The IBS-Free FODMAP Practice Kit for RDNs
The IBS-Free FODMAP Practice Kit for RDNs
Updated August, 2018.
Get your IBS practice up and running now with this 56-page practice toolkit! Why spend weeks creating your own handouts from scratch when you can use tools that FODMAP expert Patsy Catsos has developed over 10 years of working with IBS patients?
"Thank you Patsy, for continuing to provide us with up-to-date excellent information for our patients. This diet is a godsend and the toolkit makes my work so much easier as I educate on low FODMAP. I’m learning a lot also!" --Madeleine Said, RDN, CDE
The IBS-Free FODMAP Practice Kit for RDNs pays for itself after just one visit with your first IBS patient! Last updated August 2018.
This edition of the IBS-Free FODMAP Practice Kit for RDNs matches the content in Patsy’s latest book, The IBS Elimination Diet and Cookbook (formerly IBS—Free at Last!). About Patsy Catsos, MS, RDN, LD
Your purchase includes:
1. Three-visit nutrition care plan for the FODMAP elimination and reintroduction process. NEW: Three well-developed options for the reintroduction of FODMAPs: plans A, B, and C. This allows you to further personalize patients’ diets, depending on their medical needs, symptom severity, and anxiety levels.
Thirty-four pages of reproducible patient handouts for you to choose from! Want to know more about what’s inside? Scroll down to view the table of contents for the kit. We also invite you to preview the Introduction (below) to learn more about Patsy's approach before your purchase.
2. Nutrition Facts for Recipes in the IBS Elimination Diet and Cookbook will be included—free—with your kit.
3. Bonus for first time buyers! A reference copy of The IBS Elimination Diet and Cookbook for your office is now included, with free shipping ($21.12 value)! You must have a shipping address in the United States to receive this bonus. Book is not included in purchases made with a discount code.
Parts 1 and 2 of your kit are electronic downloads (PDFs) and will be available immediately. Your bonus book will be shipped to you by U.S. Postal Service media mail, which can take up to 10 days for delivery.
If you have purchased one of our kits previously, check the first page of your kit for a discount code which entitles you to 80% off the retail price of this kit. Sorry, kits purchased with the discount code do not include the book bonus, however, it can be purchased wherever books are sold.
To complete your purchase, scroll to the top of this page and look for your "cart" in the upper right hand corner. After your purchase is complete, you will receive an email with a download link which is good for 24 hours. Your download is a .zip folder with two PDFs inside. Thank you for your purchase!
Table of Contents
Three-Visit Medical Nutrition Therapy Plan
General Preparation for the Dietitian
Prior to Visit 1
Visit 1 (60 to 90 minutes)
Visit 2 (30 to 60 minutes)
Visit 3 (30 to 60 minutes)
Long Term Follow-Up
Sample Nutrition Diagnosis Statements
Digestive Health History
Functional Gut Symptom Questionnaire
FODMAP Elimination Diet Overview
Low-FODMAP Pantry Compact Version
Label Reading Tips
High-FODMAP Ingredients and Foods to Avoid During the Elimination Phase
Low-FODMAP Meal Ideas
Low-FODMAP Brand Name Food Ideas
Good Low-FODMAP Sources of Fiber
Good Low-FODMAP Sources of Protein
Good Low-FODMAP Sources of Calcium
Estimated Lactose Content of Foods and Beverages
My Sample Menu
These Foods Contain FODMAPs
Instructions for Plan A FODMAP Reintroduction
Blank Plan A FODMAP Reintroduction Schedule
Sample Plan A FODMAP Reintroduction Schedule
Instructions for Plan B FODMAP Reintroduction
Blank Plan B FODMAP Reintroduction Schedule
Sample Plan B FODMAP Reintroduction Schedule
Instructions for Plan C Food Reintroduction
Blank Plan C Food Reintroduction Schedule
Sample Plan C Food Reintroduction Schedule
Tips for Coping with FODMAP Intolerance
Food and Symptom Diary
Week-at-a-Glance Food Record
Low-FODMAP Pantry Expanded Version
FODMAP Bucket 1
FODMAP Bucket 2
(excerpted from The IBS-Free FODMAP Kit for RDNs)
Thank you for purchasing this toolkit for delivery of a FODMAP elimination diet. I have been using, and improving on, these materials since I first began using the FODMAP approach in my practice in 2007. At that time, the FODMAP concept was very new, and few people had heard of it. Today, as word has spread about this effective, evidence-based diet, there is significant demand for dietitian delivery of FODMAP elimination diets! It is very exciting work and I think you will enjoy it.
FODMAP is the acronym for a group of osmotically active, rapidly fermentable, short-chain carbohydrates. It stands for Fermentable Oligo-, Di-, and Monosaccharides, And Polyols. The concept was originated by scientists at Australia’s Monash University.
