Ask Digestivo: Regular Degular Shmegular Recipes

To the reader who asked, "but why are you a doctor if you never help anybody?"

This week, we’re putting the digest back into Digestivo, with a no BS deep dive into cooking through IBS. We’ve said it before and we’ll say it again: representation matters! Plus, a quickfire take on our most essential spices, without denigrating an entire culture in the process – can you believe? If you find yourself with questions, comments, GI troubles, or just want to chat, hit us up at askdigestivo@gmail.com 

I have a dear friend who is a lover of food but has pretty extreme IBS/digestive issues. They’re on the FODMAP diet and have been losing a lot of weight because it’s pretty restrictive, but also probably because they’re losing some interest in the foods they’re allowed to eat. I wondered if y’all might know of some good and fattening/yummy recipes (or other resources) that may reinvigorate my friend’s excitement for eating. Thank you!

-Worried Friend

The editors of this fine newsletter are no strangers to gastrointestinal distress, and will wholeheartedly affirm that it can be a huge bummer. Having to seriously restrict what you can eat can make nourishing yourself feel like a chore at best and not worth the bother at worst. Plus, as a friend’s therapist recently noted, serotonin is made in the gut! When things are feeling funky in your belly, it’s easy to feel down in general. 

As we are famously not actually medical doctors, we feel less confident dispensing any sort of real medical advice, but for the sake of… well, science, we reached out to friend of the newsletter and actual gut doc Dr. Eric Morgenstern for a little clarity on the FODMAP fad: “When it comes to dietary treatment of IBS, there’s no cookie-cutter approach, and what might be good for one person might be deleterious for another,” he explains, adding that what might work for a period of time can, much to the chagrin of the patient, suddenly lose its efficacy. There’s little good evidence-based medicine that any long termdiet can “control” IBS, but the low FODMAP diet makes sense: fermentable sugars (oligo-, di-, and monosaccharides) and alcohols (polyols) pull fluid into the intestinal tract, causing gas, distension, bloating, cramping, and diarrhea. If you eliminate these, you might control the symptoms. On the flipside, you may feel like you’re left with little that’s exciting to eat. Think of this as a washout, cutting out everything high in FODMAPs for six weeks, then slowly reintroducing ingredients, one at a time, based on your preferences. If you can tolerate it, add another to the mix and see what happens.

TLDR: Nothing is guaranteed, and different people will have different results, but “for somebody who’s dedicated – not desperate, but dedicated,” you can make some inroads with a serious six week push. “You won’t find every culprit, but you might find the heavy hitters. It’s frustrating, it’s not 100%, and as we’ve learned over the past year and a half, when medicine doesn’t give you very straightforward answers, people get frustrated.”

Since fat famously lacks fermentable sugar, it might be the place for your friend to go wild. In the spirit of sparking a little (safe, comfortable) joy in your friend's gut, I (SB) heartily recommend that your friend indulge in a full-fledged celebration of the wonders of ghee. Because ghee is essentially butter with all the milk solids strained out (i.e. practically lactose free), it seems to be FODMAP-diet friendly. It’s one of the most comforting and decadent dairy products in the game. It also happens to be the foundation of most Indian deserts, the special-sauce under tempered spices in dal, and a high-smoke-point ace in the hole for a range of other projects. For me, warmed ghee is the aroma of abundance and comfort. 

There are lots of simple ways to add some ghee into a low FODMAP diet. Add a spoonful of warmed ghee to hot white rice. You might also try sauteeing veggies (carrots and zucchini come up repeatedly and work great) in ghee with some grated ginger and, if you can tolerate it, a little cumin and salt. You could also mix some ghee with FODMAP-friendly maple syrup (dare I say add cinnamon or cardamom?) and drizzle it over roasted or boiled sweet potatoes. Stirring a spoonful of ghee into a (non-dairy) turmeric latte of sorts is also a well-loved South Asian remedy for an upset stomach. (A brief aside: we were particularly pleased to hear that low-lactose, high-fat half and half was “probably okay”, so you could even consider making that haldi dood a breve.) Speaking of subcontinental solutions, your friend might check out some Jain recipes (which traditionally do not have onions or garlic) as a jumping off point.

