First, let me preface this by saying that while all of the recipes I post on this blog are compliant with the AIP elimination phase, I have personally moved beyond that phase and reintroduced many foods from all of the AIP stages, so this post will include discussion of foods that may not work for you. This is not a post about how to stick to the elimination phase of the autoimmune protocol (AIP) while in Italy… If that is what you are looking for, stop reading now and check out this post by my friend Meagan on her blog It’s All About AIP or this one by our friend Bethany on her Italian honeymoon when she was still eating very close to the elimination phase.
My trip to Italy
My primary purpose in going to Italy was to serve as the personal chef in-residence at a week-long wellness retreat lead by inspirational author, coach, and fellow autoimmune warrior, Stacey Robbins. Obviously, since I was the chef I had control over the meals while we were at the villa and this post does not cover that aspect, but only of the times I was eating with the group out in restaurants or while traveling on my own.
Misconceptions about AIP reintroductions
Before I go further, I want to talk about some of the misconceptions about the role of non-AIP foods in the long term diet of someone with an autoimmune disease like myself. It seems that no matter how many times myself and the other leaders in this movement talk about the importance of eventually moving from the elimination phase of AIP to the reintroduction phase, some people miss the message and get stuck on the idea that every food that is eliminated initially is a “bad” food for people with an autoimmune disease and that only the foods not eliminated are “good” foods for us.
The human brain likes this kind of bad/good thinking, and indeed it is helpful to view your food options through a simple yes/no lense when you are starting out. But in truth, this leaves out a very important qualifier…
The foods that are eliminated when one starts the autoimmune protocol all have the potential to be “bad” for your autoimmune health. Some are highly allergenic, some resist digestion, some provoke immune responses, some are inflammatory. Some of these foods you are probably sensitive to and will remain sensitive to forever. Some of these foods you are not sensitive to at all and will be able to reintroduce them easily.
Some of these foods you are sensitive to right now but later on will be able to eat again in moderate quantities, once your overall health has improved after eating a nutrient dense diet that avoids all of your other food sensitivities. And to be completely honest, some of these foods will always be unclear to you; you will try to reintroduce them and sometimes feel fine and other times be unsure if you only do well with certain forms or in specific combinations or when other circumstances, such as levels of stress or sleep, are just right.
Yes, it really is that complex. The human brain craves rules and unfortunately, when you get beyond the initial elimination phase of AIP, it doesn’t get very many to hang onto. But it is important to forge ahead with reintroductions anyway. Many of these eliminated foods offer nutritional benefits and are worth eating if you can; others offer pleasure which has its own value to our overall well-being (the Italians call it “dolce vita” and is why their government gives celiacs a stipend to offset the increased cost of buying gluten free alternatives to the bread and pasta they prize so highly).
Remember this: The AIP elimination phase is meant to be temporary, but that doesn’t mean that when it ends, you simply quit and go back to eating the way you used to. Rather, you begin reintroductions and expand your diet to meet your own unique needs… and that is a lifelong process. If you need more information and guidance on how to do reintroductions, I recommend this excellent post on Autoimmune Wellness. It truly is the “definitive guide to AIP reintroductions” and outlines exactly the guidance and process I use as I coach my own AIP clients through this messy time.
What follows in the rest of this post is about me at one specific point in time (October, 2019). I started my healing journey with a healing diet all the way back in January, 2013. In the years since, my diet has evolved and continues to evolve as my body and life changes, and I expect it to continue. If I’d gone to Italy in 2013 I would have had an entirely different set of dietary needs to manage; and I’m sure I’ll have different needs the next time I go! But I hope this post proves to you that no matter what your needs are, travel is still possible and will be very enjoyable!
How I eat right now
- As a person with Crohn’s disease, I’m strictly gluten-free and try to be careful about cross contamination, though I not quite as carefully as I recommend my clients with celiac disease must do. I don’t normally eat a lot of “gluten-free” foods like bread and pasta because they don’t contain much if any nutritional value, but I do tolerate them on occasion.
- I’m strictly dairy-free. I’ve gone back and forth on this over the years, but I find that when it comes to dairy I need to be an abstainer right now. I could probably tolerate small amounts or certain forms, but I have hard time moderating my intake of dairy once I start.
- I don’t drink any alcohol. I’m not going to say that I’ll never drink again, but I really don’t have the desire anymore. Even a small amount of wine seems to make me feel sick almost before the buzz wears off, so it lacks appeal.
- I don’t eat chocolate. Sometime in the last year I seemed to have developed a sensitivity to it that makes me feel like I have the stomach flu for about 12 hours after eating it… which is NOT something I wanted to experience on this trip!
- In my normal life, I mostly avoid processed foods, especially with additives that evidence suggests are harmful for people with Crohn’s disease or other bowel conditions.
- Since 2017, I’ve been minimizing my intake of nightshades. I don’t notice any problem with potatoes, but tomatoes and peppers cause mild to moderate joint and muscle pain in me.
- Since I had bowel surgery in 2007, certain foods (beans, cruciferous vegetables, and some fruits) just don’t seem to be well digested so I’m cautious in consuming them in any quantity, lest I have uncomfortable gas and digestive upset later on. Taking digestive bitters (this is the brand I recommend to my client s who are still in the elimination phase – Amazon affiliate link) helps somewhat, but I don’t like to push the envelope… especially if I’m about to get on an airplane!
