Katy: Hey, I’m Katy Harvey, a non-diet dietitian. If you’ve spent years battling food in your body, I’m here to show you the path to healing. Here on the Rebuilding Trust with your body podcast, I teach you how to find your own freedom with food through tools, strategies, mindset shifts, and heartfelt discussions around what it means to make peace with food and your1 body while still existing in diet culture. I believe that all bodies deserve respect and that health is so much more than a number on the scale. It’s about connecting with our true selves and learning that our relationship with food is more important than the food itself.2 So if you’re ready to discover the freedom of rebuilding trust with your body, grab a seat and maybe a snack, and let’s do this.3 Anna, welcome to the show. I am so glad that you are here. Let’s just kick things off with a little bit more background and context. I’d love for you to share more about yourself and the work that you do, and we can go from there.

Anna: Great, yeah, thanks so much for having me. I’m a nutritional therapist, so I’m based in the UK, but I work with people all over the world. So mostly focused on GI symptoms, so be things like bloating and gas and erratic bowel movements. And I kind of fell into this niche, like this topic. I was thinking the other day, like, I’d never dream of having spending all day talking to people about their poo. But 20 years ago, I used to work in financial services and not be into this kind of health area at all. And then I just really completely retrained and refocused myself. But yeah, I would have been horrified, I think, to imagine talking to people about smelly gas and how many times I’ve been to the toilet that day when I was in my young twenties.

Katy: Isn’t it funny? And then I don’t know if this happens to you, but like, my clients are always like, is this TMI? And I’m like, there’s no such thing as TMI. I’ve heard it all, so bring it on. Yeah, I don’t necessarily want to talk about it outside work, but during the working day, anything goes. Like, it’s all over again.

Anna: Yeah, for sure. Yeah, well, and it’s one thing we’re like, our digestion tells us so much about what’s going on with our bodies. It’s so it is important to be able to talk about it with especially with someone like you who really knows how to interpret what’s going on. Yeah, yeah, and you know, people have quite a lot of shame about it, and it’s kind of embarrassing. And so more people have issues with their digestion than most people out there think. It’s really common to have irritable bowel syndrome. Probably like one in 10 people in their lifetime will have some kind of episode of or trouble with their digestion. And so we don’t always talk about it though with your neighbor or your work colleagues and things like that.

Katy: Same, probably more people than you realize also have some sort of digestive issues. That’s so true. Yes, we maybe don’t realize how many people are struggling because you don’t just walk around telling people about it. So yeah, okay, let’s dig into this a little bit more because you and I were talking beforehand about the fear of food and the fear of eating that can stem from having digestive issues. So talk to me about that. Like, how does that begin? And what do you see with the clients that you’re working with?

Anna: Yeah, it’s really common. A lot of people I work with are on really restricted diets, like maybe just down to a handful, like five foods that feel safe. It normally starts off with a little bit of bloating or a bit of an upset stomach after a certain meal. And people will then analyze that meal and think, oh, I think it was, I know, like too much cheese, too much for creamy pasta dish. So I’m going to cut out maybe dairy because there was dairy in that. I’m going to cut out gluten because of the pasta. I’m going to cut out onions because they were flavored in there too. Going to cut out garlic and all of those foods without really knowing whether one of those was a trigger or not.

Katy: But they had a bad experience with that meal, then they avoid it. And then maybe you have another bad experience, like you have a barbecue and a salad, and a lot of the fresh vegetables, like that left you really bloated, gave you some stomach cramps. And then you’re like, oh, maybe it was the vegetables. I can’t have all of those vegetables. And it just starts getting narrower and narrower, and people cut more and more foods out. And then every time, like your brain is trying to keep you safe, trying to make you think to avoid those situations in the future. And so it’s really natural for us to not want to go through the horrible pain or the maybe explosive diarrhea or whatever that happened after those bad situations. But actually, it might not have been the food, and that’s the problem. So when we start cutting more and more foods out, it actually can change your digestion, change how it works. And so then it becomes bigger than the particular food, even if it was at first the food that was the problem in the first place.

Anna: Yeah, tell us more about that. So how does our digestion change when we start cutting things out? Yeah, so under eating definitely slows down the digestion in some ways. So often people have slower emptying of their stomach, which means when they do eat a normal size meal, that food just sits really heavy in your stomach. You feel like you’re eating way more than you should because you feel so full. But that’s partly because your body is trying to extract the maximum amount of nutrients from it because you haven’t eaten well for a while. Maybe it’s also because you’re not producing enough of the stomach acid cause you’re worried about eating. So your body is like goes into a fight flight freeze mode. And then you don’t produce as much stomach acid, digestive enzyme.

