Diet & Nutrition

Following a diet high in fiber has a wide range of benefits, including improving bowel health, lowering cholesterol, and controlling blood sugar levels. Many fruits, vegetables, beans, and nuts contain high amounts of fiber. It is recommended that you consume 20-25 grams of fiber per day.

High Fiber Foods – Goal: 20-25 grams/day

Fruit	Serving Size	Dietary Fiber Grams
Apple, canned, peeled	½ cup	2.1
Apple, raw w/ skin	1 large	4
Apple juice	½ cup	0
Apricots, canned	½ cup	2.1
Apricots, raw w/ skins	2	1.4
Bananas	1 med	3
Blackberries, raw	½ cup	5
Cherries, raw	10 large	1.1
Cranberries, raw	½ cup	4
Dates, dried	2	1.6
Figs, dried	1 med	3.7
Grapefruit, raw	½	0.8
Grapes, purple	15	0.5
Melon	1 cup	1.5
Nectarine, raw w / skin	1 small	1.5
Orange, raw	1 small	1.6
Peach, canned	½ cup	1.8
Peach, raw w/ skin	1 med	2.3
Pear, canned	½ cup	2
Pear, raw w/ skin	1 med	4
Pineapple, raw	½ cup	0.8
Plums, canned	4 small	1.9
Plums, raw w/ skin	3 small	1.8
Prunes, dried	2	2.4
Raisins	2 Tbsp	1.5
Raspberries, raw	½ cup	4.6
Strawberries, raw	½ cup	1.6
Tangerine, raw	1 large	2
Vegetables	Serving Size	Dietary Fiber Grams
Asparagus	½ cup	3.5
Bean sprouts, raw	½ cup	1.5
Beans, green, cooked	½ cup	2.1
Beets, cooked	½ cup	2.1
Broccoli, cooked	½ cup	3.5
Brussel Sprouts	½ cup	2.3
Cabbage, cooked	½ cup	2.1
Carrots, raw	½ cup	1.8
Cauliflower, cooked	½ cup	1.6
Celery, raw	½ cup	1.1
Corn, fresh	1 med ear	5.2
Cucumber, raw	½ cup	1.1
Kale, cooked	½ cup	1.3
Lettuce	1 cup	0.8
Mushroom, raw	½ cup	0.9
Mustard Greens, raw	½ cup	1
Okra, raw	½ cup	1.6
Onion, raw	½ cup	1.2
Peas, canned	½ cup	6.7
Pepper, green, raw	½ cup	1.1
Potato, baked w/ skin	1 med	3.8
Radishes, raw	½ cup	1.3
Spinach, cooked	½ cup	6.5
Squash, summer	½ cup	2
Squash, winter	½ cup	3.5
Sweet potato, cooked	½ med	2.1
Tomato, cooked	½ cup	1.5
Tomato, raw	1 small	1.5
Turnip, cooked	½ cup	2
Yam, cooked	½ cup	3.9
Zucchini, raw	½ cup	2
Breads	Serving Size	Dietary Fiber Grams
Cornbread	1 square	1.1
French	1 slice	0.7
Pumpernickle	1 slice	1.9
Rye	1 slice	0.8
White	1 slice	0.7
Whole grain	1 slice	2.1
Whole wheat	1 slice	1.3
Rolls	Serving Size	Dietary Fiber Grams
Dinner, white	1 roll	0.8
Whole white	1 roll	1.6
Pasta	Serving Size	Dietary Fiber Grams
Macaroni, cooked	½ cup	0.6
Spaghetti, cooked	½ cup	0.8
Rice, brown, cooked	½ cup	2.4
Rice, white, cooked	½ cup	0.8
Cereals	Serving Size	Dietary Fiber Grams
100% All-Bran	⅓ cup	8.4
40% Bran Flakes	1 cup	6
Bran Chex	1 cup	8.2
Cheerios	1 cup	1.6
Corn Bran	1 cup	8.8
Corn Chex	1 cup	3.5
Cornflakes	1 cup	3.5
Grapenuts	⅓ cup	5.4
Oatmeal, instant, dry	1 package	3.3
Oats, whole, dry	¼ cup	2.9
Puffed Wheat	1 cup	4.5
Shredded Wheat	1 biscuit	2.8
Total	1 cup	3.3
Unprocessed Bran	t tsp	2
Wheat Chex	1 cup	3
Wheaties	1 cup	3.5
Legumes, Cooked	Serving Size	Dietary Fiber Grams
Beans, brown	½ cup	8.4
Beans, kidney	½ cup	9.7
Beans, lima	½ cup	8.3
Beans, pinto	½ cup	8.9
Beans, white	½ cup	7.9
Lentils, cooked	½ cup	3.7
Nuts	Serving Size	Dietary Fiber Grams
Almonds	1 Tbsp	1.1
Chestnuts	3 nuts	1.8
Peanuts, roasted	1 Tbsp	0.8
Pecans	1 Tbsp	0.5
Walnuts	1 Tbsp	0.4
Snack Foods	Serving Size	Dietary Fiber Grams
Cracker, graham	2 squares	1.4
Cracker, rye wafer	3 wafers	2.3
Cracker, saltine	6 crackers	0.8
Popcorn, popped	3 cups	3

Stomach acid reflux is a common problem. 

