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:Including Legumes on a Low FODMAP Diet

By Lyndal McNamara (Dietitian)
 

 

Legumes (otherwise known as pulses) include all types of beans, peas and lupins. The health benefits of regular consumption of legumes are well known (see table 1), predominately because they are low in saturated fat, have a low GI, are an excellent source of dietary fibre and contain a variety of phytochemicals (natural plant chemicals with health promoting effects).

Table 1: Health Benefits of Legumes

Nutritional characteristic	Associated health benefits
High in dietary fibre	-          Can assist with weight management by promoting a feeling of fullness after eating -          Contain insoluble fibre, which adds bulk to stools and assists with preventing constipation -          Contain soluble fibre, which assists in maintaining healthy blood glucose and cholesterol levels -          Contain prebiotic fibre, which is fermented by colonic bacteria to short chain fatty acids and promotes overall digestive health
High in phytochemicals	-          Contain antioxidants and other bioactive compounds, which help to protect the body against disease
Low glycaemic index (GI)	-          Contain slowly digested carbohydrates, that improve blood glucose control and insulin response in those with diabetes and reduce risk of diabetes in healthy people
High in protein	-          Legumes are a great non-animal source of protein for vegetarians and vegans
Low in saturated fat	-          Assist with maintaining healthy cholesterol levels and reducing risk of cardiovascular disease

References: please see an extensive list of references on the Grains & Legumes Nutrition Council (GLNC) website http://www.glnc.org.au/legumes/legume-references/

Legumes on a Low FODMAP diet

For those following a low FODMAP diet, legumes can be a troublesome food because they are naturally high in oligos; including galacto-oligosaccharides (GOS) and fructans.

The good news is that legumes do not need to be strictly avoided by people following a low FODMAP diet, with suitable ‘green’ serve information available for many legumes on the Monash app.

Because oligos dissolve in water, cooking and processing methods can affect the FODMAP content of legumes. For example, canned legumes or those that have been boiled and drained tend to be lower in FODMAPs as some oligos ‘leach’ out into the canning/cooking water and are removed when they are drained and rinsed. Read more here 

Dietary Recommendations for Legumes

The GLNC recommends enjoying legumes 2-3 times per week for maximum health benefits. Here are some suggestions for how to easily incorporate more legumes into a low FODMAP diet:

- Add a small can (125g) of chickpeas to stir-fries or curries – try this ‘low FODMAP Vegan Coconut & Pumpkin Curry’

- Substitute half of the meat in bolognaise sauce/casseroles for canned lentils- try this ‘low FODMAP slow cooked Lamb Casserole’:

- Sprinkle ¼ cup (53g) of cooked mung beans (boiled & drained) over salads  

- Add canned butter beans to homemade soups or stews

- Mix ¼ cup (42g) canned chickpeas with a small tin of tuna for a protein and fibre rich snack

- Add legumes to homemade dips- try this ‘Roasted Red Pepper & Pumpkin Hummus’

- Top an egg on toast for breakfast with homemade baked beans (using ¼ cup (35g) canned butter beans per person)

- Substitute meat in Asian style dishes for firm tofu or tempeh- try this low FODMAP ‘Marinated Tofu with Asian Greens and Rice’ or ‘Hot & Sour Asian Soup’:
 

Enjoy!

Diet Tips:Dietary Fibre Series- Soluble Fibre

By Shirley Webber (Research Dietitian)

Eating enough fibre on a low FODMAP diet can be challenging, but did you know that getting the right mix of fibres is also important? Food is made up of different types of fibres, namely insoluble fibre, soluble fibre, and prebiotic fibres (including resistant starch). 

These fibres serve different functions in the bowel and eating them in combination may promote different health benefits. Over the next few weeks we will discuss the different fibres types, including their function in the bowel and low FODMAP food sources. Let’s begin with soluble fibre.

Soluble fibre dissolves in water and forms a thick gel in our digestive tract. This slows gut transit time and helps us to feel fuller for longer. The gelatinous substance formed by soluble fibre also acts like a sponge during digestion, attracting fluid and softening stools to make it easier for waste to move through the bowel.

