Optimizing Your Nutrition: Part Three

woman stands at podium and gives presentation to a crowd

This is part of a series offering highlights from our panel on Optimizing Weight Loss, Digestion and Healthy Aging with Nutrition

Erin Peisach, Food Sensitivity Detective

by Alica Diehl

Erin Peisach is a registered dietitian at the University of Maryland Center for Integrative Medicine. Speaking at our nutrition panel in March, she said that if she had to make a blanket suggestion for all eaters, she’d recommend nutrient-dense, minimally processed food. However, she emphasized that every eater is an individual.

Describing her work with patients, Erin said “it’s not just about, ‘Am I eating enough carbs?’ or ‘I’m trying to lose weight; should I eat more protein?’ It’s also about how the food makes you feel.”

A big part of Erin’s job is helping patients manage adverse food reactions—abnormal responses to food. She outlined the many types of reactions, beginning with two broad categories: toxic and non-toxic.

While at some point, most people suffer a toxic response (think: food poisoning), it’s usually an isolated event and lasts only a few days. Non-toxic responses on the other hand, are ever-present in peoples’ lives.

Under the umbrella of non-toxic responses are food aversions, which may stem from negative childhood experiences; non-immune mediated responses, like lactose intolerance; and immune mediated responses, which come in three flavors: allergies, auto-immunities, and sensitivities.

Erin specializes in food sensitivities, which makes her a sort of health detective. While allergies are pretty straightforward—they produce an immediate reaction, it’s the same every time and may occur after a single molecule of exposure—sensitives are a lot more elusive. This has led some people to question their validity, but Erin assured us they are real. They just present themselves differently.

There are sensitivities to all types of food, and reactions are dose-dependent. So while consuming a trigger food in large quantities may cause a very clear reaction, a more moderate consumption may seem to have no affect. This can make sensitivities hard to uncover. Plus, symptoms vary widely, ranging from Inflammatory Bowel Disease to chronic migraines, rashes, arthritis, and more. It’s no wonder it takes a detective to get to the bottom of these food reactions!

If you think you may have a food sensitivity, Erin suggested trying a simple elimination diet. Stop eating the suspected trigger food for a few weeks, and see if symptoms subside. If that doesn’t work, or you’d feel more comfortable in the hands of a specialist, dietitians like Erin are well equipped to help you find relief.

Developing safety, persistence, trust

Healing is facilitated through safety, persistence, and trust.

  • Persistence: “People did not simply progress through this sequence and experience healing. The healing journey was a recursive, back and forth process. They found helpers, used the skills/resources that those helpers provided, found other helpers that provided more resources and used those skills and resources. As this process continued, people experienced a gradual amelioration of their suffering. Although many despaired at times, all demonstrated the quality of persistence—they refused to give up.”
  • Safety & Trust: “To connect to helpers, it was essential for people to feel safe in those relationships and able to trust that the person would be a helper and not a barrier to healing. Persons whose wounds included a violation of trust were especially careful about testing the safety of new relationships.”

Acquiring Resources

Resources support us as we heal. They include reframing, responsibility, and positivity. “Making connections enabled participants to acquire and refine resources and skills that were essential in their healing journey. People also brought their own personal strengths to the journey.”

  • Reframing: “A particularly important skill was the ability to reframe—that is to look at suffering through a different lens.” This does NOT mean minimizing trauma or pain, but rather it often means the opposite: understanding what happened was wrong, unfair, or uncontrollable and that we are not to blame for it.
    • “I think I kept trying to convince him I was crazy. And he kept saying, ‘No, you’re not crazy.’ […] You wouldn’t necessarily say a Vietnam Vet was crazy. You’d say they are responding like you’d expect to extraordinary circumstances.”
    • “I’m not the only one who have [sic] this problem. A lots, millions of people, you know. […] They don’t have nothing to do with that. I guess I have to live.”
  • Responsibility: While we don’t have control over what happened to us, we are the only ones who can help ourselves heal. “A third essential resource that people acquired or refined was the ability to take an appropriate amount of responsibility for their healing journeys. They participated actively in the process of healing. Once again, some participants already had developed this skill, and some acquired or refined it from their helpers.”
    “You need a lot of energy and a lot of work … it takes a lot of work. It doesn’t just happen. It’s not like a magic wand.” This patient understood that they had to actively participate in the healing process.
  • Positivity: “Another resource that people acquired or refined during their healing journey was choose to be positive—that is to have some optimism about their situation.” People have varying predispositions to positivity. In the study, positivity was important in helping people heal. This doesn’t mean a toxic positivity, but rather simply finding some good in life and feeling hopeful about our situations.

Helping Relationships

“Connection to others was an essential part of all the healing journeys.” Humans are social creatures, and even the most introverted of us need close relationships. Friends and family add meaning and value to life and help support us, in good times and bad. When we experience relational trauma, relationships can feel scary, but reestablishing safety and trust in relationships is where the healing happens. (To be clear, we do not mean reestablishing safety and trust with abusers, but rather finding other healing relationships.) “When safety and trust had been established, people were able to connect with helpers. The nature of the behaviours of helpers that fostered healing ranged from small acts of kindness to unconditional love.”

  • “Moving from being wounded, through suffering to healing, is possible. It is facilitated by developing safe, trusting relationships and by positive reframing that moves through the weight of responsibility to the ability to respond.”
  • “Relationships with health professionals were among these but were not necessarily any more important to the healing journey than other kinds of helpers, which included family members, friends, spirituality and their God, pets, support groups, administrators, case workers and supervisors.”


Healing probably means different things to different people, but one definition that emerged from the study is: “The re-establishment of a sense of integrity and wholeness.” Healing was an emergent property that resulted from each individuals’ complex healing journey, a result of bridged connections between resources and relationships. Healing, in this sense, does not mean cured—none of the study participants were cured of their ailments—”but all developed a sense of integrity and wholeness despite ongoing pain or other symptoms.” In varying degrees, “they were able to transcend their suffering and in some sense to flourish.” When we begin to heal, we find increased capacity for hope, renewed motivation to help others, and are more able to accept ourselves as we are.


Suffering is the ongoing pain from wounding. There is debate about whether or not one actually needs to experience suffering on the path to healing.


Wounding happens when we experience physical or emotional harm. It can stem from chronic illness or by physical or psychological trauma for which we do not have the tools to cope, or a combination of those factors. “The degree and quality of suffering experienced by each individual is framed by contextual factors that include personal characteristics, timing of their initial or ongoing wounding in the developmental life cycle and prior and current relationships.”