January 10, 2018

Examining the popular IBD Diets

History of the FODMAP Diet

FODMAP (Fermentable Oligo- Di- and Monosaccharides and Polyols) is a group of osmotically active, rapidly fermentable, short-chain carbohydrates. (Ex. Lactose, fructose, sorbitol, mannitol, fructooligosaccharides, and galactooligosaccharides.) [1]

Originated with scientists at Australia's Monash University. It is a short term diet that temporarily eliminates FODMAPs from your diet, which are a proven trigger of Irritable Bowel Syndrome (IBS)[2].

General guidelines
Reduce high FODMAPs containing food.

What is allowed?
Fruits, Vegetables, Grains, meat products, legumes, nuts and seeds

What is forbidden?
Excess fructose
Fruits: Apples, cherries, mango, pears, tinned fruit in natural fruit juice, watermelon, large quantities of fruit juice or dried fruit
Vegetables: Asparagus, artichokes, sugar snap peas
Sugars: Honey, high fructose corn syrup

Lactose
Milk & Yogurts: Regular and low fat milk and yogurts
Dairy Products: Soft cheeses (e.g. ricotta, cottage, cream cheese); custard, ice-cream

Fructans (fructo-oligosaccharides) & Galacto-oligosaccharides
Grains: Rye and rye products (e.g. rye bread, rye crackers); Wheat and wheat products (e.g. wheat bread, pasta, couscous, wheat bran)
Fruits: Peaches, persimmon, watermelon
Vegetables: Artichokes, legumes (e.g. baked beans, lentils, red kidney beans); onion and garlic and garlic salts etc.
Others: Inulin (often called fiber in nutritional supplements and products)

Polyols – Sorbitol
Fruits: Apples, apricots, pears, blackberries, nectarines, plums
Beverages: Apple and pear juice

Polyols – Mannitol
Vegetables: Cauliflower, mushrooms, snow peas
Fruits: Watermelon

Polyols – Sorbitol & Mannitol
Sweeteners: Sugar-free gums, hard candies and chocolates containing sorbitol, mannitol, xylitol isomalt, maltitol

What is unspecified?
Hydration, processed foods, coffee, fiber content

Typical day
Breakfast: 1/2 cup rolled oats + water or lactose-free milk, topped with ½ banana.
Lunch: Pumpkin & Carrot Risotto
Dinner: Brown Rice Noodle & Veggie Stir Fry with Shrimp
Snack: 1 cup total of carrot and cucumber sticks + 3-4 tbsp. cottage cheese. 

Macronutrient percentage
% fat, % protein, % carbohydrates is unspecified

Analysis:

Pros
Cons

      ·      Balanced with expansive and contractive, warming and cooling, build up and breakdown, acidic and alkaline food.
      ·      Easiest to follow compared with SCD and GAPS.
       
      ·       Hard to follow long-term
      ·       Does not account for fibre content, processed foods.


Effects: Short and Long Term Effects 
Is a short term diet that when done with a balanced macro breakdown with fibre and hydration that can be carried out long term. Balance can be achieved on this diet.





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History of the Specific Carbohydrates Diet (SCD)

This diet eliminates most carbs (primarily grains, starches, dairy, and sugars) and allowing only specific carbs that require minimal digestion, it can reduce inflammation and make eating enjoyable for people with gastrointestinal (GI) disorders.[1]

General guidelines
Reduce all simple sugars, grains, starches, and most dairy products. The premise is that unrefined carbs alter bacteria in the gut; by removing offending carbs, it changes the metabolism of the bacteria that live in the gut and reduces inflammation.

What is allowed?
Vegetables (except canned)
Legumes (except the ones noted below)
Unprocessed meats, poultry, fish, and eggs
Natural cheeses (except those listed below)
Homemade yogurt fermented at least 24 hours
Most fruits and juices without additives
Nuts, peanuts in the shell, natural peanut butter
Oils: olive, coconut, soybean, and corn
Weak tea and coffee
Unflavored gelatin
Mustard and vinegar
Saccharin

What is forbidden?
Sugars: lactose, sucrose, high-fructose corn syrup, fructose, molasses, maltose, isomaltose, fructooligosaccharides, and any processed sugar
All canned vegetables
All grains: anything made from corn, wheat, wheat germ, barley, oats, rye, rice, buckwheat, soy, spelt, and amaranth
Some legumes: chickpeas, bean sprouts, soybeans, mung beans, fava beans, and garbanzo beans
Starchy vegetables: potatoes, yam, parsnips, seaweed products, agar, and carrageenan
Canned and processed meats
Dairy: milk, milk products, ice cream, whey powder, commercial yogurt, heavy cream, buttermilk, sour cream, and the following cheeses: ricotta, mozzarella, cottage cheese, cream cheese, feta, processed cheeses, and cheese spreads
Canola oil, commercial mayonnaise, commercial ketchup, margarine, baking powder, and balsamic vinegar
Candy, chocolate, carob

What is unspecified?
Hydration, fiber content, processed food

Typical day
Breakfast: eggs with green smoothie.
Lunch: Pumpkin & Carrot Risotto
Dinner: Veggie Stir Fry with Shrimp and Baked Salmon
Snack: A big handful of macadamias, Brazil nuts or walnuts

Macronutrient percentage
% fat, % protein, % carbohydrates is unspecified

Analysis:

Pros
Cons
      ·      Balanced with expansive and contractive, warming and cooling, build up and breakdown, acidic and alkaline food.
      ·      Hard to follow long-term
      ·      Does not account for fibre and digestibility 

Effects: Short and Long Term Effects (Body, Mind, Emotions, Spirit)
Is a short term diet that when done with a balanced macro breakdown along with fibre and hydration that can be carried out long term. Balance can be achieved on this diet.