Katy: So that can then lead to bloating. And then maybe just there isn’t enough food coming through the whole system. So the whole smooth muscles that push food through your gut also slow down and become a bit sluggish. That can lead to constipation. If people are constipated, then cause of the blockages, like slow transit of food waste, you get a lot of gas build up. So as soon as we start under eating and cutting a lot of foods out, it can lead to those particular IBS symptoms that people are trying to avoid from the first place. It’s a bit of a vicious cycle. You get trapped with every time you eat, if you’re bad. But actually, you need to eat in order to kind of move forward and move through those blockages. So yeah, it’s a real tricky situation.

Anna: And then sort of mentally as well, I think when you cut a lot of foods out, by avoiding the things that feel scary, well a bit dangerous, and only sticking to the safe things, you’re kind of reinforcing that like safety behavior that actually those foods are bad, and I do need to stay safe because those things become more unknown. So there’s like a mental side to it and really yeah, a physical digestive side as well. And then also the third kind of element, I suppose, is the more food you restrict can reduce the gut bacteria diversity because they love to feed. They got bacteria in your large intestine, love to feed on different types of fiber. And fiber is normally one of those first things that people will remove, like cut out the whole grains, prebiotics like onions and garlic, and also then a lot of vegetables, mushrooms, cauliflower, chickpeas, and lentils.

Katy: Like these will all go immediately when people realize that they could be potential IBS triggers. So yeah, there’s a base three elements really in terms of digestion power, the mental blockages that we kind of put up into place to keep ourselves safe, and then in terms of the gut bacteria, like almost needing to train that back up again as you start reintroducing foods. Yeah, and talk about a complex situation. And I can totally see where people make these stories and these assumptions in their head, and their intake just gets narrower and narrower, and the symptoms get worse and worse, which further fuels the story. And you can get backed into this corner of just having that handful of safe foods.

Anna: Yeah, and then you have a lot of misinformation online, which is why I really love like, you know, knocking down that well, this weird thing is great. I really think things like that are great, where people can actually really understand some of the science behind it. Because we hear a lot about, you know, gluten inflammatory, dairy is inflammatory, and it feels quite scary, that kind of language, or like toxins or nasties that are in food. And of course, the more dangerous that you associate with food, the less likely you are to want to try it and experiment. And so when you spend a lot of time online trying to find solutions for your health problems, you kind of come across quite a lot of information that may make some food sound like normal healthy food sound quite dangerous and bad.

Katy: Oh, for sure. Yeah, and I see that all the time. One thing that I’m thinking of as you’re talking, so I’m in a mom’s group on Facebook for my area, and people will ask questions, you know, about their kids’ behavior or maybe some symptom they’re having, and they want advice. And the comments are flooded with like, you got to cut out gluten, you got to cut out dairy, you got to cut out this. And it’s like, okay, hold on, slow down. We’re jumping to so many conclusions here. And it’s like, eliminating food always seems to be the answer.

Anna: No, that’s really interesting. Yeah, yeah, I think that happens quite a bit. And obviously then in the most extreme cases, it can turn into orthorexia, where people are like wanting to be mean and pure, and everything’s got to be organic and very yeah, clean, I suppose, is the way they describe it. But again, though, even that terminology isn’t very helpful if you’re trying to think about how to expand your diet and like actually how you can develop a better relationship with your food.

Katy: Absolutely. And I would imagine even just like a healthy digestive system that functions well too. Yeah, in my experience, when I’ve had clients who come to me with a lot of IBS stuff and a very limited diet, they usually have done exactly what you’re saying. They’ve cut out gluten, they’ve cut out dairy because they heard that online. And then the other thing I’ve seen people do is they’ll go down this low FODMAP rabbit hole and they’ll adopt that as if it’s intended to be this long term lifestyle. So can you speak more to that? Like what are some of the mistakes you see people making? What are the common things that are tripping them up and talk to us about that. Like you know, it’s when a client comes to you and you’re like okay hold on you know we need to like work through some of these things.

Anna: Yeah, a lot of my clients have been on the low FODMAP diet for like two years perhaps. And it is a dietary intervention that is meant to be followed in that restriction phase for up to 6 weeks. It’s a trial. It’s a test. It’s an experiment with yourself to learn whether you react to certain fermentable fibers. For example, I could talk about chickpeas nearby removing them all out. Then we would see if you feel better. If you do, then you have an opportunity to bring them back in carefully so you get the broadest most expansive diet that you can tolerate. And there may be food that some people with IBS don’t get on well with.

