Body mass index (BMI) is a formula that establishes how healthy your weight is for your height. If you fall within the healthy weight range for your height, you’re at the lowest risk of developing some common chronic health problems. The BMI is suitable for women and men over the age of eighteen, but is unreliable for people with very muscular physiques (e.g., body builders) or of certain ethnicities (e.g., people of Asian descent). Different weight reference ranges may apply, which you can find on the Internet.
BMI is calculated using the following formula (there are many online BMI calculators for US measurements):
BMI = (weight in kilograms) / (height in meters)2
Waist circumference (WC) is a good measure of how much fat you may be carrying around the middle. Measure your waist around the navel using a tape measure and compare the value with those in the table below.
The BMI is suitable for women and men over the age of eighteen, but is unreliable for people with very muscular physiques (e.g., body builders) or of certain ethnicities (e.g., people of Asian descent). Different weight reference ranges may apply, which you can find on the Interent.
|
MEASURE |
REFERENCE RANGE |
|
BMI |
Underweight: < 18.5 kg/m2 Healthy: 18.5–24.9 kg/m2 Overweight: 25–29.9 kg/m2 Obese: ≥ 30 kg/m2 |
|
WC |
Men Normal: < 37 in Overweight: 37–40.1 in Obese: ≥ 40.2 in Women Normal: < 31.5 in Overweight: 31.5–34.6 in Obese: ≥ 34 .7 in |
In adjusting, you need to work through and acknowledge your feelings of loss. Know that you don’t need to overeat, because you should be able to have more later. With a sensible approach to eating and exercise, you’re unlikely to gain weight.
These dietary guidelines for men, women and children spell out the fundamentals of healthy eating (according to the 2015–2020 Dietary Guidelines for Americans and the American Academy of Pediatrics). The basic principles for adults are outlined below, with recommendations for the low-FODMAP diet. It’s still well and truly possible to eat healthily while following a low-FODMAP diet.
1. To achieve and maintain a healthy weight, be physically active and choose amounts of nutritious food and drinks to meet your energy needs.
The amount of appropriate food and exercise differs for each person, as does a healthy weight across different ages. Additionally, children and adolescents need to ensure they eat sufficient nutritious foods to assist with optimal growth and development. All people (children, adolescents, adults) should be physically active to help muscle strength and achieve a healthy weight. Adults should do at least 150 minutes of moderate or 75 minutes of vigorous aerobic physical activity each week.
Be aware of the possibility of gaining weight when you commence the low-FODMAP diet. In the adjustment period of dealing with the new diet, some people find they overeat the foods that are low in FODMAPs, “just because they can,” e.g., wheat-free cookies and cakes. There are many restrictions on what you can’t have, so many people overindulge on what they can. These feelings are common, but can lead to weight gain.
Use the BMI and WC charts to see how you shape up.
2. Enjoy a wide variety of nutritious foods from the five food groups every day.
The five food groups are vegetables, fruits, grain foods, protein foods and dairy foods. Eating a wide variety of foods is your best insurance for meeting your recommended requirements for vitamins, minerals, protein, energy and fiber. We need these each day for our optimum health. You should also drink plenty of water.
3. Limit your intake of foods containing saturated fat, added salt, added sugars and alcohol.
Limit your intake of foods high in saturated and trans fats, such as many cookies, cakes, pastries, pies, processed meats, commercial burgers, pizza, fried foods, french fries, chips and other savory snacks. Replace high-fat foods that contain predominantly saturated fats, such as butter, cream, margarine and palm oil, with foods that contain predominantly polyunsaturated and monounsaturated fats, such as healthy oils, margarine, nut butters (low-FODMAP) and spreads, and avocado. Low-fat diets are not usually recommended for children under two years old.
Limit your intake of foods and drinks containing added salt. Read labels to choose the lower sodium options among similar foods and don’t add salt to foods during cooking or at the table.
Limit your intake of foods and drinks containing added sugars, such as candy, sugar-sweetened soft drinks, fruit drinks, vitamin waters, and energy and sports drinks.
If you choose to drink alcohol, limit your intake following the government standard drinks guide and choose low-FODMAP types. For women who are pregnant, planning a pregnancy or breastfeeding, the safest recommendation is not to drink alcohol.
