Project Elimination: Week 2 – I make a mistake!

On Sunday I went through to Edinburgh with my wife and we had a lovely day out, but I must confess that I made a big mistake when it came to lunch. Hunger got the better of me and we went to a Pizza Express that was nearby. I made a good choice by going for the gluten-free pizza base, but they’re not nearly as tasty as their standard bases and it certainly paled in comparison with the fantastic gluten-free pizza bases you can make with the Grass Roots gluten-free pizza base mix you can buy online from FODMarket.

Anyway, I ordered my pizza and when it came I made short work of it. I didn’t suffer any ill-effects immediately, but later that evening after dinner I started having painful intestinal spasms and bloating. After giving it some thought I realised that, for all that I’d chosen the gluten-free pizza base and vegan toppings, such as dairy-free cheese and low FODMAP vegetables, there was a high chance that the pizza sauce contained garlic and possibly even minced onion.

I think that’s where being prepared on the elimination phase of the low FODMAP diet comes in because I made a mistake by allowing myself to get too hungry which led to me making an impulsive decision about what I would eat. Sadly, I know that if I’d been at home I would have been able to prepare myself a suitably low FODMAP meal, but because I was outside I just went with whatever was handy nearby.

This experience has made me realise that I think this has wider implications for people who follow the low FODMAP diet, regardless of whether they’re on elimination, reintroduction or maintaining, and that is the cold hard fact that it is hard to eat out on the low FODMAP diet.

One thing I omitted from last week’s blog post was that I’d decided against visiting my step-daughter and her family overnight last Wednesday because I knew that I would have to bring my own food and prepare my own meals because they eat a largely vegetarian diet and it would most likely be very high FODMAP.

And do you know what? Aside from the hassle factor of cooking meals for myself (never mind the cost aspect too), the main reason I decided against going to visit was because I felt embarrassed. I was embarrassed and self-conscious that I was following an eating regime which set me apart from the family and meant that I had to eat differently from them. I was embarrassed that I would have to bring low FODMAP ingredients with me to make meals specific to my own requirements.

And that makes me sad.

It makes me sad to realise this because my family would never judge me for taking care of my own health and eating whichever way is best for me.

However, it’s sad that I should feel self-conscious about taking care of myself and eating the right foods during the elimination process in order to identify what doesn’t agree with my gut.

It’s Monday now and my gut is steadily quietening down thanks to a combination of medication and eating healthy low FODMAP food, but I have to say that I am glad I had my experience yesterday because it really brought home to me the importance of making the right food choices for myself.

I’ve enjoyed being fairly symptom free on the days I’ve eaten sensibly low FODMAP and I didn’t enjoy having them return after yesterday’s mistake. It’s made me even more determined to continue seeing through the elimination phase and, once that’s completed, start identifying the higher FODMAP foods I can successfully tolerate and the ones I can’t.

I think that the low FODMAP diet is still in its infancy, but I eagerly anticipate the day when our shops, supermarkets, cafes and restaurants are all FODMAP educated and there’s a plethora of low FODMAP foods available to us in the same way that we now have a much wider awareness of coeliac disease nowadays and the importance of coeliacs eating a gluten-free diet.

This post has been somewhat rambling and I apologise for that, but I hope the honesty of my words makes it clear to anyone else out there who struggles with IBS or is in elimination and makes a mistake or feels self-conscious about making food choices as a result of their own dietary needs, that it’s okay.

You can make whatever requests you need to make food suitable for you when eating out.

You can bring your own low FODMAP food with you to places if you need to.

And ultimately, you’re entitled to take care of your body in whichever way is best for it because it’s where you live and you deserve the very best.

With love,

Jane (The Fat Foodie) xxx

Lesley Reid, King’s College Professional FODMAP Qualified Dietitian

Here are the details for Lesley, the FODMAP Trained Dietitian, who is taking me through elimination:

Telephone:
07777640035

Email: info@lesleyreiddietitian.co.uk



Project Elimination: Week 1 in Elimination Phase

Today is
Friday the 15th and I’ve been on the elimination phase for six days. I’m not
going to lie, it’s been a bit taxing at points, but it has been worth it. I’ve
definitely noticed a decrease in bloating and overall gut discomfort.

