The Arthritis Dietitian

Lupe and Brian speak with Cristina Montoya, the Arthritis Dietician.
Her knowledge, experience and Sjogren’s journey is remarkable.

Lupe and Brian speak with Cristina Montoya, the Arthritis Dietician.
Lupe and Christina have been talking on Instagram and her knowledge, experience and Sjogren’s journey is remarkable.

The Arthritis Dietitian

Lupe & Brian: Welcome to another episode of Sjogren Strong.

Brian: This is Brian.

Lupe: And this is Lupe.

Brian: And this is your weekly podcast discussing how to live an active and healthy lifestyle despite a diagnosis of Sjogren’s.


Lupe: And today, all the way from Canada, I would like to introduce Cristina Montoya. She is the Arthritis Dietician.

Brian: And we are super excited to have you on the show today, being a registered dietician. Because Lupe and I talk a lot about diet and what we put into our bodies dramatically affects how we feel. So welcome to the show.

Cristina: Thank you. I’m really excited to be here.

Lupe: Welcome! Welcome, Christina. Um, so we would like to hear a little bit about your journey with Sjogren’s. You know, when you were diagnosed? How you got a diagnosis, if you wouldn’t mind? 

Cristina: Yeah. Um, well, I ‘m from Columbia. I was born in a small town called Amaga. And when I was 8 years old, I got apparently, mumps.  You know the virus.

So my prioticgrand, they kept swelling up, swelling up. So, my mom obviously took me to the local doctor and said, Oh, that’s an infection. Let’s give you Penicillin. And back home, it’s all injections. So, I had to kind of show my butt everywhere.

And I had to take Penicillin shots every day for seven days, at a time. And I had to do with for like 5months, consecutively. And they also gave me Ibuprofen, so the swelling kind of went down.

Anyway, so it went   I was 10 years old with the same symptoms. My mom used to say that I used to fall, like, a lot. Like I used to fall, like I wasn’t that great at sports. I got tired really easily.

And I started having these, my mom said, like annoying habits.  Like I would drink water all the time. I’ll be feeling like I’m always like eating something (chewing sound) because my mouth was so dry.

And then one day, it’s like, I misbehaved. You know, I was a teenager and I was maybe 12 years old. And went roll skating with my cousin, and it was raining and all that. And my aunt, she was so mad.

And, ah, you didn’t listen, so all of you get spanked, you know. So, we all got spanked. I didn’t cry. Why are you not crying? I don’t know.

You get another spank.

Lupe: So do you think, do harder.

Cristina: So, she said, you get another one. And I just laughed. And I just laughed. I was in say, but I laughed.  But nothing came out of my eyes. I was not crying at all. That’s how I went.

So, they call me, when I was maybe 14-15, my mom kept taking me to different doctors, until finally, I actually went to nursing school, like a practical nurse. And I used to go and talk to the nurses about the anatomy, like, why is my mouth so dry? Why are my grand so swollen? How can I explain that?

So when I did, um, a practicum, I met an internal medicine doctor. He looked at my fingers. And he said, um, it looks at you, I don’t know., look like your showing some symptoms of autoimmune disease. And I was 16 at that time, I said, what are you talking about? 

Anyway, so something happened, he referred me to another internal medicine doctor. For some reason, I got in the hands of a neurologist, a plastic surgeon, an ENT doctor, because they have to cut me open, to see what was going on. And I was terrified. I was 16 and I was, Mom, I don’t want to do that. That sounds awful. And then I was reading up and there is a facial nerve, I’m going to look ugly. Mom don’t take me.

Lupe: Yeah.

Cristina: And fours, some miracle, that I used still cannot explain, when I was actually, my mom took me to make the appointment, to get the surgery done. They lost my clinical charts.

 Lupe: Oh, good.

Cristina: It got lost 

Lupe: Yeah. You took it, huh?

Cristina: And I was like, oh, I just sighed of relief. I said, mom, I’ll keep drinking water, leave me alone. And I was a teenager. I just got used to it. I just got used to, I noticed that I couldn’t eat bread. I couldn’t eat crackers. I couldn’t eat, really, cookies.  So, I used to love going for like soft cakes.

You know how, uh, in Latin America, we had these three-milk cake.

Lupe: Tres leches, yes.

Cristina: That was my favorite cake. That was my birthday cake, the tres leches cake.

Lupe: Because it’s moist.

Cristina: Exactly. But that’s what I went for. I always went like for eating banana, papaya, cantaloupe. Um, always like, things that very, very, very soft.

In Columbia, we also have, maybe it’s cultural to my region? We always have soup with our meals. So, soup with lunch, soup with dinner. So, I always have some sort of liquid with me. We had avocado. We also have like fresh juice. And I didn’t really drink that much coffee, back home.

So, some of those things, that I was able to manage because there were, like, fruits and vegetables available, to me, all the time. So, I said, okay, I can manage this.

The swelling, it started to go down, around when I was 17-18. But my mouth was still very dry, and I started getting some cavities. And I think, like you Lupe, because I heard that you were so into cleaning your teeth.

