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About one in three Americans has some kind of digestive problem. Tara Alder used to be one of them. At 19, she was diagnosed with ulcerative colitis. Anti-inflammatories and steroids helped temporarily but didn’t solve the problem. Her doctor referred her to a surgeon, who suggested removal of the diseased portion of her colon and, possibly, a temporary colostomy.

“The idea of surgery frightened me, so I asked about healing through nutrition,” Alder recalls. “I was told that ulcerative colitis had no known cause and no known cure and that it had nothing to do with my diet or nutrition.”

That answer didn’t satisfy her, so she looked into alternative healing. Inspired by a colon hydrotherapist she met, Alder started learning about how food plays a role in digestive health. She drank fresh vegetable juices to cleanse her system, began eating whole foods, and started practicing the art of food combining. Her symptoms disappeared. “I never went back to the surgeon,” she says.

Today, the 41-year-old Alder is a natural-health coach and internal-cleansing specialist in Eugene, Ore. She counsels people on sensible ways of eating to enhance their digestive system, and she says that proper food combining is a key part of her teachings. It is especially helpful not just for those of us who tend to have weak digestion, but also for folks who are under stress or are healing from a disease. It also applies to those who are simply looking to optimize their health.

While food combining is recommended by many healthcare practitioners for a range of issues, it doesn’t have buy-in from everyone. Even proponents of food combining agree that it is not a one-size-fits-all philosophy. Everyone’s digestive system is different. Some people burn hot and can handle all kinds of food combinations, while others, especially those with weakened digestion, might benefit from just some dietary rearranging.

At its core, food combining is based on the chemistry of the digestive system. And while chemistry can be complicated, the basic principle behind the practice is quite simple. “You can combine foods in a way that will enhance digestion instead of compromise it,” says Alder.

That’s more important than it might sound. Poor digestion doesn’t lead only to the mild discomfort of indigestion and gas or the sharp pain of heartburn. Digestive problems can also cause malabsorption of nutrients, which can lead to mood swings, impaired immunity, allergic reactions, poor wound healing, and skin problems, as well as an overall lack of energy.

An easy way to begin thinking about food combining is to consider the concept of time. Some foods take a long time to digest. Others move through the body relatively quickly. (On average, fruits take 30 to 60 minutes to digest; vegetables, grains, and beans take one to two hours; cooked meat and fish take at least three to four hours; and shellfish takes four to eight hours.)

When you combine foods with varying transit times, trouble may ensue, because digestion isn’t as efficient. For example, say you eat a meal that includes shrimp and pineapple. Because the pineapple is combined with the slowly digesting shrimp, it sits in the stomach hours longer than it would on its own. As a result, the sugars in the sweet fruit ferment, which leads to bloating and gas.

And, says Alder, the problems only multiply from there. If food rots in the stomach or intestines instead of being efficiently digested, we don’t absorb all of its nutrients. “Anytime you have fermentation or putrefaction, it can create gases that are toxic and even carcinogenic. These gases require energy because other organs have to work harder to detox the body. These toxins in the system may also cause fatigue, irritability, headaches, and foul breath initially, then later may result in colitis, inflammation, constipation, arthritis, high blood pressure, and other unpleasant issues.”

Time isn’t the only factor to consider when figuring out how to combine foods. The order in which you eat various foods can also affect your body’s chemistry. Different categories of foods require different digestive enzymes to break them down — and those enzymes come from different parts of the body. Amylase and lipase from the mouth and small intestines digest carbohydrates and fats. Pepsin from the stomach and other enzymes from the pancreas help break down proteins. Bile salts from the liver and gallbladder emulsify fats. And enzymes in the small intestine digest the sugars in fruits.

That means that something as seemingly healthful as a salad can cause digestive distress, says Bhaswati Bhattacharya, MD, a holistic health counselor and physician in New York City. “A salad with Gorgonzola, pears, nuts . . . dressing, and hints of this and that goes against the rules of food combining,” Bhattacharya explains. “If you think about what the ancients ate, it was very simple. They ate one food type at a time. It was because they understood [that] digestion requires time and space and order. There is a sacred flow in nature to how things compose and decompose.”

This is especially important for those with a cool “digestive fire,” as Bhattacharya puts it. She uses Ayurveda, the ancient natural-healing system native to India, as one modality to help treat her patients. In this system, “digestive fire,” or agni, is another way of talking about digestive enzymes and whether they are burning too hot or too cool. (For more on Ayurveda, see “Ayurveda: The Science of Self-Care.”)

“According to Ayurvedic texts, optimal food combining is important especially for those whose digestive fire is not as strong as it should be,” Bhattacharya says. “These include people with heartburn or acid reflux, bloating, indigestion, gas, and skin conditions such as rosacea, severe acne, and eczema.”

Bhattacharya regularly advises her patients to look to the 70- and 80-year-old people they know to see how they prepare simple, whole foods — and that they look to their own ethnic food traditions: “Instead of experimenting with the latest recipe from Top Chef or Chopped, why not experiment with ancient cultural recipes and see which ones soothe you?”

Ultimately, the key is to listen to your body, not follow a set of rules. “Why not try it?” says Alder. “It doesn’t cost any money. And sometimes it helps alleviate symptoms.” After all, isn’t feeling better worth a little experimentation?

1. Fruit With or After a Meal

Examples:

  • Strawberries on your salad
  • Mango salsa on fish
  • Apple pie or fresh berries for dessert

Why: Fruit goes quickly through the stomach and digests in the intestines. When you combine fruit with foods that take longer to digest — such as meat, grains, and even low-water fruits like bananas, dried fruit, and avocados — it stays too long in your stomach and starts to ferment, because fruit, says Alder, really acts like a sugar.

