Tuesday, 17 January 2017

Lactose and Dairy Products on a Low FODMAP Diet

By Lyndal McNamara (Dietitian)

It is a common misconception that dairy products should be eliminated when following a low FODMAP diet. The reason for this? Regular dairy products do contain a type of natural sugar called lactose, which yes, is also a type of FODMAP.

The good news is that if you have IBS and are following a low FODMAP diet, you only need to limit lactose if you suffer from lactose intolerance (speak to your dietitian about how this is diagnosed). Not sure what this means? You can learn more about lactose intolerance here.
 

 
What if I do have IBS and lactose intolerance?
No worries, you still have quite a few options…
Option 1: Keep having regular, lactose containing dairy
Say what? You might be surprised to know that studies have shown that even people with diagnosed lactose intolerance can still tolerate up to two cups (yes, 500ml!) of regular milk each day.1
But how can this be? Spreading out your regular dairy intake into small portions throughout the day will help you tolerate the lactose better.1 Research has also shown that consuming regular dairy products as part of meal rather than alone will improve tolerance.2 Some studies have even suggested that daily consumption of lactose containing dairy products, in small amounts at first but building up over time, can actually improve your body’s ability to digest lactose.3, 4
 
Option 2: Choose lactose free dairy products
Fortunately, lactose-free dairy products are now readily available in many countries throughout the world. These are still a great choice if you are super sensitive to lactose, as they contain all of the same important nutrients as regular milk, such as calcium and protein.
What makes these products different is that the lactose they contain has been broken down, making it easier for your body to digest. The downside? If lactose tolerance can be improved with regular lactose consumption, lactose free dairy products won’t help with this. Lactose free products are also generally more expensive than regular dairy products.
Also, some products that are promoted as ‘lactose free’ are naturally low in lactose anyway, so you might unnecessarily be paying more for a specialised product when the regular version is just as good. How do you avoid this? Learn which foods actually contain lactose here.
 
Option 3: Take a lactose digestion aid
There are several products available to help people with lactose intolerance digest lactose better. These contain the enzyme ‘lactase’ and are usually available in drop or tablet form from most pharmacies. They are best taken in the recommended dose when eating or drinking foods containing large amounts of lactose.


Option 4: Choose lactose free, dairy alternatives
If you are vegetarian or vegan, chances are you are already very familiar with non-dairy milk alternatives. Even if you aren’t, you have probably noticed the huge number of dairy free milks that have hit the supermarket shelves in the past few years. Whilst there are many types of non-dairy milk alternatives available, it is important to remember that if you are replacing regular milk, you also need to replace the nutrients that go along with it.
Unfortunately non-dairy milks do not naturally contain calcium, instead it must be added by the manufacturer. You should also be aware that some manufacturers add no calcium at all, or add it in much smaller amounts than would be found naturally in regular dairy milk. If you do choose a non-dairy milk, make sure to check the nutrition information panel on the packet and try to find a brand that contains at least 200-300mg of calcium per serve.
You should also check the app for suitable non-dairy milk alternatives, as not all types are low FODMAP, even though they don’t contain lactose.
Have more questions? Post them below or comment on the Facebook post and one of our dietitian’s will get back to you.


 
References:
  1. Suarez FL, Savaiano D, Arbisi P, Levitt MD. Tolerance to the daily ingestion of two cups of milk by individuals claiming lactose intolerance. The American journal of clinical nutrition. 1997;65(5):1502-6.
  2. Shaukat A, Levitt MD, Taylor BC, MacDonald R, Shamliyan TA, Kane RL, et al. Systematic Review: Effective Management Strategies for Lactose Intolerance. Annals of Internal Medicine. 2010;152(12):797-803.
  3. Hertzler SR, Savaiano DA. Colonic adaptation to daily lactose feeding in lactose maldigesters reduces lactose intolerance. The American journal of clinical nutrition. 1996;64(2):232-6.
  4. Hertzler SR, Savaiano DA, Levitt MD. Fecal hydrogen production and consumption measurements. Response to daily lactose ingestion by lactose maldigesters. Digestive diseases and sciences. 1997;42(2):348-53.