Your doctor may recommend that you avoid foods and drinks known to make stomach acid reflux worse. These include fatty foods, alcohol, chocolate, caffeinated drinks (such as coffee, tea, soda), peppermint, spearmint, and spices. If you are overweight, dieting may also help. It’s alright to drink cranberry juice, apple juice diluted with water, and herbal teas (except peppermint and spearmint). Drink lots of water.

Coffee Substitutes: Postum; Coffee (Swiss blend of chicory, figs, wheat, malted barley & acorns)

Foods & Drinks to Avoid	Acid Fruits to Avoid	Spicy Meals in These Restaurants	Many Individuals are Sensitive To:	Other Anti-Reflux Measures
Fatty foods	Orange	Japanese	Cucumbers	Don’t eat or drink for 2 hours before going to bed
Alcohol	Grapefruit	Mexican	Scallions	Avoid lying down after meals
Chocolate	Pineapple	Thai	Onions	Elevate the head of your bed 6 inches (Use a bed wedge from any surgical supply store)
Coffee, tea, caffeinated soft drinks (decaffeinated coffee still has some caffeine)	Pomegranate	Chinese	Radishes	Don’t wear tight clothing around your abdomen
Peppermint & spearmint	Tomato	Indian	Leeks	Avoid straining, weight lifting, prolonged bending, constipation
Spices & vinegar	Lemon/Lime	Some Italian		Lose weight (if you are overweight)
Citrus fruits & juices	Sour Apple			Avoid Dairy Products (Cause excess mucus, refrain)
Tomatoes & tomato sauces	Sour Grape
	Sour Peach
	Sour Plum
	Sub-Acid Fruits to Avoid
	Fresh Fig
	Pear
	Sweet Cherry
	Papaya
	Mango
	Cherimoya
	Sweat Peach
	Sweet Apple
	Apricot
	Sweet Plum
	Huckleberry
	Mangosteen

Since the likelihood of reflux increases after a meal, it is important to avoid eating or drinking for 2 hours before going to bed, except for taking any medicine prescribed by your doctor. Remember to avoid lying down after any meal.

Reflux-ACCEPTABLE Foods (If Cooked with Mild Herbs)

Meats	Fish	Vegetables & Starches	Sweet Fruits	Herbs & Seasonings	Potatoes
All Tenderloin, Flank, T-Bone & Porterhouse Steak	Sole	Beets	Bananas	Basil Leaves	All Red, White, Sweet & Yams (No canned potatoes)
Rib & Rump Roast	Halibut	Carrots	Dates	Bay Leaves
Liver	Monk	Eggplant (Grilled or sautéed only)	Figs	Chervil Leaves	Rice
Veal	Tuna	Kidney Beans	Raisins	Chives	All White, Brown & Gourmets
Chicken	Bass	Lima Beans	Thompson & Muscat	Cilantro Leaves
Capons & Cornish Hens	Smoked Fish	String Beans	Grapes	Dill Weed	Soups
Turkey	Salmon	Spinach	Prunes	Marjoram	All non-tomato, use with discretion (Creamed soups may cause excess mucus and/or reflux disorders)
Loin Pork Chops	Flounder	Artichokes	Persimmons	Oregano Leaves (Mediterranean)
Pheasant	Haddock	Asparagus	Melons	Parsley Flakes	Pasta
Quail	Lobster	Brussel Sprouts	Strawberries	Rosemary	Pesto Sauce, Garlic & Oil
Venison	Mackerel	Cauliflower	Raspberries	Sage	White Clam Sauce only
	Perch	Buttercup Squash	Blueberries	Savory
	Pike	Acorn Squash	Blackberries	Tarragon Leaves
	Shad	Butternut Squash	Sun-Dried Pears	Thyme
	Scallops	Delicata Squash		Garlic
	Shrimp	Zucchini Squash (Both yellow and green)		Soy Sauce
	Trout	Gourmet Squash		White Pepper
		Broccoli
		Parsnips
		Wax Beans
		Brocco Flower

The Low FODMAP Diet is common for those with Irritable Bowel Syndrome (IBS) or Small Intestinal Bacterial Overgrowth (SIBO) to eliminate foods that worsen symptoms. This diet follows an elimination strategy to pinpoint food triggers.