I’ve been tracking everything (and I really do mean everything!) religiously on the free version of the MySymptoms app that my dietitian, Lesley, suggested and it definitely makes you more aware of what you’re eating and how much you’re having.

The main thing I’ve noticed about going into the elimination phase of the low FODMAP diet is the importance of planning your shopping list for the meals you’ll eat in the week or weeks ahead. I’ll give you a rundown of my week’s meals further on, but at the very start of this process I used the Monash app to make myself a list of low FODMAP foods and the exact quantities I could have in order to remain within the low FODMAP limit for them. This might seem pedantic, but it made things much easier when it came to planning what I was going to eat.

It makes
the elimination phase a lot easier when you have the peace of mind to know that
there are a few meals you’ve got on standby that you can reach for when
necessary instead of mindlessly staring at the contents of the fridge or
cupboards trying to figure out what meal you can make that’s going to be
suitable.

When I
was preparing my list of low FODMAP foods I was struck by the fact that the
majority of the foods were traditional foods that we would have eaten in the
past, such as potatoes, carrots, parsnips, turnips, cabbage, kale, spinach,
common tomatoes, green beans, lettuce, radishes, green leek tips, pickled
beetroot, rhubarb, raspberries, oats, maize, rice, and vinegars.

These
are all foods which would have made up the staple diet of our ancestors because
they would have been grown on our own shores, so isn’t it interesting that they’re
the foods which are least likely to cause us digestive discomfort? Perhaps it’s
just the historian in me that’s making these correlations, but I find it a very
interesting link. It makes me wonder if the wide ranging diet we’ve become so
accustomed to due to the availability of a plethora of worldwide foods in our
supermarkets (and the easy availability of junk food) has had a negative effect
on our guts. It’s just a thought, but I’d welcome anyone’s thoughts on the
subject.

Another thing I’d like to mention is the importance of having suitably low FODMAP ingredients in your cupboards before you start the elimination phase. One thing I’d forgotten to pick up was Massell 7s stock cubes and on the first day of elimination when I made soup for lunch I sorely regretted it. Needless to say, I bought some online later that day and had them delivered promptly! Trust me, they make such a difference when you’re cooking from scratch.



On the
subject of cooking from scratch, I think that if you want to successfully go
through the elimination phase without accidentally eating high FODMAPs, making
your own food is the way to go, with the exception of things like gluten-free
bread. If you make your own food you can control what’s going into it and,
subsequently, your body.

I have
to say, I’ve eaten well this week and with the exception of finding myself
without a sweet treat to satiate my sweet tooth during the week (which I
swiftly corrected by baking some low FODMAP cookies) I haven’t really missed
anything.

As I
said in a previous post, I’m going to write another cookbook which will include
all of the recipes I’ve created during the elimination phase, but here’s a list
of my meals this week. I hope you enjoy the thought of them as much as I
enjoyed eating them!

Sunday

Breakfast: Gluten-free Crumpets with Fried Eggs

Lunch: Carrot, Ginger and Turmeric Soup with a gluten-free tuna sandwich

Snack: A banana and a mandarin

Dinner: Pork Loin in a Spinach and Sage Sauce with new potatoes and carrots

Monday

Breakfast: A gluten-free herb scone with devilled eggs.