Katy: Like I have brought back foods with people and they you know maybe they can’t tolerate lactose or actually onions are their big problem but actually everything else all the other board maps are completely fine and they don’t have to avoid all of those. So definitely people sort of lump fodmaps in the same category and think all FODMAPs are equally bad whereas each person has their individual tolerance and also just staying on that diet for so long can affect your gut bacteria yeah because they’re so cementable like your large intestine gut bacteria really need there is fuel sources which is when they fermenting it.

Anna: So it’s not intended to be just like I eat low FODMAP as if it’s like your long term way of living. No, and unfortunately, then you see that if you’re low fodmer and dairy free, gluten free, you know, you’re avoiding caffeine and sugar and a lot of other things, then it’s really tricky to manage them to socialize, to eat with other people like maybe if you have to make food for a family as well, it’s root you know, try making multiple meal so it becomes a real headache. And then also there’s this element of food taking up such a large part of somebody’s headspace that is quite hard to get over. I’m sure you see this with people here right with too.

Katy: So you know taking up a lot more head like of our thoughts and energy than it needs to. Um and it yeah cause that’s one thing it’s like if a person had like let’s say they have celiac and they do legitimately need to be pretty diligent about avoiding gluten like that’s one thing but what you’re describing is when people fall into this trap of what’s ultimately unnecessary food restrictions and it can be hard to sift through like what is and isn’t necessary how do you help a client discern that like what are some of the things you’re looking for to determine what they do and don’t tolerate.

Anna: Firstly I try and get to a baseline where we’re happy that there’s like consistent reactions. So sometimes when people take all the high fermentable high FODMAP foods out of their diets for this trial period 2 to 6 weeks if they don’t see much improvement they’re still maybe getting very bloated or they’re still going to the bathroom like five times a day but it’s kind of a little settle down a bit then I think well if you’ve managed to keep it this consistent even though there might still be other things that are causing it if you’re getting the same reactions whether you eat it or you don’t eat it then you may as well eat it.

Katy: So I would bring food back in very carefully and slowly and normally the approach with the FOD nut diet is to start with a very small amount and then over three days increase the amount and you looking for patterns does it make you bloated does it increase your abdominal pain like does it maybe create headaches or other things that you might have been noticing and if it doesn’t and you can manage that day 3 portion which is actually quite a good size portion then you should bring those back in again and the good thing about the FODMAP diet is once you’ve tested one food out of that grouping then it kind of opens up the key to other food.

Anna: So for example uh like mushrooms and cauliflower and fennel like there and celery they’re all in the same category so if you were okay with mushrooms then you may be okay with the other foods in that category is also good to test them but you’ve already tested them so with everyone there’s a way to bring back in these foods. I often start though with people if they’re on a really restricted diet of just looking at low fatmout foods to begin with because there’s nearly always some things that people aren’t eating within that category like whether it’s kiwi or aubergine or spinach or something that there’s ways to sneak those foods in first try and allow a bit more diversity getting more comfortable with flavors and textures that they’re not familiar with and then we can go into some of the ones which are maybe more likely to cause problems.

Katy: Absolutely so it sounds pretty systematic in a lot of ways and that way you guys can determine together what their unique needs are for their body.

Anna: Yeah and everybody will be different so some people will really react to garlic and other people will be absolutely fine with it so it’s just very individual depending on your genetics on your other health conditions maybe the rest of your diet so many different things that can influence how you break down and digest food so there’s no reason for everybody to cut all of those things out the same with being dairy free gluten free most people can tolerate small portions of those even if they are lactose intolerant most people can still manage a small amount of milk or cheese yogurt especially things like butter which don’t even really contain any lactose so there’s always options for expanding the diet no matter where you are yeah what you’re eating do you find that there are some people who even when you tell them that or you can kind of show them

Anna: Yeah, I think there’s a lot of fear around eating and a lot of anxiety and it’s quite hard to let go of that control and also that feeling that you’re doing something good by avoiding it. So it’s kind of like a moral thing as well. So it’s quite hard to shift that. But I think when people start to feel better, that’s a big motivator. So if you’re not getting as bloated, you’re not getting as much pain, you’re not running to the toilet as much, then you’re like, oh, this is good. I can actually eat more. I can actually enjoy my food. And then that kind of starts to build up. But it’s a process. It doesn’t happen overnight. And also, I think you’ve got to have some support. So it’s quite hard to do this on your own. You need somebody who’s kind of like an expert to help you guide you through that.

Katy: Yeah, I agree. I think having support is huge. And I love what you said about

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