“Patient Attitudes” toward diet can make a difference

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doctorHere’s another “translation for the rest of us” of a FODMAP-relevant science article: Sunanda Kane of the Mayo Clinic, “What physicians don’t know about patient dietary beliefs and behavior can make a difference,” published in 2012 on expert-reviews.com. It’s an evaluation of an article published in the journal Inflamm. Bowel Dis. also in 2012, by Zallot C, Quilliot D, Chevaux JB, et al. That makes this blog report third-hand.

It’s frustrating when our doctors don’t seem to care what we eat. This study presents that problem from a different point of view. It was a wake-up call to physicians, telling them it DOES matter how their patients feel about what they’re eating. According to the article, more than 50% of IBD sufferers in one study felt sure that food “could” play a role in relapses. Quoting Dr. Kane: “Interestingly, nearly half of the patients in each disease group believed that raw vegetables could improve their symptoms…[but] Only 36% believed that their dietary behavior could lead to … nutritional deficiencies.”

And there’s the nub. Dr. Kane’s emphasis is “don’t give up too many foods, or you could miss needed nutrition.” Therefore, it’s important for our physicians to realize how we perceive the role of our diet—to help keep us from restricting ourselves right into different kinds of poor health.

Quoting Dr. Kane: “Since eating is such an integral part of daily living and socializing, it is natural for patients to gravitate toward focusing on that aspect of life. IBD is chronic and incurable, and anything that can help to mitigate symptoms would be important to recognize…. When a patient feels that they cannot partake in social events or even the same meal in their household, this contributes to a lower quality of life and even depression.”

The author says that when doctors ignore the role of diet in gut problems, patients often turn to “self-experimentation with fad or restriction diets.”

I perked up there, since essentially the FODMAP diet is a restriction diet. Dr. Kane’s concern is that by eliminating entire food groups, we might develop deficiencies in important nutrients. For instance, Dr. Kane suggests that physicians tell certain patients that it won’t matter to their intestines if they avoid gluten.

Personally, I find the low-FODMAP diet much less restrictive than others (e.g. the Specific Carbohydrate Diet), but it’s good to be reminded how important it is to keep eating the widest possible variety of foods, to supplement as needed, and to tell your doctor that you’re following the low-FODMAP diet. Better yet: Get a dietitian on board!

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