Bhattacharya agrees: “Sugars are actually not easy to digest, according to Ayurveda, because they are heavy and require good fire to process. That is why fruits should be eaten alone.” Bhattacharya adds that fruits (especially fresh, seasonal fruits) are also “energetically purifying foods and complete foods,” and to combine them with proteins and carbs takes away their pure energy.

Instead: Eat fruit 30 to 60 minutes before your meals. When fruit is eaten alone on an empty stomach before a meal, it prepares the digestive tract for what’s to come. Water rinses and hydrates the tract, fiber sweeps and cleanses it, and enzymes activate the chemical process of digestion. That’s why, says Alder, eating fruit first makes the digestive tract “more capable of absorbing nutrition.” After a meal, wait at least three hours before eating fruit. It’s best to eat most fruits on their own — especially melons, because they are high in sugar and enzymes specific to each melon. If you want to experiment with food combining, eating fruit alone is a great first step.

2. Animal Protein Plus Starch

Examples:

  • Meat and potatoes
  • Chicken and pasta
  • A turkey sandwich

Why: Alder believes that if an animal protein is eaten with a carbohydrate, such as meat and a piece of bread or a potato, the different digestive juices will nullify each other’s effectiveness: “The protein will putrefy and the carbohydrate will ferment. The result is gas and flatulence in the system.”

Adding protein enzymes and carb enzymes into the same space and time basically makes everything “unclean,” says Bhattacharya, but she also admits that many people’s bodies are suited to traditional foods like rice and sushi, and, yes, meat and potatoes. And combinations like beans and rice, which make a healthy, complete protein, don’t apply to this “bad combo” category. “Rice and beans have a synergistic effect, promoting better assimilation of each when they are together,” says Bhattacharya.

Instead: Combine protein or starches with nonstarchy vegetables. If you do have to mix animal protein and starch, add leafy green vegetables to minimize the negative side effects.

3. Fats With Wrong Foods

Examples:

  • Olives with bread
  • Tuna with mayonnaise
  • Meat fried in vegetable oil

Why: Fats require bile salts from the liver and gall bladder to break down; mixing them with other digestive chemicals can cause distress. For example, large amounts of fat with protein slows digestion, notes Donna Gates, author of The Body Ecology Diet (Hay House, 2011). Bhattacharya says that fats and oils need to be combined according to the digestive fire of the person eating them. “If combined with foods properly, fats build a little fire and induce foods to be carried to the liver better,” she says. “Fats are to be avoided when the fire is too low in the gut, as they douse the fire.”

Instead: Gates recommends using small amounts of fat — particularly, organic, unrefined oils like olive or coconut — when cooking vegetables, grains, and protein. She also suggests that protein fats like avocados, seeds, and nuts should be combined only with non-starchy vegetables. Alder recommends always including a raw leafy green vegetable when eating fats.

4. Liquid With Meals

Examples:

  • Water during your meal
  • Juice with your meal
  • Tea right after your meal

Why: Water goes through the stomach in about 10 minutes. Juice takes 15 to 30 minutes. Any liquid in your stomach dilutes the enzymes your body needs to digest proteins, carbohydrates, and fats.

Instead:Drink as much water as you wish at least 10 minutes before you eat. After eating, wait about an hour to have any liquid — or longer for a more complex meal.

5. Two Concentrated Sources of Protein

Examples:

  • Bacon and eggs
  • Nuts and yogurt
  • “Surf and turf”

Why: Concentrated proteins take a long time to break down, taxing the digestive system and depleting energy. In Ayurveda, the combination of different meats, or meats with fish, is to be avoided.

Instead: It’s best to eat meat in the last course of your meal. “The first course should not be meat; it should be light vegetables or protein. Meat should be the last course, as digestive fire and enzymes are at their peak,” says Bhattacharya. “Never wait more than 10 minutes between courses in the same meal. Or else the digestive appetite and enzymes start to shut off.” Alder says that if you have to eat two concentrated protein sources together, it’s best to add high-water-content vegetables such as onions, cauliflower, broccoli, or lettuce.


8 Tips for Better Digestion

Beyond food combining, there’s a lot you can do about eating to enhance your digestion. Here are some tips to try out.

Before Eating

  • Buy fresh food. Strive for  local, organically grown, and seasonal whole foods.
  • Keep it simple. Avoid eating processed and refined ingredients, which, according to Ayurvedic principles, have lost their native medicinal qualities.
  • Set the tone. Creating a calm atmosphere before you eat can promote the right digestive enzymes. If you can avoid eating in bad company or when you are angry or upset, do so.

While Eating

  • Measure with your hands. As a general rule, animal proteins should be no bigger than the palm of your hand to ease digestion.
  • Eat at room temperature. Foods that are too hot or too cold can slow down your digestion.
  • Chew your food. Breaking down your food is easier on your digestion and helps optimize nutrient absorption as well.

After Eating

  • Wait before exercising. A short walk can aid digestion, but wait about two hours for intensive exercise, which can interfere with digestion.
  • Wait before sleeping. Gravity helps the release of proper enzymes and the movement of foods through the digestive system. Try to wait at least two hours after eating before hitting the hay.

Tara Adler’s Ayurveda Food Combining Chart

Food combining chart showing good combos

To view the full chart, download the PDF here.

For more on healthy digestion, see “Functional Wellness, Part 3: Digestive Health” by Mark Hyman.

This article originally appeared as “Questionable Food Combos” in the November 2013 issue of Experience Life.

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