Thursday, 12 January 2017

Low FODMAP Thai Fried Noodles with Crab

By SOME Foods 

Serves 4
Ingredients
  • 1/2 a jar of SOME Foods Thai Massaman Curry
  • 225g Banh Pho (rice stick) noodles
  • 2 tablespoons of oil
  • 2 large eggs
  • 110g bean sprouts
  • 225g crab meat, shredded
  • 1 lime
  • Coriander leaves, to garnish
Method
  1. Soak the noodles in cold water for 30 minutes, then drain. Cut them into shorter lengths using scissors to make them easier to handle.
  2. Heat the oil in a wok or large frying pan, then stir in about 2 tablespoons of SOME Foods Thai Massaman Curry. Break the eggs into the wok, cook for 1 minute and stir to scramble.
  3. Add the noodles and toss through, then add the remainder of the 1/2 jar of SOME Foods Thai Massaman Curry and mix thoroughly. 
  4. Add the bean shoots and crab, mix through and then squeeze over the juice of the lime and mix through.
  5. Serve topped with fresh coriander.
Where can I buy SOME Foods products?
  • SOME Foods Monash Low FODMAP Certified products are available for purchase online and from selected stockists within Australia. Please note that SOME Foods currently do not ship their products internationally.



Tuesday, 10 January 2017

New Year goals to improve your IBS and overall health

By Erin Dwyer (Research Dietitian)


A new year is always a good time to re-evaluate your situation and develop goals that you would like to achieve within the year. One of those goals may be improving your IBS symptoms and so we want to encourage and guide you in 2017 to continue to take steps to improve your gastrointestinal symptoms as well as your overall health. The below suggestions are targeted at those with IBS, however apart from the rechallenging, all the other suggestions can be used long term by anyone to increase your health overall

Rechallenge
Unfortunately we often see people following a very strict low FODMAP diet, that are only sticking to a small number of foods that they feel safe eating. While, this may be helping in the short term, long term the lack of variety can have a negative effect.
‘Enjoy a wide variety of nutritious foods from the five groups every day’ – this is taken directly from our Australian Guide to Healthy Eating because choosing a wide variety of foods means we are getting a variety of minerals and nutrients (micronutrients) – just what the body needs! So by limiting your food choices you may not be getting the right amounts of micro nutrients you need, and that is one reason why it is so important to re-challenge and test your tolerance to various FODMAP containing foods to see if there are more foods you can tolerate.
Another benefit to rechallenging FODMAP foods is increasing your prebiotics intake. Many of the high FODMAP foods we avoid are naturally high in prebiotics (fibres that feed our good gut bacteria). To increase your prebiotic intake, You can challenge with amber serves of high prebiotic foods like artichoke hearts, chickpeas, snow peas, sweetcorn and savoy cabbage, using the app to guide you. You can also find a list of ‘green’ prebiotic foods on this previous blog post, aim to include these in your diet more regularly: http://fodmapmonash.blogspot.com.au/search?q=prebiotics
Remember, a Low FODMAP diet is not for life – it is imperative you test your tolerance to find your threshold. For help with rechallenging, see a dietitian.
Increase your fibre
There are many health benefits associated with including fibre in your diet. Soluble fibre helps to stabilise blood glucose levels in people with diabetes. It 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. This is important for everyone. For those with constipation predominant IBS, including a variety of fibres in your daily diet can assist with maintaining regular bowel habits.
So to ensure you are eating enough fibre daily, you can use our Low FODMAP Dietary Fibre Counter, found in the ‘About’ section of the app (see image below). When you scroll down to the bottom, there you will find a list of foods and how many grams of fibre it each contains. For Australian adults we aim for 25-30g per day.