Lunch: Roasted Red Pepper and Tomato Soup with a gluten-free sandwich

Dinner: Pork Loin Chop with Rocket and Red Pepper Salad

Tuesday

Breakfast: Overnight Oats with Blueberries and Raspberries

Snack: Fruit Salad

Lunch: Sardines on toast

Dinner: Meatball Pasta Bake

Dessert: Gluten-free Chocolate Cookies

Wednesday

Breakfast: Quinoa Porridge

Snack: Banana

Lunch: Leftover Meatball Pasta Bake

Dinner: Pork Burger with Smoky Potato Wedges

Thursday

Breakfast: Scrambled Eggs with a Herb Scone

Lunch: Carrot and Tomato Soup with a gluten-free sandwich

Dinner: Yakitori Chicken Kebabs with Kale Egg-Fried Rice

Dessert: A slice of Chocolate Orange Salami Traybake

Friday

Breakfast: Raspberry Buckwheat Muffins and a banana

Lunch: A baked potato with tuna

Dinner: Jerk Pork Loin Steaks

So, all in all, a very tasty week with decreasing digestive discomfort! Roll on week 2!

Lesley Reid, King’s College Professional FODMAP Qualified Dietitian

Lesley’s details are:

Telephone:
07777640035

Email: info@lesleyreiddietitian.co.uk





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Project FODMAP Elimination Blog 2 – First Dietitian Consultation

Last Friday I had my first telephone consultation with Lesley Reid, the FODMAP trained dietitian I’m working with while going back through the elimination and reintroduction phases of the FODMAP diet.

I’d prepared
a few notes in advance which listed some of the FODMAP groups I found were most
problematic to my gut, as well as some questions I wanted to ask her, but I was
really impressed with everything she covered that I hadn’t thought to discuss.

Lesley began by taking me through an intensive questionnaire which identified important health questions. These questions included whether my IBS had actually been diagnosed by a doctor in the past (it has), my gynaecological history, and they also ruled out a number of other potential factors, such as coeliac, gastritis etc. She then asked me to tell me about my symptoms and give her a run-down of my IBS history which covered when it had begun, whether I could identify if there was anything in particular that started it, and how I manage it now (medications etc.). She also asked me about my general health which incorporated any medications I’m taking, if I have any allergies, how much exercise I take and how well hydrated I am.

After we’d discussed in great depth the ‘medical’ part of the consultation Lesley then moved on to discuss the elimination phase she had planned for me. I was prepared for her to advise me to go into the elimination phase for the standard 2-6 weeks of eating solely low FODMAP foods, but Lesley informed me that the gut microbiome is negatively affected by being on the very low FODMAP elimination phase, so it’s best not to stay in elimination for too long. Also, Lesley said that because I’ve already been through the elimination phase once before and I’m quite informed as to what triggers my gut, I should initially go into elimination for two weeks and see if my gut is symptom free at the end of it. If not, we’ll do another week and then decide whether to begin the reintroduction phase at that point.

I have to be honest, I was thrilled to hear that I might only have to do two to three weeks of elimination because it was quite daunting to consider being on it for longer, but Lesley’s positive and encouraging manner left me feeling confident that I could do it. She’d also posted two King’s College London low FODMAP diet booklets to me in advance which covered what the low FODMAP diet was and what products were suitable for the low FODMAP diet, which were handy to have on hand. Unfortunately, the King’s College booklets are only available to registered dietitians, but I’ll always prefer the Monash app anyway.

Lesley advised that I should omit dairy from my diet during the elimination phase due to my diagnosed low level cow’s milk allergy, so that we could remove it from the equation and prevent our results being skewed. She also recommended that I begin to take a probiotic supplement, so that my gut microbiome can be supported (and hopefully improved) while in the elimination phase.

One of the questions I had for Lesley was whether I could incorporate Monash app recommended low levels of some higher FODMAP foods within my diet during elimination, but Lesley said that it was better to stick to a diet which is as low FODMAP as possible. She explained that this is so that all potential FODMAP triggers are removed from the diet in order to calm the gut down during the elimination phase in preparation for the reintroduction phase.

After I came off the phone to Lesley and was processing our conversation it struck me that I hadn’t realized the number of behaviours I’d been doing that were possibly affecting my gut: wine, coffee, dairy, and even over-indulging on certain high FODMAP foods because I’ve been working on a vegan cookbook! For all that I thought I was quite educated in my own low FODMAP diet it turned out that I’d actually been quite blinkered to how I’d been eating and it took a conversation with an actual dietitian to highlight where I’d been going wrong.

