When it comes to being healthier, most people start by focussing on one of two options… food or exercise. Which one is more important is debatable, since it depends on where you’re starting from. But since you’re likely to eat at least 3 times a day, maybe 5 or 6 times with snacks, food is pretty important. The catch is that food can have a huge impact on people with food sensitivities, i.e. pretty much everyone with IBS. And it’s hard making your food choices healthier, while also ensuring your IBS isn’t triggered. So this 4-part series on being healthy with IBS will begin by talking about how to choose healthy foods when you have IBS.
Why healthy food choices matter for people with IBS
Before we get into the practical stuff, let’s take a short minute to consider why healthy food choices even matter. Your first instinct might be to connect healthy food choices with weight management. I mean, how many times have you seen ads showing you that losing weight requires you to eat salads? (Which is wrong, by the way.) But while it’s true that healthier food choices will generally assist with weight goals, it’s not the only reason to eat healthy foods more often.
Actually, there are so many reasons why healthy foods matter that I could write an entire book on it. But since we want to keep this short, here’s just a few of the things that healthier food choices do:
- Gives you more fibre. While fibre type does matter, the fact is that fibre is essential for gut health. It’s also helpful for good bowel movements, particularly soluble fibre. Resistant starch, another type of fibre, is also needed for bowel health.
- Gives you more vitamins and minerals. Vitamins and minerals are needed for your body to work optimally. And the best way to get them is from wholefoods like fruits, vegetables, wholegrains, dairy and protein sources.
- Gives you more protein. This helps you to feel more satisfied after finishing your meal and also helps to keep hunger at bay for longer.
- Limits your fat intake. While limiting fat will help with weight management, the fact is that fat can is a potential gut irritant. So less fat in your meals could actually decrease your IBS symptoms.
- Limits your sugar intake. As with fat, large amounts of sugar can be irritating to the gut for some people with IBS. So less sugar could decrease your gut symptoms. But less sugar is also helpful in keeping blood glucose levels stable, which means that you don’t get highs and lows in your energy levels.
A quick side note about mental health
Many people with IBS also have challenges with mental health conditions such as anxiety and/or depression. Why that is the case isn’t know, but we do know that it happens. But the good news is that healthier food choices can help your mental health.
New research is showing there’s a link between dietary patterns and mental health conditions, including depression and anxiety. It turns out that people who eat healthier diets – vegetables, fruit, beef, lamb, fish and wholegrain foods (i.e. a Mediterranean-style diet) – have a lower risk of depression and anxiety. And on the flip side, people who eat more processed and ‘unhealthy’ foods have higher risk of mental health challenges.
So it’s not just about having more of the good stuff, but also cutting back on the ‘not-so-good’ stuff. This means that an overall healthier approach to food choices is a better option for mental health. And since this also helps your IBS, plus other aspects of your physical health, choosing healthy foods needs to become a top priority.
Healthy food choices for IBS
The easy bits, where having IBS doesn’t really affect healthier food choices
The basic guidelines for healthy food choices is the same for people with IBS as it is for everyone else. These guidelines include:
- Eat more vegetables – about 5-6 serves per day.
- Eat fruit – about 2 serves per day.
- Try to choose leaner cuts of meat (if you eat them).
- Try to choose wholegrains when possible.
- Eat legumes – they’re good for gut health.
- Eat fish at least 2 times per week, especially the oily fishes – which is really good for brain health.
- Include dairy or calcium-fortified non-dairy alternatives each day – your calcium needs depend on your age.
- Try to eat more plant-based meals and less animal-based meals.
- Don’t overeat… eat enough, but not too much.
The hard bits, where IBS can get in the way of making healthier food choices
At least 70% of people with IBS will get some symptom relief from a low FODMAP diet. This means that most people with IBS will need to continue avoiding at least some FODMAPs in the long term, after they’ve worked out which FODMAPs they personally are sensitive to. On top of that, people with IBS often have additional food sensitivities, which means extra foods need to be avoided.
Because of that, IBS can make some of the healthy food guidelines a little challenging to meet. It can definitely be done, but it requires careful choices. For instance, while there are still plenty of low FODMAP vegetables and fruits, some need to be avoided. Legumes are another tricky problem on a low FODMAP diet, as are plant-based meals. Again, there are choices, but they’re not as straight forward as they are for people without IBS.
How to make healthier food choices easier when you have IBS
Start with a balanced and healthy FODMAP friendly plate
The easiest way to make healthier food choices is to set up your plate in a way that is balanced and provides all the core food groups. This structure stops you from over or under eating any particular food group, so you’ll meet your nutrient needs.
