Friday, August 12, 2016

How Did I Become an Interstitial Cystitis Diet "Expert?" Well Let Me Tell You!

You know, sometimes you get smart about stuff you never wanted to be smart about and that is what happened to me. In the mid-1990s, I was working as an outpatient hospital dietitian when I saw my first IC patients. Besides wondering how in the world I could help them with this frustrating disease, I was also thinking, “Boy, their symptoms sound like mine!” See, I had been struggling with “bladder infections” for years, many of them not showing bacteria in the urine.

I tried everything―avoiding baths, drinking gallons of cranberry juice (you too?), and taking boatloads of antibiotics. I saw several doctors and began to think I was going crazy. My symptoms were getting worse and worse over time and I was beginning to suspect that I had something worse than an everyday UTI.

Fast forward to 1998, when I found a great interstitial cystitis doctor, and I began my journey to get well. Although there wasn’t any research to support the idea that diet could make a difference in interstitial cystitis patients, I joined the Interstitial Cystitis Network’s Patient Support Forum and “met” thousands of people with IC who were experimenting with diet modification with great results. I tried eliminating the top ten foods and felt immensely better. I started helping people online and over the phone and eventually, wrote my first book for bladder pain patients, Confident Choices®: Customizing the Interstitial Cystitis Diet in 2005.

In addition to that first book, which was updated in 2010, I also answered the call of patients and published Confident Choices®: A Cookbook for Interstitial Cystitis and Overactive Bladder, a fingertip ready guide to over 200 bladder friendly recipes, and Interstitial Cystitis: A Guide for Nutrition Educators, giving dietitians, nurses, and other health care professionals the information they need to help interstitial cystitis patients make confident dietary choices.

To be honest, the journey has been amazing. Although I wish I didn’t have IC, I never would have met the amazing people I have over the past 20 years, nor would my career have gone in the direction of publishing books, writing for national publications, and speaking around the country to patients and nutrition professionals without it. I certainly never thought I would I find myself among a small number of nutrition experts in the United States who know how to help interstitial cystitis patients using diet to control the symptoms of this painful bladder condition.

More than anything, I am just like you. I know the frustration of having more education about my disease than the medical professionals I try to get help from. I understand balancing my dietary restrictions with the wants and needs of my family. I have felt the fatigue and anxiety of standing in a grocery store wondering what I can eat. And I have experienced the emotional ups and downs as I navigated the fickleness of having a painful bladder that interjects itself in every corner of my life. I not only have the science and experience, I have the empathy and understanding to help you and other people with interstitial cystitis navigate the path to healing.

To learn more about my journey, see My IC Story. What is your story?

Friday, July 22, 2016

Planning Vegetarian Meals on an Interstitial Cystitis Diet

I am often asked whether a person with interstitial cystitis can create a meal plan on a vegan diet. I always hesitate to answer because a vegan diet is challenging enough without the additional restrictions of another special diet like that for IC.

Just to get everyone on the same page, here are some definitions that can help:
  • Vegetarian diets in general do not include meat, poultry, or fish, although some people who eat vegetarian meals may include fish occasionally. The term "vegetarian" is fairly generic and doesn't describe whether or not a person consumes other animal products such as milk or eggs. 
  • Lacto-ovo vegetarian diets avoid all meats, but DO include milk and eggs. You may also hear of people who will only use milk products but not eggs (lacto vegetarian), or eggs but not milk products (ovo vegetarian). 
  • Vegan diets, of which you are referring, don't include any animal products at all and, by nature, are the most restrictive and difficult to balance nutritionally. There is some debate whether products created by animals (like honey) should be included in a vegan diet.
In addition to various religious restrictions, many people consume a vegetarian diet for the advertised health benefits: higher fiber, and anti-oxidant consumption and lower saturated fat.

I don't usually recommend a strictly vegan diet for people with IC unless there is a strong religious or personal moral conviction against eating meat or other animal products. Besides the fact that foods that are generally a staple of a vegan diet like soy (including endamame, soy milk, and tofu), tomatoes, citrus fruits, and some legumes (fava and lima beans) can increase interstitial cystitis symptoms, many IC patients find that a consuming high quality protein each day helps them feel better.

