Have you ever ‘prescribed’ a diet you have never tried yourself? I know I certainly have, in fact, the thought of following any diet sounds like a bore to me. However, recently I interviewed Lee Martin, a dietitian who went beyond simply advising others and actually committed to taking up the challenge himself by following the low FODMAP diet he had recommended to his IBS patients. Lee’s journey has highlighted to me just how important this seemingly boring task is to my practice.
Here’s what Lee had to say about his low FODMAP journey…
Why did you do it?
‘I had been providing low FODMAP advice for a few months and it was during clinic that one patient in particular just kept coming out with loads of brilliant practical tips. I thought I should know this and figured the only way to find out if something works practically is to do it yourself. So I talked my girlfriend Mel (a paediatric dietitian) into doing the diet for 8 weeks and we documented everything on our blog ‘Two Dietitians do the low FODMAP diet’’.
What were the key challenges?
‘The first week was by far the hardest as you have to get used to learning what foods you can and cannot eat. This meant changing my shopping and cooking habits along with creating new menus of foods I was going to eat. I basically had to prepare everything ate, as finding convenience foods when you’re out and about is a real challenge. “Initially it felt like the convenience food industry was against people with IBS- it seemed they’d all gotten together and decided every meal had to have onion and garlic in them!” But once I got used to the food restrictions it was actually relatively easy to follow thanks to the explosion in free-from food products. I was lucky Mel was committed to doing the diet with me, but I can imagine it would be much harder if living with others eating a ‘normal’ diet at the same time. We are dietitians of course which also helped but even we made a classic mistake in the first week when we bought a can of grape juice and half way through drinking it realised it was 40% apple juice.’
How did it change your practice?
‘It made me think a lot more about the circumstances and culinary choices the patient in front of me presented with. Most people can follow a list of ‘yes’ and ‘no’ foods without too many problems but habits, lifestyle choices, cooking skills and budget have a huge influence on compliance. You might not realise this if you don’t question the person about how, practically, they are going to do the diet. Although the evidence is there for the full low FODMAP dietary restriction of foods I found this isn’t always necessary in everyone and the diet must be adapted to the individual. That is what dietitians are there for; otherwise everyone may just as well follow that list of yes and no foods.’
Would you do it again?
‘Actually I have tried to follow a low FODMAP diet for a small period of time in each of the countries Mel and I have been visiting as we are currently travelling around the world. We have just spent the first 4 months in Asia so you can imagine how hard it is to follow in places like Thailand, Cambodia, Vietnam, Laos and the Philippines. Personally I don’t think anyone should try to follow the low FODMAP restriction diet when on holiday or especially when travelling, it is not worth the effort. You can however follow a modified low FODMAP diet and I have put some practical tips and information on the blog for each of the countries we travel through to help people achieve this.’
As challenging as it maybe, I’ve certainly learnt from Lee’s journey. He reminded me that anyone can download a ‘diet’, but it’s the practical, experienced advice, that produce sustainable results that our patients/clients deserve. And although our basic dietetic skills are transferable between diets, in my opinion, it’s the first-hand experience following the diet that takes what dietitians offer to the next level.
So today I’ve cleaned out the fridge of all my favourite FODMAP-rich foods as I embark on my own low FODMAP journey…time to do as I say AND as I do.
Want to know more about Lee’s journey? Check out his blog http://rmdietetic.com/