Lupe: Yes.

Cristina: So, I was like, really obsessed, right? Like flossing and cleaning and brushing. And it’s still, I was developing cavities, but they couldn’t really tell why. So, they just do, what they do, the feelings. Then what happened, when I was, let’s say, I left it alone, because, as a teenager I was just tired of not getting answers.

And I felt bad for my mom, also not getting any answer and she’s frustrated. And I just becoming a little, maybe, a young adult. So, what I decided to study nutrition, that was when I was 18 years old. I think I always had this fascination for nutrition, overall. I didn’t think of the Sjogren’s, because I didn’t know that I had it.

But because of what I was feeling and then limited choices, sometimes, I had, I was actually developing an eating disorder. So, I was like, this is what I am able to eat. bananas and drink water and that’s all. Because everything else, that’s the other thing, I had a lot of, um, uh, bowel issues.

Um, my stomach, I always have a, um, heartburn. Like I felt like, uh, I couldn’t tolerate a lot of foods, that were, like, traditional for us. Like beans, you know, and sometimes lentils and things like that. You know, they’re grown there, some fruits, like, apples and pears. I couldn’t really eat them. So I was, in a way, developing a little bit of an eating disorder. Because I did have foods available, but I really, it’s some that I couldn’t tolerate.

Lupe: Yeah, you couldn’t eat them, huh?

Cristina: Yes. So, I always have a lot of gastric issues, since I can remember, Since, I was a child, too. So that’s, um, well, I kind of manage them. So that was the reason why I really started in nutrition.  Why? To try to find an explanation where all these symptoms kind of came from. How can I manage with food?

But then when I was doing around, I was 21 I was doing my clinical rotation and in clinical nutrition back home, in managing. And for some reason, again, the elevator, it broke down, in the hospital. And so, I had to go up and down like for like 9 sets of stairs. That was 9 sets of stairs, up and down, up and down.

So my knees, started to get sore. And I came home and said, mama, I can’t walk. I really, really hurting. What am I going to do? And my mom was, I don’t know. And so, I started, then a week later, it was my wrist, then there were my fingers, then my ankles. And then it would in a month I couldn’t walk.

Lupe: Wow.

Cristina: I completely immobile, and my mom was like, what happened here? And so, from that point, my mom, I was really lucky. Maybe because I know this doesn’t happen to everybody that all these things come from rheumatoid arthritis, kind of show that, like that. Oh, so aggressively. But then, um, my mom took me to, went to see a family physician.

He was a young guy and he kind of put all the dots together. And even, that’s when he started, he was the first one to start suspecting Sjogren’s. And he mentioned that. And he was a family doctor. I’m think he just graduated and probably he just saw that, just learned about that.

Lupe: Probably.

Cristina: So it was very interesting, because I said, no. But he started, you have a dry eye, dry mouth, and you know all of the hallmark symptoms.

And I said, yes, yes, yes, yes, yes. And so, within a month. he, um, actually sent me to a rheumatologist. It was very quick. I started feeling all the RA symptoms, let’s say October, November.  And then by January I was diagnosed with rheumatoid arthritis. And they finally put a name to my   other symptoms, which is the Sjogren’s Syndrome.

They did lip biopsy, back then. And I think, there was a little bit of knowledge of Sjogren, because of the Dr Juan Manuel Anaya, the one who wrote the book, that I shared on my Instagram.

I was referred to him. And he was actually doing some research without patients with Sjogren’s, and he was really passionate about it. And he explained to me a little bit more about it, but still, there was really not much, that he could share in terms of how to manage the symptoms.

I think, it’s still kind of new, I guess, in terms of management.

Lupe: What year was this?

Cristina: That was, I think 2002-2003.

Lupe: Okay.

That’s when I remember buying that book. It was a small book on Sjogren’s, I still have it. I read more about it, but it’s still, I don’t know, it’s felt foreign, to me.

Cristina: No, I think the Rheumatoid Arthritis, is bigger, Oh no. That’s the one that is affecting my mobility. I kind of put it in the back seat, even though it’s been affected my life since I was a child. I didn’t know that. Same moving forward. I fell in love with my husband and he said, you know, I’m taking you to Canada and I’ll give you like a new life.

And the new life, was meaning like, better treatment, access to better treatments. And that’s what really happened. When I came to Canada, I had access to the biologics that come a year after I arrived here in 2008 And that was, wow. That was like a life changer. I could walk again. I could be myself again.

But then the rheumatoid arthritis is started to handle, get it stabilized, like it was better. I could manage it; I could deal with the pain. But I started to feel my eyes, were dry. I could not, I just, I couldn’t open my eyes. I had a severe bouts of irritable bowel syndrome for, six months, and I couldn’t eat anything.

I just lived off fruits and crackers. And everyone kept saying, oh no, that’s just IBS. You can deal with that, take some pills. And just, nothing works.

Then again, my mouth super dry and a lot of digestive issues, a lot of digestive issues. So, I think in 2005. I started learning more about like how to manage IBS with diet. And that’s how I really, really got into, okay, if I can manage the symptoms, I might help you with the fatigue and everything else.

