The Thatched Hut Diet: A Healthy Way to Elimination
During my third year in medical school, I went to Zululand to pursue research on tuberculosis. The British surgeon at the hospital wrote me to come in September, and several hours after stepping off the train I found out why.
Most Zulu men worked in the diamond and gold mines hundreds of miles to the north and only came home at Christmas. My first week we went to a thatched farmhouse in the heart of rural Zululand, where we treated 150 local farmers and cow-herders who presented with primarily infectious and nutritional disorders. Every patient presented with problems I had not yet even read about. The surgeon also taught me to pull teeth, as no dentists were available. A week later we went to a clinic on the Zululand border where the people commuted from their huts to factories in nearby towns. There we saw diabetes, hypertension, obesity and constipation; I was now in familiar territory.
Lurching home on the rutted roads, the wise surgeon and I talked about the phenomenon of diseases of urban life. In his thirty years in Zululand, he had never seen a case of colon cancer and only rarely saw obesity and constipation at the thatched farmhouse. “Did you notice that the lady with hypertension was wearing a watch? She is paid according to how many parts she stamps per hour. Her cousin, whom we saw last week, doesn’t even know what an hour is. The city cousin also eats city food — processed and salty.”
One year later I met a senior physician, Denis Burkitt, who had spent his life in Africa, and had described an uncommon tumor of young men and boys, Burkitt’s lymphoma. He explained that he had become an astute observer of human stools, because in Uganda, the great outdoors in which he loved to walk about, was the outhouse of preference. Ugandans had impressed him with their large, soft stools having a large water content.
Rural African stools resemble a cow pie more than an American or British stool, he told us, and have a faster transit time, with undigested roughage from supper showing up the following morning instead of days later as is often seen in the west. Most importantly, he concluded, the presence of these stools helps explain the scarcity of diseases of western civilization: constipation (and constipation’s immediate consequences, the hemorrhoids, varicose veins and hernias that result from pelvic congestion and straining at the stool), diverticulosis, irritable bowel syndrome, diabetes, obesity, elevated cholesterol and its consequences i.e. heart attacks and strokes, and colon cancer (the logic being that carcinogens in the stool will have less contact with the wall of the colon).
During the decade after our conversation, the medical community was eager to debunk Dr. Burkitt’s theory that had created such a stir. In one study, adding fiber to the diet of people who had eaten a standard western diet all their lives did not reduce the incidence of colon cancer. These subjects did not have a truly African diet, nor would they tolerate one. My own practice experience has confirmed that nearly everyone with chronic constipation, irritable bowel syndrome and diverticulosis does better eating what I call a “Thatched Hut Diet,” in honor of our Zululand clinic.
The House of Vata
A popular medical textbook defines constipation as “a lack of fulfillment following a bowel movement,” relegating the problem to the field of the subjective. Indeed some people pass a small, hard rock only once a week and are symptom-free in ignorant bliss, while others have an abundant stool several times a day yet feel the world is coming to an end. The ancient Sanskrit texts of Ayurvedic medicine profess that an easy, daily motion, like a good night’s sleep and freedom from worry, is the reflection of living in accord with the laws of nature, an expression of suitable diet and exercise and of synchrony with circadian rhythms.
According to the Ayurvedic texts, constipation is understood to be a disorder of thephysiological operating principle called vata, which governs transport and movement in the body. More specifically, the aspect of vata that generates the impulse for the expulsion of materials outward and downward through the pelvis, called apana vata, is weak and irregular. Apana means outward and the driving force for the elimination not only of stool, but also of gas, urine, menstrual fluids, semen and babies. Indeed, because the pelvis is the center of so much movement in the body, the ancient texts describe it as the seat or house of vata, which, like the seat of a government or the house of a family, is the site in which vata accumulates.
Since it governs movement, vata is like wind (and literally means wind), creating a drying, shifting, cold, rough and brittle influence in the body when it becomes imbalanced, mimicking the effects of aging. In the pelvis, a vata imbalance presents itself as a drying, irregular and weakening effect on elimination. Intestinal motility becomes weak, irregular and sluggish. Since the main function of the colon is to reabsorb water from the stool, thus making elimination much more convenient and preventing dehydration, the prolonged time the stool spends in the colon creates a drying influence. In surgery I have noticed that the colons of patients with chronic constipation resemble an aging body. The colon becomes irregular, weak, thin-walled, pouched, stretched, and dry, including its contents. The normally muscular walls with ample folds appear withered and smooth.
