Diet Tips:A dietitian’s day on a plate - Week 1 of 2

By Shirley Webber (Research dietitian)

As someone who has struggled with IBS for many years, I was relieved when I found out about the low FODMAP diet. Throughout my high schooling, I thought that having an upset stomach was “normal” and constantly feeling tired and like my head was in a giant cloud was just me being a typical teen. It wasn’t until I went to University that firstly, I realised these symptoms were not normal and secondly, I began to suspect that the symptoms may have been triggered by dietary factors.

I subsequently underwent testing to rule out serious illnesses, including coeliac disease, all of which came back negative. As a last resort, my GP suggested I have a breath tests to check my tolerance of lactose and fructose. When I found that I malabsorbed both sugars, my GP then gave me a list of all fructose and lactose containing foods that he found on the internet and told me to “never eat these foods”. That was the problem solved as far as my GP was concerned. Having seen this doctor for most of my schooling life, I trusted his every word and followed a very restricted diet for three years. I felt anxious when I ate out and found growing up in a family where food was at our core very difficult.  Increasingly, I felt that my highly restricted diet was difficult to follow and just not good enough for me.

This all changed when I read a magazine article about research into diet and gut health. This article sparked my interest in dietary research and health. At a similar time, my dad discovered that he had the same food intolerances as I did and after consultation with a dietitian, we became aware of the low FODMAP diet. Importantly, we discovered that foods should not be restricted for life, but rather reintroduced slowly to identify tolerance to specific FODMAPs. Over the next two years, I gradually tested my tolerance to new foods, reintroducing foods I was previously “not allowed”. This saw me find a much healthier diet that I could happily live with.

My personal interest in nutrition and food intolerances grew to the point that I decided to do further post graduate studies in Dietetics to better understand the complexities of food intolerances.

So now you have my personal IBS story. Next week I will give you an idea of what I eat to keep myself healthy and my symptoms at bay…a dietitian’s ‘day on a plate’.

 

Diet Tips:A dietitian’s day on a plate - week 2 of 2

By Shirley Webber (Research dietitian)

If you've ever wondered what a day in the life of a dietitian on a low FODMAP diet looks like, here is a snapshot. 

My general week day

6.00 Cup of tea

7.30 Greek yoghurt with ½ cup muesli (I slowly built up my tolerance to yoghurt)

9.00 Sourdough spelt toast with Marmalade and a cup of tea

10.30 ½ banana and hand full of nuts

12.00 Chicken stir fry (homemade) with rice or Jaffle with mince meat and vegetables (sourdough spelt bread)

** I always have a lots of vegetables with a variety of low to moderate FODMAP rating Occasionally I would throw in some high FODMAP vegetables eg. snow peas, but I’ll only eat about 4-5

3.00 Muesli bar or baby bell cheese and a tea

4.00 Glass of water

6.30 ½ Raw carrot while I’m cooking to stop myself from snacking on the food that I’m preparing and thus overeating

Dinner – Shephard’s pie with lots of vegetables. I make mine with a tomato sauce and check that there is no garlic or onion in the sauce base. Vegetables include carrots, capsicum, and the green tops of spring onion. I always top mine off with a thin layer of cheddar cheese baked in the oven, so it’s nice a crunchy on the top

Another frequently made meal in my house is roasted chicken with roasted vegetables: sweet potato, radishes, carrots, a couple of slices of beetroot and pumpkin

8.00 Peppermint tea or water

My weekends are never the same

Generally, I like to sleep in and have breakfast at 8.30 am. One of my weekend favourite breakfasts is bruschetta and poached eggs. I make this with sourdough spelt toast, topped with a variety of tomatoes, black olives, olive oil, salt and a poached egg on top.

If I’m out exercising, hiking or at the gym, I’ll snack on a banana and a Greek yoghurt in between breakfast and lunch, while drinking plenty of water.

