SOMETIMES I FEEL LIKE A NUT
Next to chocolate, I think the food I miss the most is peanut butter. Boy, do I miss those little
chocolate covered peanut clusters! Of course, I'm also fond of peanut butter sandwiches and long
threads of Thai noodles crowned with spicy peanut sauce. And once again this winter I know I'll
again have to forgo those scrumptious cookies with walnuts and macadamias. Ah well, at least
I'm not alone in my abstinence. Not only do thousands of us with IC avoid nuts, but according to
the American Academy of Allergy, Asthma and Immunology, nuts (especially peanuts) are
among the foods Americans are most commonly allergic to.
Now you're probably thinking, "Why should people with IC care whether or not nuts are
allergenic?" Well, there may be an IC-allergy connection. Studies and surveys conducted in the
last ten years have revealed that somewhere between 25% to 45% of people with IC also have
allergies that they know about. This isn't really surprising, since both allergies and interstitial
cystitis involve cells of our immune system called mast cells. And curiously, we sometimes
experience our bladders acting up when our allergies do.
The mast cell connection
Mast cells are found in many places in the body, but they're most abundant where our body
meets the outside environment (remember that when we breathe or eat, the "outside" world comes in).
We have mast cells in our bladders and our skin. They're in tissues that line our nasal passages,
lungs, and intestinal tract. And when activated mast cells are provoked, they can release
inflammation-causing substances into the surrounding area. That may mean you get a rash or
have trouble breathing whenever you eat a food you're allergic to. But according to allergists,
you can also experience other symptoms too: an itching or tingling on the roof of your mouth, a
runny nose or postnasal drip during or after a meal. You may have itchy skin, ear canals, or eyes,
or you may get some abdominal cramping or bloating. These symptoms all occur because mast
cells are reacting to the food or a breakdown product of it.
Many IC patients add bladder symptom flare-ups to their personal list of food allergy troubles.
One IC patient (who also has IBS and fibromyalgia) describes her reaction to a food she's
allergic to this way:
"The foods on the IC diet make my bladder worse, and that's pretty much it. But when I eat the
stuff I'm allergic to it's much, much worse... it's like my whole body goes crazy and the bladder
pain's just part of it. It starts while I'm eating. I get this "burny" feeling in my mouth... like the
roof of my mouth is becoming raw. Then I notice my nose is running and my tongue has these
sore, red spots on it. About an hour or so after the meal, I get the acid indigestion.... and no
amount of Tums or Mylanta seems to help. By three or four hours after the meal I've got some
pretty bad gas and intestinal cramps too. Then about ten or twelve hours later my bladder starts
in... first a soreness, then it's really on fire! When I pee it feels like knives cutting my urethra.
Sometimes I'll get a kind of vaginal itchiness too-- and if it's at night, I might wake up with hot
flashes, which I haven't had in years. My stools will turn yellow, I'll get muscle spasms in my
legs, and sites of old injuries will start hurting again (after 20 years!). The next day, my
fibromyalgia is really bad too. The next few days I'm just dead tired no matter how much sleep I
got, I can't think straight, and I'm so stiff and sore I can hardly move. It takes a week or two for
everything to calm down again."
Although her experience may be more dramatic than most, it certainly points out that for IC
patients, bladder pain can be one of the symptoms triggered by food allergies.
Problem nuts
For IC patients, peanuts (a legume, not a true nut) and most tree nuts are troublemakers
whether we are allergic to them or not. No one has yet figured out why they make our bladders
hurt. It may or may not be related to allergies. However, given that nuts tend to be allergenic, we
certainly have reason to be cautious, and particularly so if we have any other known food
allergies.
I hate giving up my favorite nuts... not just for the taste, but because they are high in fiber too
(which can offset the constipating effects of some medications). They also have one other
benefit for some people: nuts tend to be high in the amino acid, arginine. Dietary
supplementation with L-arginine (a form of arginine) may be helpful in a subset of IC patients
who have a history of bladder infections, according to one study published last year in the
Journal of Urology [1].
