Can you tell us a little bit about yourself?
I am a dietitian from Sydney, but currently living in Stockholm.
I have a website, DietvsDisease.org that provides science-based resources for those living with diet-related diseases and conditions. As you can imagine this is a huge area, so I am building the database slowly with a few topics at a time.
What is one piece of nutrition advice that you give which surprises people?
Very few foods are absolutely healthy or unhealthy – it’s the quantities you eat and your relationship with that food that makes it healthy or unhealthy.
Do you have a nutrition philosophy? What do you do with your own diet?
I rarely drink caffeine. This is because I have a strong intolerance to caffeine (genetic).
But other than that, not really.
I cook most days and eat out on occasions. I don’t really eat between meals, but if I do it will always be after dinner.
Sometimes I skip breakfast, so my first food of the day is at lunch. This is now called “intermittent fasting” so I guess you could say I do that occasionally.
Oh and if I am stressed I do get IBS, which sucks. At these times I will limit high FODMAP foods… and try to finish the tasks that are stressing me out!
Since it is IBS awareness month: what do you see as the best way to manage IBS through diet? What is your opinion of the FODMAP diet?
The (low) FODMAP diet is a clinically proven way to treat IBS for sure, and a strategy that patients can do without having to buy anything extra (like supplements).
The addition of certain probiotics can help, potentially even fiber supplements (depending on the main IBS symptoms), but these are best used in addition to other strategies like the FODMAP diet.
I’m writing a huge resource on this topic right now, it will be the best there is online hands down.
What are common food intolerances that you frequently hear of?
FODMAP intolerance is the most common for sure, especially on those with chronic stress or who have had an acute gastrointestinal issue.
Food chemical intolerances are also common and I think poorly understood by clinicians and the public. For example amines and salicylates. Admittedly I need to learn more about them myself.
An intolerance to high fat (fried) foods and chilli (capsaicin) is not uncommon either.
And then of course caffeine intolerance which I am a shining example of.
What do you see as the best way to manage common food intolerances? Is it much different to how you would manage a food allergy?
To manage an intolerance is much trickier than allergy because there is typically no test for them.
You have to eliminate the suspected problem food from your diet in a structured way so that you can identify if it caused issues or not. Likewise, you may also have to reintroduce that food in a structured way to determine how much you can tolerate (if any).
Typically with intolerance people can tolerate a small amount, and only experience issues when that threshold is exceeded.
With allergy it’s as simple as you either can eat it or you can’t eat it at all. And you can test for allergies too.
Is gluten-intolerance common for people who do not have coeliac disease? Do you have an opinion on the wide-spread claims of gluten-intolerance?
Early data suggests between 0.5-13% of people have non-celiac gluten sensitivity (https://www.ncbi.nlm.nih.gov/pubmed/25583468, https://www.ncbi.nlm.nih.gov/pubmed/2575313).
And there are of course plenty of anecdotes that support this data. So I believe it exists, particularly in those with food intolerance or certain autoimmune conditions.
Theoretically it makes sense as gluten can influence zonulin signalling, which regulates intestinal permeability or “leaky gut”. Increased intestinal permeability is common in several autoimmune conditions including type 1 diabetes and celiac disease (although we all agree gluten directly influences celiac disease).
Is there anything you would like to add to wrap it up?
Don’t stick to a low FODMAP diet for longer than necessary.
That is, if you have been following it at least 3 weeks and are almost symptom-free, then you should start to rechallenge and reintroduce FODMAPs. This important point has been lost online and in textbooks.
Restricting FODMAPs unnecessarily – for long periods of time – will only make your sensitivity even worse.
Joe Leech is a health writer currently based in Stockholm, who writes and speaks around the world, traveling for much of the year. He studied in both Australia and Finland, earning a Master’s Degree in Nutrition and Dietetics. One of Joe’s projects is Diet vs Disease which dispels inaccurate and misleading health issues. Beyond helping people to improve their quality of life through dietary modification, the site is also contributing to ending world hunger, with 5% of the ad revenue on the site going towards this cause.