Chronic constipation is the result of a vicious cycle. Initially the stool becomes pasty and dry, say after a long trip where you spend the day sitting, eating starchy foods, getting dehydrated, and missing your chance to eliminate in the morning. As things slow down, the colon fills up and stretches, and, like blowing up a balloon, the bigger it becomes, the easier it stretches. The muscles in the colon’s walls lose their mechanical advantage, and over time they lose their tone and strength. Like a slave who has been asked to shoulder an excessive burden, the exercise only makes her weaker, especially if the taskmaster adds the strain of a whip, a laxative.
Relief from Constipation
This brings us to the value of the “Thatched Hut Diet,” a diet that mimics what you wouldeat if you ate only the food that you could grow on your own bounteous land, without anyone to refine, process or package the harvest. It is also similar to what the homesteading prairie pioneers must have eaten. This diet contains large amounts of raw fiber from unrefined grains, seeds, legumes and vegetables, which absorb water, functioning like a sponge. This diet also eliminates the cement we add to our usual fare, breaking the vicious cycle by creating a stool with a high water content, which by definition is softer and more voluminous. Here are the practical points.
- Avoid constipating foods. Unfortunately, most people, including people with chronic constipation, have no idea what is actually constipating! Most critically, avoid white flour. Do you remember how you made paste as a kid? White flour and water; a few hours later everything was fused. This partly explains the high prevalence of constipation in societies that live on this staple. During the eight days of Passover, when Jews eat no leavening, taking only matzo made from flour and water, they observe the tradition of eating raisins as an antidote. The word pasta, pastry and paste, in fact, derive from the same root; so practice moderation with these and with all kinds of bread, including whole wheat, as well as with crackers, pretzels and cookies. While you are at it, skip nearly everything that is refined, processed or packaged, except raw staples like grains and lentils.Don’t forget other constipating items such as cheese, fowl, tea, potatoes, bananas and white rice.
- Identify any constipating medications you may be taking as well, including antihistamines, antacids, tranquilizers, antidepressants, antihypertensives, antispasmodics, narcotics and many others.
- Favor foods that are high in fiber content. Instead of white flour, use whole wheat or bulgur wheat, and instead of wheat, substitute barley, rye, oats, brown rice, corn, buckwheat and quinoa (a delicious Andean grain high in protein). Beware of millet, however, which the ancient texts describe as being potentially constipating.
- Add nuts and seeds to the diet. Put them in your cooking, such as stir-fried veggies and casseroles (not macaroni and cheese — the ultimate glue) and eat them for snacks. Include sesame seeds, pumpkin seeds, melon and squash seeds, sunflower seeds, etc. Use almonds with the skin, instead of blanched. Avoid peanuts, which are not really nuts, but legumes, and will just add heaviness and gas to an already uncomfortable situation.
- Drink plenty of fluids to avoid dehydration. Some people who are chronically constipated may unconsciously suppress thirst and need to count glasses of fluid drunk per day. Tea, which may be constipating, and coffee, which is diuretic, don’t count.
- Eat abundant amounts of fruit. After all, a fruit is a tree’s way of tricking an animal into eating its seed. The tree packages it in a sweet, enticing, aromatic container containing a good dose of natural fiber and laxatives, which hustle the seed through the digestive system to get deposited a few miles away in a pile of manure. There are more pleasant ways to get your dose than the traditional prune juice; taking fresh fruit is more important nutritionally and more likely to become a permanent habit, in addition to providing both soluble and non-soluble fiber. Just avoid fruits that may create gas, like pears, as well as bananas, which are constipating. One traditional Ayurvedic remedy is a handful of fresh grapes or freshly squeezed grape juice at bedtime.
- Augment your diet with other sources of fiber. The natural fibers in the Thatched Hut Diet may be all that is needed for most people. You can also add flax seeds or bran. The best place for fiber supplements is with your meals, added to oatmeal or granola, for example. One of the finest sources is flax seed. Soak a teaspoon of seeds for a few hours: they swell with water and become mucinous. In your GI tract flax seeds hold water and create lubrication. Use flax seeds that are milled (in your coffee grinder) or whole. You can also drink the soaked seeds by themselves with some juice.
- Psyllium seed husks are the treatment of choice for anyone who does not get the desired results from dietary changes alone. The ancient Sanskrit word for psyllium is isabgool, and nearly all the psyllium in the world today is grown in India, where the Ayurvedic physicians have long prescribed it as a dietary supplement. I recommend brands that utilize the unrefined husk and leave out the sweeteners and other unnecessary additives. Add psyllium gradually to the diet, starting with a bare half teaspoon and take it with juice or water just before the meal. People who start taking fiber too enthusiastically may experience bloating or gas and give up. Work up to a good teaspoon or two with each meal.
