."
C - I think that is an important distinction because it’s not the fat that’s bad but the amount of fat that may be problematic. People may take away that they cannot have olive oil or butter, for example. You can but you just have to do it in GP-friendly proportions within your general fat limit throughout the day. It can really be problematic and contribute to secondary issues that I see people having, including constipation. I thought that was really important to remind people, that it’s not really one source of fat (aside from trans-fat), it's just how much. Hopefully that starts to open possibilities a little bit.
S - Yes, I do hope that people can incorporate different sources such as coconut and olive oil, a slice of avocado, and nut butter, all delicious foods and nourishing.
Looking at the recipes from the book, I was pretty excited over the idea of the “Make Ahead Breakfast Jars.” That’s a very unique idea. Do you actually make enough hot cereal for a week?
C - Yes, this started after Lily was born when I had no time. Once she was eating grains (adding more whole foods to her diet) such as millet, quinoa and buckwheat, I was just doing this for her initially. Then I began to eat these again as well, so I would make a big batch, portion it out and store it in the fridge. Sometimes it’s breakfast, sometimes it’s a snack, when I need something that is quick, nourishing and well balanced.
I didn’t even realize that it was something people might be interested in but I when I shared it in the last program people wanted to know more.
S - That’s great. It may only take 10-15 minutes to cook but by the time you do get it started then clean the pots and pans it can take up some time not everyone has.
C - Exactly, that’s one thing I tried to include in the book also is to save time and do things more efficiently. Especially when people are following a comprehensive management plan and they’ve got physical activity, stress management, acupuncture, etc, on top of work, family or other obligations, time is a limiting factor. We make so many sweet potatoes in the crock pot now to save time!
S - Oh I love this, I started making them that way a few months ago and the house smells so good!
So do you currently have a favorite food/recipe/meal?
C - We make the baked breakfast sausage several times a week because Lily loves it! It’s so easy and I found that I do better with protein in the morning vs heavier carb meals. In general we are real big on root vegetables like the roasted root veggies and sweet potatoes in the crock pot like I mentioned. Literally, my family eats from this book! Of course there are a few things I make for my husband that are not GP friendly but we are trying to do a lot of salmon to help with Lily’s eczema and the omega 3’s are good for that and general wellness. The 10 minute salmon is probably the one I make the most often. And I do my green smoothie everyday! I go through phases through juicing and blending so right now I’m in the smoothie phase. Before I had a baby I did both but these days its usually one or the other with timing. Although I have been doing juice cubes again, I’ve started having it more often.
S - That is one thing I really need to try. I cube everything but have never tried this with juicing! When you are not getting those foods in other forms (ex. spinach, pineapple, cucumber) it’s so refreshing. Definitely trying the juice cubes soon!
With the smoothies, do you tend to rotate with milks like coconut, almond, etc?
C - We have some nut allergies so I tend to use coconut milk though I don’t use milk everyday. I just started using a protein powder (something I found another thing doesn’t work for everybody), so I don’t use milk because it makes it too heavy. I wouldn’t necessarily recommend it for everybody but it works for me at this time. Vega Sport really seems to work for me right now, it's plant based and has no fructose in it. I’m in a really nice place right now where I can eat more of what I want and try not to take that for granted, it’s a fairly new thing for me!
S - Well I think we can all appreciate that, people that have been through what we have been through could never forget that!
I have to ask, what are Lily’s favorite foods?
C - She loves turkey sausage and sweet potatoes! She was born with food allergies and because of what I already knew I was adamant about feeding her whole foods. It kind of works out that I already planned to feed her whole foods and she’s a good eater!
S - Have you had any experience with the food allergy testing for yourself?
C - Yes, I had formal food allergy testing (looks for the actual immediate reaction of severe food allergies) at the allergist office and that was all negative. But then there are certain sensitivities that we all know so much about and I wholeheartedly believe in leaky gut, food sensitivities, I definitely believe in non-celiac gluten sensitivity. But I don’t know that a lot of the testing for them are reliable, that the best way to test is the elimination diet. I spent a lot of money out-of-pocket to get food sensitivity testing and it came back with dozens of foods that I was supposedly allergic too. I tried follow it but the only things that I could eat that ended up being GP friendly were potatoes and bananas, and then to try and cycle foods every 3 days like recommended. It was one of the worst periods for me in terms of flare ups because it was so stressful. For me, it did way more harm than good. But that being said, I don’t do well with gluten at all, and whether it’s the actual protein or FODMAP I don't know. So even though I’m not a proponent of food allergy testing I do think that there is something to be said for eliminating certain foods that you may be sensitive to. And not always forever, I think you can heal your gut and introduce things in time.
S - I agree with that. I had testing before GP and it was really traumatic for me because it came back with so many foods I could no longer eat, random ones, that I suddenly became scared of and ended up on a very strict diet which made things much worse.
C - I kind of feel that way about a lot of the alternative stuff (not including some of the things that can be helpful that I've talked about) that comes across as one size fits all but people that really don’t understand GP. For example someone I saw that insisted I take hundreds of dollars of supplements and it was so painful and just made everything much more complicated and stressful. It’s hard because everybody wants an answer and are chasing ways to find out what is going on.
S - The supplements can be very scary, same experience with taking too many and the idea that they will make us all better. It doesn’t always help.
C - My number one advice for people regarding working with practitioners is that if anybody tells you they can easily cure your problem, don’t give them your money! I don’t know how many times I've heard this. Even in my program, I’m very clear to say that I’m not promising to cure you, but I am promising to help empower you to make better choices that I strongly believe are going to make you feel better and almost guarantee will improve your quality of life. I would never promise anybody that I can cure your GP, that is just a lack of understanding the complications. Not that I don’t think it can’t go away, it can and has for some.
S - There is a belief out there that it is incurable but not for everyone as we have both witnessed. Even if for some that won’t be cured then there is at least ways to manage it the best we can.
So as far as the book goes, eating for gastroparesis, what would be your number one piece of advice?
C - It may seem silly because the book is about eating, but my number one piece of advice when it comes to the book would be to not rely on diet for your entire management plan. I really truly believe the more well rounded your management plan is the more your diet will open up. If you find you can’t eat anything from the book then try working on other areas of your management plan and add in 1 new food a week. If it doesn’t work for you then it doesn’t but then try something different the next week and see how that goes.
Thank you so much for your time and sharing so much with us today!
Crystal has kindly offered to do a giveaway for a copy of the new book. Enter below and a winner will be announced via blog and FB by Thursday, 11/20.a Rafflecopter giveaway
Following the announcement for winner on Thursday I'll be sharing the Saltrelli family favorite - Baked Breakfast Sausage!
For more information on Crystal Saltrelli's new release of Eating for Gastroparesis check out the website for ordering information, resources and sample meal plan.
You can also learn about Crystal, watch her informative YouTube videos, read blog posts, recipes and so much more, go to www.livingwwithgastroparesis.com.