Foods Suitable for a Low FODMAP Diet

Fruit	Vegetables	Grain Foods	Milk Products	Other
Fruit banana, blueberry, boysenberry, cantaloupe, cranberry, durian, grape, grapefruit, honeydew melon, kiwifruit, lemon, lime, mandarin, orange, passionfruit, pawpaw, raspberry, rhubarb, rockmelon, star anise, strawberry, tangelo Note: If the fruit is dried, eat in small quantities	Vegetables Alfalfa, bamboo shoots, bean shoots, bok choy, carrot, celery, choko, choy sum, eggplant, endive, ginger, green beans, lettuce, olives, parsnip, potato, pumpkin, red capsicum (bell pepper), silverbeet, spinach, squash, swede, sweet potato, taro, tomato, turnip, yam, zucchini	Cereals	Milk *Lactose-free milk, *oat milk, *rice milk, *soy milk *Check for additives	Tofu
	Herbs Basil, chili, coriander, ginger, lemongrass, marjoram, mint, oregano, parsley, rosemary, thyme	Bread 100% spelt bread	Cheeses Hard cheese, and brie and camembert	Sweeteners Sugar* (sucrose), glucose, artificial sweeteners not ending in ‘-ol’
		Rice	Yogurt Lactose-free varieties	Honey Substitutes Golden Syrup*. Maple Syrup*, Molasses, treacle *small quantities
		Oats	Ice-Cream Substitutes Gelati, sorbet
		Polenta	Butter Substitutes Olive oil
		Other Arrowroot, millet, psyllium, quinoa, sorgum, tapioca

Eliminate Foods Containing FODMAPs

Excess Fructose	Lactose	Fructans	Galactans	Polyols
Fruit Apples, mango, nashi, pear, tinned fruit in natural juice, watermelon	Milk Milk from cows, goats, or sheets, custard, ice cream, yogurt	Vegetables Artichoke, asparagus, beetroot, broccoli, Brussel sprouts, cabbage, fennel, garlic, leek, okra, onion (all), shallots, spring onion	Legumes Baked beans, chickpeas, kidney beans, lentils, soybeans	Fruit Apple, apricot, avocado, blackberry, cherry, longon, lychee, rashi, nectarine, peach, pear, plum, prune, watermelon
Sweeteners	Cheeses Soft, unripened cheeses, cottage, cream, mascarpone, ricotta	Cereals Wheat and rye, in large amounts of egg bread, crackers, cookies, couscous, pasta		Vegetables Cauliflower, green capsicum (bell pepper), mushroom, sweet corn
Fructose, high fructose, corn syrup		Fruit Custard apple, persimmon, watermelon		Sweeteners Sorbitol (420), Mannitol (421), Isomalt (953), Maltitol (965, Xylitol (967)
Large total fructose dose Concentrated fruit sources, large serves of fruit, dried fruit, fruit juice		Miscellaneous Chicory, dandelion, insulin pistachio
Honey Corn syrup, fruisana

For those that have been diagnosed with Diverticulosis or Diverticulitis, following a diet high in fiber is recommended to reduce symptoms. In addition, a diet supplement may be recommended.

What are diverticulosis and diverticulitis? 

Many people have small pouches in the lining of the colon, or large intestine, that bulge outward through weak spots. Each pouch is called a diverticulum. Multiple pouches are called diverticula. The condition of having diverticula is called diverticulosis. About 10 percent of Americans older than 40 have diverticulosis. The condition becomes more common as people age. About half of all people older than 60 have diverticulosis. Because most people do not have symptoms, diverticulosis is often found through tests ordered for another ailment. For example, diverticulosis is often found during a colonoscopy done to screen for cancer or polyps or to evaluate complaints of pain or rectal bleeding. Diverticula are most common in the lower portion of the large intestine, called the sigmoid colon. When the pouches become inflamed, the condition is called diverticulitis. Less than 5 percent of people with diverticulosis get diverticulitis. 

What are the symptoms of diverticulosis and diverticulitis?

Diverticulosis 

Most people with diverticulosis do not have any discomfort or symptoms. However, some people may experience crampy pain or discomfort in the lower abdomen, bloating, and constipation. 

Diverticulitis 

The most common symptom of diverticulitis is abdominal pain. The most common sign on examination is tenderness in the lower left side of the abdomen. Usually, the pain is severe and comes on suddenly, but it can also be mild and become worse over several days. A person may experience cramping, nausea, vomiting, fever, chills, or a change in bowel habits.

