Dietetics - Low Fibre Diet

What is fibre?

Dietary fibre is the part of cereals, pulses, fruits and vegetables that are not fully digested in the gut. It helps add bulk to your stool (faeces) and helps to move contents through the bowel.

There are two main types of fibre: soluble and insoluble.

Soluble Fibre: Soluble fibre is a gentler form of fibre that dissolves in water and helps to bulk out and soften your stools. Examples include oats, soft flesh of fruits and root vegetables.

Insoluble Fibre: Insoluble fibre is a tougher, less digestible fibre that doesn’t dissolve in water. It bulks out your stool and stimulates the bowel to move. Examples include wholemeal bread, nuts, seeds and cereals containing wholegrain/wholemeal.

Why have I been advised to follow a low fibre diet?

A low fibre diet may have been recommended by your doctor if:

• Your bowel is obstructed, or you are at risk of bowel obstruction
• You have had bowel surgery
• You are experiencing diarrhoea or inflammation as a result of functional bowel disorder, treatment (e.g. radiation) or due to a flare-up of an inflammatory bowel disease
• A diet low in fibre may reduce the amount of gas produced, the bulk of stool passing through your bowel and the frequency of your bowel movements. This may help to reduce symptoms such as bloating, abdominal discomfort and diarrhoea. It may also reduce the risk of your bowel becoming obstructed

The need for a low fibre diet is usually temporary but can sometimes be permanent. If you need to restrict fibre as part of your long-term treatment, your dietitian will speak to you about other ways to ensure sufficient vitamin and mineral provision.

If you are used to eating a diet rich in fruit, vegetables, and whole grains, then following a low fibre diet may be challenging. However, the purpose of this diet is to help improve your symptoms and this leaflet will provide you with ideas of the many other suitable foods which you can eat.

Foods to eat and ones to avoid

Cereals

Foods you may include:

• Low fibre breakfast cereals e.g. Cornflakes, Rice Krispies, Coco pops, Frosties, Ready Brek

Foods high in fibre which should be avoided:

• Wholemeal or high fibre breakfast cereals or those with nuts and dried fruit added e.g. muesli, Bran flakes, Weetabix, puffed wheat, Shredded wheat, Crunchy nut cornflakes, Fruit and Fibre, porridge, granola, Cheerios and Special K

Bread and flour

Foods you may include

• All breads made with white flour including pitta, naan bread, wraps, muffins/barm cakes, bagels
• Crumpets, cream crackers, rice cakes, potato cakes

Foods high in fibre which should be avoided

• Brown, 50/50, wholemeal or granary bread
• Seeded loaf, breads with fruit, fibre or nuts added e.g. teacakes, hot cross buns
• Whole wheat, cracked wheat or brown crackers e.g. rye

Potatoes

Foods you may include

• Peeled cooked potatoes, mashed, chipped or roast (remove all skins)
• Inside of jacket potato

Foods high in fibre which should be avoided

• Potato skins

Rice, pasta and other

Foods you may include

• White rice, white and tricolour pasta and spaghetti
• White noodles, couscous, rice noodles

Foods high in fibre which should be avoided

• Whole wheat or brown pasta or noodles, brown rice or wild rice, bulgar wheat, quinoa

Cake and biscuits

Foods you may include

• Cakes, plain or cheese scones, biscuits and pastries made with white flour - no nuts, seeds or dried fruit added e.g. rich teas, custard creams, plain sponge cakes
• White muffins, croissants, pancakes

Foods high in fibre which should be avoided

• Whole wheat biscuits e.g. cereal, fig roll, flapjack, fruit scones
• Cakes or pastries with fruit, seeds, nuts or seeded jams

Fruit

Foods you may include

• Fruit with all pips, pith and skin removed: e.g. ripe banana, apple, pear, peach, mango, melon, lychees, tinned fruit
• Smooth fruit juice (maximum 200mls daily)

Foods high in fibre which should be avoided

• Fruit with skin, seeds, pips and/or piths attached: e.g. oranges, satsumas, raspberries, strawberries, blueberries, blackcurrants, passion fruit, kiwi fruit, coconut, dried fruit, figs, pineapple, dragon fruit and grapes
• Smoothies or fresh fruit juice with seeds, or pulp

Vegetables

Foods you may include

• Vegetables peeled and cooked with stringy or tough bits removed: Turnip, carrot, butternut squash, pumpkin, sweet potato, parsnip, courgette, cucumber, ripe avocado and aubergine
• Tomatoes skinned and deseeded. Puree or passata
• Well-cooked florets of cauliflower and broccoli (stalks removed)

Foods high in fibre which should be avoided

• Vegetable skins, seeds and or pips attached
• Cabbage, curly kale, celery, fennel, leeks, okra, peppers, spinach, sprouts, sweet corn, yam, cassava, plantain
• Salad vegetables including lettuce, beetroot, onions, garlic, artichokes, olives, mushrooms
• Pulse vegetables including peas, mangetout, beans (e.g. French, broad, string and baked beans)

Meat, fish and protein alternatives

Foods you may include

• Meat, poultry, ham, bacon, fish, eggs, Tofu, Quorn (in moderation) sausage rolls, meat pies, sausages- avoid ones that contain whole pieces of onions such as caramelised onion

Foods high in fibre which should be avoided

• Beans (including baked beans, edamame), pulses, lentils, chickpeas, Tempeh, nutritional yeast, spirulina, nuts and seeds
• Pies or pastries made with wholemeal flour, beans, nuts or seeds

