Fructose intolerance manageable with proper diet

My son has been complaining recently about tummy aches after eating certain fruits like grapes and watermelon. Lately, he can’t seem to tolerate apple juice even though it’s his favorite drink. Could the fruit be causing his pain? I thought that feeding him fruits was a healthy choice?

Generally, fruits and vegetables are a healthy choice for children. In fact, according to the U.S. Department of Agriculture, it is recommended that children ages 2-3 eat 1 cup of fruit per day, those ages 4-8 consume 1-1.5 cups, those ages 9-13 consume 1.5 cups, and those 14-18 consume 1.5-2 cups of fruit per day.

Fruits, fruit juices and some vegetables, however, contain a naturally occurring sugar known as fructose. Fructose is also found in honey, table sugar and high-fructose corn syrup used to sweeten many processed foods and beverages. Some people may suffer from fructose intolerance, a condition in which the body’s digestive system doesn’t absorb fructose properly. This can result in abdominal pain, bloating, constipation, diarrhea and gas for some.

According to a 2010 study by the American College of Gastroenterology (ACG), fructose intolerance is common in children with recurrent or functional abdominal pain, but the condition can be effectively managed with a low-fructose diet. It seems the condition is more prevalent in teenage girls who suffer from chronic abdominal pain, the study’s authors said.

According to the study, “Fructose Intolerance/Malabsorption and Recurrent Abdominal Pain in Children,” fructose intolerance in children is typically diagnosed by exclusion, meaning other gastrointestinal conditions like Crohn’s disease and ulcerative colitis are ruled out as the cause of the abdominal pain.

Once these have been ruled out, your doctor can test your son for fructose intolerance by administering a fructose breath test, which measures the rise in hydrogen in a person’s breath after an oral dose of fructose, according to the Cleveland Clinic Children’s Health Team.

If your child is diagnosed with fructose intolerance, you should see a registered dietitian to determine foods that are OK to eat and those that should be avoided. Generally, people with fructose intolerance should limit their intake of high-fructose foods such as juices, apples, grapes, watermelon, asparagus, peas and zucchini, according to the Mayo Clinic.

While it may be difficult to both find foods with low fructose and get your son to not eat foods with high fructose, there is good news for those with fructose intolerance: The ACG study found that more than half of patients who are fructose intolerant are able to maintain a low-fructose diet and are able to notice an immediate improvement in their symptoms.

Chow Line is a service of the College of Food, Agricultural, and Environmental Sciences and its outreach and research arms, OSU Extension and the Ohio Agricultural Research and Development Center.  Send questions to Chow Line, c/o Tracy Turner, 364 W. Lane Ave., Suite B120, Columbus, OH 43201, or turner.490@osu.edu.

Editor: This column was reviewed by Irene Hatsu, state specialist in food security for Ohio State University Extension.

With alcohol, stopping at one or two is best

During the holidays, I have to admit that I tend to drink more alcohol than usual. I think I could use a reality check. When you’re out with friends or at a party, how much is enough?

The science is pretty clear on this one: The Dietary Guidelines for Americans recommends no more than one drink per day for women and two drinks per day for men.

Unfortunately, some people interpret that as an average, but it’s not. If you consume alcohol only on Saturday night, it’s not OK to imbibe seven drinks all at once — or 14 if you’re a guy. It’s not even recommended to partake in that second or third drink (again, depending on your gender). “Moderate drinking” has defined limits, and that’s what they are. Note that pregnant women, anyone under age 21, and people who have certain medical conditions or who are taking certain medications are among those who should not drink alcohol at all.

It’s also important to know what constitutes “one drink.” It can be 12 fluid ounces of beer (5 percent alcohol), 8 ounces of malt liquor (8 percent alcohol), 5 ounces of wine (12 percent alcohol) or 1.5 ounces of hard liquor (40 percent alcohol, or 80 proof).

For many people, the one or two drink per day maximum might seem overly restrictive. But there are good reasons for the recommendations, and the CDC does a good job explaining them (cdc.gov/alcohol). Alcohol consumption above these limits is associated with a variety of short-term risks that most people are aware of, including car crashes, acts of violence and sexual risky behaviors. It’s also linked with an increased risk of chronic conditions, such as high blood pressure and cancers including mouth, throat, esophagus, liver, colon and breast cancer. For some conditions, the risk increases even with very low levels of alcohol consumption — in fact, the CDC says, for breast cancer and liver disease, there is no safe level of alcohol consumption. And, although past research indicated moderate drinking might be good for the heart, more recent studies suggest maybe not.

