RESTRICTED DIET: FIBRE-RESTRICTED/LOW RESIDUE DIET

Question 1

INDICATION FOR A FIBRE-RESTRICTED DIET

Answer 1

• Acute phases of diverticulosis.
• Infectious enterocolitis.
• Ulcerative colitis.
• Crohn’s disease when the bowel is markedly inflamed.
• Presence of fixed radiological strictures.
• The intestinal lumen is narrowed.
• The transition between a completely liquid diet and a normal diet in patients convalescing from surgery, trauma or other illness.

Question 2

CONTRA-INDICATION OF A FIBRE-RESTRICTED DIET

Answer 2

• Irritable bowel syndrome.
• Diverticulosis, except in acute phases when the lumen of the colon is stenosed (narrowed).
• Duodenal ulcers.
• Crohn’s disease.

Question 3

PURPOSE OF A FIBRE-RESTRICTED DIET

Answer 3

To prevent the formation of an obstructing bolus of high fibre foods in patients with narrowed intestinal or oesophageal lumens. To reduce the frequency of painful stools in acute phases of diverticulitis or inflammatory bowel disease.

Question 4

CHARACTERISTICS OF A FIBRE-RESTRICTED DIET

Answer 4

A diet that contains a minimum amount of dietary fibre and connective tissue. High fibre foods contain 1.4g or more of dietary fibre per serving.

Question 5

NOTES TO CONSIDER WHEN IMPLEMENTING A FIBRE-RESTRICTED DIET

Answer 5

o Patients with gastrointestinal disorders may need a great deal of supportive help from the dietitian.
o If a low residue diet is indicated, all fruits and vegetables, including prune juices, should be eliminated except white potatoes without skin and strained fruit and vegetable juices.
o There is limited evidence that milk, which contains crude fibre, may contribute to the faecal residue. Thus with certain patients, it may be wise to restrict milk to 2 cups a day.
o The diet should be individualized according to the patient’s specific food tolerances.

Question 6

MILK AND MILK PRODUCTS ALLOWED AND TO AVOID IN A FIBRE RESTRICTED DIET

Answer 6

ALLOWED: ALL

TO AVOID:
Low residue diet: only 2 cups of daily of all milk products

Question 7

MEAT AND MEAT ALTERNATIVES ALLOWED AND TO AVOID IN A FIBRE RESTRICTED DIET

Answer 7

ALLOWED:
All meat, poultry, eggs, seafood, cottage cheese and other mildly flavoured cheese (plain cheeses).

TO AVOID:
Chunky peanut butter, nuts, seeds, dried beans, dried peas, tough gristly meats, hotdogs, sausages, sardines, fried meats, strongly flavoured cheeses. Any made with whole grain ingredients, seeds, nuts, fired beans, peas, lentils and legumes.

Question 8

BREAD, PASTA, CEREAL AND RICE PRODUCTS ALLOWED AND TO AVOID IN A FIBRE RESTRICTED DIET

Answer 8

ALLOWED:
Refined breads, rolls, biscuits, muffins, crackers, pancakes, waffles, plain pastries and raison bread.
Refined cooked cereals (cream of wheat, cream of rice, malt o meal, grits and farina), refined dry cereals (Cheerios, cornflakes, puffed rice, puffed wheat, special K) kix and sugar snacks.
Refined pasta, white rice, saltines and tapioca.
Cooked white and sweet potatoes without skin.

TO AVOID:
Any bread made with whole grain flour, bran, seeds, nuts, coconut, raw or dried fruit (except raison bread), cornbread, any crackers containing more than 1.0g fibre per serving.
Oatmeal, any whole grain, bran or granola cereals, any containing seeds, nuts, coconut or dried fruit. Any cereal containing more than 1.0g fibre per serving.
Wholegrain rice and pasta.
All others

Question 9

VEGETABLES ALLOWED AND TO AVOID IN A FIBRE RESTRICTED DIET

Answer 9

ALLOWED:
Vegetable juice without pulp. The following cooked vegetables: yellow squash (without seeds), green beans, wax beans, spinach, pumpkin, eggplant, potatoes without skin, asparagus, beets and carrots.
Tomato sauce, puree and paste.
Frozen, canned or raw asparagus, green beans, yellow beans, bean sprouts, beets, cabbage, carrots, celery, cauliflower, cucumber, eggplant, collard, dandelion or mustard greens, green pepper, lettuce, mushrooms, onion, rutabaga, spinach, summer squash, tomato and zucchini.

TO AVOID:
Vegetable juices with pulp, raw vegetables, cooked vegetables not on the allowed list. Dried beans, peas, lentils, legumes, sauerkraut, winter squash and peas.

Question 10

FRUITS ALLOWED AND TO AVOID IN A FIBRE RESTRICTED DIET

Answer 10

ALLOWED:
Fruit juices without pulp, canned fruit except pineapple, ripe bananas, melons, peeled and cooked apples, orange and grapefruit without membrane. Canned or cooked apple slices, apple sauce, cherries, grapefruit, grapes, oranges, peaches, pineapple and plums. Canned fruit cocktail, raw bananas, cherries, grapefruit, grapes, melon, oranges, peach and pineapple.

TO AVOID:
Fresh fruit, except those on the allowed list, prunes, prune juice, dried fruit, jam, marmalade and all berries.

Question 11

FATS ALLOWED AND TO AVOID IN A FIBRE RESTRICTED DIET

Answer 11

ALLOWED:
All oils, margarine, butter, cream, salad oils, mayonnaise. Bacon, plain gravies and salad dressings.

TO AVOID:
Any fats containing whole grain flour, bran, seeds, nuts, coconut or dried fruit.

Question 12

BEVERAGES ALLOWED AND TO AVOID IN A FIBRE RESTRICTED DIET

Answer 12

ALLOWED:
Coffee, tea, milk, carbonated beverages and fruit drinks.

TO AVOID:
Any beverage containing raw egg or fruit or vegetable pulp.

Question 13

COOKING METHODS ALLOWED AND TO AVOID I A FIBRE RESTRICTED DIET

Answer 13

ALLOWED:
•	Boiling 
•	Steaming
•	Grilling
•	Roasting

TO AVOID:
• Frying
• Braising
• Sautéing

Question 14

DISCUSS PLATING AND GARNISHING IN A FIBRE RESTRICTED DIET

Answer 14

• Plate neatly like the normal meal.
• Use cooked and peeled fruit and vegetables to garnish
• Avoid herbs that are not allowed