So, that’s when, in 2005 I also whet to the Sjogren’s Society of Canada. I went to one of their conference here, and wow, that was an eyeopener. I was like, Oh my God, this is all that has been happening to me all these years, and I didn’t know Uh, and then I actually went to the Sjogren’s Foundation Conference, 33 years ago when it was in, was held in Tampa three or four years ago.

And also, there, I learned so much, that even, um, my husband said, he came with me and he learned. And he said, no, I want to know. I want to, I want to know what’s going on with you. So, he came, he joined me, and he attended the whole conference. And, so from there I started saying, okay, there’s got to be more to it.

You know, with autoimmune diseases, they still say, well, nutrition is not going to cure it, we know that., But it’s about, like, management of symptoms. I really found that a lot of my digestive symptoms, I could manage with diet. I believe around 80-90% of patients with Sjogren’s, who suffer irritable bowel syndrome.

Patients with Sjogren’s, also are a higher risk of developing celiac disease, compared to other, autoimmune conditions. Also, patients with Sjogren’s, when you compare to other autoimmune inflammatory arthritis are at a high risk or more hypersensitivity to certain foods, particularly gluten milk. Some developed to eggs and corn.

He kind of goes back to physiology. And the one thing that we take for granted is the saliva.

Lupe: Ugh, yeah!

Cristina: Saliva, like gold. I don’t even know what if it tastes like, because I never had it.

Lupe: Oh, you never had it, even as a child?

Cristina: I honestly can’t remember because back from, I was 8, I’m 38 years old, almost 38. So, it’s been 30 years.

So if you tell me what saliva taste like, maybe when I take a cookie from my baby’s mouth.

Lupe: Yeah.

Cristina: I tasted saliva.

Lupe: Wow.

Cristina: So, that’s when I took an interest. But the other thing is, Lupe, that has really bothered me, not knowing much of that side of Sjogren’s, is when I was pregnant, there is, you know, how Lupus and Sjogren’s sometimes overlap, right?

The symptoms and antibodies.

Lupe: Yes.

Cristina: They told me, you know, your antibodies, they anti-viral, I can remember the other one they’re dangerously elevated. So, they could cross the placenta and affect the baby’s heart. And I was like, what, it took me like 15 years to get pregnant.

Yeah, I know.

Lupe: And then they tell you this, that’s scary.

Cristina: And then, they said, oh no, but don’t worry, it’s only 1- 2%, who are at risk. And I said, excuse me, I’m the 1-2% who has Sjogren’s and rheumatoid arthritis.

Lupe: Exactly.

Cristina: When people tell me that, I get upset because it’s like, I’m the1-2%.

Lupe: Exactly.

Cristina: Of that population. Uh, well, luckily the medical team at Sunny Brooke Health Sciences, where I had baby, they were very diligent. I heard there’s a window, between week 20 and 24, that they have to, they check, they do, um, uh, equal eco cardiogram, to the baby’s heart. Just to make sure that it’s pumping well. And everything is going well. And so, after that window if everything is okay, then the baby will be fine.

But then after he was born, he was again checked, to make sure his heart was fine. But then again, you have that risk neonatal Lupus Syndrome, for the babies. So, he was on the monitor for dad. I didn’t know when it comes, like planning a pregnancy, if that, I didn’t know about that. And also, actually I didn’t even think I could have babies, because for 15 years we, nothing happened.

Lupe: Right.

Cristina: And when you really read upon autoimmune diseases in Sjogren’s and particular, it seems to affect fertility. And in fact, just decided to show up without deciding, like I’m going to be told. And then he said, no, I’m coming here.

Lupe: I’m here.

Cristina: Here I am. I’m here. Here I am, mom. So that was quite wild.

And having that fear and not, I had the support from the hospital, but I went online, and I have Mamas Facing Forward Support Group, which is amazing. And they really helped me, to kind of ease that anxiety about what’s going on. And I met other moms who had Sjogren’s. But it’s just, how is it that the rheumatoid arthritis who was putting my baby at risk, it was the Sjogren’s.

That’s a little bit on my journey, Lupe.

Lupe: But now you have a baby and she’s fine.

Cristina: Year. So, now it’s fine. He’s being a monitor at the hospital. So, they did check his antibodies when he was born then and six months after. And then when he turns a year, in February, they’re going to do another test. Just to make sure that antibodies are out of his system.

He hasn’t developed anything related to the Neonatal Lupus Syndrome. And honestly, he is a miracle. I love him to death. I just can’t believe it. And when I say him, I feel that anything is possible.

Cause that baby fought so hard from the moment he was conceived.

Lupe: It like your little miracle baby.

Cristina: He is my miracle baby. And I see him, and I say, if he can do it, I can do it.

Lupe: That’s, right.

Cristina: Yeah. So, it’s really my motivation. And my husband, he is extremely supportive and so understanding, of my condition.

He I wonderful cook, just like Brian, I’ve heard.

Lupe: Yes, yes, we’re lucky.