The lower limit for women is not simply because women normally have a smaller body size than men. Differences in body chemistry and composition also play a part. Muscle is better at metabolizing alcohol (breaking it down and removing it from the body), and men typically have more muscle mass than women. So, given the same drink, women may experience the effects of alcohol more quickly and for a longer time than men, and it’s more likely that drinking will cause long-term health problems in women.

If you think you can’t have a good time at a party without three, four or more glasses of alcohol, then you’re right, it’s time for a reality check. Try enjoying a glass or two of sparkling water with a twist before pouring that glass of wine. At the very least, space out drinks to enjoy no more than one per hour, sipping water, iced tea or other non-alcoholic beverage in between. And focus more on the friends and family that you’re gathering with instead of what’s in your glass. You’ll feel better, and without all of the empty calories that alcohol provides, you might look better, too.

Chow Line is a service of the College of Food, Agricultural, and Environmental Sciences and its outreach and research arms, Ohio State University Extension and the Ohio Agricultural Research and Development Center. Send questions to Chow Line, c/o Martha Filipic, 364 W. Lane Ave., Suite B120, Columbus, OH 43201, or filipic.3@osu.edu.

Editor: This column was reviewed by Carolyn Gunther, specialist in Community Nutrition for Ohio State University Extension.

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Healthy eating: The gift that keeps on giving

My grandchildren are coming for an extended visit over the holidays. I’ve been concerned about some of their eating habits, but as their grandma, I don’t want to make a big deal about it. What are some subtle things I can do while they’re here to encourage them to eat a little better?

What a great grandma! You deserve kudos for noticing potentially damaging eating habits developing in your grandchildren and caring enough to nudge them in a healthier direction.

Here are some ideas to try from youth nutrition specialists with Ohio State University Extension:

  • Adopt a “water first for thirst” policy. When the grandkids ask for something to drink, pour a nice big glass of ice water for them instead of high-sugar soft drinks or other beverages. Experts generally recommend children 4-8 years old drink 4 cups of water a day (without added sweeteners), and that increases to 7-8 cups for ages 9-13, and 8-11 cups for ages 14-18. For teens, that translates into drinking enough water to fill a 2-liter bottle. Lowfat (unflavored) milk also is a nutritious option. However, limit 100 percent fruit juice to less than 8 ounces a day, and avoid sweetened drinks altogether. Consider dressing up water by adding strawberry and orange slices or cucumber slices and mint.
  • Start a tradition of making healthful smoothies for breakfast or an afternoon snack. Just pack the blender full of fruit, such as bananas, strawberries, pineapple, peaches or mandarin oranges, plus ice cubes, yogurt and juice. You could even add fresh spinach for green smoothies. No need for extra sugar or ice cream. For thicker smoothies, try using frozen fruit.
  • Speaking of fruits and vegetables, keep a good variety on hand and make it as easy as possible for your grandchildren to eat. Depending on how old your grandchildren are, try slicing fruits and vegetables into bite-size pieces. In one study, younger elementary-school students said they found whole fruit to be too cumbersome to eat comfortably, and started eating much more of it when fruit was sliced for them. For preschoolers, be sure to cut grapes and cherry tomatoes in half before serving to be sure they aren’t a choking hazard.
  • While you’re at it, double up on vegetables both for snacks and during meals — most children don’t eat nearly enough. For snacks, consider having a large clear bowl in the fridge with ready-to-eat baby carrots, celery sticks, bell pepper strips, cucumber slices, and broccoli and cauliflower florets.
  • Other healthful snacks to consider keeping around include nuts, whole-grain crackers, rice cakes and air-popped popcorn.
  • Pay special attention when you’re eating out, when it’s very easy to overconsume empty calories. Try to steer them away from fried and breaded foods, even fried fish, chicken and vegetables. If french fries or potato chips come with a meal, ask if it’s possible to substitute a salad, fruit or soup.

Chow Line is a service of the College of Food, Agricultural, and Environmental Sciences and its outreach and research arms, Ohio State University Extension and the Ohio Agricultural Research and Development Center. Send questions to Chow Line, c/o Martha Filipic, 364 W. Lane Ave., Suite B120, Columbus, OH 43201, or filipic.3@osu.edu.

