IBS—Free at Last!

IBSDietplan.org Interviews Patsy Catsos About IBS and FODMAPs

IBSDietplan.org interviewed me on these questions:

• How to find a dietitian knowledgeable about FODMAPs
• Is  FODMAPs restriction accepted by the mainstream medical community?
• How to decide between FODMAPS, SCD and Heather Van Vorous/Help for IBS
• FODMAPs restriction v. elimination
• FM v. FODMAPs

Thanks to IBSDietplan.org for the opportunity to get the word out!

Lunch Ideas for Vegetarians!

Guest post by: Jillian Smith, Nutrition student at the University of New Hampshire and Intern

Lunch is a difficult meal for many people. The endless possibilities can be confusing. When to eat, what to eat, how much to eat, are all common worries that individuals face. To some, lunch means a sandwich at noon. To others, it means a couple of snacks between breakfast and dinner. Whatever your view of lunch is, it is an important component of the diet. 

As a vegetarias on the FODMAPS elimination diet, you will find it beneficial to make your own lunch. This ensures proper nutrient composition especially adequate protein. If you are on the go, think of ways to pack up your lunch for a tasty meal away from home. As noted before, keep it interesting. Try leftovers from your dinner the night before or create something new. Don't stick to the same old traditions. Be creative in the kitchen and lunch will be a breeze. Here are some ideas that lead to a delicious lunch:

- Make a sandwich with gluten-free bread such as Udi's white sandwich bread. Spread some mayo and add your favorite allowed veggies. Add a slice of cheddar cheese to amp up the quantity of protein.

- Instead of a vegetable sandwich, smear the bread with nut butter and add slices of banana. Press the two sides together and enjoy this kid-friendly feast. 

- Roll it up! Spread tahini sauce on a Trader Joe or Food for Life's brown rice tortilla, and add your favorite mix of greens, cucumbers, red peppers, shredded carrots, and cheddar cheese for a greek-style wrap. Rice tortillas can be a little crumbly, and they handle much better when slightly warmed in the microwave with a sprinkle of shredded cheese on top before stuffing.

- Make your salads interesting. Combined different fruits, vegetables, nuts, seeds, and cheeses to always keep you on your toes. Homemade dressing makes it special! Try a blend of fresh lemon juice, olive oil, salt and pepper.

- Bake up a frittata and serve with a small side salad. The protein in the eggs will keep you naturally satisfied. 

- Bake a pizza! Use a gluten-free pizza crust such as Udi's pizza crust and top with your favorite vegetables. Sprinkle with shredded cheddar cheese and bake to perfection.

- Make a large batch of soup and freeze so it is always on hand. Serve a warm bowl of soup with some rice crackers for a favorable crunch. 

These lunches will have you forgetting that you are ever eliminating foods from your diet. Try them today and bring delight into your mid-day meal. 

Breakfast Ideas for Vegetarians on the FODMAPs-Elimination Diet

Guest post by Jillian Smith, Nutrition Student at the University of New Hampshire and Intern

Breakfast is often said to be the most important meal of the day. There are many theories, such as "skipping breakfast increases your risk for overweight and obesity" or "skipping breakfast slows down your metabolism", that make headlines in the media. Whether or not you believe the trendy research, breakfast is a very significant meal. Breakfast gives your body fuel to perform requested activities. A good breakfast kick-starts the day allowing you to remain satisfied for several hours.

Breakfast should be a balanced meal. It should be composed of foods that are good sources of protein, carbohydrates, vitamins, and minerals. Vegetarians need to pay extra attention to the amount of protein consumed during breakfast to ensure an adequate intake of daily protein. A lack of protein in the first meal of the day makes it difficult to consume the proper amount of protein throughout the day. The following list of foods are great breakfast ideas to help vegetarians initiate their days with a burst of protein:

- 1 cup of cheerios with 1 cup of lactose-free milk. Top with almonds or chopped walnuts and your favorite allowed fruit.

- Eggs served any way! Make an omelet with cheddar cheese and vegetables for a surprising treat.

- Try seitan for breakfast. Add seasonings, salt and pepper and bake for a twist on traditional breakfast sausage. Serve with eggs!

- Make a batch of maple-syrup sweetened granola and serve on top of lactose-free yogurt with your favorite fruit. Add nuts to the granola to increase the quantity of protein!

- Serve up some good ole' fashion oatmeal. Top with a splash of lactose-free milk, nuts, and fruit. Add a teaspoon of maple syrup for a sweet concoction.

- Toast a piece of gluten-free bread such as Udi's white sandwich bread or FoodforLife's wheat and gluten-free English Muffins. Top with nut butter and banana. Make it a sandwich and eat it on the run.

