Respected dietitian and co-owner of Food Savvy, Sarah Elliott is dedicated to helping people with their food and digestive issues. She talks to Sara Greig about food allergies and intolerances, what’s involved in seeing a dietitian and the FODMAP diet.
Why did you become a dietitian?
At 19-years-old I was diagnosed with Crohn’s disease. I quickly realised that what I ate made a difference to how I felt. It would have been wonderful to have a person I could have spoken with to help guide me through the maze of food options out there!
What is Crohn’s Disease and what are the symptoms?
Crohn’s disease is an Inflammatory Bowel Disease. This is a lifelong autoimmune disease which is typically managed with medication. Diet is being shown to have an increasing impact. The symptoms aren’t pleasant and include diarrhoea, bloating, abdominal pain, weight loss, bleeding from the bowels and nutrient deficiencies such as anaemia.
What can a dietitian do to help adults and children who might have food intolerances or allergies?
We can see patterns of food and symptoms people often can’t see. After many years of working in this area our team are great at asking the right questions to guide people on the right track. We also have people come to see us who know their food intolerances/allergies but need help with menu planning and getting all the nutrition they need. With children we need to be particularly mindful of their nutritional growing needs. We have a specialist paediatric dietitian who sees all our children.
Are there any tests you recommend?
If you suspect an allergy, having a RAST test (a blood test used to determine the substances to which a person is allergic) via your GP is a good place to start. Keeping a detailed food and symptom diary is a great tool for both yourself and if you decide to see a dietitian. It really helps us pick up on patterns of symptoms and associated trigger foods. Other useful tests include a coeliac screen (ensure you are eating gluten daily to have this done), iron and CRP test (C-Reactive Protein Test, which measures inflammation in the body).
Food Savvy uses the low FODMAP diet to help people. What is a low FODMAP diet and what kinds of digestive issues can it help with?
The low FODMAP diet was developed by the Monash University in Melbourne. It is used to help control symptoms associated with Irritable Bowel Syndrome (IBS). Certain food components can cause the bowel to distend by drawing in fluid and generates excess gas when they are fermented by bowel bacteria. The main dietary components are indigestible sugars that provide fast food for your bacteria. These sugars have been given the acronym FODMAP which stands for: Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols. Basically fancy names for different sugars!
The symptoms which can be relieved include bloating, gas, abdominal cramping/discomfort, diarrhoea, constipation and associated fatigue. Examples of high FODMAP foods to avoid include onion, garlic, apples, pears, and cauliflower.
How can changing your diet affect IBS?
It has been life-changing for some of our clients. We’ve had people come off medication, return to work, have confidence being away from a bathroom, gain/lose weight (as needed), have more energy and save money on toilet paper! The FODMAP diet has ~75% success rate but there are other strategies which can work too. It really is worth looking into. However don’t follow the strict low FODMAP diet for too long. The research shows it can reduce some of the good bacteria in your gut. Reintroductions are really important.
What would a typical consultation with a dietitian involve?
We find it really important to understand issues from your point of view. So a lot of talking is done to find out what your concerns or goals are. This includes what you have already tried, your medical/family background, your food preferences, culture, medications and supplements and how you eat (a lot of talk on this one). How you eat includes things such as your pace of eating, the types of food you eat, which foods you feel upset you, what your hunger cues are like, etc.
Then a plan is made depending on your goals. We would then typically follow up between 2-4 weeks later.
What interests you most about health and nutrition?
My favourite topic at the moment is the gut microbiome. All the billions of bacteria living their own lives inside us. Even though they are microscopic there is ~1.5kg of them, that’s crazy! The way we live and in particular, eat, has a big impact on them. We are just beginning to understand this so it’s fascinating to follow.
What is your favourite healthy meal?
I’m loving grain based salads at the moment as we come into warmer weather. So brown rice or soba noodles or bulgur wheat mixed with rocket, capsicum, chives, olives, feta, avocado, cooked/chilled broccoli – then served with a protein. Usually miso marinated chicken or falafel.
What is your favourite place to eat out in Wellington?
I’m going to be completely bias and say my husbands cafe Ti Kouka, but I do love the food there. They also have a low FODMAP menu I help ensure is above board and train the staff regularly on how to cater to those with intolerances and allergies. I also enjoy Pita Pit for a quick on the go option. My kids love it too.
Is there anything special you are working on right now?
We have been in the process of developing a low FODMAP cookbook, but it is a slow moving project! Plus we have just introduced Nutrigenomix testing to our clinic. We are also looking at bringing a BodyGem unit to Wellington. It basically measures your resting metabolic rate so you know how many kilojoules your body needs at rest. This will be really useful for those wanting to gain/lose weight or for athletes.
For more information about how a registered dietitian can help you please visit Food Savvy.