Tuesday, 2 September 2014

Bad Bellies and Diet

In my opinion, the most frustrating thing about having FM is its sheer complexity, as fructose is in almost every food. Additionally, having UC adds an extra layer of complexity for me. From what I understand, this is a common problem in general for people with IBS and/or IBD. Many people, including myself, have therefore tried to simplify things by creating special types of diets, hoping to make things easier to manage on a daily basis.

This week, I am therefore going to share some of my research into these types of diets, as well as how I have adapted them for my own needs.

COMMON DIETS FOR BAD BELLIES

In my research and so on, I have often come across discussions about different types of diets that are suitable for IBS and/or IBD. Here is a summary of the ones that I have read about most:


The Gluten-Free Diet – This diet is mainly designed for people with Coeliac Disease, and focuses on eliminating all foods containing gluten (wheat, rye, triticale and barley). This diet can also be useful for people with FM, as many foods that contain gluten also contain high amounts of fructans. Here is a good summary of this diet. For those with FM, however, this diet can still be risky, as mainly gluten free products use corn flour as a substitute for wheat flour. Additionally, specialty gluten-free products can be expensive, so some people can find it difficult to maintain this diet.

The Low FODMAP Diet – The Low FODMAP Diet was developed by Dr. Sue Shepherd in 1999, as a form of treatment for people with IBS, and has two phases – first, restricting all high FODMAP foods for 6-8 weeks, and then developing the diet to suit the individual’s condition. FODMAP stands for Fermentable Oligosaccharides (includes fructans), Disaccharides (includes lactose), Monosaccharides (includes fructose) and Polyols (includes sorbital and xylitol). Dr. Shepherd has now began developing her own range of "FODMAP Friendly" foods, as well as encouraging other companies to make their foods "FODMAP Friendly." Foods identified as "FODMAP Friendly" carry the below logo. While this is a very good diet to help with identifying trigger foods and tolerance levels, in some cases it may not be appropriate, as some people only have problems with one or two types of foods, or their problem foods may not be fully covered by the FODMAP categories.



The Paleo (Paleolithic) Diet – Reportedly the most popular diet in the world in 2013, the Paleo Diet is based on the premise that we should only eat the same sorts of foods as our ancestors did, and keep to the types of foods that our bodies are built to digest. In essence, this means no processed foods. Here is a good resource for understanding this diet. This diet is said to be very healthy and this has been supported by several studies. Some are still sceptical however, arguing that this diet is not necessarily sustainable, as the life expectancy of our ancestors was much lower than it is today.

Going Organic – This diet focuses on consuming only foods grown naturally, in order to avoid consuming harmful chemicals and environmental damage. This includes avoiding plants grown using pesticides or fertlisers, avoiding meat from animals given growth hormones or other drugs, and only using products from animals raised in a “free range” environment. Here is a useful summary of the main arguments for going organic. This diet can also be problematic however, as it can be difficult to determine whether foods are definitely organic, and organic foods are often more expensive.

The High-Fibre Diet – The High-Fibre Diet is often recommended for people with IBS-C, as previously discussed in this post, as it can help to reduce constipation. The most fibre-rich foods are often fruits, vegetables, and whole grains. However, this diet is not suitable for people with IBS-D, as too much fibre can cause diarrhea. Here is a good list of fibre-rich foods. Additionally, it can be difficult for people with FM to maintain this diet, as many high-fibre foods also contain high amounts of fructose or fructans.

The Low-Fibre (Low-Residue) Diet – The Low-Fibre Diet is therefore recommended for people with IBS-D, as it can help to reduce diarrhea. It is also recommended for people who have had bowel surgery. Rather than completely eliminating all fibre, this diet focuses on consuming only soluble fibre. Here is a useful summary of high- and low-fibre foods.

The Low-Fat Diet – This is of course a very common diet for weight loss, however it is also recommended for people with IBS because high-fat foods usually have lower levels of fibre, and can therefore cause constipation. Here is a good guide for following the Low-Fat Diet. When following this diet though, it is important to remember that not all fats are unhealthy, as discussed here.


The above diets are generally more appropriate for managing IBS, however some aspects of them are also applicable for those with IBD. As discussed in this article, people with IBD should avoid high-fibre and high-fat foods. In addition to this, it is important to keep hydrated, foods with prebiotics or probiotics may be helpful, and vitamin supplements may be necessary (as discussed in this previous post).

Have you found a diet that works best for you? Please comment below.

MY DIET

While all of the above diets have their benefits, in my own experimentation so far, I have found that neither of them are quite right for my situation. This is because none of them are specifically tailored for people with FM or UC. Therefore, through a combination of trial and error, elimination and substitution, I am slowly developing my own diet.

I have previously discussed my main trigger foods and tolerance levels, and these elements have helped guide me when I am thinking about what to eat each day. Additionally, I have found that different types of diets can be useful for certain situations. For example, when I am going to a function or event, it is sometimes easier to just list “gluten-free” for my dietary requirements. When cooking for myself, however, I will usually aim for something closer to the Low FODMAP diet - selecting the aspects applicable to my FM - as I am able to have more control over the ingredients used. Additionally, if I am having trouble with my bowel movements, I may try to either reduce or increase my fibre intake.

In my experience, and also in my general opinion, there is no such thing as a perfect diet, and it is neither healthy nor sustainable to be too restrictive in what you eat. As I mentioned in my first post, restricting my diet too much following my FM diagnosis just resulted in weight gain and fatigue. I am therefore focusing on what my version of healthy is, both because of, and in spite of, my FM and UC.

Have you had similar experiences with your diet? Please comment below.

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