- Homemade granola can be a remarkable cure, providing more useful fiber with fewer calories and fat than the packaged varieties. Use whole oat, rye, barley and almond flakes, bran, flax and sesame, pumpkin and sunflower seeds. Bake it well, because these grains are harder and rougher than wheat. Mix the raw grains with a little warm olive oil or ghee (clarified butter) before baking at 325 degrees, stirring often until it turns a few shades darker. I spoon in some maple syrup as it is cooling. You can then add dried fruits such as raisins. A bowlful with milk or yogurt is all many people may need to conquer their irregularities.
- Eat everything fresh , and reduce your use of canned, frozen, packaged and even leftover foods. In addition to making food constipating, processing and preserving removes many vitamins and minerals. When you are shopping, remember the thatched hut.
- Get plenty of exercise. The best kinds are those that involve some bending to massage the abdominal contents, so housework counts as well as yoga postures that involve forward bends.
- Re-establish your colon’s circadian rhythms using the gastro-colic reflex. Whenever you eat, nerve and hormone messages are sent by the stomach to the colon, signaling that new inventory has arrived and that room needs to be made by moving out the old. The Ayurvedic texts recommend a glass of warm water in the morning on arising. Find a regular time ten to thirty minutes later to sit on the toilet non-judgmentally for a minute or two, even if you think nothing will transpire. This is akin to toilet training. Culture this habit for a month or two and your colon will begin to keep time with the drumbeat of dawn.
- Cultivate good stool habits. Make your visits to the bathroom brief and pay attention to what is going on in your body. Leave War and Peace in the den. Don’t strain; this is the best prevention for hemorrhoids and fissures.
- Try eliminating from a squatting position. One summer I noticed that Asian visitors, who had been walking barefoot outside, left footprints on the toilet seat. They were using the toilet the way nature originally intended. It is not, however, the way the manufacturer intended, and can result in a broken toilet. Instead, try putting two tin cans about six to eight inches high as footrests on both sides of the bowl. If this position, which naturally compresses the abdominal contents and tilts the pelvis, seems more efficient, you can purchase a permanent, more elegant footrest that slides behind the bowl and out of the way.
- Avoid laxatives. Use them only to prevent or relieve the most uncomfortable circumstances. Keep in mind that constipation is best managed through prevention, and that regular use of senna, castor oil, irritant laxatives, milk of magnesia, cascara and their like can only make the problem worse by interfering with the normal tone of the colon and creating both dependence and tolerance; you will eventually need increasingly bigger doses. If people with healthy elimination find themselves constipated for several days after taking a laxative for a diagnostic test or a therapeutic cleanse, just imagine what laxatives are doing to your already feeble, listless colon.
- One fortunate exception to the above advice is the regular use of an Ayurvedic remedy known as triphala. “Phal” means fruit, and triphala is a combination of three fruits that have been dried and powdered and usually pressed into tablets. Triphala is traditionally used as an upper digestive aid, and as a tonic. It nourishes the skin and eyes, and aids weight loss; its side benefit is gentle laxation. Triphala can be taken in the morning or at bedtime; the usual dose is one to six half-gram tablets. If you are a regular user of laxatives, don’t expect much from triphala until you have implemented the rest of the program above. Triphala can be found at most health food stores.
- Enemas are unnecessary if you properly implement this Ayurvedic program. If, however, hard, impacted stools still develop, it is preferable to use a simple oil retention enema than to take a laxative. The oil will soften and lubricate the stool and make it easier to pass, without disrupting your natural rhythm, as would a laxative. The Ayurvedic medical texts recommend sesame oil, but olive oil is a reasonable substitute. Avoid mineral oils which are harsh and do not have the same nourishing effect on the rectal and colonic walls. Discard the contents of a Fleet enema syringe (the best thing for someone with chronic constipation to do with these irritating salts, in my opinion) and use the syringe to administer two ounces of lukewarm sesame oil. Lie on your left side for ten minutes afterward to allow the oil to ascend the sigmoid colon, and then go about your day (with an optional disposable liner in your underwear in case you forget the oil is there).
One precious side benefit of the Thatched Hut Diet is that similar regimens rich in fresh produce have also been shown to prevent other common serious disorders: heart disease, cancer, hypertension and obesity. Learn to cook and enjoy whole, unrefined cuisine and every aspect of your health will benefit.
Jay Glaser, MD is a board certified internist in Massachusetts.