Dairy, wheat, or both?
#315845 - 10/01/07 11:00 AM
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welshsarah
Reged: 06/30/07
Posts: 297
Loc: England, UK
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Hi there, my dietitian says i have to eat dairy for 3 months and NOT wheat in order to find out which foods i'm intolerant of. I suspect i'm intolerant of both so don't want to eat dairy. But since my dietitian has said not to eat wheat and that i must include dairy i don't know what to do. Any suggestions? It's baffling me!
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Sarah
IBS-C
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I would be very weary of this advice. First of all, it doesn't take 3 months to figure out if you're intolerant to one specific food. Second, recommending to eat dairy for someone who is having digestive problems seems very wrong. Every doc I've seen has told me to cut back on dairy or cut it out completely. That includes 2 family doctors, a dietitian, a naturopath, and two GI specialists (and of course, Heather).
Do some searches online for food intolerances and elimination diets. It's pretty similar to Heather's Break the Cycle diet. Fall back on foods you know are safe, and eat only that for a few days. Then introduce a food you suspect and monitor your symptoms.
If you're trying to figure out if you have a food allergy, that is different from an intolerance. You may need to cut it out for longer than a few days. I suspect this is what the dietitian actually means for the wheat in your case. Wheat is a common allergen, but I'm not so sure it's considered common to be intolerant to it.
Maybe you could clarify with your dietitian if they are checking for food intolerance or food allergy. Also, a second opinion is not a bad idea. I've had better success with dietary advice from my naturopath than from a dietitian. It may be something to look into.
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Kat
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K2
#315863 - 10/01/07 11:53 AM
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Jordy
Reged: 08/12/06
Posts: 2095
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Has your naturapath recommended that you avoid any types of foods, like gluten or fructose? Or do you just not eat dairy?
What advice does your naturapath give you?
Sounds like you have a found someone who really is able to help you! 
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IBS-C with pain and bloat
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Thanks for your reply K2. I always get confused with intolerance and allergy. I think my dietitian's trying to figure out if i have an allergy as food eliminating is the only method we use in the UK to figure out if someone has a food allergy.
I've done lots of searching online and i think that both wheat and dairy are a problem for me as when i've eliminated them both in the past it's worked well. However, i'm afraid to cut wheat and dairy out at the same time as my dietitian says that it will interfere with the results and we won't be able to see which one is the culprit. So she said only cut out wheat for 3 months. It's confusing.
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Sarah
IBS-C
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In that case I would cut out dairy first, then wheat. Reason being is that at least wheat (in the form of white bread for example) is easy to digest. Milk is not. In order to help your IBS while you try to figure out an allergy, cut out the dairy first. It's also a good thing to do it one at a time, take it slow, because then you can adjust your diet without feeling too deprived.
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Kat
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I think you're right in what you're saying but i'm a bit scared to go against my specialist's advice as she's the expert and i don't want to be disrespectful. Do you know what i mean? Or am i just being ridiculous?
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Sarah
IBS-C
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Re: K2
#315877 - 10/01/07 12:20 PM
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K2
Reged: 01/29/06
Posts: 1191
Loc: Canada
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So far I'll say this. She has helped me find a better mineral supplement (mostly for immune system health but also to try and regulate muscle spasming). She's mostly helping me with immune system health for now because that is the reason I came to her. I just found out she has IBS as well, so I found this pretty interesting.
I'm just starting on the food allergy thing, so I'll post about that once I know more. I've only had two appointments so far, and we're focusing on my immune system. She's asked me more questions than I've asked her. She did in fact tell me to try a wheat-free diet (although not a gluten-free) because it is one of the most common allergens. It was also the basis of my diet for 24 years, so I think it makes sense. In terms of overall health, it is good to get a variety of grains, not just wheat. So I'll probably be cutting out wheat temporarily, and then having it on a non-regular basis.
I might ask at my next appointment about fructose. I know you have been trying to avoid fructose lately, has it helped? One thing I found confusing was a website that listed fruits as being high in fructose (as compared to glucose) and the only real offenders were apples and pears. Mangoes were pretty low. Syl if you have a good reference to a list of fructose/glucose content in fruits I'd be interested. It's all just so confusing.. I'd assume if you were following a low-fructose diet for a few weeks and didn't notice any change in symptoms, then it's probably not a problem.
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Kat
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Oh I understand completely. My first GI told me to eat more bran. My goodness I was cooking bran muffins every week and boy was I in the bathroom a lot! I wanted to believe her and wanted to do everything she said because I thought she should be right. I've always thought that doctors should be right.
In this case, ask your dietitian why she is recommending dairy products for you when it is general knowledge that this is a problem food for anyone with digestive problems. Asking questions is not being disrespectful, and neither is getting another opinion. I wouldn't wait to go back for an appointment, try just calling in and asking. Also maybe ask why you can't cut out dairy first instead of wheat first?
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Kat
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Thanks K2. I really appreciate your replies. It's good to know that it's not just me who thinks doctors should be right. I think i will give her a call because it's getting to me. I'm tired of feeling ill and it getting in the way of life. Now i just need to find my dietitian's number... If i can't find her number i think i'll just cut out both and let her know the results when i see her in December... Desperate times! Thanks again 
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Sarah
IBS-C
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The USDA Nutrient Database is a reasonably good source of information. For example, for 100 grams of (a) apple without the skin it gives the amount of glucose as 3.25 grams and fructose as 6.03 grams and (b) pear the amount of glucose as 2.76 grams and fructose as 6.23 grams.
The source of information I uses as a definitive source is the reference given below. The authors have created and tested a low fructose diet specifically for IBS. The list the favourable and unfavourable foods as follows:
Unfavorable foods (i.e. more fructose than glucose)
Fruit - Apple, pear, guava, honeydew melon, nashi fruit, pawpaw/papaya, quince, star fruit, watermelon
Dried fruit - Apple, apricot, currant, date, fig, pear, prune, raisin, sultana
Fruit juices
Fruit pastes - chutney, relish, plum sauce, sweet & sour sauce, BBq sauce.
Coconut
Dried fruit bars
Honey
Fortified wines
HFCS
Corn syrup solids
Fruit juice concentrates
Favorable foods (i.e. fructose equal to or less than glucose)
Stone fruit: apricot, nectarine, peach, plum (caution - these fruit contain sorbitol)
Berry fruit: blueberry, blackberry, boysenberry, cranberry, raspberry, strawberry
Citrus fruit: kumquat, grapefruit, lemon, lime, mandarin, orange, tangelo
Other fruits: ripe banana, jackfruit, kiwi fruit, passion fruit, pineapple, rhubarb, tamarillo
Reference
Shepherd SJ, Gibson PR (2006). Fructose malasborption and symptoms of irritable bowel syndrome: guidelines for effective dietary management . Journal of the American Dietetic Association 106 (10): 1631–9.
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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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