Editor: This column was reviewed by Carol Smathers, field specialist in Youth Nutrition and Wellness for Ohio State University Extension.

This column is being distributed earlier in the week than usual in anticipation of the Thanksgiving holiday.

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Steel yourself: ’Tis the season for sweet treats

 I don’t usually have much of a sweet tooth, but during the holidays I tend to go overboard on cookies and other baked goods at parties and when people bring treats to the office. This year, it seems to have started already. Any ideas to help me keep in control?

Actually, it sounds like you may be a step ahead of most people. According to the 2015-2020 Dietary Guidelines for Americans, about 70 percent of U.S. adults and children consume more added sugars than recommended — and not just during the holidays.

The guidelines say to keep added sugars to less than 10 percent of daily calorie intake. That means if your recommended calorie intake is 2,000 calories, your goal should be to keep sweets to a maximum of 200 calories a day.

It’s hard to estimate how many homemade gingerbread cookies or slices of pecan pie that might be. But since you can find added sugars in many types of foods and beverages, including salad dressing, yogurt and energy drinks, it’s a good idea to do what you can to limit the holiday treats to a reasonable amount — one or two small items a day, at most.

You’re probably thinking that, during the holidays, that’s easier said than done. But here are some thoughts to keep in mind as the celebrations begin:

Decide in advance that you’ll choose only the treats you will truly, deeply enjoy. Some sweets are definitely worth the indulgence, but, let’s face it, others aren’t. Give yourself permission not to sample items for fear of insulting the baker (even if it’s your supervisor at work or your very best friend), and make up your mind now to pass on the items that aren’t your very favorites. And for those treats that are worthwhile, imagine taking one modest portion from the platter and slowly savoring each bite. Many dietitians recommend this mindful approach to eating not just during the holidays but all year round to reduce the extra, empty calories we often mindlessly consume.

Find ways to cut back on other added sugars in your diet this time of year. Sugar-sweetened soda, fruit drinks, coffee and other beverages account for nearly half the added sugars that Americans typically consume. Opting for ice water, sparkling water, or plain coffee or tea instead of high-sugar drinks most of the time can go a long way to allowing you to feel just fine about indulging in an iced butter cookie or slice of pumpkin roll. And beverages are just one aspect of the diet to consider. If you normally have cereal with added sugars or toast with jelly for breakfast, for example, choose unsweetened alternatives during this time of year.

At holiday gatherings, position yourself so the goodies aren’t in your line of vision. Remember the old joke about the “see-food” diet? It’s true — visual cues are often hard to ignore. But you can make this work for you, too. Keep a fruit bowl on your kitchen counter to make it easy to grab an apple before you leave for a party. Filling up on fruits and vegetables always makes it easier to blithely decline an extra treat.

Chow Line is a service of the College of Food, Agricultural, and Environmental Sciences and its outreach and research arms, Ohio State University Extension and the Ohio Agricultural Research and Development Center. Send questions to Chow Line, c/o Martha Filipic, 364 W. Lane Ave., Suite B120, Columbus, OH 43201, or filipic.3@osu.edu.

Editor: This column was reviewed by Irene Hatsu, state specialist in food security for Ohio State University Extension.

For a PDF version of this column, please click here.

Managing diabetes is not always easy

 My husband has type 2 diabetes, and lately he has been frustrated about his blood sugar. Even though he gives himself the proper dose of insulin according to his carbohydrate intake, his glucose levels often don’t go down as much as they should. He has a doctor’s appointment, but can you shed some light about what’s going on?

Talking with his doctor, or a registered dietitian or diabetes educator, to gain some insight is a good idea. But many things can affect blood glucose levels. He might need to adjust his insulin, but physical activity, or lack of it, can make a big difference. Worry, frustration and feelings of burnout regarding diabetes have also been associated with higher blood sugar levels, according to a 2010 study in the journal Diabetes Care. The biology and the science behind insulin and blood sugars aren’t as cut and dried as you might wish.

Your husband also might benefit from a new online course developed by Ohio State University Extension. “Dining with Diabetes: Beyond the Kitchen” is available for free at go.osu.edu/DWD_BTK, as part of the online eXtension campus, which is a service of the U.S. Cooperative Extension System. The course includes:

  • Narrated PowerPoint presentations on “Carbohydrates,” “Fats and Sodium,” and “Vitamins, Minerals and Fiber.”
  • Videos with ideas on making smarter decisions at the grocery store.
  • Links to information from authoritative sources.
  • Quizzes to test your knowledge.
  • The ability to post questions and experiences — and to read those of other participants.

