SHOULD YOU TRY A RESTRICTIVE DIET?

Are you sensitive to certain foods and wonder if eliminating foods from your diet might help? A restrictive diet can certainly help reduce symptoms sometimes, but they can also have unintended consequences such as nutrient deficiencies and disordered eating. As such, restrictive diets should be used judiciously and ideally on a short-term basis. This month I’m breaking down restrictive diets and helping you determine when and if it is something to explore.

If you are considering following a restrictive diet, it is important to talk to your doctor about the potential risks and benefits and how to make sure that you are getting enough nutrients. Working closely with a dietitian can help you stay on track as well.

So, when might it be appropriate to use a short-term restrictive diet? There is evidence that a low FODMAP diet may help to alleviate symptoms for those diagnosed with IBS. It can also be used for someone diagnosed with SIBO and/or fructose malabsorption. While the low FODMAP diet can help alleviate symptoms (sometimes rather quickly), the diet is low in fiber, and can exacerbate constipation in some people. It also requires avoidance of a variety of healthful plant foods including some vegetables, fruits, and grains. If you are not careful to make sure to have as large a variety of foods as possible when following this diet, it can be possible to develop nutrient deficiencies. That is why this diet is meant to be used as a short-term therapeutic diet, followed by a systematic reintroduction. When doing a reintroduction in this manner, it can help you determine which fermentable carbohydrates you may have a problem with, and help you to know if you just need to limit the amounts of fermentable carbohydrates you have in a meal (known as FODMAP stacking).

Another medical condition that can benefit from a restrictive diet is IBD (inflammatory bowel disease), which includes Crohn’s and ulcerative colitis. (While IBD and IBS sound similar, they are very different disorders, and managed differently. Please refer to my previous blog and newsletter, which discuss the differences). There is evidence that the SCD, or specific carbohydrate diet, can be helpful in managing symptoms in IBD. I am particularly intrigued by the IBD-AID, which is being studied by at the University of Massachusetts, as it starts with something similar to the SCD, but then moves in phases, to eventually progress the diet, as tolerated, to include foods that can help support a healthy gut microbiome with the goal of improving outcomes in IBD. You can take a look at some useful information regarding this approach at:

https://www.umassmed.edu/nutrition/ibd/ibdaid/

You may have heard of using an elemental diet for reducing GI symptoms as well. This is a decision that should not be made lightly, as it involves consuming no solid food at all, usually for a 2 week period at a time, and instead consuming only an elemental formula as the sole means of nutrition. I have a tendency not to recommend this type of restriction for most IBS or SIBO patients, due to the potential for leading to disordered eating. There are some cases of severe IBD symptoms where this type of bowel rest may be medically necessary, and can help improve outcomes. I recommend only pursuing this type of diet with the help of your healthcare provider and a dietitian.

One condition that requires a life-long dietary avoidance is celiac disease, which will be discussed in detail in the next newsletter.

Natural medicine can work very well to improve GI health. Please contact Dr. Heather Buckle ND, FABNO if you have questions about integrative solutions for any gastrointestinal issues you may have. If you live in Washington state and would like to learn more about Dr. Buckle’s naturopathic approach to your wellness, please call (206) 643-2239 or CLICK HERE to schedule a consultation.