Interview with KLAUDIA BRZYWCY – clinical dietician dealing with, among others patients with Lyme disease.
Does the diet matter when treating Lyme disease, that is, can it affect the course of the disease or a faster recovery?
Yes of course. Although the diet itself is not able to cure the patient with Lyme disease because it also requires other components (including drugs and supplements). Nevertheless, it is of great importance and is an indispensable element of therapy. It allows you to optimize the treatment process, take care of the patient’s well-being, reduce symptoms, strengthen immunity, and even affect the regeneration of the body at the cellular level. Often, without the implementation of dietary care, it is not possible to include the therapy at all.
It happens that I get patients who, somewhere in the deepest recesses of the Internet, read about the diets that can “starve Lyme disease”. Meanwhile, using such a diet, patients do not “smother” the disease, but themselves. Sometimes their diets are so restrictive that they can not be balanced. Which means that it is not possible to provide adequate quantities of macro- and micronutrients and vitamins for proper functioning. They also do not have adequate
calories. The hardest thing is when the patient is afraid to eat because he thinks he will hurt himself. Meanwhile, not always less is better. A correct diet can not be extremely restrictive or devastating. The correct diet must provide the body with all the necessary ingredients and is very important in the case of people suffering from Lyme disease, because it depends on the patient’s immunity and healing. Therefore, in many patients, the therapy must be started with a diet consultation and the construction of an appropriate nutrition plan.
But the same Lyme disease therapy, I mean antibiotic treatment, also associated with diet. And rather rather demanding, eliminating. Patients who take antibiotics must remain on an antifungal diet…
Yes, but that does not mean that such a diet must be excessively restrictive and devastating. On the contrary – it must be properly balanced and adapted to the needs of a given patient. It has to satisfy his energy needs.
What are the main recommendations of an antifungal diet?
The antifungal diet is similar to a low carbohydrate diet. It is necessary, in very general terms, to completely reject sugar in all forms (sucrose, fructose, including agave syrup, honey or maple syrup …) and processed food. That is an absolute minimum. You must also realize that sugar in various forms is added to almost all processed products that can be bought in stores, which is why it is so important to develop the habit of reading labels.
Is xylitol allowed?
In small amounts. I have no objection only to stevia. Although I suggest that patients try to get away from the sweet taste at all.
What may not be easy… Although on the other hand, if patients start to get better thanks to such a diet, it may be easier for them to maintain it …
This diet also has other aspects besides antifungal prophylaxis, it generally relieves fatigue and prevents postprandial somnolence, which occurs after carbohydrate-rich meals. Unfortunately, due to problems with insulin, many Lyme patients experience this. A low carbohydrate diet causes these problems to disappear. Many patients also suffer from chronic fatigue, and thanks to this diet they regain their energy. They feel much better. Therefore, they usually have no problems with its use, because they experience its beneficial effects on their own well-being.
How long should the patient stay on the diet? Because it should not be interrupted right after finishing antibiotics, it is obvious …
After finishing the antibiotic therapy, a so-called withdrawal period follows. The patient usually takes in herbs, supplements and probiotics. The duration of this treatment varies between patients. However, it would be good if the patient continued to use a low carbohydrate diet during this period, and only later extended it to a larger amount of carbohydrates. Although I know that for many patients such a diet becomes habitual and they use it constantly after the end of treatment in a slightly extended version. They just feel very good thanks to it.
And what about the patients who do not treat themselves with antibiotics but only use herbs? Should they also use a specific diet?
They are not obliged to comply with an antifungal diet, but they should definitely use a low carb diet. This applies to all patients with Lyme disease, regardless of the methods of treatment. And especially those suffering from neurological Lyme disease. Many patients, thanks to the diet, manage to relieve their symptoms significantly. The diet can decide on the success or failure of the treatment. It is also important because some patients, due to hormonal or metabolic disorders associated with Lyme disease, have problems maintaining normal body mass. And that creates further problems.
It is important what you say, because it is worth realizing that abnormalities related to body weight can also be one of the symptoms of Lyme disease.
Yes, it sometimes happens that patients can weigh up to ten kilos in two months, even though they have not significantly changed their diet. Sometimes, however, they can have an excessive weight loss also for no known reason. Therefore, the use of individually developed for each patient, low-carb, balanced diet – taking into account all other illnesses, as well as food allergies, intolerances, as well as culinary preferences – is so important.
The diet should be arranged individually for each patient with Lyme disease, but are there any general rules that are common to everyone?
In my opinion, it is very important that the diet is determined individually depending on the patient’s health and this is the principle we follow in St. Luke Medical Center in Gdańsk, where I work. However, if we talk about general assumptions, you should eat three to five meals a day (optimum is four), preferably every three hours, although I leave patients the opportunity to adjust the time between meals (from 2.5 to 4 hours). The diet of people suffering from Lyme disease should contain some more fats and proteins and less carbohydrates than the diet of healthy people.
Are we talking, of course, about vegetable fats?
Not necessarily. Butter is also acceptable in small quantities, as well as fish fat or from other animal sources. But, of course, balance is the most important thing. The main source of fats should be unrefined and cold pressed oils. The most important is that they be of the highest quality. Similarly, like all food. It is very important that it is of good quality and unprocessed industrially, not containing chemical additives.
And what about drinks? What is best to drink and what to avoid?
Sweetened carbonated drinks are not allowed, but also fruit juices, also those made at home. Alcohol is also excluded. However, vegetable juices are allowed (with the exception of carrot and beetroot juice), as well as all herbal infusions like mint, chamomile (excluding St John’s wort (Hypericum)). And, of course, water.
What about coffee?
If the patient has no problem with their cortisol levels, and it would be difficult to completely give up coffee, then one cup per day is allowed. It must, however, be of good quality, absolutely not soluble and necessarily without sugar.
The thing is that many people with Lyme disease have serious problems with a decrease in cortisol levels in the afternoon and an overly fatigued feeling …
And then drinking coffee is a mistake. That’s why I mentioned that I allow my patients to drink coffee only if they do not have problems with levels of cortisol.
It seems that laying out the right diet for a specific patient must take into account many detailed elements and it is not easy. What is the basis of such a diet, the starting point, what should be paid special attention to?
That’s why it should be an individualized diet tailored to the needs of a particular patient. There are not two identical people, so there can not be two same diets. There will be other energy demand, and thus other amounts of micro- and macro-elements and vitamins will be needed. Other culinary preferences, other food allergies, intolerances. Something that needs to be weaned in one patient, another will be able to eat. You must also try to maintain the patient’s nutritional comfort. If this is not absolutely necessary, we do not change eating habits.
And if the treatment is successfully completed, will the patient continue to adhere to some dietary recommendations?
Certainly, they should not immediately introduce products that they have previously eaten and which are not healthy. It would be good if they kept at least part of the habits related to healthy eating. It does not have to be a diet as low in carbohydrate as during the treatment, but it would be good if they would give up highly processed and sweet foods. It is important that they read the labels of the products they buy and discontinue from those containing sugar and chemical additives. This applies to everyone regardless of their health condition.
Interview lead by Małgorzata Tadrzak-Mazurek