Therefore, a good compromise to a vegan diet might be a lacto-ovo vegetarian diet. People with interstitial cystitis generally find that eggs are soothing when they are in a flare, and also, many feel that vanilla milk shakes, warm milk with vanilla, or cottage cheese are soothing foods. You could also consider including fish one or two times a week. If possible, choose organic sources of eggs and milk/milk products to minimize exposure to hormones, steroids, and other chemicals that could stimulate your IC symptoms.

If you choose not to consume any animal products at all, it becomes essential to "complete" your protein intake by consuming the various types of plant based foods each day. A good rule of thumb is to include something from each of the amino acid rich plant groups each day: vegetables, legumes, grains, and nuts/seeds. Each of these food groups supplies a different set of "essential amino acids." Combining these essential amino acids helps ensure that you are getting the most protein possible out of a vegan diet. 

For more information on planning meals with interstitial cystitis, see: Customizing the Interstitial Cystitis Diet: A Confident Choices® Book

Tuesday, July 12, 2016

What Do Omega 3 Fatty Acids Have to Do with Interstitial Cystitis/Painful Bladder Syndrome?

One of the most common questions I get about interstitial cystitis and diet is, "What supplements should I take?" The answer is not quite so easy since in most cases, we can get a balanced diet from just eating a wide variety of foods. One exception may be sources of omega-3 fatty acids which are important for cellular protection, immune support, as well as cardiovascular health. Omega 3 fatty acids are healthy fats found in foods in three main forms: DHA, EPA, and ALA.

DHA and EPA, or the “fish oils”, are found in salmon, trout, and other fish. These omega-3 sources have been shown by some studies to reduce a person’s risk for heart disease, eye disease, and possibly cancer. DHA has been studied in Alzheimer’s disease (AD) patients and may act as a partial mediator, possibly lowering the risk of AD in some genetic forms of the condition. ALA is found in flaxseed and in small quantities in canola and soy. ALA has not been show to have any significant effects in humans and must be converted to DHA in order to be used, hardly an efficient process. In addition, some studies have discovered that men who eat an average of 1,500 mg. a day of ALA in the form of flax seed oil actually have two times the risk of advanced prostate cancer than those who consumed half that amount. Consumption of flax seeds have not been shown to be a problem for men, and ALA in general does not seem to be a problem for women. 

So why all the hype? Although there isn't any direct evidence that omega-3 fatty acid consumption is related to interstitial cystitis, there is emerging research suggesting that low levels of omega-3s may correlate with inflammatory conditions. In addition, omega-3 fatty acids are, in general, important for cellular health. They are a key component of cell membranes and important for healthy cell replication. This is especially true of epithelial (skin) cells. Many people may not know that the urothelial cells of the bladder wall are very similar to the epithelial cells of the skin. It wouldn’t be too much of a stretch then to believe that omega-3 fatty acids could be important for a healthy bladder. 

Omega-3s, like other nutrients, don’t stand alone, so the best way to get these essential nutrients is directly from food. Consuming three to four servings of fatty fish a week provides most people with the amount of omega-3 fatty acids needed to maintain good health. Some fish may be contaminated with heavy metals or other toxins, so it is important to vary the type of fish consumed and not consume these fish if you are pregnant, nursing, or if your physician has cautioned you against eating fish. The ALA in flax seeds is best digested when the seeds are ground just prior to eating. Flax seeds are also a great source of fiber and lignans, nutrients being investigated for use in the prevention and even treatment of a variety of conditions. 

If you are interested in taking omega-3 fatty acids in supplement form there are a few common sense guidelines:
  • Look for a supplement with more EPA than DHA. A ration of 3:2, EPA to DHA, is common
  • Avoid supplements made from algae oil, which contain only DHA. 
  • Avoid cod liver oil. It is high in vitamin A, which can be toxic in large doses. 
  • Look for brands that meet certification standards, such as the International Fish Oils Standard (IFOS) or the United States Pharmacopeia Convention (USP).
Omega-3 supplements from capsules, liquid or gels are equally effective. Some brands claim to be odorless, however these are usually more expensive. Most people find that taking the supplements with a meal works best.

If you are a nurse, dietitian, or other nutrition professional, you can earn continuing education for reading Interstitial Cystitis: A Guide for Nutrition Educators.

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Saturday, July 9, 2016

Balancing the Bad with the Good: Managing Stress Helps Manage IC Symptoms

How are you feeling? I mean really feeling today? As I write this, the world is messy right now. And sad. And confused. And if you are like me, all of this unease can settle in your body as depression and anxiety as well as physical pain. No matter what is happening in your world, sometimes it is helpful to take a break from the "breaking news" and alarming stories we hear day after day.

