Dr. Allan Horowitz, published newspaper article, The Liberal, Copyright September 18, 1985

Question: Thank you for your interesting and informative column.

I am experiencing ulcer-type acid symptoms which are presently being checked by my doctor. Only this year, too, Rheumatoid Arthritis has been diagnosed for which I take Feldene, as needed. I am also taking Eltroxin for a marginally-functioning thyroid. The gland itself is functioning marginally, but the pituitary, I believe, has to work too hard on its behalf.

Would you be able to suggest a bland diet for the gastric disorder which could accommodate general, balanced nutrition? Can a bland diet also have fibre?

Do you know if skim milk has the same coating ability in the stomach as two percent milk?

Can you suggest a hot drink (non-acidic) to replace coffee, tea or hot chocolate? I’m down to one coffee a day which is difficult to eliminate because of a headache reaction to no coffee at all.

I hope these nutrition questions are not too tall an order. Sincere thanks for your kind attention to this inquiry.

Answer: The first priority you should have is to find out exactly what is causing your gastric symptoms. The rheumatoid arthritis, thyroid disorder and the stomach problems may all be related in some way or more likely are just three separate conditions which you are unfortunate enough to be afflicted with.

When the doctor has finished his testing, an exact diagnosis should become clear. If it is an ulcer then there is medication which you can take to not only alleviate your symptoms, but also to heal the ulcerative tissue. Your doctor will inform you of your next step once the tests are finished.

It sounds as through you have already made up your mind that you will need a bland diet. If you have decided this because you find that bland foods do not cause any gastric upset where as more flavourful, spicy foods do, then you are correct in searching for this kind of diet.

However, the current thinking is that a patient who has an ulcer may eat whatever food agrees with him or her. If chilli, hot dogs, and pizza can be tolerated without stomach upset, then these foods are perfectly alright to eat.

The simple rule of thumb most experts are now going by is “if it bothers you, don’t eat it!”

However, you are correct in wishing to achieve a well balanced nutritional diet. An excellent diet which combines good nutrition, and is also extremely bland, is the “Pritikin Program.” This diet puts an emphasis on low fat, low cholesterol, high fibre-carbohydrate foods.

It is an excellent diet for those who wish to lower their blood pressure, lose a few pounds, help their digestive system, and increase their general state of health.

The critics of this diet say it is too bland for most people to stick to, and it is unrealistic to expect people in North America to limit their fat intake to five to 10 percent of their total calories. (The average North American diet now contains about 40 to 45 percent fat.)

When you read this diet (available in most book stores) you will see that a bland diet certainly can contain fibre.

When you ask about the coating ability of milk, it also seems to me that you plan to drink milk as a protection against stomach acids. This doesn’t work, and as most experts now believe, milk and milk products may end up producing more stomach acid than was present before.

Skim milk is much healthier for you because of its lower fat content. Because of this low fat you probably will not feel the stomach being “coated” as much as with two percent milk.

However, remember that this is basically just a feeling of a coating and no real good comes of it anyway. If milk increases your acid symptoms, then stay away from it totally. If you do this, however, you should take a calcium supplement.

If you get a headache when you abstain totally from caffeine then I would definitely suggest a gradual elimination of all caffeine from your diet (such as what you are currently doing.)

Caffeine and its relatives stimulate the cerebral cortex, the central nervous system, the heart muscle, and also have other effects in the body which seem to give most people a “pick-up.” Generally people who eat a diet high in refined carbohydrates (sweets) and fats need this “pick-up” more than other people.

I suggest that before you withdraw completely from caffeine, you try to eliminate all refined carbohydrates, and drastically decrease your intake of animal fats (meat and dairy products.)