Cristina: And he is always making sure, Oh, I have to make the gravy, the sauce. And the chicken needs to be tender. Make sure it’s the chicken thigh, not the chicken breasts, because she’ll choke on the chicken breasts.

Lupe: Yes.

Cristina: So, little things like that, we have learned over the year.

Lupe: We appreciate it.

Brian: Thank you for sharing that incredible journey with us. And it’s awesome to hear that you have such a great support network.

Lupe: And you have a great doctor. You had a great doctor back there. And I know that you still keep in touch with your doctor because he sent you a book, to Canada.

Cristina: Oh my God. I could not believe it.

Lupe: Oh, I was so excited for you. I was so excited for you.

Cristina: I just, wow. I found him on Twitter. And, he was like, Cristina, and I said, Oh my God.

Lupe: And he remembered you.

Cristina: He did. I was like, wow. I was amazed and so proud of him. Like, he’s so passionate about the outreach, he continues doing research. And, I’m so proud. I would love to see him again, in another setting, but that was, great.

Brian: So, let’s talk a bit about the dietician portion of your life. Why you chose that path. And how it affects your Sjogren’s and arthritis.

Cristina: Interestingly enough, when I recently graduated, because I was diagnosed with rheumatoid arthritis, I actually volunteer for the Arthritis Foundation in Columbia, in Medellin.

And I did a lot of presentations and talked to the patients. And I really liked that. And people have so many questions and how to prepare meals. And I started to take a little bit of interest in that. And then my life kind of changed when I came to Canada, and while I have to my credentials as a registered dietician in Ontario.

So, I had to deviate from that path, a little bit, so I could get some more of the Canadian experience. But it’s still surprisingly, when I work in a long-term care homes, and a lot with elderly. And we have a lot of things in common when it comes to dry mouth, right? And having swallowing difficulties.

So, actually, I learned quite a bit about the management of swallowing difficulties, which I really enjoyed. Then when, really, in 2015, when I started getting involved with the Sjogren’s Society of Canada, they again asked me to do a few presentations on nutrition and to share my Sjogren’s journey.

I wrote an article for the Sjogren’s Foundation back then. And it was about irritable bowel syndrome. I think it was in 2015 or 2016. And also, I started writing for the Sjogren’s Foundation in Spain. I sent an article and wrote in Spanish. Things kind of, again, happened and I was, let’s say I got a job where I was asked to put down everything I’ve done.

I built up my Arthritis Dietitian, sort of, um, a little bit of a perceived potential conflict of interest. So, what I had built for maybe two years and placing awareness and the fact that at this point, these sorts of job was helpful for my condition, at that time, in terms of distress levels and all that.

So, I kind of put the Arthritis Dietitians journey on the side. I kind of let it there, like dormant, for like, maybe three years. Until this year when I was (inaudible) bought madly and I started having all these questions again. And I started getting really encouraged by former patients or former connections that I did online. On Twitter, like The RA Guy, I had this interview, Lean Anderson. The lady Maria from Mama’s Facing Forward.

And I saw that they were doing such a great job with patient advocacy and education, that I felt, you know, I think I have knowledge and patient experience that I could share, that could help other patients. And my journey has been quite long, it’s been like 30 years with it.

That’s what nice decided, I’m going to launch my Arthritis Dietitian blog again. So, it really happened this year, again.

Lupe: And you’re doing a great job.

Cristina: Thanks!

Brian: We notice recipes in a meal prep section on your website.

Cristina: Yes, I’m working on it

Brian: And it’s tough. I mean, we actually attempted to share recipes for a while and it didn’t seem like our audience, at the time, was interested in, you know, learning how to prep certain meals and cook certain meals.

And I think it takes, you know, somebody that’s really motivated in controlling what’s happening to them physically, to tackle diet. Because it is such a big part of our life. What we eat, what we put in our mouth, we do it three plus times a day.

I was brought up with breads and pastas and meats and heavy meals, to where it wasn’t always, I don’t want to say it wasn’t quality food, it was all quality food, but it necessarily always wasn’t healthy. And it’s hard to change that behavior when you were brought up that way.

Cristina: I completely understand that. Because even as a dietician, we don’t always have the perfect diet. I don’t think there’s such a thing as perfect diet because I do like, I like to enjoy my food. You know, if I have a piece of chocolate, I want to enjoy that piece of chocolate. There are so many other things in my life that I had to dread, and I feel pain.

So, that one day, I want that piece of chocolate, I want my chocolate! I want that chocolate. But it’s one of those things that unfortunately, because, how to manage.

And what I learned, and I think is helping me, mostly when my baby started eating solids. And it’s kind of clicked that., you know, that what, I’m nourishing him now, whatever I put in his mouth, now, it’s going to have the consequences of his lifestyle, later on in life, right?

And I still, even though they say, obviously, that is not a guarantee that he’s going to develop an autoimmune disease, it’s still in the genetic makeup. Is there, but to me it’s more about building a healthy relationship with food, you know?