Here’s how to create a healthy meal when you have IBS:
- Fill one-half of your plate with vegetables and/or fruits, making sure to choose low FODMAP options. Most meals will be veggie focussed, but if you like sweeter breakfasts, or like to add a little fruit to salads or other meals, fruit can be used instead of veggies.
- Fill one-quarter of your plate with proteins, focussing on leaner choices that are also low FODMAP. For instance, lean meats or poultry, eggs, fish, legumes, or high-protein dairy (e.g. hard cheese, lactose-free yoghurt).
- Fill up one-quarter of your plate with grains or starchy carbohydrates, ensuring that they’re low FODMAP portions. When choosing grains, try wholegrains such as quinoa, rolled oats, brown rice, millet. But you can also use potatoes, small amounts of sweet potato, polenta, buckwheat, gluten-free pasta and low FODMAP breads.
- Add a small amount (1-2 tbsp) of healthy fats. Good ideas include avocado, extra virgin olive oil, or low FODMAP nuts and/or seeds.
- Add flavour that suits your meals and tastes, such as fresh or dried herbs and spices, or low FODMAP sauces.
For more info that will help you to create a healthy and balanced low FODMAP plate:
- 4 tips for making a low FODMAP diet healthier
- 4 tips to help you eat enough low FODMAP calcium-rich foods
- How I get my calcium on a dairy-free diet
- 4 tips for adding flavour to a low FODMAP diet
- 7 key low FODMAP swaps you should know
- 4 tips for making your favourite recipes low FODMAP
- 5 essential tips for low FODMAP label reading
- 4 tips for healthy and quick low FODMAP meals
Choose healthier snacks to get more of the food groups that you’re missing
I’m a big believer in using snacks to even out your food choices across the day. That way you won’t miss out on any important nutrients. For instance, if you don’t eat fruit in your main meals, you’ll need to eat fruit in your snacks. Alternatively, if you don’t get enough veggies/dairy/grains in your main meals, then they’ll need to go in your snacks.
For me, snacks usually revolve around fruit and ‘dairy’ (or almond milk in my case), because I don’t get enough in my main meals. But some days, my veggie intake is low and I need veggie-based snacks. And other days, a snack of tuna on crackers is a better choice if I haven’t been eating much protein.
The next thing to keep in mind is that snacks shouldn’t be as big as a regular meal. And that you should only eat as much as you need to satisfy you, but no more. So don’t overeat at snack time or one of two things will happen: (i) you’ll be too full to eat a more balanced main meal; or (ii) you’ll be full at your main meal but will eat it anyway and so eat more than you need.
There are 3 components to making a healthy snack:
- Protein, e.g. cheese, yoghurt, milk, nuts or seeds, nut butter, egg, fish, meat or legumes.
- Fruit or vegetable, about 1/2 to 1 cup of a low FODMAP option.
- Grain or carbohydrate, depending on how hungry you are. This could be crackers, crispbreads, or bread – so long as they’re low FODMAP options.
Sometimes you’ll want to add a little treat into a snack, with is an optional fourth component. For instance, 10g of dark chocolate, a little drizzle of maple syrup, or maybe a mayonnaise-based dip or sauce for a savoury snack.
For more info on building snacks, check out this article with all the info, along with 20+ low FODMAP snack ideas.
But do you always have to make healthier food choices?
The short answer… No.
What I want you to pay particular attention to is the term ‘healthier’. Once upon a time, it was believed that to be healthy, you had to only eat unprocessed foods from the core food groups. This meant cutting out pre-made foods, doing all the cooking yourself, and removing all non-essential foods from your diet. Plus, not using fat or sugar.
We now know that a healthy and balanced diet has room for some fats and sugars, and that non-essential foods aren’t evil. We also know that some pre-made foods can make healthy eating much easier. Plus, we’ve learned that enjoying food and not feeling restricted helps people to make healthier choices most of the time. So it’s about being healthier, but not being obsessive about it.
This is particularly important for people who have considerable food restrictions, even before making healthier choices… i.e. people with food sensitivities, such as people with IBS. This is because being overly restricted makes it more likely that you’ll binge on restricted foods when they become available. For more info and how to deal with this situation, read 4 tips for making a low FODMAP diet less restricted.
So no, you don’t always have to make the healthiest of choices and you don’t have to cut out all treat foods. As a general rule, 80-90% of your food choices should be healthier ones. This means that on most days, you should try not to eat more than one treat. That said, there will be days when you’ll have more than that. But if you stick with this general rule most of the time, then an occasional less healthier day won’t be much of an issue.