There are many health benefits associated with including soluble diet in your diet. Soluble fibre helps to stabilise blood glucose levels in people with diabetes. Soluble fibre may also lower levels of low density lipoprotein cholesterol (LDL-C), also known as bad cholesterol level. This may reduce risk of heart disease and bowel cancer. For those with constipation predominant IBS, including a variety of fibres in your daily diet can assist with maintaining regular bowel habits.

What foods contain soluble fibre?

Soluble fibre is found in some vegetables and fruit, oats, lentils, legumes, nuts and seeds. Including small quantities of these foods may improve stool consistency, but avoid large quantities which may exacerbate symptoms. 

Fibre supplements such as psyllium husks are also rich sources of soluble fibre. However, being fermentable, psyllium husks are tolerated by some people with IBS, but not all, so include in small doses initially and/or under the guidance of your dietitian.

Here are a few examples of foods you can trial in your diet to increase your soluble fibre intake:

• Breakfast: Add 30g of rolled or quick oats to your yoghurt or breakfast smoothie in the morning
• Snack: Have a fruit such as orange, passionfruit or banana.
• Lunch: Include wholegrain bread, brown rice or beans as an element of your meal
• Snack: Try a handful of low FODMAP nuts and seed
• Dinner: Include a variety of vegetables into your meal. High soluble fibre options include: brussels sprouts, sweet potato, turnip, collard greens, eggplant, carrots, potato, okra and green beans. Refer to the Monash app for serving size suggestions.
• Dessert: Try making a chia seed pudding: http://fodmapmonash.blogspot.com.au/2015/11/strawberry-chia-pudding-recipe.html

Diet Tips:Dietary Fibre Series - Prebiotic Fibre

Erin Dwyer (Research Dietitian)

 

We know eating enough fibre on a low FODMAP diet can be challenging and that getting the right mix of fibres is very important, so let’s discuss prebiotic fibre.

There has been a lot of talk recently about prebiotics and probiotics and how they can affect the gut, but what really are they?

Prebiotics (including resistant starch) are non-digestible fibres found in certain foods that can stimulate the growth of some bacteria. This means that instead of being broken down within the gut the prebiotic fibre travels through the gut, stimulating growth and/or activity of probiotics i.e. the good bacteria!

Here's a list of foods that are high in prebiotics that have a 'green serve’ size – take a look at the Monash low FODMAP App to find out more!

Fruits and Vegetables	Grains and Cereals	Legumes, lentils, nuts and seeds
Artichokes	Oats	Mung beans
Beetroot	Buckwheat kernels	Lima beans
Butternut Pumpkin	Wheat free Gnocchi	Nuts – Almonds and hazelnuts
Pomegranate seeds	Wheat bran	Canned chickpeas
Dried paw paw	Pasta (wheat/spelt), cooked and cooled	Canned lentils

If you are following or have followed a low FODMAP diet you may notice many of the foods listed above are high in FODMAPs. This is because fructans and galacto-oligosaccharides (GOS) are prebiotic fibres.

So if prebiotics are often high in FODMAPS, but considered part of a healthy diet, how can they be included on a low FODMAP diet?

Here are a few ideas to get you started

·         Firstly, remember that a low FODMAP diet is only meant to be LOW in FODMAPs, not completely depleted of FODMAPs

·         Also, after the initial strict phase of the diet, you may find through the rechallenge phase that you actually tolerate moderate serves of fructan and GOS rich foods quite well

·         Certain canned legumes that have been rinsed and drained are lower in FODMAPs - you can find a safe ‘green serve’ of legumes and lentils in the Monash FODMAP App. Try this recipe http://fodmapmonash.blogspot.com.au/2016/01/low-fodmap-vegan-coconut-pumpkin-curry.html

·         You can purchase wheat free Gnocchi for a low FODMAP option, serve it with a low FODMAP pasta sauce and salad – You can try this recipe http://fodmapmonash.blogspot.com.au/2016/09/low-fodmap-chicken-and-gnocchi-pasta.html

·         Add ¼ cup (green serve) of pomegranate seeds to your salad for great texture and a little sweetness

·         Snack on some almonds or hazelnuts (10 for a green serve)

It is also important to remember to continually test your tolerance to FODMAP containing foods, you may find you can tolerate different prebiotics in varying amounts. For some guidance in reintroduction you can look back on this past blog post:

http://fodmapmonash.blogspot.com.au/2015/06/just-2-6-weeks-it-is-not-diet-for-life_8.html