Milk and products

Foods you may include

• Milk and milk alternatives e.g. soya/oat/nut milks (fresh, evaporated or condensed)
• Cheese, cottage cheese, cream cheese, cheese spreads, vegan cheese alternatives
• Cream/coconut cream. Plain smooth yoghurt or fromage frais, soya yogurts, ice cream, custard

Foods high in fibre which should be avoided

• Muesli or nut yogurts, or yogurts with whole fruit
• Cheese with added nuts or dried fruit e.g. cranberries

Miscellaneous

Foods you may include

• Plain or milk chocolate
• Boiled sweets, toffee, fudge, wine gums, mints
• Crisps
• Honey, lemon curd, treacle, syrup, marmite, shredless marmalade and seedless jam
• Condiments e.g. tomato sauce, brown sauce, soy sauce, mayonnaise, stock cubes
• Smooth nut butters

Foods high in fibre which should be avoided

• Any Chocolate containing fruit, nuts or seeds
• Popcorn
• Marmalade with shreds or jam with seeds
• Crunchy nut butter

Suggested low fibre meal plan

Breakfast

• Low fibre cereal with milk with a low fibre fruit on top e.g. rice Krispies and banana
• Or White bread, toast, croissant or muffin - with butter or margarine and seedless jam/rindless marmalade/smooth nut butter
• Or fried, scrambled or poached egg on white toast or sausage and bacon sandwich/Quorn sausage

Lunch

• Soup avoiding beans/lentils and bits (if homemade choose low fibre options outlined above) or sandwiches (white bread) with a protein source. i.e. ham/cheese/chicken/tuna/egg/vegan cheese
• Or rice/pasta/potato with protein source (examples above) and vegetables (low fibre options)
• Serve with pudding e.g. jelly and ice cream, milk pudding, sponge, custard, yogurt/soya yogurt, small portion of suitable fruit and cream

Dinner

• White rice/pasta/potato with protein source and vegetables (low fibre options)
• Or cheese omelette/pizza/fish in sauce/chicken burger/chicken breast, pork or lamb chop and gravy/Quorn products/tofu with mashed or boiled potato/chips/white rice
• Or small portion of cottage/shepherd's pie/corned beef hash with low fibre vegetables
• Serve with pudding e.g. jelly and ice cream, milk pudding, sponge, custard, yogurt, small portion of suitable fruit and cream

Snack/supper ideas

• Slice of plain cake, plain biscuit, crumpet
• Cheese and crackers, crisps, sausage roll
• Crème caramel/mousse
• Smooth yoghurt/seedless jam tart, hot or cold milky drink

Fluids

Remember:

• To drink at least 6-8 cups of fluids (about 1.5-2 litres) of fluids per day (unless otherwise instructed by your dietitian or doctor)
• This can include water, tea, coffee, no added sugar squash and lower fat milky drinks/soya milk

Balanced diet

It is important to maintain balance in your diet.

The following can act as a guide as to how to ensure healthy choices in your daily eating habits.

Protein

Our bodies need protein to work properly and to grow or repair themselves.

• Choose healthier and leaner cuts of meat; consider avoiding addition of fats to these products when cooking i.e. choose grilling, boiling or steaming rather than frying. Use meat alternatives e.g. Quorn, tofu
• Include 2-3 portions per day
• Consider two portions of fish per week, aim for one of these portions to be an oily fish source

Fruits and vegetables

Aim for 5 portions spread across the day (ensure these are restricted to low fibre options).

Dairy

• Dairy products are good sources of energy, protein and calcium. Calcium forms the building blocks of healthy bones and teeth. Milk and dairy products help form part of a healthy diet
• Most alternative milks such as soya milk are fortified with calcium but always check the packaging
• Aim for 3 portions per day

Carbohydrates

Starchy foods are a good source of energy and the main source of a range of nutrients in our diet, such as starch, calcium, iron and B vitamins.

• These include rice, potatoes, bread, pasta etc. (choose low fibre options)
• Aim for 5-6 portions per day
• Try to avoid eating too many refined carbohydrates as these are often high in fat and sugar e.g. cakes, crisp and pies

Poor appetite or weight loss on a low fibre diet

Strategies to help with a poor appetite

• Eat little and often. Eat three small meals and two to three snacks every day. Include a variety of foods that you enjoy
• Have starchy foods at each meal, such as breads, potatoes, rice, pasta, cereals
• Include a protein source in at least two of your meals throughout the day (meat, chicken or turkey, fish, eggs, cheese or yoghurt)
• Avoid drinks half an hour after or before your meals to avoid feeling too full or bloated
• Have a pudding at least once a day - if you are too full after a meal wait 30 minutes before having a dessert
• Have high-calorie snacks between meals, such as cake, biscuits, crackers with cheese, bread sticks and toast with butter/ margarine/honey/seedless jam/ smooth nut butters

Your dietitian or doctor can advise you on suitable oral nutritional supplements should it be necessary for you.

Food fortification

Try adding one of the following to low fibre bread/toast:

• Thickly spread butter or margarine
• Seedless jam, honey, syrup, cream cheese, meat or fish paste
• Smooth nut butters
• Cheese or vegan cheese alternatives
• Oils e.g. olive oil/olive oil-based spreads

Try adding one of the following to puddings:

• Double cream, Clotted cream, full fat yoghurt, ice cream or custard
• Seedless jam, honey, syrup or sugar
• Coconut cream