- Relax with FODMAPs-friendly banana pancakes drizzled with real maple syrup or spread with a bit of sugar-sweetened blueberry preserves. These wonders will have you begging for more.

Get creative. Add new and different ingredients too keep you satisfied. Play with your food until you find something nutritious and enjoyable! Next post: Lunch Ideas for Vegetarians!

FODMAPs - Dos and Don'ts for Vegetarians

Guest post by: Jillian Smith, Nutrition Student at the University of New Hampshire and Intern 

The FODMAPS elimination diet may seem difficult for vegetarians. Foods commonly consumed by many vegetarians, such as soy products, milk, and legumes are not allowed during the primary phase of the diet. Not only do these foods make up a large portion of the vegetarian diet, but they are also typically high in protein. Vegetarians may wonder how to consume enough protein. However, there are many foods included in the FODMAPS elimination diet that are allowed and provide plenty of protein to the diet. Don't let confusion or worry slow you down. The following list of do's and don'ts will help navigate vegetarians embarking on this diet. 

Do:

• Choose vegetarian high protein, low FODMAPs foods: quinoa, green peas, spinach, nuts, nut butters, seeds, seed butters.
• Make a large batch of seitan and add it to any meal. It works in casseroles, stir fries, or on the grill. It freezes well, too. (Note: seitan contains wheat gluten--in fact it IS wheat gluten.)
• Use lactose-free dairy products instead of other dairy substitutes. Lactose-free milk contains about 8 grams of protein per 8 oz. serving. Lactose-free cottage cheese is another great source of protein containing about 12 grams of protein per half cup serving. 
• Eat breakfast for dinner. Cook up your favorite egg dishes and serve them for dinner. Its a fun way to incorporate this high protein food into your diet. 
• Read labels! Get familiar with food labels of your favorite foods. Find higher protein alternatives. 
• Get creative! Try new and different combinations. Adding new flavorings to dishes will help you forget the absent foods.  

Don't:

• Rely on almond or rice milk for protein. They have only a 1-2 grams of protein per 8 fluid ounce serving.
• Stay on the elimination phase for more than two weeks. You need to liberalize your diet sooner than meat-eaters in order to get adequate nutrients.
• Don't over think it. The FODMAPS elimination diet will be easier with a clear and relaxed mind.

FODMAPS for Vegetarians

Guest post by: Jillian Smith, Nutrition Student at the University of New Hampshire and Vegetarian

At first glance, the FODMAPS elimination diet may seem daunting. You search and search, but soon realize that foods like milk, beans, and soy products are absent from the list of allowed foods. Don't fret. It should not be too tough for lacto-ovo vegetarians to get by for a couple of weeks during the trial using lactose-free milk products, eggs, nuts, and seeds as protein sources. It is important to monitor your diet to ensure that you are consuming at least 46 grams of protein each day for women and at least 56 grams of protein each day for men. 

There are many allowed foods included on the FODMAPS elimination diet that are high in protein. Quinoa, an amino acid rich seed, is an alternative to many grains. One cup of cooked quinoa contains about 8.14 grams of protein. Adding vegetables such as green peas and spinach to your diet is a sure way to increase your protein consumption. Nuts and seeds are an easy way to fill you up while providing an extra boost of protein. Sharp cheddar cheese and lactose-free dairy products are great substitutes for the dairy products previously eaten. A meat substitute known as seitan can be used in place of soy products. It is produced from vital wheat gluten and contains about 26 grams of protein per half cup servings. It is easy to find ways to ensure proper protein intake. It just takes a moment of research and an open mind. 

After the challenge phase, adding back beans, lentils, and soy products gradually, as tolerated will help meet the daily requirement for protein. Vegetarian sources of protein are an important part of the diet, so vegetarians may choose to eat most of their FODMAPS in this form, and keep their buckets from filling up by continuing to use lactose-free milk products, lower FODMAPS fruits and vegetables, and limiting the amount of wheat products in their diets most of the time.

Vegans must pay extra attention to their diets. Without lactose-free milk products and eggs it going to be more difficult to get enough protein on the elimination phase. Including foods high in protein such as quinoa and seitan will help a lot, but there may be a situation where the alternate approach described in Chapter 6 will be useful. Most vegans are definitely going to be eating galactans in order to meet their protein requirements. Using the food frequency tool in the book, the vegan can review his/her diet for other outstanding sources of FODMAPS and focus on cutting back on them.

My New Gig as a Sharecare Expert

Visit me on Sharecare! Several months ago I was invited to become a Sharecare expert. It's been a great experience so far. More about Sharecare:

"Founded in 2009, Sharecare is an interactive social QA platform created by Jeff Arnold and Dr. Mehmet Oz in partnership with Harpo Studios, HSW International, Sony Pictures Television and Discovery Communications.

