Patient Name Date Registered Dietitian/Dietetic Technician Telephone LOW-FIBER, LOW-RESIDUE DIET Why limit fiber? Fiber is limited in your diet to avoid irritation of the intestinal tract and to reduce the frequency and total volume of fecal material. What is fiber? The term FIBER refers to the portion of carbohydrates (starch) not capable of being digested. Fiber containing foods generally include raw or dried fruits, vegetables, whole-grains, legumes, and nuts. What is residue? The term RESIDUE refers to the indigestible content of food. Residue containing foods generally increase the fecal residue and stool weight and are therefore limited. Foods that are high in residue include fruits, tough and fibrous meats with gristle, and vegetables. KEY PRINCIPLES The low fiber diet allows you a wide variety of foods. This diet contains foods that are low in dietary fiber and are non-irritating to the digestive tract. Foods with some fiber (fruits and vegetables) should be well cooked. Highly seasoned foods are to be avoided. Your physician will advise you on the length of time that you must remain on a low fiber diet. Generally, this diet is temporarily used until digestive processes normalize; then you can advance to your regular diet, only avoiding foods that you cannot normally tolerate. GENERAL GUIDELINES Allow milk and dairy products as tolerated. Cook vegetables well and limit to 2 servings daily selected from the allowed foods list. Limit fruits to 3 servings daily selected from the allowed list. Use only white or refined bread and cereal products prepared without seeds and nuts (white bread, rolls, or crackers, bagels, waffles, french toast, white rice, macaroni, noodles, spaghetti, white refined hot cereals (Farina, Cream of Wheat, Low Fiber, Low Residue Diet KL 1 Copyright 2005 Rhode Island Hospital
Cream of Rice), Corn Flakes, Rice Krispies, puffed rice, Cheerios, and Special K. Use ground, well cooked or tender beef, lamb, ham, veal, pork, poultry, fish and eggs. Avoid fried and tough, fibrous meats with gristle and highly seasoned luncheon meats and sausages. Sweets and desserts such as sugar, syrup, honey, jelly, plain hard candies, gumdrops, jellybeans, gelatin, fruit or water ices, popsicles, cakes and cookies without fruit or nuts are allowed. Do not eat peanuts, coconut, nuts, seeds, or popcorn. Coffee, tea, fruit punch may be consumed. Allow carbonated beverages to get flat before drinking. Finely ground spices and herbs may be used. If you have an ostomy, avoid highly seasoned foods and garlic. A standard multivitamin with minerals is recommended to be taken daily. Milk (as tolerated) Foods from this group are good sources of protein, calcium, phosphorous, riboflavin, and vitamins A, B12, D, and E. All of these are important for building and maintaining bones and teeth of the body. Vegetable (Limit to 2 servings: 1 serving = 1/2 cup, cooked.) Vegetables are a good source of iron, calcium, and vitamins A, C, E, and K. A good vegetable intake promotes clear and smooth skin, good eyes, bone growth and assists in normal clotting function of MEAL PLANNING GUIDELINES Food Groups Choose Avoid All milk and milk-based products. the body. Bread/Starch (6-11 servings) This group provides carbohydrates or sugar to keep the body functioning. Carbohydrate saves the protein so that it may be used for body building and repair. This group is a good source of Asparagus tips, beets, carrots, chard leaves, green and wax beans, mushrooms, pimiento, pumpkin, spinach, zucchini, summer squash, fresh tomato without skin, tomato sauce, paste or puree. Any vegetable juice. Tender lettuces. White, light rye (no seeds), finely milled wheat or corn bread or rolls (no seeds), soda crackers, saltines, melba toast, cheese crackers, biscuits, tapioca, pancakes. All refined cooked cereals (Farina, Cream of Rice, Cream of None - except those containing nuts or restricted fruits. All raw or deep fried vegetables. All dried peas and beans; skins or strings, pickles, corn, peas, lima beans. Bread, rolls, crackers with bran, seeds, dates, raisins or nuts; pumpernickel bread; popcorn, corn chips, granola. Low Fiber, Low Residue Diet KL 2 Copyright 2005 Rhode Island Hospital