If you find you’re not eating enough fibre, make sure your carbohydrate choices are mostly wholegrain, increase your fruit and vegetable intake and read these blog posts for more IBS specific info: http://fodmapmonash.blogspot.com.au/search?q=fibre
Be prepared
The low FODMAP diet can be tricky if you’re not prepared, don’t avoid going out and don’t let yourself go hungry, instead try some meal planning: http://fodmapmonash.blogspot.com.au/2016/11/a-guide-to-low-fodmap-meal-planning.html
Also stock your fridge, pantry and bag with nutritious low FODMAP snacks so you know that if you may not have access to any other suitable options you won’t go hungry or instead reach for foods that aren’t as nutritious. E.g yoghurt (lactose free if necessary), appropriate amounts of nuts, vegetable sticks and wheat free crackers with homemade dips, hard cheeses and low FODMAP fruits.
Go for 2&5
This tip is for everyone, IBS or not, as less than 4% of Australians meet the recommended serves for fruit and vegetables per day. The Australian Guide to Healthy Eating advises people consume 2 serves of fruit and 5 serves of vegetables per day. This is, much more than currently Australia’s average, current fruit and vegetable intake is only 2.7 serves per day.
  • Aim for 2 serves of fruit per day, there are plenty of Low FODMAP options and you can also test your tolerance to seasonal moderate (amber) and high (red) fruits, add some on your breakfast or eat a piece for morning tea.
  • Aim for 5 serves of vegetables, include vegetables as your mid meal snacks, and serve an extra side of salad or vegetables with your dinner. Also, give a new vegetable recipe a go to make things more interesting, try this one: http://fodmapmonash.blogspot.com.au/2016/11/zucchini-pasta-with-cabbage-and.html
For more information on serve sizes and the Australian Guide to Healthy Eating head to: https://www.eatforhealth.gov.au/

Turning these 5 food changes into habits can take a while, so start small and work your way up for long term health benefits!

Friday, 6 January 2017

Japanese Inspired Salad with Salmon and Miso dressing

By Lyndal McNamara (Research dietitian) 





Ingredients (serves 4)

Salad:
  • 300g hot smoked salmon (or cooked fresh salmon), flaked apart 
  • 100g packet vermicelli rice noodles, cooked and drained 
  • 1 baby cos (romaine) lettuce, finely shredded 
  • 1 small avocado, thinly sliced 
  • ¼ small red cabbage, finely shredded 
  • 2 large carrot, grated or finely julienned 
  • 100g firm tofu, cooked to your liking  
  • 1 cup small broccoli florets, blanched 
  • 1 tbs. black sesame seeds 
Dressing:
  • 1 heaped tbs. miso paste 
  • 1 tbs. rice wine vinegar 
  • 1 tbs. lime juice 
  • ½ tsp fresh ginger, finely grated 
  • 2 tbs. dark sesame oil 
  • 1 tbs. garlic infused olive oil 
  • 2 tbs. plain yoghurt 

Method:
  1. Prepare all salad ingredients as listed above. 
  2. Add salad ingredients to a large bowl and toss to combine  
  3. Add all dressing ingredients into a small jug and whisk until well combined  
  4. Pour dressing over salad and stir to coat evenly prior to serving  

Nutrition Information/serve: 

Energy
2318kJ
Protein
29.8g
Carbohydrates
26.2g
Fat
35.6g
Saturated fat
7.1g
Fibre
7.7g
Sodium
292mg
FODMAPs
LOW

Thursday, 22 December 2016

Survival guide to the festive season: Part 3

 By Shirley Webber (Research Dietitian)

Keep it fresh


If you’re invited to join family and/or friends for a Christmas at their place then offer to bring a salad or a vegetable mix that you know you would enjoy and work for you. Get creative with the flavours and bulk it up with all your favourite ingredients. This way if this salad or vegetable side is the only thing on the table to suit your tolerance levels then you can be sure there is a tasty meal there for you. Also I’m sure your host wouldn’t mind the extra help.


Hydrate the right way


Christmas time may feel you wishing you could have an unlimited caffeine supply available at any second but this can contribute to symptoms for many people. You may also be a victim or the energy spike and early in the day and feeling the caffeine jitters that can make you feel even worse in the evening with a restless night sleep and the vicious cycle continues. If that is you swap your afternoon coffee fix for an afternoon herbal tea. There are plenty to choose from on the app.   
Also caffeine can cause symptoms for some people so avoid the urge to have more than you know your body can tolerate.

This also goes for alcohol which can increase symptoms and further contribute to the stress of Christmas. Try alternating your alcoholic drinks with water during your celebrations.
As always drink plenty of water to stay hydrated and to help those of you with constipation as a predominant symptoms to maintain your regular bowl habits keeping things moving through and helping you enjoy the festivities.

