FODMAPs are Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polys (sugar alcohols) that are poorly absorbed in the small intestine. They are osmotic, meaning they pull water into the intestinal tract. When consumed in excess, they may be fermented by intestinal bacteria, which can lead to gas, bloating, cramping and/or diarrhea and other symptoms common with Irritable Bowel Syndrome (IBS). Eliminating dietary FODMAPs might alleviate these symptoms. In addition to what is listed below, raw, unsalted nuts and seeds (except for pistachios) are allowed in appropriate serving sizes (2 Tablespoons). Follow the low-FODMAP diet for 6 weeks. After this, if symptoms have resolved, you can add foods back in one at a time to identify your ‘trigger’ foods. Please schedule an appointment with the dietitian to oversee this ‘challenge phase’.

Low FODMAP Meals and Snacks:
Scrambled eggs with spinach and feta
Oatmeal topped with sliced banana, almonds and brown sugar
Lactose-free yogurt with strawberries and crushed walnuts
Rice pasta with chicken, tomatoes and zucchini
Sliced turkey on a gluten-free wrap with lettuce, tomato, Swiss cheese, and mustard
Quesadilla with corn tortilla and cheddar cheese

Food Category High FODMAP Foods Low FODMAP Alternatives
Vegetables Asparagus, artichokes, onions(all), leek bulb, garlic, legumes, sugar snap peas, onion and garlic salts, beetroot, Savoy cabbage, celery, sweet corn Alfalfa, bean sprouts, green beans, bok choy, capsicum (bell pepper), carrot, chives, fresh herbs, choy sum, cucumber, lettuce, tomato, zucchini.
Fruits Apples, pears, mango, nashi pears, watermelon, nectarines, peaches, plums Banana, orange, mandarin, grapes, melon
Milk & Dairy Cow’s milk, yoghurt, soft cheese, cream, custard, ice cream Lactose-free milk, lactose-free yoghurts, hard cheese
Protein Sources Legumes Meats, fish, chicken, Tofu, tempeh
Breads & Cereal Rye, wheat-containing breads, wheat-based cereals with dried fruit, wheat pasta Gluten-free bread and sourdough spelt bread, rice bubbles, oats, gluten-free pasta, rice, quinoa
Cookies & Snacks Rye crackers, wheat-based biscuits Gluten-free biscuits, rice cakes, corn thins
Nuts & Seeds Cashews, pistachios Almonds (less than 10 nuts), pumpkin seeds
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Gastroparesis, also known as delayed gastric emptying, is a condition in which food moves too slowly through the digestive tract. The muscle contractions of a normally functioning stomach mechanically breakdown food, propelling it into the small intestine for absorption. With gastroparesis, these muscles are dysfunctional, preventing the stomach from emptying properly. Common symptoms include nausea, vomiting, early satiety, bloating, abdominal pain, weight loss and malnutrition. While there is currently no cure for gastroparesis, the dietary and lifestyle modifications may help with signs and symptoms:

Dietary and Lifestyle Modifications:

  • Eat small, frequent meals.
  • Choose low-fat foods.
  • Reduce fiber intake. Avoid fibrous fruits and vegetables like oranges and broccoli. Choose well-cooked fruits and vegetables without seeds and skins.
  • Modify the consistency of foods by replacing solid foods with purees and soups.
  • Drink water with meals.
  • Try gentle exercise after eating.
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Gluten is a protein found in wheat, barley, rye, triticale, malt and some oats. A gluten-free diet is used to treat Celiac Disease and may be considered in patients thought to have a gluten sensitivity or diarrhea predominant irritable bowel syndrome. A gluten-free diet helps control signs and symptoms and prevent long-term complications; it is the only treatment for Celiac Disease.

Avoid all food and drinks containing:
Malt (including malt flavoring and malt vinegar)
Triticale (a cross between wheat and rye)
Wheat (all types of wheat including whole, bromated, enriched, phosphate, self-rishing)
Alternate forms of wheat
*Speak with your doctor or dietitian to determine if you need to avoid oats.