Yes, bad things happen and as human beings, we want to be "in the know" at all times. But it is becoming too much. Each news story is worse than the last. It is easy to believe some days that the world is truly coming to an end....but let's consciously and deliberately balance what we are putting in our minds. Remember the "random acts of kindness" trend? Let's try that again. Talk to your family. Talk to your neighbor. Look people in the eye and smile...offer to help people who need a hand. Be kind to servers in restaurants and leave a little extra tip. Say something positive to everyone you meet..."you have nice eyes, the color of your shirt lights up your face." Teach a child how to be kind to animals...they will grow to be kind to humans later. Go to a place of worship....or fill yourself with peacefulness by visiting a forest. Take a look at a flower blooming...or a blade of grass....or let sand run through your fingers. Buy an adult coloring book and let your creativity flow. If we change our perception of the world....the world will change.

PS: One way you can recognize someone in the IC Community that is spreading love, kindness, and support is to nominate them for the Interstitial Cystitis Network's Angel program. Simply email Jill Osborne at For more information see: 


 Helping Yourself Is the First Step to Getting Well

For step by step guidance for creating your own personal interstitial cystitis meal plan, see: Confident Choices®: Customizing the Interstitial Cystitis Diet.

For some basic, family-style, IC bladder-friendly recipes, see: Confident Choices®: A Cookbook for Interstitial Cystitis and Overactive Bladder

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Sunday, May 1, 2016

Are You a Victim or Victor?

By Guest Blogger, Maria McConville, MS, RDN, CPT, CWC

Victim: one that is tricked, duped, mistreated, injured, destroyed, or sacrificed.
Victor: one who defeats an enemy or opponent – a winner.

We all know what it feels like to be a victim of something. Being victimized makes us feel powerless, defeated, and demoralized. But to be the victor, we feel strong, powerful, and confident.

Could being a victim or victor be a choice?

I believe in many circumstances, yes, it is our choice. Whether we are the victim or the victor depends a great deal on our Locus of Control (LOC). Those with more external LOC blame other people or bad luck for things that happen and feel they have little to no control. Those with stronger internal LOC hold themselves responsible for the things that transpire in their lives and feel that they are in control.  Let me give you a few examples:

A person with more external LOC may say, “I can’t eat healthy because my spouse is a meat and potatoes person and that’s what I have to cook.”  Or, “I can’t exercise because I have a stressful  job and after work, I drive my kids around to all their activities.”  These people tend to be the victims of their surroundings or circumstances. They are the people who show up late for a meeting but blame the traffic for their lateness.

Conversely, a person with more internal LOC may say, “My spouse prefers meat and potatoes so I make and eat a small amount of those, but I fill my plate with vegetables.”  Or, “While my kids are at soccer practice, I will walk on the track next to their practice field.” These people hold themselves responsible for not adequately planning for traffic instead of blaming the traffic .

When we point the finger at others or circumstances, we absolve ourselves of responsibility and fall victim, feeling weak and overwhelmed. Taking responsibility, on the other hand, helps us become in command and triumphant.

Being a victim of our circumstances holds us back from meaningful and purposeful growth and change. It keeps us stuck in our muck.  But, through choosing to take control over our thoughts and circumstances and orienting to a more internal LOC, we propel ourselves forward and progress with decisive action.

A very poignant example of this concept comes from the story of Viktor Frankl who was a Jewish prisoner in the death camps in Nazi Germany.  Frankl’s capturers treated him horribly, as you can imagine.  However, Frankl decided that the one thing the German guards could not take from him was his freedom to choose his thoughts. Between his torture and his response to it, was his freedom or power to choose that response.  

Frankl chose not to be disparaged or victimized.  He helped other prisoners find meaning in their suffering and dignity in their prison existence.  They did not let the atrocities steal the freedom of their thoughts and they refused to fall victim to their atrocious situation. Liberated after three years in concentration camps, Frankl returned to his home country of Vienna, where he lectured on psychological healing. He wrote his world-famous book entitled, Man’s Search for Meaning.

I often wonder whether it was happenstance that “Viktor” was Frankl’s first name… perhaps it was no coincidence at all.  Choosing to be the victor will help you take control of the lifestyle habit you want to change whether it is losing weight, starting to exercise, or eating better.

We can orient ourselves to a more internal LOC by taking responsibility for our thoughts, emotions, action, and subsequently our circumstances. 