Participants who sign up and view all presentations and videos, complete the quizzes, and submit a final evaluation are eligible for a quarterly drawing for a $100 Amazon gift card.

Your husband might particularly be interested in one of the resources available in the course, a blog post from the Joslin Diabetes Center. It describes how a high-fat meal can affect blood glucose, both by slowing the time it takes for the glucose to be digested and reach the bloodstream, and by affecting the liver’s ability to absorb glucose. Depending on your husband’s eating habits, this might help explain what’s happening with him.

The online course is an offshoot of in-person Dining with Diabetes classes offered periodically in 27 Ohio counties by OSU Extension. The three-session program, co-presented by an Extension educator and a certified diabetes educator, provides information on menu planning, carbohydrate counting and other topics, and includes live cooking demonstrations of healthy recipes with taste-testing. To find out if the program is offered near you, contact your county Extension office. Find it at go.osu.edu/extoffices.

Living with the ups and downs of diabetes can be aggravating. But getting answers to questions when they arise, and connecting with others facing the same issues, can help.

Chow Line is a service of the College of Food, Agricultural, and Environmental Sciences and its outreach and research arms, Ohio State University Extension and the Ohio Agricultural Research and Development Center. Send questions to Chow Line, c/o Martha Filipic, 364 W. Lane Ave., Suite B120, Columbus, OH 43201, or filipic.3@osu.edu.

Editor: November is National Diabetes Month. This column was reviewed by Dan Remley, Food, Nutrition and Wellness field specialist for Ohio State University Extension.

Steam, roast vegetables to retain nutrients

 What is the best way to cook vegetables so nutrients aren’t destroyed?

You’re right — the heat involved in cooking vegetables can destroy some nutrients, but for others, it actually enhances their absorbability. For example, both beta carotene (think carrots) and its relative, lycopene (tomatoes), are more easily absorbed by the body after cooking. Cooking changes the structure of these nutrients’ molecules, allowing our bodies to absorb them much more efficiently. Adding some healthy fat, such as olive or canola oil, also helps.

With different nutrients reacting differently to the cooking process, it can get confusing. As a general rule, limit cooking time: The less time a vegetable is exposed to heat, the more nutrients it will retain.

You’ll also want to limit the amount of water that vegetables are exposed to in both food preparation and cooking, because water-soluble vitamins, such as folate and vitamin C, easily leach out when vegetables are soaked or cooked in lots of water. So boiling vegetables in a pot full of water should almost always be your last choice if you want to maximize retention of nutrients.

Steaming is a great option, either in the microwave oven or on the stovetop. The cooking process is fast, which limits the vegetables’ exposure to heat, and it prevents vegetables from sitting in water.

In the microwave, the steam and the energy itself work together to heat vegetables rapidly. Because microwave ovens widely differ in wattage, it might take some trial and error so vegetables cook evenly and don’t get overdone. Believe it or not, it can be helpful to read the appliance manual and follow its recommendations. If you can’t find your copy, look online. Whether in the microwave oven or on the stovetop, be sure to use a tightly lidded container so the steam doesn’t escape and the vegetables cook more quickly.

Dry methods of cooking, such as roasting or grilling, are other great options. Be sure to coat vegetables with a thin layer of oil to help their surfaces heat more quickly, allowing them to cook faster. Dry cooking methods also remove moisture, helping create a richer, more intense flavor than other cooking methods.

Whatever cooking method you choose, keep these other nutrient-retaining hints in mind:

  • If a vegetable has an edible skin — potatoes or summer squash, for example — leave it on. Many nutrients are concentrated in or just below the skin, and the skin protects the vegetables from losing nutrients during the cooking process.
  • When cutting vegetables before cooking, opt for larger chunks. The less surface area that’s exposed to heat, the fewer nutrients you’ll lose.
  • Don’t crowd. Cook vegetables in a loose pile or a single layer to allow the heat to access all food surfaces quickly and evenly. Again, the quicker vegetables cook, the more nutrients you get.

Cooking vegetables properly just might encourage you to eat more of them. Berkeley Wellness, part of the University of California, Berkeley School of Public Health, has a helpful guide, “60+ Healthy Ways to Cook Vegetables” at berkeleywellness.com — search for “cooking vegetables.”