And it’s about enjoying those with families. And the thing that we can bring together. What I love about in my family, in particular, is because we, um, we live with my baby’s grandparents. So, my husband’s actually, my husband’s heritage is Pakistani. It’s an interesting mix, it’s a Pakistani and Colombian. And we prepare the meals and they’re all like flavorful and all that.

So, even with my in-laws, I say, you know what? We want to, the meal planning, for instance. It’s almost liked a lifestyle. Because it’s setting up a little bit at that time, perhaps on the weekend, that your kind of planning ahead, as much as you can. Cause sometimes you don’t really have all the energy.

But it’s still important to stay, okay, I have, at least, if I cut up all the veggies, at least I can reach out to them. If I’m not strong enough, I’m too fatigued. I can put it in a blender, make the smoothie. But you have it available. You put it, at least in your mind that this is going to make me feel better.

But when you actually have in your freezer, pizzas and like, the ready to eat Hungry Man type of foods, the microwavable foods that, you know, that is still a preservative. And they’re full of inflammatory items there. Then that’s not really going to help.

Lupe: Right.

Cristina: So, I think that I started slowly. Even for myself, kind of getting into the groove of all the meal prep and the meal planning. So, I go through a process. I go sit down with my husband and mother in law. I say, what are we having for the week, right? So, I know with my mother in law, actually, I love her food.

I always say, it’s Sjogren’s friendly. Because I was always like, curries its lentils or chickpeas. And so, there’s always these nice soft things.  They have like, ah, yogurt got to, it’s like a yogurt sauce with cucumber and cilantro. So, it’s always, it’s always so easy to swallow and to eat.

We make sure that we include what, um, what kind of everybody likes. We make up like a grocery shopping list and we’ll go together. And the moment we come home, we sit for maybe an hour to cut up the veggies, put them in containers. And then you just kind of take them out. And I actually found out that my in-laws, even started eating more veggies because they had it all readily available there.

Lupe: Oh, right on.

Cristina: It takes a little bit of, I guess, a little bit of getting used to.  But I think it’s rewarding; it will pay off. Because even for me, I’m thinking about going back to work, you know, for my 8-4 job. And I want to make sure that I have all the foods, you know, ready from for my baby and for myself, because I travel quite a bit for my job.

So I don’t want to grab anything that is just a fast food. I want to make sure that I know what is in my food, because I bring it from home. And you’d think oh might be so expensive. And that’s my order, like when I’m going to take that approach, that sometimes you feel that you had to spend so much money on, um, making, uh, like an anti-inflammatory diet.

And I don’t think so. Like what is it really? When do you want to go for, like, a plant-based diet, are you going to use a lot of legumes, right? So, when you buy the legumes, like the dry, and you make it at home, you make it at home, you actually want to get rid of all those carbohydrates that are not very well tolerated.

When you soak it overnight and then you kind of cook a batch, like you’ll cook the whole thing and then you pack it and Ziplock bags or something. And you label it and then put it in the freezer. And so one day you just feel like having beans, just stick it in, defrost it, season it a little bit and it takes maybe five minutes or 10 minutes to warm it up and season it with whatever herbs you have at home.

So it doesn’t really have to be that hard. And once you see the foods kind of available in your freezer, and I said, okay, I’ll think I can eat this. Or you can make your own bags with, um, like a premade, uh, smoothie bags, right? So, you’re going to put, in a Ziploc bag, you already had like a mix of oats and you have chia seeds, or flax seeds and you put some nuts in it.

And so you kind of have the premade and then the next morning that you already have, maybe the frozen vegetables just add it on in the smoothie in the blender, just take the smoothie and go, right? Maybe these are ways you can save energy. You can kind of have things that are readily available.

When you have the energy to do that, it’s, it’s so worth it. I honestly feel that, that made a big difference.

Brian: I never thought about doing the premade smoothie. Just having everything pre chop, precut in a bag, drop in the blender and maybe add a little fresh juice and go. That’s a great idea.

Cristina: Yeah. There are days that basically, let’s say my staple, personally because of Sjogren, I think that are, again, like very soft and, and that’s why sometimes I can’t eat lettuce, so I’m not a big promoter of salad, personally. When I eat lettuce or I eat a fresh celery, it gets stuck in my throat.

So for me, salads, I’m not a big promoter, but I think I’d rather put the Spanish in my smoothie, because it’s easier for me to swallow. Then eating a salad, right?

Lupe: You know what? I find at that spinach, because I used to eat a lot of salads and I just haven’t in a while, and I find that spinach is hard for me to swallow, as well. There’s a lot of foods.

Cristina: What about kale? How do you find eating kale?

Lupe: Um, I think kale is not so bad. And I like kale because, I know I talk about it too much on the podcast, but it helps me go to the bathroom. It really helps me go because if I don’t eat healthy, I don’t go for days, you know, and then you feel uncomfortable.

Cristina: Oh. No, absolutely. And that’s probably one of the other symptoms, we can talk about it and another time. But one thing that I’m passionate about is how Sjogren’s really leads to irritable bowel syndrome.

Lupe: Yeah.

Cristina: What you can do about that. But again, one of the things I say, if I go for breakfast, right? So, I’m at breakfast, I always like to keep also quinoa, like I cook quinoa in bulk.

