Summertime….an opportunity, at least here in the Northeast, to get outside more, be more active, and take advantage of all the summer produce. Its also tempting to go off the diet while traveling or having dinner out. This can get really tricky. I often have patients ask me about compliance, and how much we need to do in order to attain and remain in remission. While this varies individually and with severity and type of disease, basically NO ONE has to be 100% compliant. Not only is it rarely possible, it may not even be advisable.
BALANCE is key: this means not narrowing the diet so much that you don’t get the variety necessary to achieve the diversity of a beneficial microbiome, and also narrowing the diet can lead to nutrient deficiencies. Make sure you are not stuck in a rut, doing the same thing day in and day out. You can have your favorites but get variety. Variety of proteins (eggs, fermented dairy, legumes, nuts and seeds, lean animal and fish protein if you choose) for about 15-20% of the diet, variety of veggies (mostly non-starchy) for the majority of the diet, variety of fruit, while also adding these foods in the textures you can digest and absorb. We also need prebiotics every day, and probiotics most days. The fats (good fats like monounsaturated and omega-3 fats) and carbohydrates (like oats, carrots, squash) are also very important.
IBD-AIDers might also like to hear about the “new foods” we are considering for addition to the diet, but are awaiting more research to confirm them. This includes barley (for those without celiac) which is all but proven to be ok (!). We are also looking as cassava (processing is important), and grains such as teff, millet, quinoa, and amaranth. I think cassava may be ok in the right form, but I’m less enthusiastic about the others due to lack of prebiotic properties.
What about plant-based IBD-AID? This is fantastic and can work REALLY well for many people. Meat is hard to digest, and if you can’t afford organic…. the meat may not be quality. Folks with IBD are sensitive to digestion and to the quality of food. Word to the wise here: processed vegetarian food is not better than other processed foods. Manufacturers differ with what they use for excipients and food additives (ingredients that do not need to be listed on the label since they are thought to be safe). How do we know? We don’t….
Definition of food additive:
- Broadly includes any substance that becomes a component of food or otherwise affects the characteristics of food.
- Excludes substances that are recognized, among qualified experts, as having been adequately shown through scientific procedures (or, in the case of a substance used in food prior to January 1, 1958, through experience based on common use in food) to be safe under the conditions of their intended use.
The food supply is rapidly changing.
There are several food additives that do not have to be listed on the label, if they are “generally recognized as safe” (GRAS). The Food and Drug Administration has made permanent a rule that allows food companies to add new ingredients to the food supply and are only asked to “volunteer” information regarding the safety of these ingredients. Thousands of substances have already been added under the rule, which was first proposed in 1997 and has effectively been in place ever since. The GRAS list is pretty outdated…and can be found here: https://www.accessdata.fda.gov/scripts/fdcc/?set=SCOGS
This is chicory! The leaves are great in salads, the root is nice as a powdered addition to coffee. This is a lovely prebiotic.