Chow Line is a service of the College of Food, Agricultural, and Environmental Sciences and its outreach and research arms, Ohio State University Extension and the Ohio Agricultural Research and Development Center. Send questions to Chow Line, c/o Martha Filipic, 364 W. Lane Ave., Suite B120, Columbus, OH 43201, or filipic.3@osu.edu. Please note new postal address as of Oct. 20, 2016.

Editor: This column was reviewed by Carolyn Gunther, community nutrition specialist for Ohio State University Extension.

 

Yogurt: So many choices, lots to like

 There seem to be a lot more kinds of yogurt than there ever used to be. I like it, but is yogurt really that popular?

Yogurt has made big gains over the years. Although it’s leveling off, yogurt consumption has more than doubled over the last 15 years, according to the National Agricultural Statistics Service. During that time, Greek yogurt appeared on the market and quickly gained steam, now accounting for about half of all yogurt sales.

What’s the appeal? Yogurt has a lot going for it. It has a good amount of calcium, although the amount can vary. To determine how much calcium is in your favorite yogurt, look for the Percent Daily Value for calcium listed on the Nutrition Facts label, and multiply it by 1,000 mg, which is the Daily Value for calcium. For example, if the label says a serving of your yogurt has 25 percent (0.25) of the Daily Value for calcium, then it has 250 mg. To compare, a cup of milk has about 300 mg.

It’s important to note that the recommended daily amount of calcium for people varies, from 1,300 mg for 9- to 18-year-olds, to 1,200 mg for men 71 and older and women 51 and older, to 1,000 mg for those in between. So, you have to do a little mental math to know if you’re getting enough. Fortunately, when the new Nutrition Facts labels appear on foods in 2018, they’ll list the actual amount of calcium in grams.

Also like milk, yogurt has a good amount of protein. A cup of plain low-fat yogurt has 12 grams of protein, compared with 8 grams in a cup of 2 percent milk. Again, your mileage may vary with the type of yogurt. To verify, check the Nutrition Facts.

Most types of yogurt also contain beneficial bacteria naturally found in the intestinal tract, but which can sometimes use a boost. These live cultures, such as Lactobacillus acidophilus, can improve digestive health and strengthen your immune system. Unfortunately, you can’t really tell how much of this bacteria is in the yogurt you eat. Even in yogurt with a “Live and Active Cultures” seal, which verifies the yogurt had at least 100 million cultures per gram (or 10 million for frozen yogurt) at the time it was made, the number of good bacteria can fade over time.

Although yogurt is a highly nutritious food, flavored varieties might contain more added sugar than you’re comfortable with. Flavored regular yogurt often has about 24-30 grams of carbohydrates, some from added sugars and some naturally from the sugars in the yogurt’s milk and fruit. Light varieties, with low- or no-calorie sweeteners, have half as many carbs. When the new Nutrition Facts labels come out, you’ll be able to easily see how much of the carbohydrate is from added sugars.

Or, opt for plain yogurt. It won’t have any added sugars, and you can add your own flavorings, such as vanilla, or top it with fresh or frozen berries yourself.

Plain whole-milk Greek yogurt is also a good substitute for sour cream. Along with some added tang, it provides fewer calories (190 per cup compared to 480 in sour cream), less fat (9 grams compared to 45), more protein (20 grams compared to 5) and more calcium (250 mg compared to 7). So, it’s worth an experiment or two to see how it might work in your recipes.

Chow Line is a service of the College of Food, Agricultural, and Environmental Sciences and its outreach and research arms, Ohio State University Extension and the Ohio Agricultural Research and Development Center. Send questions to Chow Line, c/o Martha Filipic, 2021 Coffey Road, Columbus, OH 43210-1043, or filipic.3@osu.edu.

Editor: This column was reviewed by Dan Remley, field specialist in Food, Nutrition and Wellness for Ohio State University Extension.

For a PDF of this column, please click here.

Kids not eating fruit? Try cutting, slicing it

 How can I get my grandchildren to eat more fruits and vegetables when they’re visiting? I am lucky that I get to have them over often, but I can’t seem to entice them to eat much produce.

You’re not alone. Most children (and teens and adults for that matter) don’t eat enough fruits and vegetables, according to data from the U.S. Department of Agriculture.

But for kids, you might try thinking small. That is, if you don’t already, try slicing fruits and vegetables into bite-size pieces. You might be surprised at the results.

