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question for Syl re FODMAPs and EFI diets
      #368170 - 09/14/12 08:00 AM
Desert Phoenix

Reged: 12/17/03
Posts: 137


Hey Syl,

Hope you're doing well.

I've now completed a trial of the FODMAPs diet and it has definitely been a success. I would say the diet has resulted in approx. 50-60% symptom reduction.

I was surprised by this, because I've done exclusionary diets in the past that eliminated dairy and wheat, but I had never eliminated the full combination of FODMAP foods.

However, as pleased as I am with the results, following the FODMAPs diet alone doesn't seem to be the full picture for me.

I was wondering if you might have any recommendations about where to proceed from here?

My goal is to try to get even more symptom reduction before I try to add back in foods that I've eliminated. My problem in the past has been that no elimination diet has ever given me enough symptom stability to make it possible to objectively evaluate whether the reintroduction of specific foods was problematic.

I now believe it may be possible to achieve this, but I sense that I need a little bit more symptom reduction.

As mentioned in past correspondence, following the EFI diet alone never really resulted in great benefit for me. Consequently, I have not been strictly adhering to the EFI principles (including during the FODMAPs elimination diet).

Perhaps a good first step would be to combine the EFI and FODMAPs diets and see if that results in further improvement? If I remember correctly, I believe you mentioned that you take this approach. While following the EFI diet in isolation never worked that well for me, perhaps it will be more effective now that I'm eliminating/reducing FODMAPs intake.

Or another combination approach might be to try eliminating grains in addition to FODMAPs (there's so much talk these days about grains being problematic for some - and my reasoning here is that if fermentation is the core issue, an overall reduction in carbs - no just high FODMAPs carbs / might be beneficial), or following one of the anti-yeast diets in addition to the FODMAP diet (my reasoning here is that perhaps this would further cut down on the amount of fermentation/malabsorbtion in my gut by cutting out those foods that promote yeast growth/fermentation).

What would be your best guess as to the best direction in which to concentrate my energies?

Having tried so many elimination diets in the past, I had more or less come to the conclusion that diet just wasn't a determining factor for my IBS. My success with the FODMAP diet has however led me to believe that it may after all play a significant role.

It may also be that many of the food/food categories I eliminated in the past that had no positive effect on my IBS are in fact problematic. In order words, eliminating these foods didn't seem to have an effect, but that might have been because I was still eating too many other foods that were causing symptoms.

Anyway, thanks for any comments you may have!

Greetings from NM,
Chris

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Re: question for Syl re FODMAPs and EFI diets new
      #368177 - 09/14/12 09:43 AM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

Yes - it is definitely worth while following a combination of the EFI and FODMAP diets. Many of us do. The problem with the FOODMAP diet is that advocates have not read the actually research papers. For example, in the paper linked to in my second link in my signature it says "If adherence was strict, attention may be needed to modify intake of resistant starch and insoluble and soluble fiber. Other dietary triggers such as food chemicals may need to be considered, as should potential factors such as caffeine, fat, meal size and regularity." The EFI diet deals well with these other issues.

--------------------
STABLE: ♂, IBS-D 50+ years - Science of IBS

The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS

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Re: question for Syl re FODMAPs and EFI diets new
      #368182 - 09/14/12 02:18 PM
Desert Phoenix

Reged: 12/17/03
Posts: 137


Thanks, Syl.

What is meant by "resistant starch"? Starches that are poorly absorbed (such as - perhaps - sweet potatoes)?

Chris

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Re: question for Syl re FODMAPs and EFI diets new
      #368186 - 09/15/12 05:12 AM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

A resistant starch is a functional fiber that acts like a soluble fiber. Resistant starches are undigestible. The sticky and gluey stuff found in oatmeal and sticky rice after it is cooked is resistant starch. Potatoes and sweet potatoes have resistant starch when cooked. You might find Understanding Resistant Starch of interest.

By the way - there is no clinical evidence to support the notion that yeast overgrowth or Candida have anything to do with IBS. You might find this message of interest. There is plenty of misinformation on the Internet

--------------------
STABLE: ♂, IBS-D 50+ years - Science of IBS

The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS

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Re: question for Syl re FODMAPs and EFI diets new
      #368188 - 09/16/12 02:15 PM
Desert Phoenix

Reged: 12/17/03
Posts: 137


Thanks for the info.

I also found this blurb on candida by Andrew Weil:

http://www.drweil.com/drw/u/QAA125503/Concerned-About-Candidiasis.html

Chris

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EFI rules new
      #368190 - 09/17/12 06:53 AM
Susie1985

Reged: 05/04/11
Posts: 211


Great about the progress with the FODMAPs. Here are the four EFI rules that are mentioned/expounded on in other parts of this website, just as a summary:

1. no alcohol
2. no caffeine
3. less insoluble fibre (IF) than soluble fibre (SF) per meals (peel, deseed and cook until soft) (use a soluble fibre supplement)
4. limited fat per meals - one meal calories coming from fat:25% maximum. (1g fat has 9kcal, 1g carb has 4kcal, 1g protein has 4kcal)

-rough guide fibre content of foods (actual fibre proportions and content depends on variety and ripeness and there is no accounting for resistant starch (RS), which means that e.g. bananas and black beans both have more functional fibre than stated due to high RS contents, which act as SF):
http://huhs.harvard.edu/assets/File/OurServices/Service_Nutrition_Fiber.pdf
-fat content of oil - 1 tablespoonful of oil has 120kcal coming from fat!! (e.g. 100g raw chicken breast has 110kcal from other, 1 medium potato has 150kcal: so you can safely cook 200g of raw chicken breasts with that one tbpsoonful of oil and one boiled medium potato or 100g chicken breast and two medium potatoes with one tbsp of oil)

--------------------
now: stable through EFI+FODMAP dieting (no lactose/no fructose/some fructans and some polyols)

before: IBS-D(pseudo-diarrhoea), bloating, often unbearable pain esp from too much fat: Apr 2007- Dec 2010


FODMAPs: http://www.todaysdietitian.com/newarchives/072710p30.shtml


[I've tried VSL#3 -> I could tolerate v good amounts of IF (even with less SF), it worked great (but overall I find it too expensive)]

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Re: EFI rules new
      #368192 - 09/17/12 11:43 AM
Desert Phoenix

Reged: 12/17/03
Posts: 137


many thanks for this helpful summary!

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