What will you choose… Victim or “Viktor?”

Maria McConville is a registered dietitian nutritionist and author of the weight-loss workbook, Lose the Diet – Find Yourself for sale on To learn more about Maria and her book, visit her website:

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Monday, January 25, 2016

Beauty and the "Beast!" An Interstitial Cystitis Patient Speaks Out

IC patient Britani Warner, "I will not let my illness take over all of who I am."
From Julie: I am the first to admit that one of the benefits of working in the interstitial cystitis online communities of the ICN Forum and my Facebook pages (Confident Choices® and Interstitial Cystitis Diet) is that I have met some fantastically resilient people who are not shy about sharing their chronic illness stories and coping strategies. One of my new friends, Britani Warner, agreed to share her story with you today. Now, we aren't saying that every patient has to wear make-up to feel better, but as you read this story by feisty Britani, think of what you CAN do to normalize your life as a chronic illness patient. Are you a musician and miss singing or playing your instrument? Are you an artist who has abandoned your brushes and paints? Or are you an aspiring chef who has become discouraged by the IC Diet? How can you reclaim these parts of yourself? Let's let Britani inspire us!

Britani and her family of pups!
Britani Warner: Let's face it. Living with a chronic illness is exhausting. The pain, fatigue, and side-effects from medications can keep us pretty worn out and not feeling like doing much of anything, much less taking care of our personal appearance. However, especially bad days, I have found that if I just put on some makeup and let my awesome purple hair down, my outlook on the day is much brighter.  How could you be sad with purple hair, right?!

Being sick can make you look sick, and when you look in the mirror and see those dark circles under your eyes, it can be quite disheartening. Throwing on some cosmetics to cover those pesky dark spots and brighten those tired eyes can make a huge difference in your mood for the day. Even if your body hurts and you're tired, looking good can help you feel good, even if just by a tiny little bit (and that tiny little bit counts a whole lot when you live in pain each and every day).

On those days when all I want to do is lay on the couch in my pajamas, just painting on some cat eyes and applying several layers of mascara (because we all want three-inch long lashes, right ladies!) brightens my mood. The way I see it, if I'm gonna be a sickie, at least I can be pretty. My tired, aching body will not reflect in my face. I dare people to say to me, "But you don't look sick!" I will not let my illness take over all of who I am. Taking care of my appearance not only makes me feel a little better when the "beast" of chronic illness rears its ugly head, but it also allows my face to reflect who I truly am on the inside: a beautiful warrior.

 Chronic illness will not win this fight.


For more information on coping strategies and living with interstitial cystitis and other chronic illnesses see: Customizing the Interstitial Cystitis Diet: A Confident Choices® Book.
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Monday, January 18, 2016

An IC Diet Road Map!

Like most other things in life, if you are trying to manage your interstitial cystitis symptoms with the IC Food List, you need a plan. Imagine that you are going to take a vacation. If you are like most people, you probably start choosing a destination weeks or even months in advance. You will likely spend time deciding on transportation, entertainment, and lodging. If you are driving, you might study maps to familiarize yourself with the various routes you can take. Or, if you are flying, you might compare the price and convenience of various airlines.

Now imagine the confusion and frustration that would result if you just woke up one day and decided to take a vacation. Just choosing where you want to go would be paralyzing, let alone knowing what clothes to pack, or how you will figure out last minute transportation. Of course, you can drive to your destination, but would you set out to an unfamiliar place without a map or directions? (As an interstitial cystitis patient, you would probably want to know where all the bathrooms are too!)

Just like planning a vacation, spending a few minutes each week planning IC friendly meals based on the interstitial cystitis diet can save you the agony of making last minute decisions. Having meals planned in advance along with recipes can even reduce the temptation to eat outside of the home. Also, creating a grocery list from your menus and shopping once a week, will save you the frustration of shuffling the contents of your refrigerator and pantry or running to the store at the last minute to find that one elusive ingredient.

Not everyone can afford an IC Diet consultation with me, but that is why I wrote the books. With a little help, I believe most people can do this themselves! It's a new year! Give it your best!

For step by step guidance for creating your own personal interstitial cystitis meal plan, see: Confident Choices®: Customizing the Interstitial Cystitis Diet.

For some basic, family-style, IC bladder-friendly recipes, see: Confident Choices®: A Cookbook for Interstitial Cystitis and Overactive Bladder

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