Research by the Food and Brand Lab at Cornell University indicates that slicing fruit could increase consumption, at least in school cafeterias. You might find similar success at home.

For the study, published in 2013 in the American Journal of Preventive Medicine, researchers first interviewed 23 elementary and middle school students and found two primary reasons why they avoided fresh fruit. Surprisingly, younger students said they found whole fruit to be too large and cumbersome to eat comfortably. Students with braces or missing teeth said the same thing. The second reason? The older students, particularly girls, said they felt the whole fruit was messy and unattractive to eat in front of others.

The researchers decided to test how slicing fruit, specifically apples, would affect consumption. They provided eight elementary schools with a commercial apple slicer. When students requested an apple, a cafeteria worker would slice it before giving it to the student. By doing so, the sales of whole fruit increased in the schools by an average of 61 percent.

The researchers then followed up their study in middle schools. Of six middle schools in a district, three were provided the commercial apple slicer, and three weren’t. In all, the slicers increased average daily apple sales by 71 percent. The researchers also examined cafeteria waste to determine how much of the apples served were eaten. They found that in schools with the fruit slicers, the percentage of students who ate more than half their apple increased by 73 percent.

This all points to how important it can be to pay as much attention to how food is served as to which food is served when it comes to encouraging kids to eat fruits and vegetables. Other research has shown that promoting cafeteria salad bars with superhero-type characters can increase consumption of vegetables. And, of course, children tend to pick up habits from watching important adults in their lives, so be sure to model the behavior you want to see them imitate.

Another thing to consider, depending on how old your grandchildren are, is to make sure there are no choking hazards. The USDA suggests cutting foods like grapes and cherry tomatoes in half before serving them to preschoolers.

For more information about overcoming barriers to eating healthy, take a look at the Cornell lab’s website at foodpsychology.cornell.edu. For tips from the USDA according to age group, see choosemyplate.gov/audience.

Chow Line is a service of the College of Food, Agricultural, and Environmental Sciences and its outreach and research arms, Ohio State University Extension and the Ohio Agricultural Research and Development Center. Send questions to Chow Line, c/o Martha Filipic, 2021 Coffey Road, Columbus, OH 43210-1043, or filipic.3@osu.edu.

Editor: This column was reviewed by Carol Smathers, field specialist for Ohio State University Extension in Youth Nutrition and Wellness.

For a PDF of this column, please click here.

Restrictive diet can help ease intestinal issues

 I have a friend who no longer eats wheat products, onions, garlic or a lot of other foods. She said it’s because she has been experiencing stomach problems and a “low-FODMAP” diet was recommended. It sounds serious. What is it?

FODMAP is an acronym used for foods containing certain carbohydrates that aren’t absorbed well in the intestines and can be rapidly fermented in the gut. In some people, they cause gas, bloating, abdominal pain, excess fluid, constipation and diarrhea. The acronym stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols — a mouthful, which is why you will hear the term “FODMAPs” a lot more often than the actual words it stands for.

The low-FODMAP diet was developed in the last 10 years by Australian researchers to treat people with irritable bowel syndrome. The syndrome is pretty common, but relatively few people have severe symptoms. It is sometimes confused with the more serious inflammatory bowel disease, which includes Crohn’s disease. The conditions have similar symptoms, but people with inflammatory bowel disease can also experience rectal bleeding and fever, and the disease can cause serious complications, including intestinal blockages, ulcers in the intestine and problems getting enough nutrients. Although it’s a separate medical condition, there is some evidence that a low-FODMAP diet could help people with this disease, as well. But the bulk of studies have focused just on people with irritable bowel syndrome.

One recent study, published earlier this year in the journal Gastroenterology, followed more than 90 patients for six weeks. Half followed the low-FODMAP diet, while the other half — the control group — simply avoided large meals, binges, and caffeine and alcohol, which are known to irritate the gut. More than 50 percent of the low-FODMAP group reported major improvement in abdominal pain, while only about 20 percent of those in the control group did.