4. Encourage, support and promote breastfeeding.
5. Care for your food; prepare and store it safely.
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Enjoy plenty of vegetables of different types and colors, as this provides us with a variety of vitamins and minerals. Try to eat five servings of low-FODMAP vegetables each day, preferably from each of the groups below:
As you work through the reintroduction process of Step Two, you may find you can tolerate an ever greater variety of vegetables. If you find during Step Two that you can tolerate a particular type of FODMAP, don’t forget to include any of the vegetables high in that FODMAP, as tolerated. You will also notice that the recipes show you how you can include new vegetables according to any FODMAP you find you may tolerate during the reintroduction process. Legumes and lentils are also included in this vegetable food group. These are high-protein plant foods, but because they contain the FODMAPs GOS and fructans they won’t be suitable for everyone. These are restricted during Step One of the low-FODMAP diet; however, for vegetarians, especially vegans, they are a valuable protein. For vegans and those who tolerate the GOS challenge, I recommend trying small amounts over a few meals rather than a large serving in one meal. Also, lentils contain less FODMAPs than legume beans, so you may find you tolerate these better.
Legumes include baked beans, lentils, soybeans, kidney beans, broad beans, mung beans, chickpeas, lima beans, navy beans and cranberry (borlotti) beans. Legumes are often more convenient in their canned form, but are also widely available dried. If you consume these on your low-FODMAP diet, I recommend trying small amounts over a few meals rather than one large meal based on legumes. Note that cooking and draining lentils lowers FODMAP content.
Fruits are a great snack idea and really nutritious. Try to include two pieces per day from the following low-FODMAP suggestions during Step One of the low-FODMAP diet. Refer to charts for fruits containing high levels of a FODMAP that you may find you tolerate after completing Step Two of the low-FODMAP diet – you may be able to expand the range of fruits you can enjoy! Remember to spread out your fruit intake to be the equivalent of one piece of fruit at a time, every two to three hours:
Enjoy grain (cereal) foods, such as low-FODMAP breads, cereals, pastas and noodles, as well as rice, polenta, buckwheat, sorghum, millet, oats and quinoa. Choose wholegrain varieties over refined varieties (e.g., sugar and white starches), as wholegrain varieties offer much more nutrition and help minimize the risk of chronic disease. For example, where possible choose brown rice rather than white; oat, quinoa or wholegrain cereal rather than puffed rice or cornflakes. These grain foods contain carbohydrates, which give us energy. Wheat-, rye- and barley-based breads, cereals, pasta and crackers are high in FODMAPs when eaten in large amounts, and are recommended to be restricted during Step One. However, if you tolerate the Fructan A challenge, you may find that you can include these in your diet again, according to your own tolerance levels.
Low-FODMAP protein foods include plain lean meats and poultry, fish, eggs and tofu. Nuts, seeds and legumes are all also considered protein foods, however these can be higher in FODMAPs. During Step One, restrict cashews, pistachios, legumes and lentils but enjoy other nuts and seeds in moderation. Once you complete the reintroduction process, you may find you can include more of these high-FODMAP foods in your diet. It is recommended that adults eat between one to two servings of lean protein foods per day.
These high-protein foods are also good sources of iron. Iron helps your body carry oxygen in the blood, and women need more because of blood losses during menstruation. Red meat and offal are excellent sources of iron (e.g., beef, lamb, kidney, liver and liver-based pâté). Good sources include chicken, sardines, salmon, tuna, pork and eggs. Iron from animal sources is called heme iron and is more easily absorbed by the body than iron from plant foods. Women can meet their daily iron needs by eating an average serving (4 ounces) of beef or lamb, two servings (½ cup each) of leafy green vegetables, a handful (about ⅓ cup) of low-FODMAP nuts, 1 cup of low-FODMAP wholegrain cereal or two slices of multigrain low-FODMAP bread.
It is still recommended that you limit saturated fat. However, “low-fat” is no longer the center of the healthy fat philosophy. Many naturally occurring fats are considered valuable sources of energy and nutrients, and are encouraged in the diet.
Low-FODMAP milk-based foods and beverages include lactose-free milk, lactose-free yogurt and all formed/block/hard/yellow cheeses. A full selection can be enjoyed during Step One of the low-FODMAP diet. Reduced-fat varieties are preferable. If you tolerate lactose during the reintroduction process, you can enjoy regular varieties of milk and yogurt (low-FODMAP flavors) and soft cheeses.
Milk-based products are all excellent sources of calcium, which the body uses to build bones and teeth, and to keep them hard and strong. Osteoporosis is a condition of weak, brittle bones and can affect males and females, but it is most common in elderly women. To help minimize the risk of osteoporosis, we are all encouraged to include two to three servings of milk-based products in our diet every day. Milk-based products are the richest sources of calcium. Other foods such as sardines, tuna and salmon with bones (if canned), calcium-fortified plant-based milk drinks, almonds and Brazil nuts provide smaller amounts of calcium.
