Elimination stations

In a bid to work out why I'm still having tummy ouchies, I recently made an appointment with dietitian Joanna Baker from Everyday Nutrition. We talked about how some of the foods that irritate my stomach don't seem to fit with the food groups that I'm already avoiding (gluten-free, dairy-free and low fodmaps). Joanna introduced me to the low food chemical diet (also known as the failsafe diet which reduces the amount of naturally occurring food chemicals: salicylates, amines and glutamates being consumed). It sounded like a really un-fun diet, but Joanna assured me it was worth doing an elimination diet to try and figure out what my food triggers are, because I may be able to then reintroduce foods that I'm currently avoiding (OMG please someone tell me I can start eating cheese)! As an added "bonus", the failsafe diet also means I've had to avoid perfumed products, mint toothpaste, and try and stay away from perfumed areas e.g. my yoga studio where they burn incense on the regular.

An elimination diet, is a short-term diet where certain foods are removed from your diet and then slowly reintroduced to see if you have a reaction. Let me tell you, an elimination diet is NOT fun. In my case, the elimination diet was gluten-free, dairy-free, low fodmaps and failsafe. 

Here's what I've been allowed to eat over the past month:

  • Peeled zucchini
  • Peeled white potatoes/brown rice/white rice
  • Unprocessed fresh meat (excluding pork and processed meat) - must be cooked and eaten within 24 hours; or cooked, frozen and then eaten within 24 hours.
  • Potato crisps (only certain brands)
  • Eggs
  • Decaf coffee with rice milk or soy milk (gluten-free soy milk only)

As you can imagine, the past month feels like it's been about 3 years long, I'm desperate to eat something different, and I'm sick of the sight of zucchinis. However, the good news is that my stomach has been feeling wayyyy better.

And now for the exciting and scary stage. Next week I'm starting to re-introduce foods, starting with lactose-free milk. I've already decided that I'll be having my first sample at home when we have a good stock of toilet paper. Wish me luck!

If you suspect you have food intolerances or food allergies, please do not attempt an elimination diet on your own. An elimination diet needs to be closely supervised, to make sure you continue to get enough nutrition in your diet. Dietitians are also better at ensuring you're eliminating the right foods e.g. some foods are both high in fodmaps as well as high food chemical, so you could easily remove a food group unnecessarily. Find a good dietitian before giving up any food group. If you're hunting for a dietitian, make sure you ask them about their approach to make sure it matches with your goals. I chose Joanna because she is pro-whole foods, and is a coeliac on a low fodmap diet herself, so understands what it's like to live on a restricted diet. She lives in Melbourne, but does Skype appointments - so bonus for me.

P.s. dietitians are not nutritionists. A nutritionist is not necessarily qualified, whereas a dietitian is qualified to post-graduate level.

 

What the Fod are FODMAPs?

Years ago, when I was advised by my gastroenterologist to avoid high FODMAPs foods, I cried.

Huge, salty tears complete with loud sobs. There may even have been foot stamping ...

Life seemed tough enough being gluten, dairy and tomato free, without having to cut out a whole lot more of the noms.

Turned out that the gastro guy wasn't just being a jerk, and a low FODMAPs diet did actually help to reduce my tummy ouchies quite significantly.

So what the fod are FODMAPs?

The low FODMAPs diet was developed by Dr Sue Shepherd, as a way of treating irritable bowel syndrome (IBS).

The theory is that foods that are high in Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols are poorly absorbed by some people; and instead of the foods digesting, they hang out in the small intestine causing bacterial overgrowth and fermenting. This fermentation in the gut causes pain, diarrhea, constipation, wind and bloating - the symptoms of irritable bowel syndrome (IBS).

Image courtesy of http://www.nutridesk.com.au/

High FODMAPs foods include tasty noms such as garlic, onion, lactose, high fructose foods, chickpeas, lentils and wheat. Check out the full list of what to eat and what to avoid here.

Flavour without the FODMAPs

But fear not, life without FODMAPs doesn't mean you can't have flavour.

Here are some ingredients you can use to add flavour without triggering IBS:

  • Ginger
  • Golden or maple syrup
  • Herbs such as basil and rosemary
  • Lemon or lime juice
  • Salt and pepper
  • Spring onions (only the green part)
  • Chilli
  • Chives
  • Asafoetida powder - tastes like onion

You could also try making garlic infused oil - yum!

Good news for FODMAP-ers!

The good news about FODMAPs is that unlike a food allergy, which usually involves complete avoidance, many people on a low FODMAPs diet can tolerate some high or moderate FODMAPs foods, or may not react at all to some high FODMAPs foods. For myself, I can tolerate a lot of avocado, can tolerate a small amount of garlic, but can't tolerate any mushrooms.

It's a case of trial and error with FODMAPs to find out what you can tolerate. And as with any diet, it's recommended you do this with the help of a medical specialist. 

If you're ever in Melbourne ...

And finally, I'd like to show off this AMAZING place that I recently visited while visiting my sister in Melbourne.

Fox in the Box does FODMAPs friendly, gluten-free and lactose-free meals. And it all tastes amazing! 

If you're in Melbourne, check them out! They even have a discount for members of the Victorian and Tasmanian Coeliac Society. AWESOME!!!!