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Many nutritional therapists advise certain clients to avoid eating carbohydrate foods and protein foods at the same meal. This approach to diet (food combining) is commonly known as the Hay diet, after Dr Hay, who first publicized the possible benefits of this practice. The theory is that eating both proteins and carbohydrates at the same meal hinders digestion. Most medical experts are dubious, but many people suffering from gastric ailments find food combining works for them.

There are good reasons to believe it has benefits, especially in cases where the digestive system is weakened by illness (e.g. ulcers), medication (e.g. NSAIDs; see here), or injury (e.g. alcohol poisoning). Proteins and carbohydrates are digested in very different ways and require contrasting digestive environments. Proteins, for example, stimulate the production of highly acidic gastric juices in the stomach, while carbohydrates are digested in neutral-to-slightly-alkaline conditions further along the digestive tube, in the intestines. A normal, healthy gut can simultaneously deal with both; that is how most of us eat. But if the system is flagging, the digestive processes may be affected. One theory suggests that excessive acids produced in the stomach during the digestion of protein may be difficult to neutralize, thus slowing the breakdown of carbohydrates.

The well-respected American nutritional therapist, Paul Pitchford, takes a comprehensive approach to food combining in his book, Healing with Whole Foods. He presents three different eating plans. The first (Plan A) is designed to improve normal digestion, and is based on four rules:

1 Proteins are eaten early in a meal, followed by carbohydrates. For example, meaty antipasti before pasta with herbs and garlic, followed by fruit. Remember: simpler meals digest better.

2 Salty foods should be eaten first.

3 Proteins should be combined with non-starchy green vegetables.

4 Sweet foods and fruit should be eaten alone or in small quantities at the end of the meal.

Plan B is for people with sensitive digestive systems or who are ill. The basic rules are the same as for Plan A, but in this case proteins and carbohydrates must be separated into different meals, with green non-starchy vegetables eaten with both. Tomatoes, lemon and the juice of limes can be combined with meat because they add to the acidity during digestion. (This makes a small steak served with a lettuce and tomato salad, dressed with olive oil and lemon juice, a healthy meal – if you skip the chips!) Fruits are to be eaten alone. Milk and dairy products are not to be combined with meat.

The third Pitchford plan for food combining is a surprise. Plan C champions the ‘one pot meal’, which echoes traditional cooking in India, China and other parts of the world. No attempt is made to separate foods: they all go in a pot with plenty of water and are allowed to cook together slowly over a low heat where a kind of pre-digestion takes place. One expert in this kind of cooking is quoted as saying, ‘The various foods have settled their differences in the pot.’ These are watery foods – stews, soups and congees – and ideal for people who are weak, chronically ill or who have trouble chewing. They are also good for the rest of us. A home-made soup or stew is a real treat when you are tired and cold. This is old-fashioned comfort food at its best!