Another approach I (JS) might suggest is doubling down on sauces and condiments to zhuzh up blander staples. Some of these recipes have a clove of garlic which I’m boldly suggesting you omit, but for whatever verkakte reason, garlic oil is A-OK in terms of FODMAPs (same with onion oil), so feel free to sub if/where you think it’s appropriate. If you’re seeking something light and bright, a little nuoc cham goes a long way toward livening up crunchy salads, simple grilled proteins, and summer rolls. You might also revisit reverse marinated vegetables – grill, sautee, or roast your favorite veg, then bathe them in a quick and easy blend of olive oil, ACV, a pinch of sugar, and chili flakes, finished with a flurry of fresh herbs. If you’re after something creamier, you might dip your toe into the world of tofu-based dressings: blending firm tofu with sesame and miso makes for a lovely shira-ae, or sub low FODMAP coconut aminos for soy sauce in this silken tofu dressing from L*cky P**ch. Speaking of coconut amino/soy swaps, I think you could figure out a version of this Central Asian kuksu, served cold or hot, using buckwheat or rice noodles and (sadly) omitting the kimchi.

There’s also a host of seed and nut-based sauces to consider – tragically cashews are high in FODMAPs (vegan Caesars will just have to wait), but there’s a lot you could do with pepitas and walnuts, to name just a couple. For pumpkin seeds, you could try this herby lime dressing from Gabriela Camara, or this creamy version from Betty Liu. With walnuts, I’m intrigued by this bazha from Naomi Duguid, a traditional Georgian dipping sauce, as well as these stuffed eggplant rolls from Caroline Eden and Eleanor Ford. Kamal Mouzawak’s muhammara, if made with gluten free breadcrumbs, is another great option. And there’s hardly a more comforting Persian khoresh than fesenjun – I like Naz Deravian’s version, served with sabzi polo. With a bit of Greek or nondairy yogurt, you might repurpose leftovers into one of our favorite naughty fusion dishes, maast o sabzi polo.

And of course, there’s always confit – olive oil and duck fat are FODMAP free vehicles ready for slow cooking all sorts of peak season produce, steakier cuts of fish, pork belly and poultry.

What is the “one spice” you’re cooking with a lot these days?

Love and light, 

Gene Weingarten

SB: Curry, of course! No, I kid. I don’t think I could pick just one spice, as someone whose extensive spice cabinet often subs in for a personality. I have, however, been hitting the smoked paprika pretty hard these days. It’s great in cheesy sauces, on sauteed onions, and sprinkled on roasted vegetables. Since I also can’t follow directions, I would be remiss not to remind you all that chaat masala is the spice of the summer. 

JS: I’m resisting the urge to break the rules with a spice blend like SOMEBODY here and will begrudgingly name fennel seed as my one and only spice. A true vers, she’s equally at home in sweet and savory contexts (roast chicken, biscotti), and maybe even doubles as a breath mint in a bind.

PETITS FOURS

  • Pegging us both as absolute suckers for neroli, timeless hangs, rock tank swimming, and “the life,” the algorithm served us ads for DS & Durga’s latest limited edition scent Sweet or Do Nothing and we’re genuinely contemplating splitting a bottle, sisterhood of the traveling parfum style

  • Speaking of on the nose finds, we recently stumbled upon ghee-based lipcare company Ghlee. Their balms come in peppermint, rose, chai, and mango but we feel the real challenge will be in not eating them straight from the tube. (@Dr. Morgenstern: Is lip balm FODMAP safe???)

  • This newsletter loves a canine pain in the ass, and even we were surprised and upset to learn that our former governor was asking around for someone to take his much maligned dog Captain off his hands after he resigned in disgrace. Luckily, we’ve heard there are a few takers already.

  • Alexa, play Liquid Dreams by O-Town: this Wild Arc Farm Amorici Field Blend, a dark and juicy (rosato) horse in my Leon & Son warehouse sale haul (comprised primarily of what friend of the newsletter Lexi dubbed “cheeky pet nats”), made me (JS) feel just a little less grim about the shortening of the days. We’re not usually size queens, but we’d opt for a magnum in this case – a great choice to bring to your newsletter editor friend’s park birthdays, maybe.

Quick note: we’re off next week because Salonee is moving (!) and Jake is engaging in some super spreader travel. We’ll see you after Labor Day with our first ever issue edited by two (!!) Brooklyn dwellers. Get ready for some Alice Waters-style egg spoon action on the Eastern Parkway median.