Friday, 28 October 2016

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



Tuesday, 25 October 2016

Roast Pumpkin, Halloumi & Millet Salad with Lemon-Herb Dressing

By Monica Rundle & Lyndal McNamara 

Serves 4


Fancy a meat free meal this week? Packed with plant sourced protein, healthy unsaturated fats and filling dietary fibre, this delicious vegetarian recipe ticks all of the boxes! Best of all it is low in FODMAPs, so suitable for the whole family to enjoy. 


Ingredients

Salad:
·       1 tsp. olive oil
·       ½ Japanese pumpkin, cut into large pieces (approx. 1kg)
·       1 tsp. cumin
·       1 tsp. cinnamon
·       1 tsp. paprika
·       200g canned brown lentils
·       1 C cooked millet
·       1 tbsp. currants
·       2 C rocket
·       1 tbsp. pine nuts
·       1tsps. pumpkin seeds
·       150g halloumi cheese, cut into 1cm thick slices
·        

Dressing:
·       1 bunch coriander, roughly chopped
·       Juice of 2 lemons
·       ¼ C olive oil
·       ½ tsp. cumin
·       ½ tsp. ground coriander
·       Salt and pepper to taste

Method

Step 1
Pre heat oven to 180 degrees Celsius. Toss pumpkin in oil, paprika, cumin and cinnamon and place on lined baking tray. Roast in oven for 45 minutes of until tender.
Step 2
In the meantime, drain and rinse lentils well. Add lentils, millet, currents and rocket to a salad bowl.
Step 3
In a frying pan, add pumpkin seeds and pine nuts and lightly toast. Stir frequently and remove from heat once golden brown. Add to salad bowl.
Step 4
Preheat a nonstick frying pan over a high heat. Place halloumi slices in the pan, sear the first side for one minute and flip and sear for 1-2 minutes on the second side. The cheese should be golden and crunchy on the outside and soft inside. Once cooked, remove and add to salad bowl.
Step 5
Remove the cooked pumpkin from the oven and add to the salad bowl.
Step 6
Add all the dressing ingredients to a jar and shake to combine. Poor dressing over salad and gently toss salad together.


Tips: 
- To make this recipe suitable for vegans or dairy free, omit halloumi cheese or replace with suitable dairy-free cheese alternative 
- Halloumi cheese can be quite high in salt, so we recommend choosing a salt-reduced variety if available 

Nutrition Information/serve: 

Energy
2048kJ
Protein
19.5g
Carbohydrates
32.3g
Fat
29.5g
Saturated fat
7.3g
Sodium
1100mg*
Calcium
380mg
*Calculated with recipe using non-salt reduced halloumi

Friday, 21 October 2016

NEW US RESEARCH: The Low FODMAP diet superior for the relief of abdominal pain and bloating

The Low FODMAP Diet & mNICE Diet Compared

By Dr Jane Varney


 
An interesting study was published by our colleagues at the University of Michigan this week (1). The US study compared the effect of two dietary interventions on IBS symptoms in people with diarrhoea predominant IBS (IBS-D). The interventions in question were the low FODMAP diet and a more traditional dietary approach, known as mNICE (modified guidance from the National Institute for Health and Care Excellence).

Ninety-two eligible subjects were recruited into the study, all of whom had IBS-D and most of whom were female (71%). Participants were randomised to either a low FODMAP diet or the mNICE diet for 4 weeks. Because this was also not a feeding study, a dietitian taught participants how to follow their respective diets, but participants were required to put this advice into practice and prepare their own meals. Resources developed at Monash and Michigan Universities were used to teach participants how to follow the low FODMAP diet. Guidance given to the mNICE group included to eat small frequent meals, to avoid trigger foods and to avoid excess alcohol and caffeine. This guidance was considered ‘modified’, because high FODMAP foods were not specifically excluded as would typically be the case on this diet.



 


 
The study revealed a number of interesting findings:

·         The diets were equally effective at providing ‘adequate relief’ of overall IBS symptoms, with improvements experienced in 41% of participants in the mNICE group and 52% of participants in the low FODMAP group.

·         More participants in the low FODMAP group experienced an improvement in abdominal pain, 51% versus 23%, p=0.008.

·         The greatest benefit of the low FODMAP diet was for relief of abdominal pain and bloating, with improvements in stool consistency, stool frequency and urgency also observed in this group.

Take home messages:

·         The low FODMAP and mNICE diets improve symptom control in roughly half of all people with IBS-D.

·         The low FODMAP diet may be a superior choice for the relief of some symptoms, namely abdominal pain and bloating
 
  1. Eswaran SL, Chey WD, Han-Markey T, Ball S, Jackson K. A Randomized Controlled Trial Comparing the Low FODMAP Diet vs. Modified NICE Guidelines in US Adults with IBS-D. Am J Gastroenterol. 2016.
 

Tuesday, 18 October 2016

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!