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History of the GAPS diet

The GAPS diet was derived from the Specific Carbohydrate Diet (SCD) created by Dr. Sidney Valentine Haas to naturally treat chronic inflammatory conditions in the digestive tract as a result of a damaged gut lining.  SCD gained great popularity after a mother, Elaine Gottschall, healed her own child of Ulcerative Colitis and became an advocate for SCD.  Elaine Gottschall is also the author of the popular book, Breaking the Vicious Cycle:Intestinal Health Through Diet.  Through years of research and clinical experience, Dr. Natasha Campbell-McBride adjusted her protocol to fit the individual healthcare needs of her patients suffering from a variety of intestinal and neurological conditions as a result of an imbalanced bacterial ecosystem within the GI tract.  The GAPS Diet focuses on removing foods that are difficult to digest and damaging to gut flora and replacing them with nutrient-dense foods to give the intestinal lining a chance to heal and seal.[1]


General guidelines
  • Combine vegetables (raw/fermented/cooked) with meats and fish at each meal to balance pH.  Meats and fish accumulate as acids in the body while vegetables have a strong alkalizing affect.  Too acidic or too alkalizing states are not ideal. 
  • Eat fruit (except avocado) on their own in between meals so not to interfere with the digestion of meats.
  • It is more important to find organic (or local not containing pesticides) fruits and vegetables than organic fresh/frozen meats if cost is an issue for families.  Animals have their own detoxification system that may neutralize some of the antibiotics/hormones used on them.
  • Have plenty of natural fats in every meal from meats, butter, ghee, coconut (if tolerated) and cold pressed olive oil.  Animal fats are particularly valuable (lard, tallow, raw butter/ghee, lamb fat, duck fat).
  • Consume a cup of bone broth or meat stock with every meal.  Many patients have difficult digesting fats in the beginning of the diet and may only be able to tolerate a few tablespoons while the body is healing.
  • Fermented foods are a focal point in the protocol.  This includes fermented vegetables, yogurt, kefir, and sour cream.  Fermented beverages include kvass, kombucha, and water kefir are also allowed. Please note, some patients are unable to tolerate these products in the beginning and may need to be temporarily avoided.  Listen to your body and introduce foods very gradually, observing for any negative reactions.
  • Avoid all processed foods in packages and tins.  These include all refined carbohydrates and foods that contain preservatives, artificial colorants and chemicals, etc.  They are extremely detrimental to digestive system and the healing process. 


What is allowed?
Same as the SCD

Vegetables (except canned)
Legumes (except the ones noted below)
Unprocessed meats, poultry, fish, and eggs
Natural cheeses (except those listed below)
Homemade yogurt fermented at least 24 hours
Most fruits and juices without additives
Nuts, peanuts in the shell, natural peanut butter
Oils: olive, coconut, soybean, and corn
Weak tea and coffee
Unflavored gelatin
Mustard and vinegar
Saccharin

What is forbidden?
Same as SCD

Sugars: lactose, sucrose, high-fructose corn syrup, fructose, molasses, maltose, isomaltose, fructooligosaccharides, and any processed sugar
All canned vegetables
All grains: anything made from corn, wheat, wheat germ, barley, oats, rye, rice, buckwheat, soy, spelt, and amaranth
Some legumes: chickpeas, bean sprouts, soybeans, mung beans, fava beans, and garbanzo beans
Starchy vegetables: potatoes, yam, parsnips, seaweed products, agar, and carrageenan
Canned and processed meats
Dairy: milk, milk products, ice cream, whey powder, commercial yogurt, heavy cream, buttermilk, sour cream, and the following cheeses: ricotta, mozzarella, cottage cheese, cream cheese, feta, processed cheeses, and cheese spreads
Canola oil, commercial mayonnaise, commercial ketchup, margarine, baking powder, and balsamic vinegar
Candy, chocolate, carob

What is unspecified?
Hydration, Fiber content

Typical day
Breakfast: eggs with green smoothie.
Lunch: Pumpkin & Carrot Risotto
Dinner: Veggie Stir Fry with Shrimp and Baked Salmon
Snack: A big handful of macadamias, Brazil nuts or walnuts

Macronutrient percentage
% fat, % protein, % carbohydrates is unspecified

Analysis:

Pros
Cons
      ·      Balanced with expansive and contractive,     warming and cooling, build up and breakdown, acidic and alkaline food.
      ·      Accounts for rules of digestion, processed foods and fermented food sources
      ·      Encourages listening to the body and introducing foods slowly
      ·      Hard to follow long-term
      ·      Does not account for fibre content and digestibility.
      ·      Nuts and seeds can be very irritating and hard to digest with inflamed intestines.


Effects: Short and Long Term Effects (Body, Mind, Emotions, Spirit)
Is a short term diet that when done with a balanced macro breakdown along with fibre and hydration that can be carried out long term. Balance can be achieved on this diet.

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