Friday, February 22, 2013

What Can I Eat When I'm Sick and Following a Low FODMAPs Diet?!

A little over a month ago, I got sick.   I woke up at 3am and felt like I had food poisoning.  I then proceeded to wake up every hour, on the hour, after that and you know.....get sick.  Thankfully I was off that day, so I was able to stay home and relax my stomach all day (and my body, for that matter). My mom, a nurse, reminded me of the importance of the "BRAT" diet.  You've heard of the BRAT diet, right? It stands for Bananas, Rice, Applesauce, and Toast.  These foods are bland and lower in fiber, so the premise is that they will provide some nutrients while giving your gastrointestinal tract a much-needed break.  There are apparently some extensions to the diet; BRATTY (with Tea and Yogurt), and BRATCH (with CHicken or CHicken soup).  I think it's a given that plenty of liquid should be included in this diet as well, as many people with GI upset are losing fluids and electrolytes when they "get sick".



 

But what if you follow a Low FODMAPs diet? Could these remedies possibly make the problem worse?  I found out last month just how hard it is to be sick while on a low FODMAPs diet.  I learned some things, so please take note (and feel free to add what you've learned yourself in the comment section, because I'm no pro when it comes to eating low FODMAPs while sick!)


  • Bananas:  On the BRAT diet you are supposed to eat bananas that are slightly more ripe because the unripe bananas have more of a fiber called "resistant starch".  This starch resists digestion in the small intestine, and then gets fermented in the colon.  It's typically fine to consume (in small amounts) on a low FODMAPs diet, but may cause further GI problems if eaten in excess while you're having GI upset (hence the reason why the BRAT diet suggests eating them ripe!).  I would be careful not to have more than 1/2-1 full banana (and make it small, and more ripe) per day when trying to give your GI tract a break, and following a low FODMAPs diet.  Some people can handle more than others, so eat with caution.
  • Rice:  Rice is fine, but make sure it's lower in fiber, because the purpose of the BRAT diet is to provide bland and lower fiber foods.  Most likely white or brown rice would be fine (brown rice usually doesn't have much fiber anyway).  Also, do not season the rice with anything other than perhaps a dash of salt.
  • Applesauce:  Stay away.  Loaded with FODMAPs.
  • Toast:  When I was sick I was seriously craving sourdough bread.  According to the low FODMAPs app (from the Monash University), sourdough bread is only ok when it's made from wheat-free grains.  Ugh.  That's rare here in the states!  Plus, when I sent Nick to the store to pick up some fresh sourdough bread, I had him read the ingredients to me and to my horror I found that all of them also had honey (not low FODMAPs)!  Ugh again.  I still ate it.  But your best bet is a wheat-free bread (or just look for gluten-free, because that's automatically going to be wheat-free) and be sure to read the ingredients and watch out for things like honey, HFCS, apple concentrates or pear concentrates (yes, I have found these in breads before, they are out there).

  • Chicken:  A bland, boiled chicken is fine, but be careful with chicken soup (see below)


I also enjoy popsicles and cold foods when I have stomach/GI issues.  In fact, I like switching between hot soup and cold ices or popsicles.  I don't know why, but that's my thing.  I ate this Italian Ice on the day I was sick, and it really hit the spot.  Notice the ingredients below, all fine on a low FODMAPs diet.



Simple ingredients! These are best.  The guar gum and xanthan gums, which are used to bind ingredients together, may cause problems if eaten in excess ( I say "may" because I'm not 100% sure about these ingredients), but in this case I don't see any issues. 



What if you have the common cold?  The BRAT diet isn't really the best "remedy" for a cold.

Source: iStock Photo


When I'm at home with a cold, I crave popsicles and hot soups.  But of course there are other remedies like hot tea, honey, and neti pots!  What can you have on a low FODMAPs diet? Read below.
  • Popcicles/cold foods:  I recommend a simple Italian Ice like the one pictured above.  Or, if you can find a brand of popsicle that doesn't contain High Fructose Corn Syrup, that would be great (they are hard to find!).  Sometimes it's best just to make your own (but, no one wants to do that when they have a cold and feel run down).


HFCS, no bueno


What about the "sugar-free" versions? Well....you can't win with those either, they usually contain sugar alcohols (or the "P" in FODMAPs, "polyols")

Sugar alcohols are a type of polyols.  You need to really limit these on low FODMAPs



  • Hot Soups:  Good luck finding any soups that don't contain onion or garlic.  You'll have to stick to simple broth.  You'll also have to give up your goals of eating "only natural foods" when you have a cold and you really crave some hot soup.  Why?  Because most of the broths that I have found on the market that are deemed "ok" for those following a low FODMAPs diet are also loaded with unnatural ingredients.....


Not so natural, but...ok to eat on low FODMAPs.  No FODMAPs ingredients here!


The label below contains many more "natural" ingredients (I mean, I know what these ingredients are!)  However, it's loaded with FODMAPs; onion, honey, and mushroom.

So natural and yummy, but....so many offenders on this list!




  • Hot Tea:  Yes, yes, yes!  Drink it up.  Just make sure you aren't buying a tea that is flavored with honey.


Source: iStock Photo




Other things to think about?  Throat lozenges and cough drops.  Many of them contain honey and/or pure fructose, just be aware (and they may not cause big problems if you are just doing 1 every couple hours).  Something else I would recommend are citrus fruits, like clementines and oranges (but not orange juice, most are off-limits).

And my best advice?  Drink plenty of water, and stay active.  Yes, you read that right, stay active! Exercise boosts your immune system and if you can add some small amounts of activity and/or exercise into your routine, even if you have a cold, it may help reduce the duration. Take it from me, it works.


QUESTION:  What tips do you have for beating a cold or stomach bug while following a low FODMAPs diet, or even if not following a low FODMAPs diet?

Don't forget to check out my latest low FODMAPs post, with more helpful tips and resources.


Thanks for reading!

The Candid Rd
NOTE: I love comments!  But, be sure to come back to read any replies to questions or comments, as they do not go directly to your e-mail.


7 comments :

  1. Great post! It makes sense that a lot of cold stuff contains honey since that is so helpful for cough/throat issues. Oh well!

    I think Edy's popsicles do not have HFCS, but I'll have to double check on that. I usually can't eat that stuff either and I have Edy's pops sometimes :)

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  2. This is a really interesting post! I just finished up shadowing an RD for my clinical rotation and she had mentioned that the BRAT diet is on its way out. Have you heard that? She said staying hydrated and drinking Gatorade or other 'lytes replacers work the best.

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    1. Yes, I have heard this before, but I still recommend the brat diet because it's helpful and EASY! I also recommend chicken soup and Gatorade (or other elextrolyes like Nuun tablets) and other fluids. There are just so many more non-BRAT options these days, but that's so easy!

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  3. Honey in sour dough? I would've never guessed! Let's just never get sick, mmkay? Miss ya :)

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  4. Ugh, you poor thing! Sorry to hear you were so sick last month - that's just the worst. This post is a fantastic guide and I'm definitely going to refer back to it for some of my clients. There's so much to think about with FODMAPs!

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  5. i always thought it was better eat more ripe bananas? maybe i heard wrong. What about Kefir? I always think that with a little banana helps.

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    1. Actually the really ripe bananas have too much fructose, therefore they aren't good for a low fodmaps diet. The less ripe bananas don't have that free fructose to cause bloating. Kefir would be good, but for some it's best to stay away from dairy when they are sick (I stuck with rice KRispies, almond milk, and a dash of PB2!) haha

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