Sharecare is designed to greatly simplify the search for quality healthcare information and provide consumers with the necessary tools to make smart health choices and live healthier lives. Our mission is to answer the world's questions of health and achieve a collective wisdom by developing a comprehensive database of all of the questions of health and wellness and actively recruiting industry experts to answer them. Leading physicians, nurses, hospitals, clinics, authors, healthcare companies and non-profits connect, interact and share their collective expertise encouraging consumers to ask, learn and act upon questions of health.

We are dedicated to providing consumers with information they can trust and connecting them with industry experts and other knowledgeable consumers in order to educate, empower and continue the conversations of health."

FODMAPs-Friendly Dietitian Directory

As a service to both readers and colleagues, I've posted a (fledgling) list of FODMAPS-Friendly Dietitians.

• Dietitians have volunteered their contact information and their interest in working with IBS/FODMAPs clients. IBSFree.net has not verified their credentials or experience.
• You will get better counseling from your dietitian if you express your interest in a FODMAPs-elimination diet at the time you make your appointment.
• Dietitians interested in being included in this directory can write me at patsycatsos@gmail. I welcome listings from Registered Dietitians in the United States, or the equivalent credentialed professionals in any country.

Need to Lose Weight? How to, on the FODMAPs-Elimination Diet

People with IBS can be overweight for all the ordinary reasons, but having IBS presents some unusual challenges around weight management. While trying to "eat healthy", many IBS sufferers find out the hard way that they don't tolerate a diet high in all the fruits, vegetables, whole grains and low-fat dairy products they are urged to eat. That understandably makes it difficult to eat a diet appropriate for weight loss. Although weight loss is not the primary purpose of the FODMAPs-elimination diet, it is certainly possible to lose weight while following it, and many of my client do just that. Key points:

• The food lists can be used as a guide to selecting the grains, fruits, vegetables and milk products that are the least likely to cause GI distress in those with FODMAPs intolerance, so go ahead and eat healthy for a change! It's a great feeling!
• Portion sizes of foods that are in bold-face type in the book should never be exceeded, because they have small amounts of FODMAPs. I usually recommend just one "bold-face" food per meal or snack.
• On the other hand, portions of the other allowed foods can be adjusted to meet your needs. If you are trying to lose weight, consider using the portions provided in the food lists as a guide.
• Most people who are trying to lose weight should limit "allowed extras" to about 100 calories per day.
• The sample menus provided in the book provide approximately 2000 calories. Althought that is a common "reference" calorie level, it may be more than you need, especially if you are sedentary, female, older, or of small stature. Try cutting back one serving from each food group. Don't consume less than 1200 calories without professional guidance--it is hard to get adequate nutrients on less than 1200 calories.
• Don't be to eager to replace wheat-based baked goods with commercial gluten-free products, which tend to be loaded with calories, sugar and fat. It is easier, cheaper, tastier and healthier to just steer away from breads and baked goodies than to try to replace them.
• To lose about 1 pound a week, a person should cut back about 500 calories per day. Take a hard look at what you are eating and see what you could do without or change. The best candidates for losing calories without losing valuable nutrients are extras like candy, desserts, alcoholic beverages, and refined carbohydrates. Big bowls of white rice or wheat free cookies might be FODMAPs-friendly but can still provide too many calories for your needs.
• Exercise is a lot more fun when you don't have to worry about being within a 20-yard dash of the toilet! Now that your diarrhea is better, maybe it's time to start an outdoor exercise program. Walking, biking, kayaking, hiking...they all can be yours again!

Please remember, this post is for educational purposes only. Please consult your own health care providers for specific advice about weight management or beginning an exercise program.

 

 

The Perfect FODMAPS-Friendly Multi?

What criteria can we use to select a FODMAPS-friendly multivitamin with minerals (MVM)? First of all, consider waiting until you have worked your way through the elimination phase and all the challenge phases before adding any MVM so you don't interfere with your "experiment". But if you find yourself on the elimination phase of the diet for an extended period of time, a multivitamin may be called for. Points to consider:

• no "food" ingredients or other potential allergens such as colors, yeast, gluten, etc.
• a capsule with powder inside, a powder, a chewable or a liquid to maximize absorption in case of rapid transit time or damaged absorptive surfaces in the gut
• very little to no calcium, magnesium, or iron to minimize GI side effects (take separately if indicated)
• not much more than 100% of DV for most nutrients unless treating a specific deficiency (except maybe vitamin B-12)
• doesn't cost an arm and a leg
• widely available
• one- or two-a-day dosing
• folate in the form of L-methyl folate
• of course, no lactose, fructose or sugar alcohols as sweeteners

I haven't found my "dream" MVM, usually have to settle for hitting as many of the above points as possible. If you've got the answer, please share!