There is at least some good news for IC sufferers: bladder reactions to nuts are very individual.
Many, but not all people with IC, can eat at least some nuts. The most bladder friendly ones are
cashews, almonds, or pine nuts.
Safer nuts
Pine nuts seem to be the most bladder-friendly nut with the most people being able to eat
them. Almonds and cashews run a close second. Pine nuts are often used in Mediterranean
dishes. Try shaking a few on dressing-free salads to perk up the flavors.
Almonds can substitute for pecans or walnuts in many desserts. Try almonds and carob chips
in cookies you'd normally bake with chocolate and walnuts. You can often find cashew and
almond butter in natural food stores. (If the cashew and almond butters are only available
unsalted, you can add your own salt to enhance the flavor). If you can't have almonds, you may
be able to use almond extract in recipes to get the almond flavor without the almonds. By the
way, you may also find out that your bladder reacts to the nut or seed itself, but not the oil
from it. Again, experimentation is the only way to know for sure.
Here are two easy and delightful recipes that use almonds and pine nuts to lend flavor to
vegetables.
REFERENCES
1. G.E. Korting, S.D Smith, M.A. Wheeler, et al.; A randomized double-blind trial of oral
L-arginine for treatment of interstitial cystitis; Journal of Urology, Vol. 161, pages 558-565; Feb
1999.
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BEANS WITH ROSEMARY AND PINE NUTS
serves 4
If you enjoy the pungent aroma of rosemary, you'll love this Italian dish.
2 cups frozen green beans
1 Tbsp. margarine
1 Tbsp. olive oil
1/2 tsp. dried rosemary, slightly crushed
1/8 tsp. garlic powder
1 dash salt
2 Tbsp. pine nuts
Cook green beans, drain and set aside. In skillet, melt margarine over low to medium heat and
add olive oil. Stir in garlic powder, salt, and rosemary. Add green beans and pine nuts. Cook,
stirring over medium heat until beans and pine nuts are heated through and thoroughly coated
with oil and margarine mixture. Turn into a serving bowl.
NOTE: Be sure you don't use the flat, Italian beans. These may be irritating to your bladder.
Also, if you have vulvodynia, it may be best to avoid beans altogether because of their oxalate
content.You can however, substitute lightly steamed strips of zucchini squash.
101 calories per serving, 9 grams fat per serving
ALMOND CHICKEN
serves 4
This delicious low fat and soy sauce-free Chinese recipe was featured in this column last year
but is so good it bears repeating!
1 cup Campbell's Healthy Request Chicken Broth (see note)
1/2 tsp. onion salt (see note)
2/3 cup carrots, peeled and sliced
4 boneless skinless chicken breast halves
2 Tbsp. dark Oriental sesame oil (see note)
1 Tbsp. cornstarch
1/2 cup sliced almonds
1/4 cup water
Bring chicken broth and onion salt to a boil in a saucepan, add carrots, cover, and turn heat to
low. Cook 5 minutes, then turn off heat. Meanwhile, cut chicken into cubes, about 3/4-inch in
size. Stir cornstarch into water in a cup and set aside.
In a skillet, heat sesame oil and stir-fry chicken over medium heat until meat is cooked. Add
carrots and broth, then almonds, while stirring continuously. Scrape up any bits of meat clinging
to the pan. Add cornstarch water to skillet and cook while stirring until sauce is thickened.
401 calories per serving, 28 grams fat per serving. Good served with steaming hot brown rice.
NOTES : It's important to use a chicken broth that has no MSG, as most other brands do.
Although onions tend to be problematic for IC patients, onion salt in small amounts seems to be
pretty safe unless you have a food allergy to onions. If so, substitute garlic salt or plain salt. Be
sure to use the dark Oriental sesame oil (it has the color of molasses), not the light colored
regular sesame oil.