12.30 pm Lunch is usually a meat (chicken or deli ham) and salad sandwich with tomatoes, ice berg lettuce and avocado. If I’m feeling adventurous I might add a teaspoon of chutney or mustard

4.00pm I usually drink tea in the afternoon

6.30pm Dinner is a big family affair which usually involves a barbeque. Salmon with a bit of lemon, butter and salad is popular in warm weather or roasted vegetables if it’s cold out

Eating out

I still enjoy eating out. I tend to choose Japanese as it is freshly cooked and I can ask for onion and garlic to be left out (those two ingredients are my main concern). If I eat other cuisines I tend to order non-marinated chicken or meat with mixed vegetables. I always run my dietary requirements passed restaurant staff and have found chefs are generally willing to alter meals for me. An advantage of living in Melbourne is that the low FODMAP diet was developed here by Monash University. Therefore, I find that there is good awareness of food intolerances compared to other countries. This said, awareness of the low FODMAP diet is growing worldwide, so this is a positive sign. 

I think that even though I struggle with IBS it is important to still have a diet that includes a wide variety of foods to ensure that I get all the nutrients that my body needs. Food is meant to be enjoyed, so go ahead, try new things and get creative!

What’s on your plate?

Diet Tips:Alleviating Symptoms Part 2

Diarrhoea management
By Shirley Webber

Carrying on in our series about alleviating IBS symptoms, this week we will discuss diarrhoea management.

Fortunately, many people achieve relief from diarrhoea on a low FODMAP diet, but if you have eaten the wrong thing, or have a bout of diarrhoea due to gastroenteritis or another cause, you may find the following tips helpful.

•  If your diarrhoea is excessive, you should consult your doctor. They may advise you to try some over the counter diarrhoea stop medications (eg. Immodium). They may also recommend rehydration with an electrolyte replacement solution.
• Drink lots of water to replace lost fluids.
• Soluble fibre absorbs water and slows transit time through the digestive tract. Including small quantities of foods rich in soluble fibre (such as oats, green peas, sweet potato, turnip, carrots or psyllium) may improve stool consistency, however avoid large quantities that may exacerbate symptoms.
•  If your diarrhoea has left you feeling cold and drained, rug up and reach for a comforting heat pack.

Diet Tips:Meal planning your day for a low FODMAP diet?

By Shirley Webber

Stuck for ideas on what to make for your meals this week? Check out our app for some recipes to add some flavour to your day.

We have highlighted some of our favourite recipes from the low FODMAP app, our blog and a new addition to add variety to your recipe bank.

Breakfast	Vegetable and egg muffins http://fodmapmonash.blogspot.com.au/2016/02/vegetables-muffins.html
Morning snack	Yoghurt and mixed berries One tub of lactose free yoghurt with a hand full of mixed berries with optional oats. (See the app for the recipe in the breakfast sections.)
Lunch	Tuna salad with cruskits Nicoise salad with tuna and for some extra crunch you may like to have your salad with some rice cruskits. (See the lunch recipe section to guide you on making this salad and enjoy with our low FODMAP certified cruskits from Arnott’s)
Afternoon snack	Eggplant dip and vegetables Carrots, cucumber and red capsicum with 4 Tbs of eggplant dip Yes you may be thinking 'but isn’t eggplant dip usually high in FODMAPs?' Well this one isn’t. Ingredients: 2 medium eggplants (about 2 pounds or 900 grams) 60 ml lemon juice 1/4 teaspoon ground cumin 1/2 teaspoon sea salt – or normal salt 2 tablespoons chopped fresh parsley leaves 1 tablespoon olive oil 2 tablespoons of cottage cream cheese – optional Directions: Preheat the oven to 200°C. Line a baking tray with baking paper. Place eggplants on the tray and prick the skin of the eggplant several times with a toothpick. Roast for 35 minutes or until eggplant is soft. Set aside to cool. Cut the eggplants in half lengthways. Using a spoon, scoop out the flesh into a bowl and roughly chop. Add the lemon juice, olive oil, cumin and salt. Mash with a fork until well combined. Store in an airtight container and refrigerate until you are ready to use the dip. Enjoy!
Dinner	Grilled steak, steamed vegetables and wedges (See the dinner recipe section in the app for a guide on making this meal)
Dessert	Cranberry jelly and fruit (See our app dessert section for this and more delicious treats to try)

           

Diet Tips:Alleviating Symptoms Part 3

Abdominal Pain and Bloating
By Shirley Webber

This week we are highlighting some strategies to manage abdominal pain and bloating that generally occur due to a build up of gas in the intestinal tract. These are the most common IBS symptoms.