Unless specifically labeled ‘gluten-free’, avoid:
Bread and bread products like croutons, crackers and matzo
Baked goods like cake, cookies, cupcakes, muffins, scones, doughnuts and pie
Oats (if permitted per your doctor or dietitian)
Soup and soup-bases
Soy sauce

Allowed foods:
Fresh, unprocessed foods like beans, meat, poultry, fish, eggs, fruits, vegetables and nuts
Most dairy products
Gluten-free grains & flours
Corn and cornmeal
Hominy (corn)

Read ingredients and/or speak with servers to ensure that no gluten-containing ingredients have been used:
Deep-fried foods, even if non-gluten based like French fries and tortilla chips
Imitation meat or seafood
Processed deli meats
Salad dressings, sauces and gravies
Seasoned rice mixes
Seasoned snack foods like potato chips
Self-basting poultry
Any gluten-free food that has been contaminated
Cross-contamination occurs when gluten-free foods come into contact with foods that contain gluten. It can happen during the manufacturing process or during food preparation at home or in a restaurant. It is important to read labels and handle foods carefully. Always speak with servers about your dietary restrictions when dining out.
*In addition to foods and beverages that may contain gluten, check that all vitamins and medications are gluten free by reading bottles, speaking to your pharmacist or calling companies directly.

Switching to a gluten-free diet can be challenging but there are many substitutes and resources. Meet with the dietitian for additional information on how to live healthfully gluten-free.

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A diet high in fiber may help alleviate constipation and bowel irregularity, lower cholesterol or blood sugar, and assist with weight loss and maintenance.

The amount of fiber you need depends on your age and gender:

Gender Age 50 or Older Age 50 or Younger
Male 38 grams 30 grams
Female 25 grams 21 grams

Tips for increasing fiber:

  • Start your day with a high-fiber breakfast like oatmeal or cold cereal with more than 5grams of fiber per serving. Hint: look for cereals with ‘whole grain’, ‘bran’ or ‘fiber’ in the name.
  • Focus on fruits, vegetables, whole grains and beans.
  • Choose high-fiber snacks like fresh fruit (especially berries), nuts, plain popcorn and raw vegetables with hummus.
  • Speak with your doctor about whether a fiber supplement is appropriate for you.

High Fiber Foods:

Fiber: 4 grams per cup, cooked

Whole-Wheat Pasta
Fiber: 6.3 grams per cup, cooked

Bran Flakes
Fiber: 7 grams per cup, raw

Fiber: 5.5 grams per medium fruit, raw

Fiber: 6.7 grams per half, raw

Fiber: 7.6 grams per cup, raw

Fiber: 8 grams per cup, raw

Brussels Sprouts
Fiber: 4.1 grams per cup, boiled

Fiber: 5.1 grams per cup, boiled

Fiber: 8.8 grams per cup, cooked

Fiber: 10.3 grams per medium vegetable, cooked

Lima Beans
Fiber: 13.2 grams per cup, cooked

Black Beans
Fiber: 15 grams per cup, cooked

Fiber: 15.6 grams per cup, cooked

Split Peas
Fiber: 16.3 grams per cup, cooked

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Elevated cholesterol can increase your risk of developing heart disease. Although there are risk factors that you cannot control such as age, gender and family history, others are modifiable such as increasing physical activity, maintaining a healthy body weight and dietary modifications.

Dietary Modifications:

  • Start your day with oatmeal.
  • Choose fruits, vegetables, whole grains, beans, lean protein and nuts.
  • Limit red meat and eggs. Replace whole eggs with egg whites or a cholesterol-free egg substitute.
  • Choose fatty fish like salmon.
  • Replace butter, trans fat margarines, and polyunsaturated oil with canola oil, olive oil, or plant sterol spreads. Flavor with oregano, basil, parsley, rosemary, thyme, cilantro, coriander, or cumin.
  • Look for products specifically created for low-cholesterol diets. Many of these foods have been fortified with plant stanols and sterols that help to block the absorption of cholesterol.

Your doctor will advise you if your levels are not adequately lowered by diet and exercise alone. Please consult with the dietitian for additional heart healthy diet tips.