I don’t season it or anything, just paint, just boil it. And also put it in Ziplock bags. And I like to have my oatmeal mixed quinoa, it’s kind of nutty taste to it. And they also add a little bit more their plan-based type of protein. So, I know my oatmeal’s for breakfast, like, definitely that my go for breakfast cause it’s just easy to swallow.

And the oatmeal’s, you can also, like, pump it up with anything, right? You just add nuts and dry fruit. You can, uh, also, I love, like, nuts and dates and things like that. Chia seeds, like, you just can put anything in there. And I try to, kind of use more like the almond milk or the coconut milk.

Because over the years, I found that more sensitivity to the fluid milk. I can tolerate yogurt and cheese, but it’s fluid milk, not so much.

Brian: On occasion, we’ll actually make our own almond milk when we can find almonds at a decent price, in bulk, that are raw. It’s amazing the flavor we get from making our own versus what one would buy in a store.

Cristina: It really is, it really is. It’s just the unfortunate that almonds are so expensive up here.

Brian: Yeah.

Lupe:  Yeah, here too.

Brian: They’re expensive here, as well. And you know, that’s why we price shop. If we can find bulk raw then we’ll do it. But, you know, the sad thing is about it too, it only keeps for a few days in the fridge once you’ve. Once you’ve pressed it,

Lupe: Cristina, are there any foods that cause inflammation and are there any foods that help reduce inflammation?

Cristina: Well, I think that Brian mentioned them earlier, is that American diet. Surprisingly, I wasn’t too familiar with it when I came to Canada. Because we don’t have, I didn’t grow up with fast food, types of food, fried foods.

So anything that is really high in sugar, like simple sugar, high in vegetable oil that contains a lot of Omega 6. So, anything that is fried and refried and refried, right? So, we usually find that when we go to a restaurant or a fast food, in particular, a lot of that we find, um, carbohydrates. Like I mean, a lot of like the white bread, and that’s sort of thing that can also maybe increase information.

But I think, like we always say, everything in moderation. But in terms of, um, anti-inflammatory foods, what we found is, I go back again, like old school for the Mediterranean diet.

I think the Mediterranean diet, got it right when it comes to the balance. Because you know how, nowadays, you’ve talked about the Keto Diet, and I’ll do the, the Paleo Diet, and that’s going to help me. And you’ll have to eliminate like a bunch of food groups and then you’re going to feel great.

Yeah, you eliminate these foods for like 30 days and then you go back and need your normal foods. But, you know, the thing is that you’re going to have an autoimmune disease for the rest of your life, until they find a cure.

Lupe: Correct.

Cristina: So it’s about finding balance on what you eat and what you can access. And like what your budget allows too, right. Cause a lot of these diets can promise, Oh, you are going to feel great, but you have to spend like thousands of dollars in supplements. I don’t think that’s fair.

Lupe: Correct? Yeah.

Cristina: I go back to how I, in my own way, of how I grew up in my grandparent’s farm. It was also a Mediterranean diet style. Everything that we had in terms of vegetables, it was local, right, as much as we could. Because we actually got the foods and fruits from the farm.

Then we mostly ate plant-based protein, which is came from sources, like beans and lentils, chickpeas. We also ate rice, back home, a little bit of corn, And I think red meat, very little, like only maybe once a week or every other week, because it was expensive. Eggs, we ate that every day. But now when I kind of look back and you look at the Mediterranean diet, that’s really the concept of it.

You have like a base of a whole grain, if you can tolerate them, great. Right? I’m now becoming too familiar with the whole grain situation because I’ve been gluten free for 23 years now. And the reason why, is because I develop a severe sensitivity and it has been very challenging for me to get a diagnosis of celiac disease.

So my dietician, who’s an expert in celiac disease, she said, stay gluten free 100%. Cause it just triggers my symptoms. What I will say is, uh, get the proteins from nuts and legumes, as much as you can. The red meats or even the chicken, you reduce the amount,

Getting a healthy fat, from I say olive oil, extra Virgin olive oil. I’m not too crazy about like avocado oil or the expensive oil because you know what, just eat the avocado and then you’re going to get more antioxidants and fiber from it. Instead of spending $10-$15 on a bottle. Maybe for flavor, if you want to use it, but he’s not necessary. It’s not really going to be that anti-inflammatory.

Lupe: Yeah.

Cristina: There is a little bit of, um, a research done on coconut oil, where they’re  saying that part of the amount of saturated oils that are contained, in the coconut, it helps to kind of  give  a little bit of energy to the cells in  the digestive track, right? So, it helps them to heal faster if there’s any, sort damage or like a leaky gut type of thing.

I like to go simple. But simple, and then your meal prep and the you can get it right. We would think that we have to make everything so complicated. Like, let’s say like curcumin or turmeric, it has anti-inflammatory effects, but if you eat like, uh, a hundred grams of it, who’s going to eat a hundred grams of turmeric?  That’s too much,

Lupe: I think for, uh, you know, people with Sjogren’s, because we have a lot of fatigue, maybe once a week, Saturday or Sunday, pick a date, meal prep for the week, and that way you’ll eat healthy the entire week.