When researchers at Monash University coined the term FODMAP, there was little modern nutrient data on the FODMAP composition of foods. Since then, more FODMAP composition data has been produced at Monash University and elsewhere. In addition, there are now a variety of available diet plans or tools based on FODMAPs, and I’m sure there will be many more to come. (An apt analogy would be calorie-restricted diets for weight management. The calorie content of foods is the primary data, and there are thousands of weight loss plans.) You will use your clinical judgment to select the most appropriate tool from a wide array of options for each individual client. This kit is one set of tools for FODMAP elimination and reintroduction.
In the world of FODMAPs, there is a constant tension between the broad strokes that will help patients understand what is being asked of them during the elimination phase and finer details that might make the materials more accurate, but harder to use. In my practice, I go for the broad strokes for most patients. For example, if a ½ cup portion of vegetables is low enough in FODMAPs, I include it in my low-FODMAP pantry. Contrast this with the Monash University Low-FODMAP App, which makes the portion size for vegetables as small as necessary to reach what can be called “low-FODMAP”— equally reasonable, just a different choice on how to translate the material to patients. I add details and finer points (such as those in the app) at follow-up visits as problem areas are identified. The teaching tools in this kit also have a greater emphasis on managing the FODMAP load of the entire meal (so-called FODMAP stacking), and on reintroducing FODMAPs, compared to many other tools. You should own the Monash app, as should your more sophisticated patients who will appreciate it as a reference. Sales of the app support the FODMAP laboratory analysis program at Monash University. There are quite a few more foods in the app than in these handouts, which attempt to cut the project down to size for typical American patients. Those patients who need to keep it simple, and who eat mostly standard American foods, can use these handouts exclusively. Your philosophy may vary, and you will no doubt make choices that are right for you and your patients.
Another reason to keep it simple and stick to the broad strokes during the FODMAP-restricted phase is the fact that published data about FODMAPs is a moving target. As more data is published, frequent updates to teaching materials are required, and it becomes increasingly apparent that it is not a good idea to make too many assumptions. For example, grapes are low in FODMAPs. One would think that raisins would be as well, but laboratory analysis shows otherwise. Still, I have had to use logic as best I can to decide how to advise patients about many food ingredients; these judgments may change as more data becomes available. There are some cases where Australian processed foods analyzed at Monash differ significantly from those in other countries. For example, barbecue sauce in the U.S. contains high-fructose corn syrup, while it does not in Australia. Another “moving target” problem: Monash doesn’t necessarily publish all their raw data on the FODMAP composition of foods. Broccoli is a case in point. Some previously published Monash data on the FODMAP composition of broccoli would seem to be at odds with the current “green” status of whole broccoli and broccoli heads/crowns in the Monash app, and with the type of FODMAPs it is described as containing. Since I am not privy to what would appear to be new data from their lab, I have been reluctant to add broccoli to the low-FODMAP pantry, particularly since my clinical experience suggests it is a common cause of digestive complaints when consumed in large portions. FODMAP Friendly has now published independent data about broccoli consistent with Monash’s “green light” and I have decided to go ahead and add broccoli to the pantry. I am hedging my bets and limiting the portions to ½ cup. These are the sorts of judgments I have made after much consideration, and they may change over time as more data is published. Of course, you are free to form your own judgments or to edit the pantry for specific patients.
Even if we did have a more complete database, we would still be unable to precisely calculate our patients’ FODMAP intakes due to the natural variability in foods, resulting from different crop varietals, climate, weather conditions during the growing season, ripeness, etc. I frequently must remind readers, patients and yes, even dietitians, to keep their eyes on the big picture and let some of the small stuff go. We must learn to live with some uncertainty if we are going to help our patients now, even though a complete FODMAP composition database is simply not a reality today. In fact, the idea of a perfect low-FODMAP diet is a mirage. Luckily, even with some mistakes and over-generalizations, the FODMAP-restricted diet works for up to 80% of well-selected IBS patients if the overall FODMAP load of the diet is lowered sufficiently.
A FODMAP elimination diet is a short-term learning diet. The goal is to determine whether FODMAPs are symptom triggers; if so, which ones are well or poorly tolerated, and to what degree. These tools were not written to cover “everything anyone ever said you should try for IBS.” The focus of this kit is deliberately narrow. You will find a FODMAP elimination diet does not exclude the laundry list of things people with IBS have been told they shouldn’t eat or drink (chocolate, red meat, alcohol, spicy food, carbonation, etc.). Many patients are, in fact, very pleased to discover that they can tolerate things previously considered taboo for IBS, while others may not have that experience. Of course, your nutrition care for your patients may encompass many aspects beyond FODMAPs, as you help them reach the goals of satisfactory symptom management, adequate overall nutrition status and improved wellness; it is understood that the handouts in the kit will frequently require customization for your patients’ food preferences, food philosophies and other medical conditions.