What causes diverticular disease?

Although not proven, the dominant theory is that a low-fiber diet causes diverticular disease. Doctors are not certain what causes diverticula to become inflamed. The inflammation may begin when bacteria or stool are caught in the diverticula. An attack of diverticulitis can develop suddenly and without warning. Some potential factors that may increase your chances of getting diverticulitis are Western dietary patterns (high in red meat, fat, and refined grains), obesity, and smoking. On the other hand, dietary fiber intake and diets high in fruits, vegetables, and whole grains, and physical activity is associated with decreased risk. 

How is diverticular disease treated?

Diverticulosis

Increasing the amount of fiber in the diet may reduce symptoms of diverticulosis and prevent complications such as diverticulitis. Fiber keeps stool soft and lowers pressure inside the colon so that bowel contents can move through easily. The American Dietetic Association recommends consuming 20 to 35 grams of fiber each day. The doctor may also recommend taking a fiber product such as methylcellulose (Citrucel), psyllium (Metamucil), or wheat dextrin (Benefiber) one to three times a day. These products are available in powder, pills, or wafers and provide 2 to 3.5 grams of fiber per dose. Fiber products should be taken with at least 8 ounces of water. Avoidance of nuts and seeds has been recommended by some physicians out of fear that food particles could enter, block, or irritate the diverticula. However, no scientific data support this treatment measure. Eating a high-fiber diet is the only requirement highly emphasized across the medical literature. Eliminating specific foods is not necessary. People differ in the amounts and types of foods they can eat. Decisions about diet should be made based on what works best for each person. Keeping a food diary may help identify what foods may cause symptoms. 

Diverticulitis 

Uncomplicated diverticulitis with mild symptoms usually requires the person to rest, take oral antibiotics, and be on a liquid diet for a period of time. Sometimes an attack of diverticulitis is serious enough to require a hospital stay, intravenous antibiotics, and possibly surgery.

This is meant to be a general guideline and will vary with each patient.

 *If you have CELIAC DISEASE or SPRUE, avoid wheat, barley, rye, and their derivatives.*

Usually Tolerated (In Moderation)	Use Caution	Avoid
Soluble fiber: oatmeal, berries, beets, cooked lentils, legumes, split pea soup, chickpeas, peas, carrots, yams, peaches, blueberries, strawberries, grits, Cream of Wheat, papaya, mango, kiwi	Citrus & tomato	Crude fiber (residue): Eggplant skin, bell peppers, cucumber skin
Organic yogurt [Greek: Total, Stonyfeld]	“Diet” sugar-free products	MSG (pain & diarrhea)
Fish, shrimp	Alcohol	Large seeds, husks
Rice, pasta, couscous, noodles, pastina	Grapes	Nuts
Egg whites	Chocolate (constipating)	Potato skins
Lentil soup	Raw broccoli	Spicy food, curry
Homemade chicken soup, dumplings	Raw cauliflower	Fried foods, fats
Banana, plantain, polenta	Cabbage	Carbonated beverages
Rice Krispies, Special K	Coleslaw	High-fructose corn syrup
Chamomile & herbal teas	Cold cuts	Snapple, Gatorade
Nectarines, apricots	Iceberg lettuce	Garlic, onions
Watermelon, honeydew, cantaloupe	Popcorn	All artificial sweeteners: Splenda, Equal, Sweet’N Low
Avocado, olive oil	Dairy	Diet soda
Udon noodle soup, tender, cooked baby spinach	Caffeine	Sugar-free gum & candy
Graham crackers	Cheese (bloat)	Zone bars, Power bars
Broccoli and cauliflower (tolerated best in a pureed soup)	Lactose	Green tea
Cooked mashed rutabaga, turnip, parsnip
Homemade vegetable soup
Waffles, pancakes, mashed potatoes
Crackers: Low-salt Wheat Thins, rice crackers, unsalted Saltines
Baby leaf/red leaf lettuce in small amounts
Stewed, tender meat, Beef Bourguignonne
Small pieces of cooked carrots, celery, zucchini with rice, pasta, and couscous

Hints

• Chew well 
• Eat 6 small meals a day
• Use chewable vitamins 
• Drink liquids between meals 
• Eat slowly

Treatments for certain medical conditions cause changes in bowel patterns, including frequent, formed bowel movements or diarrhea (frequent, watery bowel movements). These may be accompanied by abdominal cramping, increased gas, or mucous discharge from the rectum. Diarrhea causes food to pass quickly through the intestines, so water and nutrients are not adequately absorbed. If diarrhea is severe (more than three watery bowel movements a day) or persists for a long time, you may become dehydrated (lose too much water) and lose weight. Frequent formed bowel movements do not cause dehydration, but they can cause discomfort. This information describes a diet that is helpful in preventing or treating diarrhea and frequent formed bowel movements. It requires limiting or avoiding foods that may irritate the intestines, increase the bulk in your bowel movements, or increase the movement of food through the intestines. 