Another thing I’d love to share with you all is that I’d said to Lesley that I assumed she wanted me to keep a food/symptom diary, but she actually recommended that I download an app called MySymptoms which enables you to record your food, liquid, medication, supplements, stress levels, exercise, environment, symptoms, bowel movements, energy levels and sleep quality for every day and the times they occur. This enables the app to correlate your ‘intake’ with your symptoms. It’s also a great tool because you can generate a PDF to send to your dietitian at the end of the week. (I’d actually forgotten to ask Lesley of she wanted me to send her my PDFs daily or at the end of each week, so I messaged her and got a really quick and friendly reply saying weekly was fine.)

I genuinely can’t stress enough how beneficial it has been to start this process with a FODMAP trained dietitian. Aside from the fact that Lesley is fully aware of all of the health aspects which are involved in an IBS patient, she’s also really opened my eyes to how important my own diet decisions are when it comes to managing my IBS and FODMAP intake. If you’re thinking of beginning the low FODMAP diet or even if you’ve never consulted a dietitian before and are just eating low FODMAP, I’d highly recommend consulting a FODMAP trained dietitian, such as Lesley.

Before I
began the elimination phase I put a lot of work into generating a list of very
low FODMAP foods for myself, so that when it came to making breakfasts,
lunches, dinners and snacks it’d be easier than having to think off the top of
my head. I also started writing a book of recipe ideas for myself which were
all suitable for the elimination phase, so that I always had a recipe at hand
that I could quickly make without the danger of accidentally eating high
FODMAPs.

I’m not
going to lie, it was much harder to create recipes which were suitable for the elimination
phase as opposed to my usual maintaining phase low FODMAP recipes, so as a
result, I’ve decided that I’m going to write an elimination phase cookbook
which will include all of the recipes I’ve used during the elimination process.

In a sense, I suspect that the reintroduction phase is going to be tougher because I’m going to have to stay fairly low FODMAP until I’ve identified my new FODMAP triggers, but I’m committed to following the process through in its entirety because it’s going to be worth it in the long run.

Lesley Reid, King’s College Professional FODMAP Qualified Dietitian

Lesley’s details are:

Telephone:
07777640035

Email: info@lesleyreiddietitian.co.uk

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Cucumber and Mint Salad (serves 4)

Cucumber and Mint Salad by The Fat Foodie

I’d say it’s fairly well known that I prefer my salads to be on the robust, substantial side, so it’ll not come as a surprise to you that this Cucumber and Mint Salad can be eaten either as a side dish to accompany a piece of grilled fish or chicken or on its own as a fresh lunch.

This Cucumber and Mint Salad in itself is very simple, comprising of just cucumber wedges, sliced bell pepper and cubes of salty feta cheese, but it’s elevated to something quite wonderful by the minty vinegarette it’s dressed in.

The standard vinegarette ingredients of white wine vinegar and olive oil are enhanced by the addition of dried mint and lime juice, creating a salad dressing which is tart, but herby at the same time. I’m not a big fan of salad dressings with a strong vinegar flavour, so I tend to make my vinegarette on the conservative side, but feel free to add more white wine vinegar or dried mint to yours, if you wish.

I make this Cucumber and Mint Salad a great deal because it’s perfect on the side of a piece of grilled salmon or chicken breast, but it also satisfies my appetite as a packed lunch at work. It’s just a great all-rounder salad choice.

Ingredients for the Salad Base:

1 cucumber (diced)

160g feta cheese (or non-dairy cheese)

1 red or yellow bell pepper

Ingredients for the Salad Dressing:

2 tbsps olive oil

1 tbsp white wine vinegar

1 tsp dried mint

The juice of 1 lime

1/2 tsp ground black pepper

1/2 tsp salt

Method:

Prepare the salad ingredients as directed and then place them in a large bowl.

Mix all of the salad dressing ingredients together and then toss it through the salad and serve.

The Fat Foodie Cookbooks are now available on Amazon Worldwide!


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