If you’re lactose-intolerant, choose lactose-free cow’s milk (which has as much calcium as regular milk) or choose a calcium-fortified soy milk made from soy protein or soy extract (not whole soybeans), or rice or oat milk. Soy, rice and oat milks do not naturally contain high levels of calcium, so check the ingredients list and food labels to ensure calcium has been added so that it is an equivalent to regular milk.
Over the past decade, the messages about health and the eating of fat have changed. It is still recommended that you limit saturated fat. However, “low-fat” is no longer the center of the healthy fat philosophy. Many naturally occurring fats are considered valuable sources of energy and nutrients, and are encouraged in the diet.
Trans-fatty acids tend to act like saturated fats and are not desirable in the diet. These fats can be formed in the processing of some fats and oils.
To understand the terminology of fats, here is a description of the four common types of fats in foods.
So, the gist of the good fat/bad fat message is:
Sugar and some sugary foods and drinks (such as candy and soft drinks) are full of energy (kilojoules), but contain no vitamins and minerals. Many sweet foods, such as cakes, cookies and chocolate, are high in sugar and fat and mostly low in fiber. Excessive sugar intake can cause cavities and contribute to weight gain by providing excess energy in the diet.
Salt can cause high blood pressure in some people. The major source of salt in the diet is processed foods, but many people are in the habit of adding salt during cooking or at the table. Ensure you taste your food before adding salt – your food may be flavorful enough without it. Instead of adding salt, flavor your food with low-FODMAP alternatives.
Sugar and some sugary foods and drinks (such as candy and soft drinks) are full of energy (kilojoules), but contain no vitamins and minerals. Many sweet foods, such as cakes, cookies and chocolate, are high in sugar and fat and mostly low in fiber. Excessive sugar intake can cause cavities and contribute to weight gain by providing excess energy in the diet.
Try to choose snacks with little or no added sugar, such as fresh low-FODMAP fruit, vegetable sticks and low-FODMAP dips, low-fat cheese, low-FODMAP nuts, unsweetened yogurt or popcorn.
Dietary fiber is the part of plants that can’t be broken down by our body. It’s found in grains, fruits, vegetables, legumes, nuts and seeds. Meat, eggs, milk, cheese and fats do not naturally contain any dietary fiber. It’s recommended that women consume 25 grams and men 30 grams of fiber per day. Dietary fiber is one of the essential components of our diet, but most people don’t include enough in their daily diet. As part of a healthy diet, fiber has been shown to assist regular bowel habits, help with weight control, lower blood cholesterol and improve diabetes management. Adequate fiber in the diet has also been shown to reduce the risk of bowel cancer. When you restrict wheat from your diet, it can result in a reduced intake of usual breads and cereals, and your diet can become low in fiber. Fortunately, there are plenty of wholegrain, high-fiber, low-FODMAP breads and cereals that you can enjoy and still meet your daily fiber target. See the fiber hints to guide you. If you need a hand planning your diet to obtain enough fiber, have a chat with your dietitian.
Boost your fiber intake in your low-FODMAP diet by choosing wholegrain, unrefined cereal and grain foods. Choose fresh fruit instead of juice and also leave the skin on your fruit and vegetables where possible. See the difference that just a few wise choices can make to your fiber intake by comparing the high-fiber column with the low-fiber column in the table below:
|
LOW-FIBER MENU* |
FIBER (GRAMS PER SERVING) |
HIGH-FIBER MENU* |
FIBER (GRAMS PER SERVING) |
|
Breakfast |
Breakfast |
||
|
Orange juice |
0 |
Whole orange |
2.4 |
|
Puffed rice cereal |
0 |
Gluten-free flax cereal |
5 |
|
Milk |
0 |
Milk |
0 |
|
White low-FODMAP bread, toasted |
1.2 |
Grainy low-FODMAP bread, toasted |
1.6 |
|
Lunch |
Lunch |
||
|
Cheese sandwich on white low-FODMAP bread |
2.4 |
Cheese and salad sandwich on grainy low-FODMAP bread |
4 |
|
Plain wheat-free cake |
0 |
Pecan and cinnamon muffin |
1.8 |
|
Dinner |
Dinner |
||
|
Steak |
0 |
Steak |
0 |
|
French fries |
2.5 |
Baked potato (with skin) |
4 |
|
Fried egg |
0 |
Mixed low-FODMAP vegetables |
4.5 |
|
Ice cream |
0 |
Lactose-free yogurt with low-FODMAP fruit salad |
2.6 |
|
Between meals |
Between meals |
||
|
Chocolate |
0 |
Low-FODMAP fruit |
2.5 |
|
Rice cakes with jam |
0.5 |
Rice cakes with crunchy peanut butter |
2.5 |
|
Total fiber |
6.6 |
Total fiber |
30.9 |
*approximates used