Cristina: Exactly. One day you may have, you know, the energy to come home and make up a nice stir-fry with your veggies. And you have maybe, you might have the time to marinade, you chicken and you baked it, or you stir fried it and that’s that.

I love going for like whole grains, I love my quinoa, personally, I love it. You can make like quinoa bowl, like in probably 15-20 minutes. Cause sometimes people say, oh no, but um, I would just call and order in. within the 15-20 minutes, like get your pizza, you already have your meal, if you did your homework, on it on a weekend.

Lupe: That’s what Brian says. So, for me, I find that when I eat sugar, you know, I try to stay away from sugar, as much as I can. But for me, I find that if I eat too much sugar, it causes brain fog. Are there any foods that you feel cause brain fog or make brain fog worse? For me, it seems to be sugar. Any other things out there?

Cristina: I haven’t looked into that, but I probably going to look into that, now that. you asked me. Personally, I do feel the same with sugar, especially these days that I haven’t eaten anything, any sugar. And I’ve been going crazy, without any sugar. But I think it has a place in terms of that inflammation portion.

That once you have eliminated that sugar and you re introduce it, if like you trigger that inflammation that you didn’t really need it. Your kind of already had gotten off of it. So, I think a sugar could be one component.

And again, it depends of what you may be sensitive to, right? So if you might be a person or one with Sjogren’s, with multiple food sensitivities, when you add those foods into your diet., for instance, the food sensitivities that I mentioned, like gluten or dairy or corn or soy, if you are one, a patient that has the sensitivities, that may affect that.

Then the levels of fatigue and maybe their brain fog. But that’s really individual, Lupe. I find that really, really, all of us are really different. We may have to label the Sjogren, but it’s still, each person is a universe.

Lupe: I totally agree. And that covers the next question I was going to ask you, why, why is it so important for people with Sjogren’s or any other chronic illness to focus on their diets, as part of their treatment?

Cristina: I always see it as almost a holistic approach. Cause even the diet alone won’t do it. And I’ll give you an example. I could have, you know, the perfect diet. I could have, I’ve been eating my greens at half a plate, a quarter of grains, a quarter of protein, perfect., you know, picture perfect.

But your stress level is over the roof, you’re thinking about your condition so much. There is no time to rest, no time for physical activity, everything seems like just all overwhelming. Even your body is not prepared to take in those excellent nutrients that you’re eating. Is almost like going to the garbage.

So, it has to be, you have to kind of maintain that mind, body connection. Not only having that balance, a healthy balance, in your diet. But also, that balance with your mind, your spirit, and your body. I honestly believe in that.

And there is actually research that when there’s this gut-brain connection, that if one of them is disconnected, then the body doesn’t really take well those nutrients.

That’s why I find is so important to include a little bit of meditation in your life. If you’re not into staying too like quiet, go for a little walk, try to kind of take a little, unplug yourself y from the phone or the computer or TV. Just do something for yourself, so your body can actually take in all those nutrients. That’s how I see our balanced, healthy lifestyle.

Lupe: Yeah.

Cristina: It’s not only just diet.

Lupe: I agree everything balances itself out.

Cristina: But one thing I do say, though, in terms of the Sjogren’s, what I learned, maybe other patients haven’t had as severe symptoms, that I experienced, myself. I feel like everybody’s thirsty all the time. And if they’re eating like a sandwich, without a glass of water, I feel like they’re going to choke. But that’s not true, they have saliva. I’m always, like, when I’m feeding my baby, I’m like, here drink, but he’s fine.

So, I always find that, in my mind, in my project, in life project, I wanted to say, I want to create something that is like, it’s tasty. It doesn’t have to be like boring food, but they’re easy to swallow. Something I can eat without having to drink, have a sip of drink or something. That’s my ideal meal, right? Where I can include all those nutrient rich foods, without choking.

Lupe: Exactly. And you know what, even I’ve stopped eating certain foods because they’re hard for me to chew.

Talk to us a little bit about the walk that you just did, uh, the beginning of October.

Cristina: Yeah. So, our Sjogren’s in Canada, is not as big as the Sjogren’s Foundation, but they try to also raise awareness and do a little bit of education.

Our walk was like within a small region, so we actually just started a support group. So, like a new chapter trying to, to reach out to new members here, um, on our region., cause we’re a little bit, maybe an hour, an hour and a half from Toronto, like downtown Toronto.

So we wanted to kind of create a little bit of a group here, um, we added some resources. So, we invited some family and friends. And um, on that particular day, a former mayor was there, in park. So, it was kind of fun to, to raise a little bit of awareness around these people. And so, we try to support our little society, in terms of, uh, education. I find it so valuable. And so that’s what we did.

I actually baked my tres leches cake.

Lupe: Oh, yay.

Cristina: And I bought it. And, um, everybody loved it. And so, it was one of the favorites. So yeah, I was a little get together, trying to see what we can do for next year to raise a little bit more awareness and more fun. Again, for education and for the sustainability of the society, here in Canada.