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A low-residue diet, with less than 10-15 grams of fiber daily, is often recommended in the management of diverticulitis, Crohn’s disease, ulcerative colitis, bowel inflammation, new colostomy/ileostomy or recent intestinal surgery. Dietary guidelines by food group are listed below. For additional guidance and to ensure that you are getting adequate nutrition, speak with the dietitian.

Milk and Milk Products:
Choose up to 2 cups of low-fat milk products including yogurt, cottage cheese, buttermilk, kefir or sherbet. Limit cheese to 1.5oz per day.
Avoid milk products with nuts, seeds, granola, fruit or vegetables added to them.
Avoid all milk-containing products if you are lactose intolerant. Choose milk and yogurt alternatives made from soy, rice or almond.

Breads and Grains:
Choose grains with less than 2g of fiber per serving like refined white breads and cereals (e.g. Special K, Corn Flakes, and Rice Krispies), cream of wheat, white pasta, and crackers, pancakes and waffles made from refined white flour.
Avoid refined grains with seeds and nuts.
Avoid whole-grains like quinoa and brown rice, whole-wheat pasta, oatmeal, popcorn and whole grain breads, crackers and cereals.

Choose vegetable juice without seeds or pulp and canned and well-cooked vegetables without seeds such as yellow squash, spinach, pumpkin, eggplant, potatoes without skin, green beans, wax beans, asparagus, and carrot.
Certain vegetables like lettuce and cucumber (without seeds) may be tolerated raw.
Avoid vegetable-based sauces and soups with seeds.
Vegetables to avoid include broccoli, Brussels sprouts, cabbage/sauerkraut, lima beans, mushrooms, okra, onion, parsnip, peppers, potato skin and sprouts.

Choose fruit juice without pulp and canned, soft, well-cooked fruits without seeds or skins such as applesauce.
Raw fruits that can be enjoyed include very ripe apricots, bananas, cantaloupe and honeydew.
Avoid berries, raisins, dried fruit, figs, prunes and prune juice and all fruit skins.

Choose tender, well-cooked poultry, fish, lean beef, eggs (cooked until yolk is solid), tofu and smooth nut butters (like almond or peanut; limit to 2 Tablespoons per day).
Avoid tough, gristly, fatty and fried meats as well as those highly processed like sausage, hot dogs, bacon and deli meats.
Avoid nuts and chunky nut butters.
Avoid dried beans, peas and lentils.

Limit fat to less than 8 teaspoons per day. Acceptable fats include oils, butter, margarine, mayonnaise, cream cheese and smooth sauces and dressings.
Avoid coconut and avocado.

Smooth condiments are acceptable. Avoid chunky relishes and pickles.
Avoid spicy foods.
Avoid desserts that contain any ingredients listed that are not OK to eat like berries, nuts or coconut.
Avoid chocolate and caffeine.
Speak with your doctor about whether alcohol is acceptable for you.

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Symptoms of acid reflux may include abdominal pain, belching, sour taste, nausea or chest pain. If you and your doctor have decided that GERD (gastroesophageal reflux disease) is the cause of your symptoms, diet and lifestyle modifications may help.

General Dietary Guidelines:
Eat small, frequent meals.
Drink fluids between meals, not during them.
Focus on low-fat, high-protein foods.
Stop eating before you get too full.

Avoid beverages which may worsen your symptoms:
Mint and/or caffeinated teas
Other caffeinated beverages such as energy drinks
Soda, seltzer and other carbonated beverages

Avoid foods which may worsen your symptoms:
Citrus fruits such as oranges and lemons
Tomatoes including tomato sauce and salsa
Mint or peppermint
Fatty or spicy foods such as chili or curry
Onions and garlic
Any foods that cause symptoms

General Lifestyle Modifications:
Maintain a healthy body weight.
Quit smoking- Smoking may increase your risk for heartburn as it may increase the amount of acid secreted by your stomach.
Avoid lying down after meals and eating within 2-3 hours of bedtime. Elevate your head while you sleep with a pillow or wedge.
Wear loosely fitting pants and belts.
Keep in mind that everyone is different and what is tolerated by one person may not be by another. Work with the dietitian to evaluate your diet and ensure adequate and appropriate nutrition. If symptoms persist, please consult with your doctor as you may require medication or further evaluation.

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