Remember to enjoy this time with family and friends and make time to relax and refresh before the New Year.


Wednesday, 21 December 2016

Survival guide to the festive season: Part 2

Include carbs in your regular meals


This may be a daunting thought for some people with IBS but carbohydrates play a very important role in providing energy and fibre to your diet.

Having said that, choose your carbohydrates very carefully. Try opt for a “healthier carbohydrate” option when choosing your breads, grains, seeds or pasta. The grainier you can go the better to sustain your energy level for longer. Go for something with a low GI (glycaemic index).

The more refined a food is (eg. biscuits, cakes, chips or white breads) the quicker you will get an energy spike followed by a quick crash leaving you hungry and reaching for a quick fix snack.  

Some examples of low GI foods on the Monash low FODMAP app include:
  • Grainy bread (we have some certified bread that are low in FODMAPs packed with grains and seeds),
  • Basmati or brown rice
  • Pasta (try the Good Gut Pasta if you haven’t already – We’re loving this)
  • Oats, muesli or wholegrain oat cereal biscuits (mix this in with a smoothie, yoghurt or eat with your milk of choice)
  • Mixed non-starchy vegetables
  • Small serve of starchy vegetables (eg. ½ small sweet potato, 1 small potato, ½ cob sweet corn)
  • Small serves of fruit
  • Legumes (small serves tend to be well tolerated and are the perfect accompaniment to bulk up your salad or mixed vegetables)
  • Low fat dairy foods
  • Meats  (non-processed and fat trimmed)
Include these throughout your day to help you maintain momentum through the Christmas mayhem.

Prepare your pantry and have snacks ready


When rushing from one task to the next it is easy to get stuck for time to prepare a meal with takeaway the easy option. Add a variety of foods to your shopping list to make sure low FODMAP options are always at hand:
  • Eggs, canned tuna, lentils or beans
  • Frozen fruits and vegetables, canned tomatoes or pasta sauce
  • Microwavable rice or gluten free or quinoa pasta (Check the app for more pasta options)
  • Rice crackers
When you do manage to prepare a meal make extra so you can stick some in the freezer and know that that when you get pressured for time at least you have a meal waiting in the fridge ready to go.


Stress and anxiety can increase symptoms and unfortunately symptoms increase stress. It’s a vicious cycle. It is tempting to reach for food as comfort during this time so make sure you have some low FODMAP nuts, fruits, yoghurt or muesli bars ready and avoid the symptom cycle.

Tuesday, 20 December 2016

Survival guide to the festive season: Part 1

By Shirley Webber (Research Dietitian)

Is the thought of a Christmas feast stressing you out? Well here are a few tips and tricks to help you through the party season.

There are many challenges to be faced during this festive season from catching up with work colleagues and friends for celebratory drinks, nibbling on finger food and frantically running all over town to find the perfect gifts. This all makes for a month of and following a normal diet can feel almost impossible.

Reaching for takeaway and the munchies becomes increasingly easier but can leave many with symptoms and zero energy for meeting deadlines and enjoying this time of year. This inevitably leads to the “I’ll be good after Christmas” and the New Year’s resolutions to be “healthier”. The best way to avoid the symptoms, adding weight and/or need for resolutions is to form some habits that will not only help you through the holiday period but will set you up for a better start to 2017.

You can start now by following our top 5 tips for maintaining a healthier holiday.


1. Make time for breakfast!




You may have heard the saying that breakfast is the most important meal of the day however from a number of published research articles the breakfast meal itself may not be what’s important but rather the behaviours that breakfast encourages.

When skipping breakfast people tent to get hungry quicker in the day and may then compensate for this missed meal by eating a larger meal for lunch or increases the likelihood of snacking which may then lead to the creeping up of weight or even worst IBS symptoms due to eating the first thing your hands can reach.

Studies have shown that having breakfast can kick start your metabolism with the body burning 10% of the energy that you consume and if your breakfast includes a protein this goes up to 15%. This diet induced thermogenesis (DIT) slows down throughout the day so you can make the most of it at breakfast time.

Another breakfast bonus is that studies have shown that those people who regularly eat breakfast also tends to be more active in the morning and therefore could burn more energy. Now that’s just what you want during this busy time.