Lupe: It looked like you guys really had a lot of fun.

Cristina: Oh, it was fun. It’s amazing, I brought my nieces. My husband goes with me everywhere. And it was great to have all this support system. And I guess we start small and then hopefully we start to spread the word and get a little bit more creative in how to do that.

I think you guys do an excellent job. Like, I’m always, like, salivating, the saliva, I don’t have when I see your posts.

Lupe: You know, what? We are doing, what we can to help bring awareness to Sjogren’s. And I mean, I try to share my experience. Because, you know, basically everybody’s on their own journey, but, um, we do what we do because, to build community, so people know that they’re not alone. And it helps people.

Cristina: Yeah, I think it does. I have one of my dear friends, that she also has RA and Sjogren’s and the way she supported me, one of the things that I love doing and relaxes me, is going to Toastmasters meetings.

And that’s how I started getting my English, kind of a little bit better, by attending those. And I also used that platform to talk about Sjogren’s, and these are new diseases and. And when I was in one those meetings, I was just putting eyedrops in my, you know, my eyes and then this lady came to me and asked me that, do you minds, she just ask me like, can I see his fingers. Do you have Sjogren’s too?

Lupe: What did she do?

Cristina: Yeah, it’s out of nowhere. And she goes, and I say, yeah. And then some day we became really good friends and we tried to see each other. But at the same time, when we have, you know, not so good day, or  you know, it’s raining, we feeling sore and we have plans to meet, by the one of us says, you know, today for a good day. No, I completely understand, and I say, let’s do another day.

Sometimes we feel a little isolated when you have, you know, the friends who are, you know, apparently healthy.  No, no healthy issues and just are canceling all those plans. And then that kind of start, like, you know, maybe you don’t want to be with us or you’re always canceling.

And it makes me feel a little depressed. Right? But sometimes when you have that small community, when you do understand each other, and when we get together, we maybe go for a cup of tea and we know how precious that time is, because we made it. We felt good, and we wanted to see each other and no judgment.

Lupe: Yeah. You know, um, I’ve lost, I’ve lost a few friends because you don’t have energy, or you cancel, or you push it out. But on the flip side, I’ve met so many new people and I’ve made new friends, that understand, so that’s a plus.

Cristina: Yeah. That’s true. You start seeing, what is it that going to really nourish your life? I always feel it’s about like nourishing everything around you, not only food, but everything else, it’s so important. Especially when you’re living with this condition.

Brian: Most definitely. As we wind down here, if there was one thing regarding diet that you could speak to those newly diagnosed with Sjogren’s, what would that one piece of advice be?

Cristina: I would say that, I think it’s worth to try the anti-inflammatory diet, in terms of going back to basics, as I mentioned. I could either do more plant-based foods, soft foods. Things that are really gentle on your, like cooked vegetables. Thinking about how these foods are going to nourish you.

You don’t have to make changes all at once, take one step at a time. Let’s say, if you are newly diagnosed and you were the person who have breakfast at McDonald’s every single day or  eating out every single day, for every single meal, maybe try to make an effort of making a homemade meal, once or twice a week.

It’s small steps. Until you reach that goal. That may be what you take conscious of what you actually put in in your meal. It’s almost liked a wipe out. Once you get used to eating those homemade meals, you know what you’re putting into it. Once you go out and eat that fast food meal, you’re not even going to have a taste for it

Brian: Right?

Cristina: You need to build up to it. It’s not going to happen overnight. It’s not your fault. You go back to what you used to do because it’s comfort. Don’t beat yourself up. There’s always going to be another day, a new and you can try again. That’s how I feel when it comes to the diet. Just take small steps at a time.

Don’t think that you, that you see on the internet, it’s the huge deal, oh my God, you have to eliminate all these things? No. If there’s a certain food that you know that he’s making you uncomfortable, then don’t eat it.

Brian: That’s awesome advice. Um, if people wanted to follow you and what you’re doing, do you prefer them do that on Instagram or Facebook or where, where are you out there, in the web sphere?

Cristina: I’m really liking Instagram. I post on Facebook, like I go to my Facebook page, but I think mostly Instagram, would be my go-to.

Brian: Awesome. And we will have links in the show notes to her Instagram and Facebook, um, at the bottom of this episode. And is there anything you would like to leave our listeners with as we close out?

Cristina: No. Thank you for having me and giving me this opportunity. I would love to come back. And I will just continue following you and just stay strong.

 Brian: No. And Lupe actually brought you to my attention. And how food because you know, she’s not the one in the kitchen prepping most of the time. And she’s like, Oh, there’s some great ideas here, check this out. And your energy and your upbeat. And that’s exactly what we’re trying to do here on our platform. So, thank you for being you.

Cristina: Ah, thank you. I appreciate it. It’s so nice meeting you. It just felt like I met with a couple of friends. I appreciate that.

Lupe: I love you. And I love following your page. And I love your attitude. And I’m glad we connected on Instagram. Let’s keep living Sjogren’s Strong.

Until next time, sip constantly and stay hydrated.


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