·       Often a heat pack placed on the area of pain can help to loosen up the muscles and alleviate some of the pain and discomfort with cramping. A heat pack also allows more blood to flow to the area where the heat is placed and can assist in relieving the cramping.

·       Over the counter medication such as Buscopan or Mintec may help with managing symptoms. Ask your pharmacist what they would recommend.

·       Stretch it out – sometimes a bit of Pilates or yoga stretching can help with relieving some of the gas that is built up in the gastrointestinal tract reducing the pressure on the gut and therefore reducing the pain.

·       Better out than in. If you do have gas then it is okay to let it out. If you’re in a closed environment and feeling uncomfortable to deflate, go for a walk outside or move away from others. Remember gas is a sign of a healthy gut – see a previous blog post on this http://fodmapmonash.blogspot.com.au/2016/02/a-bit-of-bloating-is-beneficial.html

           

Diet Tips:Alleviating Symptoms Part 4

Stress/Anxiety Related Symptoms
By Shirley Webber

A major contributor to IBS symptoms in some individuals is stress. Many of you will have experienced an increase in symptoms prior to a job interview or a public presentation… We wrap up our series on alleviating symptoms with some tips to help manage this potential contributor:

Stress/Anxiety related symptoms

·         Find stress management strategies to help you through the situation.

·         You might find it helpful to talk to someone – someone close to you, a colleague or a professional counsellor.

·         Exercise can be a great stress reliever for many people and can help relieve your symptoms. Again this doesn’t have to be strenuous - just getting moving can help. 

·         If the stress that you are experiencing is high level and is continuing for an extended period of time then we recommend discussing this stress with your regular GP for extra support strategies.

·         You might also benefit from gut directed psychological therapies such as hypnotherapy and cognitive behavioural therapy.

Diet Tips:Rote Grütze – Red fruit pudding

By Shirley Webber

Ingredients: 200g Strawberries 100g Raspberries 30g Blueberries 20g Cherries 1 Vanilla bean pod 350ml Cranberry juice or red grape juice 2 Tbsp. Corn starch 30g Sugar	Zutaten: 200 Gramm Erdbeere 100 Gramm Himbeere 30 Gramm Heidelbeere 20 Gramm Kirsche 1 Vanilleschoten 0,35 Liter roter Fruchtsaft (Cranberry-Saft oder Traubensaft) 2 EL Speisestärke 30 Gramm Zucker
Serves: 4 25 minutes	Portionen: 4 25 Minuten
Directions: Wash berry mix, dry and halve the large berries and remove stones from the cherries. Halve the vanilla pods lengthways and scrape out the seeds. Stir the corn starch in with 2 Tbsp. of water until smooth and add to the boiling fruit juice. Stir while the mixture is boiling and add the prepared fruits. Remove from heat and add sugar to taste. Stir the mixture. Leave to cool. Remove vanilla bean just before serving. Fill the red fruit mixture in glasses and serve with lactose free yoghurt and garnish with dark chocolate.	Zubereitung: Gemischte Beeren putzen, kurz waschen und große Beeren evtl. halbieren und entsteinen Kirschen. Die Vanilleschoten längs halbieren und das Mark herauskratzen. Vanilleschoten und –mark und den Fruchtensaft aufkochen. Stärke und 2 EL Wasser glatt rühren und in den kochenden Fruchtsaft gießen. Unter Rühren aufkochen und die vorbereiteten Früchte dazugeben. Vom Herd nehmen und mit Zucker abschmecken. Rühren Mischung. Grütze abkühlen lassen. Vanilleschote kurz vorm Servieren entfernen. Die Rote Grütze in Gläser füllen, laktosefreie Joghurt dazugeben und mit dunkle Scokolade garnieren.