Food Groups Choose Avoid some B-complex vitamins and minerals, which are important for growth, blood formation and basic body functioning. Wheat, and oatmeal). White and sweet potatoes without skins. Corn Flakes, Rice Krispies, Special K, Cheerios, puffed rice. Fruit (Limit to 3 servings a day) Fruits are a good source of carbohydrate or sugar, which supplies energy for body functions. Fruits are also a good source of vitamin C, which is important for wound healing and resisting infections. Fruits are a good source of vitamin A. Some fruits are a source of iron. Meat (6-8 ounces daily) Foods from this group are a good source of protein, which is important for growth, building and repair of body tissue, builds blood, forms antibodies that fight infection, and is important in clotting. Meat also provides iron and phosphorous which helps cells use oxygen. Iodine is provided from fish products. Vitamins A, B- complex, E and K are also supplied by this group. Fat (in moderation) Fat is the transporter of fat soluble vitamins A, D, E, and K. It is an important source of energy and promoted healthy skin. Any fruit juice except prune juice unless allowed by your physician. Ripe banana, avocado, melon, orange and grapefruit without membrane, peeled and cooked apples, canned fruits other than pineapple, berries, figs, prunes, and fruit cocktail. Eggs; baked, boiled or broiled tender beef, veal, lamb, poultry, pork, ham, liver, tender game, fresh, frozen, or canned fish or shellfish. Cottage cheese and any other mildly flavored cheese tolerated. Smooth peanut butter. Any, including butter, margarine, cream, mayonnaise, vegetable oils, shortening, cream cheese, sour cream, plain gravy, cream sauce, crisp bacon, whipped topping, salad dressing made from allowed ingredients. Raw fruits except those listed as allowed. Fresh, canned, or dried prunes, berries, pineapple, figs, and olives. *Prune juice may be allowed by your physician. Tough, gristly, spiced, cured or pickled meats, hot dogs, luncheon meats, sausage, sardines, deep fried meats and barbecued meats. Strongly flavored cheeses, crunchy peanut butter. Any fat used in deep frying, nuts, seeds, and olives. Low Fiber, Low Residue Diet KL 3 Copyright 2005 Rhode Island Hospital
Food Groups Choose Avoid Beverages Any, not including Alcoholic beverages. ingredients that are restricted. Soup Any made from allowed ingredients. Those containing restricted ingredients or those that are Dessert and Sweets These foods provide carbohydrates or sugars, which are good sources of energy. Seasonings and Condiments These foods are a good method of flavoring foods without increasing salt. Ice cream without seeds, nuts, coconut, or raisins. Plain milk puddings and custards, sherbet, flavored gelatin without restricted fruits. Cakes, pies, cookies or cobbler without restricted ingredients. Sugar, brown sugar, clear jelly, honey, syrup, marshmallows, chocolate, cocoa. Pepper, extracts, vinegar, lemon juice, catsup, smooth mustard, allspice, basil, bay leaves, cinnamon, ginger, marjoram, turmeric, onion, cumin, oregano, paprika. strongly seasoned. Any made with nuts, coconut, raisins, seeds, berries, jams, dried fruits, preserves, marmalades or other restricted ingredients. Cayenne, chili powder, garlic, whole spices, seeds, etc. SAMPLE MENU Breakfast Lunch Dinner Apple juice (1/2 cup) Rice Krispies (1 cup) Poached Egg (1) White toast (2 slices) Margarine, Jelly 1% milk (1 cup) Chicken noodle soup (1 c.) Crackers Macaroni and cheese (1 c.) Green beans (1/2 cup) White bread (1 slice) Margarine (1 tsp.) Banana (1) 1% milk (1/2 cup) Baked chicken (3 oz.) Mashed potatoes (1/2 cup) Cooked carrots (1/2 cup) White bread (1 slice) Margarine (1 tsp) Gelatin (1/2 cup) 1% milk (1/2 cup) Low Fiber, Low Residue Diet KL 4 Copyright 2005 Rhode Island Hospital
RECIPE Down Home Macaroni and Cheese (All Recipes; submitted by Kraft Foods http://pasta.allrecipes.com/az/dwnhmmcrnindchs.asp) Serves: 6 Ingredients: ¼ cup Butter or margarine ¼ cup Flour 1 teaspoon Salt 2 cups Milk, (1% or non fat) ¼ lb. Velveeta Pasteurized Prepared Cheese, cut up 8 ounces Kraft shredded cheddar cheese 2 cups Elbow macaroni, cooked and drained 2 tablespoons Seasoned dry breadcrumbs Method of Preparation: 1. Melt 3 tablespoons of the butter in a large saucepan on low heat. Blend in flour and salt; cook and stir 1 minute. Gradually add milk; cook, stirring constantly, until thickened. 2. Add prepared cheese product and 1 ½ cups of the shredded cheese; stir until melted. Stir in macaroni. 3. Pour into lightly greased 1 ½ quart casserole. Melt remaining 1-tablespoon butter; toss with breadcrumbs. Sprinkle casserole with remaining ½ cup cheese and breadcrumb mixture. 4. Bake at 350 F for 20 minutes or until thoroughly heated. Low Fiber, Low Residue Diet KL 5 Copyright 2005 Rhode Island Hospital
FURTHER RESOURCES WEBSITES: American Dietetic Association: www.eatright.org BOOKS: Scala, Dr. James; Eating Right for a Bad Gut. New York: New American Library, 1990 Bonci, Leslie MPH, RD; ADA Guide to Better Digestion: ISBN 0-471-44223-2ADA Guide to Better Digestion ORGANIZATIONS: Crohn s and Colitis Foundation of American New England Chapter 280 Hillside Avenue Needham, MA 02494 (800) 314-3459 or (781) 449-0324 Email: ne@ccfa.org If you have further questions about your diet, you may call the Rhode Island Hospital Nutrition Hot Line. A Registered Clinical Dietitian will return your call. HOT LINE NUMBER: 444-4526 Low Fiber, Low Residue Diet KL 6 Copyright 2005 Rhode Island Hospital