How I handled this in Italy
- Being gluten-free in Italy is extremely easy. There is a high degree of awareness of celiac disease and food allergies in general (“allergico alimentare”). Gluten-free options seem to be available practically everywhere and menus in restaurants usually have a picture key of the major allergens. [“Senza” means “without,” so look for the words “senza glutine” on packaged goods. There are tons of articles and blog posts on the internet with additional guidance on how to do this and a simple Google search will tell you everything you need to know!] I ordered a gluten-free meal for the flight on Alitalia and had gluten-free breads and pasta a few times while I was there.
- Being dairy-free in Italy is also easy, again because they really respect food allergies. One of the excursions we took was to a cooking class at Locanda Demetra in Montalcinno, where they truly went above and beyond once they found out I wasn’t just lactose intolerant like the other members of our group, but really couldn’t have any dairy. They made sure I had a rice cheese alternative to use in the dishes we made and cooked mine in a separate pan. At gelato shops, I was able to get a fruit “sorbetto” and enjoyed it fully!
- Italians love wine, but they also respect non-drinkers and I’m fine with being around others who are drinking. I was able to enjoy the aroma of wine and had a tiny taste when someone told me the wine was particularly fantastic, but otherwise I just participated in the social aspects of the wine drinking and used my water glass for toasting.
- It was a bummer to not be able to eat chocolate, but it worked out fine. In both cases when we were in a restaurant and none of the desserts worked for me, they gave me a special plate of fruit and I was very happy. The whole persimmon I had at the restaurant at the thermal spa, Terme San Giovanni Rapolano, was one of the most delicious things I ate all week!
- As mentioned above, I normally just skip bread and pasta entirely because they are highly processed foods that probably don’t do me any favors in the long run… plus, they usually aren’t very delicious! But the Italians seem to have cracked the code and they tasted fantastic, so I enjoyed the gluten-free breads and pasta in moderation in Italy and felt fine.
- Before I left for this trip, I tested tomatoes and had no immediate discernable reaction, so I decided that I would experiment with them further in Italy. At first I thought I would only eat them once or twice, but they ended up on my plate at least once a day and I definitely felt it. The pain was not severe and abated by the time I got home, but it was good to reaffirm that I am correct to continue avoiding most nightshades, most of the time.
- Before my flights, I made a point to fast for at least 12 hours ahead of time and that helped me feel much more comfortable in the air. I also kept a bottle of digestive enzymes in my bag and popped them before any meal that contained my personal digestive “trigger” foods. For the most part, this worked and my digestive function was at least as predictable as it is at home.
Please join the conversation!
Have you traveled to Italy and successfully navigated dietary restrictions? Feel free to share tips and highlights of your time there in the comments below, so that future people who stumble upon this post in the future can use all of our collective wisdom!
3 replies on “How I ate in Italy and maintained my autoimmune health”
This is a very helpful account, and I was pleased to see that although you argue strongly for reintroductions, you are very up front about the many reintroductions that haven’t worked for you. I have relatively mild crohn’s that I’ve managed for five years through the AIP diet and low-dose-naltrexone and lifestyle adjustments. I have not been able to reintroduce that much. If I’m not under a lot of stress, and if I’m sleeping well, I can eat white rice quite regularly, the occasional white potato, the occasional black pepper seasoning, the occasional chocolate square, and the very occasional egg yolk. If I try to eat them more frequently,or in regards to other reintroductions, I experience a panoply of inflammatry symptoms- general achiness, brain fog, disturbed sleep, etc. Maybe if I was willing to give up my morning espresso I might be able to tolerate more reintroductions. But it’s that espresso that allows me to stay on the AIP diet at all. I’m very attached to it.
I’ve traveled in Europe quite a bit in the last five years, following the AIP diet, and I’ve become very good at navigating restaurants there. Each country has their vocabulary for restrictions, and it’s good to learn that before going, because as with restaurants in the US, one needs to be quite explicit about what gluten, for example, is – otherwise you’ll end up with a dish with breadcrumbs or flour, while they leave out the bread. The great thing about Italy is that it’s not hard to order fish or meat that’s grilled, and simple vegetables with olive oil. And white rice! I tend not to eat the Italian gf pastas because they all have corn. There is one brand, available in the US, that’s made from white rice, and it’s quite good.
Thanks again for your report from Italy!
That’s very validating, as a fellow Crohn’s patient, that nightshades are a no-go. I’ve lamented a long time about not being able to include them (if only I could have tomatoes!). Potatoes similarly seem to be fine (without skin), but the other nightshades give me joint pain in my hands and red, itchy eyes. I thought it was interesting in Dr. Gauree Konijeti’s last study (the IBD patient survey) that a lot of other IBD patients also can’t tolerate nightshades; I wouldn’t have guessed that as a trigger food group. I’m hopeful for more seeds and maybe some nuts to work out.
Btw, your experience training for a 5k inspired me to do the same! It’s in 3 weeks and I’m well on my way to being ready. Running, while a slog, makes me feel much better all day. Two years ago I would have been far too fatigued to even attempt this, but AIP has materially improved my life. Thanks for the inspiration!
[…] developed this recipe as I was preparing to cook at a wellness retreat in Italy, where I would be accommodating multiple food restrictions among the attendees. I ended up not […]