General Guidelines:

• Drink plenty of liquids during the day (eight to ten 8-oz glasses)
•  Avoid alcohol and liquids with caffeine since they can dehydrate you
•  Drink small amounts (four ounces) at mealtime to avoid filling up on liquid
•  Eat small amounts of food throughout the day rather than three large meals
• Snack midmorning, midafternoon, and in the evening
• Avoid swallowing air when you eat and drink by chewing with your mouth closed and not using a straw when you drink.

HIGH FIBER FOODS – Fiber is the part of your food that does not get digested or absorbed and forms the bulk that makes your stool. You need to restrict fiber to treat or prevent diarrhea.	HIGH-FAT FOODS – Excessive fat can also contribute to diarrhea. You should limit the amount of butter, margarine, oil, and salad dressing you use.	FOODS AND LIQUIDS CONTAINING LACTOSE – Lactose is a sugar found in milk and milk products. When your intestines are irritated, lactose may not be completely digested, resulting in gas, cramping, and diarrhea.	OTHER SUGGESTIONS – A number of other foods and liquids may irritate your intestines and cause diarrhea. We recommend that you avoid:
FOODS TO AVOID	FOODS TO AVOID:	FOODS TO AVOID:	FOODS TO AVOID:
Whole-grain breads and cereals	Fried foods	Milk (whole or skim)	Alcohol
Bran	Gravies	Cream, sour cream, and creamy cheeses	Pepper
Brown rice	Cream sauces	Processed cheese, Ice cream, sherbet	Spices
Raw vegetables, including lettuce, cooked vegetables that cause gas (e.g., onion, garlic, cabbage, cauliflower, and broccoli)	Luncheon meats		Soy sauce
Fresh and dried fruits Juice with pulp (e.g., prunes and oranges)	Sausages		Very hot beverages
Beans	Olives		Carbonated beverages
Peas			All artificial sweeteners (Splenda, Equal, Sweet’N Low, aspartame, sorbitol, etc.)
Nuts			Caffeine
Seeds
Corn and popcorn

The following list of foods can take the place of the foods we have suggested you avoid: 

PROTEIN:	VEGETABLES:	FRUITS AND JUICES:	BREAD, CEREALS, AND GRAINS:	DAIRY:
Tender meats (with the fat trimmed)	Cooked squash, peeled eggplant, carrots, asparagus, mushrooms, green and wax beans Potato without the skin	Bananas	White and Italian bread, rolls, plain bagels, English muffins, Saltines, graham crackers	Lactose-free milk
baked or broiled Poultry (with the skin removed)	Tomato juice and puree (with pieces of tomato removed)	Applesauce	Cold cereals (corn flakes, corn Chex, puffed rice, rice Chex, Rice Krispies)	Lactose-free cottage cheese or ice cream
Fish (water-packed if it is canned)	Vegetable juice	Cooked or canned fruits with the skin and seeds removed (e.g., apples, peaches, apricots, plums, pears, pineapple, fruit cocktail)	Hot cereals (Cream of Rice, Farina, Cream of Wheat)	Yogurt
Eggs		Strained cranberry sauce	White rice	Sorbet
Tofu (wrapped only)		Fruit juices and nectars without pulp (e.g., apple, grape, cranberry)	Spaghetti, noodles
Smooth peanut butter

If you change your diet and still have more than three loose, watery bowel movements in a day, let your doctor know; medication may be prescribed. If your diarrhea is severe, you should:

• Eliminate all fruits (except bananas and applesauce) and vegetables from your diet
• Drink increased amounts of fluid, especially broth and Gatorade

Conclusion

There are many factors that can contribute to a sensitive stomach. We have pinpointed foods that worsen symptoms and should be avoided. In addition to diet changes, certain supplements can be taken to improve symptoms. 

We recommend that you review these guidelines and talk with your doctor and/or a dietitian about how you can individualize them to meet your own needs. Some people will only need to limit certain foods, whereas others may require a very restricted diet. Also, if you are on a special diet, it may be difficult for you to follow these guidelines and still be sure you are getting adequate nutrition. Clinical dietitians are available to counsel you about your diet. If you would let to meet with a dietitian, please let your doctor or nurse know. We hope these guidelines are helpful to you.