Have you noticed that news comes in waves? Within the past few weeks, both chocolate and caffeine have been in the news for their apparent health benefits: regular chocolate consumption seems to have a remarkable ability to protect against heart disease, and caffeinated coffee appears to help fend off depression in women.
What’s especially interesting to us is the relationship of chocolate and caffeine to PMS and PMDD, though they are related in somewhat different ways. Premenstrual chocolate cravings are familiar to many women, and no one knows exactly why they occur. However, if just a little hits the spot, you’re healthier for having it. On the other hand, overindulging in a sugary, fatty confection can hit the waistline, and the complexion, hard. We don’t think that eating a moderate amount of chocolate has a direct effect on premenstrual symptoms one way or another.
Caffeine, on the other hand, is widely recognized to be a PMS trigger, and caffeine avoidance is usually one of the first self-help steps recommended in popular press articles on finding relief from premenstrual syndrome. This caffeine can come from coffee, decaf coffee (yes, there’s still some caffeine left in decaf), tea, and—oh no—chocolate.
Why should caffeine make PMS and PMDD symptoms worse? For one thing, there is no doubt that caffeine, especially when taken to excess, causes anxiety; anxiety causes stress; and stress and anxiety are two of the signature symptoms of PMS and PMDD. Also, stress actually causes PMS. Caffeine isn’t great for blood sugar, either: it makes your glucose spike higher, and fall further, and that is a recipe for stress, and stress…see where we’re going?
These findings about coffee, women, and depression are fascinating, though we can’t figure out why something that makes anxiety and PMS worse would make depression better. Maybe future research will shed light on those questions, but for the moment we have more faith in the chocolate study. It’s a type of research called a meta-analysis, which is an extensive study of very high-quality studies, making it highly credible. It is pretty clear that, for whatever reason, chocolate is good for your heart.
The coffee study is also a good study, but suggests that the more coffee a woman drinks, the less depressed she’ll be. This just doesn’t sound right, not least because anxiety and depression go together. Drinking over two cups of coffee per day is associated with other problems, and any stimulant needs to be treated with a healthy dose of respect. If you’re concerned about PMS and PMDD symptoms, steer clear of coffee altogether. And enjoy your chocolate.
Everyday, we are bombarded with tidbits of information about what is good or bad for our health. But this overly simplistic media coverage misses the fact that what is good for one person may often be bad for another. Of course, the conventional medical thinking that prevails in drug companies, most doctors’ offices, medical schools, and hospitals also attempts to apply a “one size fits all” solution to many health situations. The ancient Aesop’s fable tells us: “One man’s meat is another man’s poison.” Appreciation of this simple truth could remove a great deal of confusion and misunderstanding about what is healthy and what is not healthy.
I am reminded of this every time a patient exclaims: “But I thought X was good for me!” This exclamation could come about because I’ve suggested cutting out alcohol, or dairy, or wheat, or coffee, in order to see if those items are food allergens—or it could come about because of advice to rest an injured ankle or knee in someone who is very keen to keep working out. Whatever the case, people often think that there can be a simple formula that determines “what is good for you.”
In the case of PMS, there are certain things that make symptoms worse: coffee and caffeine, cigarettes, and alcohol. But more important are the foods that are fine for some people and not for others. Some women will find caffeine makes PMS a little worse while for some it creates huge problems. While that is not completely surprising in the case of caffeine and alcohol and cigarettes, many women are surprised to learn that foods that are part of everyday diets like wheat and flour, dairy, and refined sugar can make premenstrual symptoms spin out of control for some.
In fact, everyone is different. For some people, dairy is a healthy source of calcium and protein; for others, it causes respiratory problems including asthma, allergies, and bronchitis. And this is true not only for dairy. I’ve seen thousands of women cure their own illnesses when they discovered that wheat, sugar, coffee, alcohol, and a host of other foods were the main cause of their health problems. This is true for PMS, depression, fatigue, and many other health concerns.
Another problem with trying to answer “Is X good for you?” is that what is healthy at one point in your life might become a problem later. For instance, you might need to stop or cut back on your usual exercise routine in order to allow an injury to heal. This could apply to diet as well: if you were living in Florida in your 20s and thriving on a vegan raw food diet, and then you move to Minnesota in your 40s, that raw vegan diet probably no longer suits your body and it certainly no longer suits the climate.
You can see why it might be confusing to my patients when I tell them that non-fat yoghurt or whole wheat or a glass of red wine with dinner might be damaging their health. They’ve heard from the media and their doctors that these are good for them. Doesn’t dairy build bones and provide vitamin D? Aren’t wine and chocolate good for the heart? Doesn’t coffee improve concentration? There are studies that make the case for each of these effects, but in real life, unlike the research lab, there is no one answer that applies to all individuals, so there is no correct answer to the question “Is such and such good for you?”
There are a few things we can declare with certainty are good for nearly everyone’s health: moderate exercise; vegetables; meditation; adequate restful sleep. And each of those diet or lifestyle changes would do wonders for PMS. When it comes to foods, and the non-foods like chocolate, tea, coffee, sugar, and alcohol that we consume with our food, the notion of healthfulness must be decided on an person-by-person basis. Dietary rules that apply to everyone equally are of some value, but can be dead wrong in certain cases, and can certainly cause a great deal of confusion.
Fortunately, there is a simple way to find out whether something is affecting your health, and it’s a lot less expensive, and more accurate, than any blood test: cut a suspected foodout of your diet entirely for 30 days, and then reintroduce it. If your symptoms go away while you avoid it, and then return when you reintroduce it, you’ve made an important discovery about your health! This sounds so simple: you probably read this paragraph in ten seconds or less. But I’ve seen this simple 30-day experiment completely transform people’s lives and their health.
One note of caution here: some women don’t get PMS every month. They might have it three out of four months, or it may fluctuate in intensity from month to month. If this is the case for you, eliminating a food for only 30 days probably won’t tell you much, because you might be due for a light or non-PMS month anyway. In that situation, you may need to avoid the food for however long it would take to really convince yourself that it was the food, and not your natural variation, that made the difference.
It’s worth restating: I’ve seen food allergy identification and elimination work amazingly well thousands of times in my practice. In fact, I believe that anyone with any health condition is probably is eating some specific type food that is bad for her, but fine for someone else (even another person with the exact same health condition!). What is “meat” for someone else may be “poison” for you.
