Vicki Kobliner, MS, RDN, of Holcare Nutrition provides functional nutrition services for children and adults seeking an integrative approach to health.
Please Note: Eating Restrictions are a major symptom in the PANS/PANS diagnostic criteria. (link to aspire symptom list) Please consult directly with your therapist and/or doctor before implementing dietary changes, especially if there is concern regarding food. Care must be taken to not exacerbate or trigger obsessive-compulsive thoughts and actions. If your child has restricted food intake, please speak with your doctor about CBT and ERP therapy as well as Parent Management Techniques as well as any medical reasons contributing to restricted food intake. Remember, there is no one set diet for anyone, including those with PANS/PANDAS; diets should be individualized for one’s unique nutritional and medical needs.
Gabriella: Vicki, thank you so much for taking the time to sit with us and talk to the ASPIRE community about food choices that support health during this time of social distancing due to COVID-19. I have listened to your lectures for many years and learning from you over the years. I have been fortunate enough to work with you on one of my son’s diet and nutrition. So it is an honor to have you here with us today.
How do dietary choices fit into the PANS/PANDAS Three-Pronged PANS/PANDAS treatment triangle?
One, many foods contribute to inflammation. One prong of the treatment triangle is to Remove Source of Inflammation. In the case of infection triggered PANS, we typically are talking about using anti-microbials. But we can take that one step further by removing or reducing other sources of inflammation and this can include food.
Two, many foods support a healthy immune system. One prong of the treatment triangle is to Treat the Dysregulated Immune System. Some foods support the immune system, while others suppress the immune system.
Gabriella: Vicki, can you give us some tips on surviving and thriving on a quarantine diet? I know many are stressed out about how to stock up on enough food so they can successfully socially distance themselves and not go to the store every few days.
Vicki: It is so important to stock up your pantry and freezer with nutrient dense food that isn’t based on a lot of wheat and rice products. Nutrition is the foundation of our immune system. We want to support our immune system by eating right, getting enough sleep, lowering stress, getting exercise, and working with our doctor to support our health. It is important to remember that all dietary choices should be individualized.
Gabriella: Where are you buying foods these days? Any suggestions for places other than the local grocery store?
Where We Are Buying
- Online stores helps maintaining Social Distance. Examples:
- com– busy
- Local shops
- Our small, local stores are taking orders by phone. Check with your local store, not your local big chain, but local small shop.
- Subscription Food services. Examples:
- Misfits market
- Imperfect foods
- Butcher box
- Walden local meats (local to the east coast)
Gabriella: I have been packing my freezer and pantry with food. I just have two quick suggestions. Write a list of what is actually IN the freezer. I know I might know what everything is in there right now but I might not in two weeks. So I write a list of what is in there and some of the recipe ideas for some of them so I make sure I have the other ingredients I need at hand.
Okay, let’s start with the freezer. I don’t have a separate freezer but want to get it packed with the best food.
Vicki: Thanks for those tips! Definitely, the freezer should be packed and stocked!
Maximize Your Freezer Space
- Prep the meat before you freeze it.
- Cook and shred chicken for a number of dishes instead of freezing a whole chicken. Takes up a lot less space.
- Prep veggies before you freeze too.
- Spinach and other veggies take up lots of room when they are raw.
- Freeze in portions amounts that make sense for you
- Freeze eggs – crack, put in ice cube trays, then in bags
- Green N Pack are BPA free bags
Gabriella: Okay, onto the pantry.
Vicki: Pack your Pantry with whole foods, and choose grains other than just wheat pasta and rice. Again, focus on nutrient dense food. You can fill a pantry with a huge variety of foods, tastes, and textures.
Nutrient Dense Pantry Items
- Nuts & Seeds
- nut/seed butters
- nut flours
- Dried Fruit:don’t take up a lot of space
- Veggies: Get a variety, so you are not bored by your choices
- Fresh and freeze or buy frozen
- Roots veggies provide a lot of variety and are nutritious
- Squash can last a long time on the counter.
- Canned Veggies – try things other than peas and corn
- Heart of palms, artichoke hearts, pumpkin
- Dried Mushrooms. Those with fungal issues may not tolerate mushrooms. All choices should be individualized.
- Jackfruit: a lot of fiber and can be used many ways.
- Seaweed Snacks: concentrated nutrition, provide that salty snack
- Veggie Chips: Terra, Bare or forager
- Canned Fish:
- Tuna – couple of concerns but wild caught or pole caught, only once per week
- Sardines, Salmons are great options
- Beans: change up the texture, so you don’t get bored – soft/mushy, crispy salty, soups
- Dried are great for space saving
- Canned is fine
- HipPeas – a snack- fiber, protein
- Brami – moist flavore lupini beans
- Biena Bean – roasted beans snacks
- Bean flours
- Bean Pastas – Banza is high in protein and fiber, Tolerant. Explore Asian mung bean, Trader Joe’s has a red lentil and black bean
- Aseptic boxes stack well and don’t take up much room
- Dried Meats
- Jerky – Meat sticks – lots of great grass fed, organic options
- Epic Bars – (they also make a nut bar)
- Grains: Carb alternatives to rice and gluten, But remember you don’t want starch to be the predominant part of the diet
- Rice we need to be careful because of the arsenic levels
- Quinoa and buckwheat – great texture, higher in protein
- Millet & Amaranth
- Nutritional Yeast: cheesy flavor, high in vitamins B12 and other b vitamins, nutrient dense
- Bars: can be a good whole food, not filled with protein powders or isolates or high in sugar
- Lara, Epic, Rx, Perfect (refrigerated)
- Orgain Protein Drink: organic, there is a dairy based and a vegan version and
- Protein Powder:
- In stores: Now, Jarrow
- Order Online: Designs for Health, Metagenics
- Herbs: Lots of herbs and spices have important immune boosting and antimicrobial qualities
- cumin, tumeric, oregano, cinnamon
- Spirulina: Lots of protein – add to drinks or soups – nutrient dense powders.
Gabriella: What are your thoughts on fermented foods, and tofu and other soy based foods.
Vicki: As I said earlier, all diets must be individualized per person. Those who have issues with histamines need to avoid or be cautious with fermented foods. As far as soy, between dairy cross reactivity and GMO status I really do not recommend. I only recommend organic edamame and miso on an individual basis and only a few times a week at most.
Gabriella: I know everything is a bit stressful right now but if we use this experience as an opportunity for growth, can we utilize the lessons you have laid out for us today when we are off social distancing? Eating nutrient dense food and not relying on processed, packaged items will be something we want to continue for the rest of our lives, right?
Vicki: Oh, absolutely. Good nutrition is something we need to prioritize whether social distancing because of a highly contagious virus or not.
Gabriella: Are you available for telehealth appointments with new patients right now?
Vicki: Yes, I would love to help families set the right course.
Nutrition and dietary choices need to be individualized and I can help guide you in creating choices that are optimal for you.
Gabriella: Thank you so much for all this information!
Vicki Kobliner and her colleagues at New England Center for Health are continuing to host a series of zoom calls on COVID-19. The schedule will be updated weekly.