COMBATING CROHN'S WITH SINCERELY NOURISHED

I am so excited for today's post! It is full of a ton of valuable information for people struggling with IBD or digestive issues of any sort and explains the true importance of having a registered dietician as part of your care team. Lucky for me, one of my childhood friends, Raquel, is a super knowledgable RD who deals with Crohn's patients on a regular basis. On top of her day job she also has a blog that is full of recipes that are not only nutritious but also super yummy.  Raquel is also extremely passionate about fitness and overall helping people learn to live happy, healthy live!

She offered to answer some FAQs for Crohnically Blonde readers to help us navigate the wild world of trying to figure out what we should and should not be eating. All of her tips are extremely helpful and are very easy to incorporate into your daily routine. I know for me this information really helped to clear up a few things that I had questions about. In addition, it really made me realize that I need a Registered Dietitian that I can utilize on a regular basis. I hope you all enjoy and find a ton of value in this post, just like I did!

BEFORE WE START... HERE IS A LITTLE INFO ON RAQUEL/ SINCERELY-NOURISHED.COM

Raquel Redmond is a Registered Dietitian working in acute care in Philadelphia. She is an advocate of eating well and being well without the pressure. She can help you reach your goals! Browse recipes and nutrition tips, or reach out to work with her to assess your dietary needs on her blog. Sincerely Nourished (http://sincerely-nourished.com/blog) is a source for nutrition advice and ways to improve your quality of living focused on healthy eating, disease prevention & management.

I, personally, love her blog and keeping up with her meal suggestions via her Instagram (@dietitianraquel). My favorite thing about her recipes and suggestions are how doable they are. Not only does she feature original recipes but also suggests meals/snacks while you are on the go and meal ideas for eating out. Go give her a follow! You will not be disappointed. 

NOW FOR THE GOOD STUFF.....

CB: It seems like everyone I talk to has different "trigger foods" that spark their symptoms. Is there a specific science behind what foods are truly the worst for Crohn's sufferers or does it really depend on the person?

SN: Unfortunately, there is no science behind it! The best thing you can do to avoid symptoms is to eat well. You may not be able to digest or absorb all the nutrients you eat so it is paramount that you stick to a healthy diet and get enough fluids. People with Crohn’s and UC are at risk for malnutrition due to diarrhea, loss of appetite, decreased intake and/or malabsorption, corticosteroid use, and inflammation. Make sure to eat every 3-4 hours and try to avoid skipping meals. Avoid caffeinated and sugary drinks and try not to use sugar substitutes.

I’m sure you’ve heard it before, but try keeping a food diary that also includes your symptoms. You may find that certain foods give you symptoms on a consistent basis and should limit or avoid them. I have found that people who are strict about keeping a food diary are able to control their symptoms better.

The Low FODMAP diet may be an option for you if you continually have symptoms. Talk to a Registered Dietitian to find out more!

CB: What are the best anti-inflammatory foods to eat either during a flare up or to prevent one?

SN: Anti-inflammatory foods are fruits such as berries and oranges, green leafy vegetables and tomatoes, fatty fish and nuts, olive oil and turmeric. You definitely want to avoid foods that promote inflammation such as fried foods, soda, simple carbohydrates and processed meats. 

When you don’t have symptoms, include whole grains and a variety of fruits and vegetables in your diet. This way you will get a variety of anti-inflammatory foods. You may want to take a chewable multivitamin daily! If you are not getting enough calcium in your diet, then you should take a chewable calcium supplement with vitamin D.

P.S. Supplements could contribute to your GI symptoms. It is important to check the labels, read the ingredients and make sure that there is no interaction between the supplement and medications you are taking. You should consider eliminating unnecessary supplements from your routine.

CB: Often times Crohn's patients get put on liquid diets (either clear or full). What are some ways to still make sure you are getting enough nutrients and protein to sustain you throughout the day?

SN: As you probably know, it is extremely hard to meet your calorie and protein needs while on a clear or full liquid diet. In an acute care setting we generally recommend supplements (i.e. Ensure, Boost, Carnation Instant Breakfast etc.) to help people meet their nutrient needs. If you are able to tolerate supplements I would recommend you drink them while on these diets. At home you will have more options and probably tastier options than while admitted to the hospital. A dietitian can help you come up with more options and recipes. 

Clear liquids: jello, broth, juice, water ice, a clear supplement
Full liquids: anything on a clear liquid diet, cream soups, ice cream, yogurt, oatmeal, cream of wheat, smoothies, regular supplements

CB: What foods/drinks are the best for getting an added dose of probiotics?

SN: Probiotic food trends are on the rise! A probiotic supplement may not contain the strain of probiotic that works best for you. Supplements contain only the most common strains of probiotics. But, you can totally get probiotics from food! Try kombucha (my favorite), kefir, sauerkraut, kimchi and other fermented foods to eat your probiotics. Yogurt is also a good source. Probiotics may increase gas and bloating so try these foods in small amounts.

Sometimes the Crohn's friendly food options are limited when traveling or attending events. What are some tried and true snacks that you recommend to throw in your bag before leaving the house?
Some of the best grab and go snacks are the same for people with and without IBD. A handful of nuts or nut based bar (think KIND bar) is easy to put in your purse or pocket. A piece of whole fruit is also easy on the go. If you have a lunch box and ice packs you can get a little more creative. Yogurt, fruit cups, cheese sticks or hummus are all good options. A Registered Dietitian can give you even more options that work with your body.

CB: Does Crohn's/UC change the way your body absorbs or metabolizes food?

SN: Yes, IBD can change the way your body absorbs and digests food. Most commonly it may negatively impact the absorption of nutrients. Due to mucosal inflammation your body may not absorb everything you eat. This is why it is so important to maintain a good nutritional status while you don’t have symptoms!

CB: I lot of people I know suffering from IBD (me included) are constantly on steroids. These are notorious for causing weight gain. What are your tips for staying slim even while on high doses of these medications?

SN: If you are taking a steroid you should stick to a low fiber diet. While having symptoms such as abdominal pain and diarrhea you should remain on this diet. When symptoms decrease you can slowly add small amount of whole grain foods and high fiber fruits and vegetables. Don’t continue adding more fiber into your diet if you start having symptoms again.

Steroids can also increase your blood sugar. You may need to pay attention to how many carbohydrates you are eating. Carbohydrates include fruits, dairy products and starchy foods. A Registered Dietitian is trained to help you control your blood sugars through diet while you are taking steroids if this becomes a problem for you.

P.S. If you are taking Methotrexate or Sulfasalazine you should take an extra 1 milligram of folic acid daily except on the day you receive Methotrexate.

CB: Why is it so important to have a Registered Dietitian to work with if you suffer from Crohn’s/UC/IBD?

SN: Working with a dietitian can help ease the burden of constantly worrying about what to eat! We can’t totally prevent flare ups, but in addition to your medications we can help make eating a more enjoyable occasion. If you would like to work with me – please reach out! I can also make a referral to a dietitian in your area.

xx.