For many people, the new year offers an opportunity to embrace fresh starts and self-improvement goals. But for Tara McCarthy, a clinical nutrition specialist at the Boston Children’s Hospital Division of Gastroenterology, Hepatology, and Nutrition, her New Year’s resolution is unique. Every January, she commits to four weeks of eating the same restrictive diet followed by the children she treats with Eosinophilic Esophagitis (an allergic reaction to food that causes the esophagus to swell) and other food intolerances and allergies.
In May, McCarthy also goes gluten free for her patients with celiac disease (an intolerance to a protein found in wheat, barley, rye, and some oats that damages the intestine lining).
Following her patients’ diets enables her to experience first-hand what it’s like to avoid common allergens such as dairy, wheat, egg, soy, tree nuts/peanuts, and fish/shellfish.
It can be tricky finding good substitutes and selecting the best recipes that can be adapted for different needs. The insights she gleans from her month-long experiment enable her to better help her patients and families stay within their eating plans with less stress.
Food for thought
“Each year I also pick a different theme. For example, I designate at least one meal a day that will contain no processed foods, I drink 12 ounces of an amino acid- based formula each day, or I find five new recipes per month to integrate,” McCarthy explains.
She believes that by experiencing the challenges for herself, she can offer guidance to patients — as well as moral support — that helps them feel less alone and less overwhelmed. For instance, she tests out a variety of foods and recipes to determine which ones are good, and which ones are intolerable. For the latter, she experiments to find ways to tweak them to taste better for her patients.
Now about to start her eighth year on this January diet, McCarthy has the regimen down pat. Yet, she admits that when she started this tradition, it was harder than she had expected.
A not-so-weighty lesson
“The first year I followed the diet, I lost 10 pounds quickly,” she says. “This helped me realize that when you take a food group away, you need to replace it with more calories in something else. I was so focused on being free of everything that I realized I wasn’t doing a good job. We tend to tell patients what to avoid but not what to eat,” she says. This causes much stress for families and leaves them struggling to fill in the gaps.
“When a child gets the diagnosis that they will have to eliminate foods from their diet, the parents can feel overwhelmed or even upset. They don’t know how they will follow all of the restrictions. They have to make dinner tonight and lunch tomorrow and don’t know what they will do to integrate new foods or recipes,” McCarthy says.
“Now that I have experienced the diet, I have a deeper connection and I can talk to the patients about different types of food products and recommend what they might like,” she says. “For instance, I know which milk substitutes taste best. The milk substitute for me is a really essential piece and there are a lot of plant-based ones that are good. I also try to find a snack to add in some extra calories. I particularly like coconut milk rice pudding, which is a warm yummy treat,” she adds.
A family affair
The diet has become a real family affair for McCarthy. While her children (ages 10, 12, and 14) don’t do the entire month-long diet with her, she does require them all to eat her allergy-free dinners and give their feedback.
“I know when my kids like something, my patients with allergies will also like them, so it’s a keeper,” McCarthy says.
McCarthy says that new foods can be an acquired taste. Some things she tried and didn’t like initially tasted much better when she tried them again.
Although the majority of patients will eventually adapt to their new way of eating, not everyone finds it possible. “In some cases, I’ll go in with the family to an appointment with their Boston Children’s physician when the diet is just impossible to follow and then we will all work as a team to figure out how to fix it,” McCarthy says. She points out that Boston Children’s also offers classes for patients and families with newly diagnosed celiac disease to learn about the diet and why it is important. Having families together in a room with patients all going through the same thing helps them to know they are not alone.
She points out, “I follow this diet every January for 30 days. The 31st day is my birthday and I go back to a non-restricted diet again.” But she recognizes that for most of her patients, this restricted way of eating is their new “normal” and she says it’s important to respect that. By walking in their shoes, even briefly, she can help families feel less alone and be more accepting of their situation.
“I get letters from families saying that their children felt connected to me because I understand what they are going through. That makes my efforts all worthwhile. I plan to continue my tradition every single New Year,” she adds.
Dairy-free rice pudding recipe
One of McCarthy’s favorite allergen-free treats is warm rice pudding made with coconut milk. Here’s how she makes it.
- ½ cup Basmati rice
- 1 can (13.5 oz) coconut milk
- 2 cups water
- 2 Tbs sugar
- ¼ teaspoon cinnamon
- ¼ teaspoon vanilla extract
- Combine rice, coconut milk, water, and sugar in a medium-sized saucepan and bring to a boil.
- Reduce heat and simmer ingredients for about 20 minutes, stirring occasionally until all liquid is absorbed.
- Turn off heat and add vanilla and cinnamon. The rice pudding will thicken as it cools. Enjoy this treat warm or cold. This is also a great dish to make ahead of time for a large crowd; just double or triple the recipe.
Learn more about the Division of Gastroenterology, Hepatology, and Nutrition.
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