Unfortunately, it can be difficult for consumers to identify low-FODMAP foods, and, as the diet regimen is relatively new, the list of foods continues to be updated. Among the foods to be avoided are asparagus, artichokes, onions, garlic, snow peas, cabbage, cauliflower, celery, mushrooms, sweet corn, apples, cherries, pears, mango, nectarines, peaches, plums, watermelon, apricots, dates, milk, yogurt, cream cheese or other soft cheese, ice cream, rye, wheat breads, wheat pasta, cashews, pistachios, honey, agave, high-fructose corn syrup, and other sweeteners including sorbitol, mannitol and xylitol. According to the Academy of Nutrition and Dietetics, while soy milk and silken tofu are high in FODMAPs, firm tofu is low, and soybean oil is FODMAP-free.

It can be easy for people who self-restrict on the low-FODMAP diet to fall into a diet too low in fiber or dairy and miss out on important nutrients. So, it’s strongly recommended that anyone following a low-FODMAP diet do so under the care of a gastroenterologist or registered dietitian familiar with the diet. After initial restrictions, the medical team can reintroduce higher-FODMAP foods and monitor for symptoms that may recur.

Chow Line is a service of the College of Food, Agricultural, and Environmental Sciences and its outreach and research arms, Ohio State University Extension and the Ohio Agricultural Research and Development Center. Send questions to Chow Line, c/o Martha Filipic, 2021 Coffey Road, Columbus, OH 43210-1043, or filipic.3@osu.edu.

Editor: This column was reviewed by Carolyn Gunther, specialist for Ohio State University Extension in Community Nutrition Education.

For a PDF of this column, please click here.

What will happen when fiber is no longer fiber

 I understand that the recommendation for fiber intake is going up. When will we see that reflected on Nutrition Facts labels?

The new labels should be on foods by July 2018. And you’re right, the Daily Value — the number on Nutrition Facts labels that indicates the recommended intake for nutrients — is increasing from 25 grams of fiber a day to 28. As with any Daily Value number, this is the recommended level for someone eating a 2,000-calorie-a-day diet. The higher number is based on findings of the Institute of Medicine, which recommends that people consume 14 grams of fiber for every 1,000 calories consumed. Unfortunately, most people don’t get nearly that amount.

Along with Daily Value update, the Food and Drug Administration also actually provided a definition of what counts as fiber for Nutrition Facts labels. And unless the rules are updated before taking effect, some fiber that’s included in many processed foods today won’t meet the new standard.

There are many different types of fiber, and they don’t all act in the body the same way. So, in the new definition, the FDA requires that any fiber included on the Nutrition Facts listing have an established “beneficial physiological effect” — that is, it has to be considered beneficial to human health. Such benefits include reduced blood glucose, cholesterol or blood pressure; increased satiety, which would help people reduce calorie intake; improved laxation or bowel function; and increased absorption of minerals, such as calcium.

The FDA will allow any fiber that’s intrinsic and intact in the food itself — the fiber naturally found in fruits, vegetables and whole grains, for example — to be included in the grams listed under “fiber” on the new labels. But it won’t include everything.

Today, food manufacturers often extract and isolate fiber from foods to add to high-fiber breakfast bars, protein shakes, cereals, breads, yogurts, granolas and even calorie-free sweeteners. They can also chemically synthesize some types of fiber.

These “isolated or synthetic” types of fiber not only provide additional fiber to the processed food, but also often help provide the flavor and texture that the food manufacturer is looking for in the finished product. However, not all types of this kind of fiber have been shown to have the human health benefits the FDA is looking for.

So far, the FDA lists 25 fibers in this category as making the grade, allowing them to be counted as fiber. They include psyllium husk, guar gum, pectin and cellulose. But in its review of the scientific literature, the FDA could not find health benefits of other types of fiber often used in processed foods, including inulin, bamboo fiber, soy fiber, pea fiber and wheat fiber. As it stands now, those ingredients, like all fiber, would have to be included in the amount of carbohydrate in the food but would not be counted in the amount of fiber.

The agency could update the list of what’s allowed to be included in the fiber listing as scientific evidence develops. But as it stands today, many of the “high-fiber” foods you see on grocery store shelves may no longer meet that criteria under the new rules.

Chow Line is a service of the College of Food, Agricultural, and Environmental Sciences and its outreach and research arms, Ohio State University Extension and the Ohio Agricultural Research and Development Center. Send questions to Chow Line, c/o Martha Filipic, 2021 Coffey Road, Columbus, OH 43210-1043, orfilipic.3@osu.edu.

Editor: This column was reviewed by Dan Remley, field specialist for Ohio State University Extension in Food, Nutrition and Wellness.

For a PDF of this column, please click here.