# Fructose, lactose intolerance & IBS



## Ms. Mickey (Mar 8, 2002)

Hi Heather ~ I tried to meet you at SouthHill Mall in Puyallup about 6 months ago but my daughter had a really bad attack, I went the next day and bought your book "Eating for IBS". It's a GREAT book!!! My daughter in the last 8 months has been dignosed with fructose, lactose intolerance and in the past month her GI Doctor has said that shes suffering from IBS. They have ran all the test and couldn't find anything else wrong. My problem is that I also need recipes for a preteen girl. Her food options are running very slim!!!!! Please help, Lisa


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## Heather Van Vorous (Oct 2, 2001)

Hi Lisa - So glad to hear that you liked the book. I hope your little girl is feeling better soon.Avoiding fructose and lactose can be helpful for IBS, though it's even better to eliminate dairy altogether as it's not just the lactose that causes GI problems.All of the breads, breakfasts, and most of the soups/sandwiches in Eating for IBS are pretty kid-friendly. The chicken main dishes are also mostly traditional and many of them are actually recipes I grew up on and loved as a child. If your daughter likes seafood, you can always simply grill or broil something and squeeze on a bit of fresh lemon juice, or make a boiled shrimp cocktail. It's also easy to make fast and simple meals for her that are probably close to what you're used to: skinless chicken breasts broiled with barbecue sauce, tofu hot dogs, gardenburgers, grilled tuna sandwiches made with fat free mayo and soy cheese slices, spaghetti without meatballs or cheese and a low-fat sauce. See what your local health food market has in stock in terms of low fat vegetarian (and non dairy) versions of: burritos, deli meats and soy cheeses for sandwiches, frozen pizzas, soy burgers, "chicken" nuggets, etc. You may be able to easily make your traditional recipes safe for her without much effort. Replace ground beef with TVP (soy flakes available at health food markets) for tacos and sloppy Joes. Use soy milk for dairy in any custard, pudding, chowder, etc. recipe. Use two egg whites instead of whole eggs. And use nonstick skillets and Pam instead of frying in oil.Can you give me some ideas for what foods your daughter likes? I'll try to tailor some suggestions or suggest recipes for her.Best,Heather


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## Ms. Mickey (Mar 8, 2002)

Hi Heather ~ Thank you so much for getting back to me so quickly. I'm still very new to all this, like yesterday I made her a scrambled egg sandwich for her lunch but didn't even think about the egg yolks being in it. She is still lossing weight and I feel that I need to gather everything I can to read on IBS. Is it really common for people with IBS to have fructose and lactose intolerances? I plan on getting your other book "IBS The First Year", hopefully by this weekend!!! I heard on the BB that your starting a cooking show (I think that is totally AWESOME) do you know when we can look forward to that? My daughter can't seem to handle bar-b-que sauce or tomato sauce very well. Some of her favorite dishes are: Shrimp Scampi, Pizza, Pasta dishes, Fish, Lean Chicken, Burgers, Salads and some sandwiches. We have taken her off sugar and replaced it with dextrose (we found a place that sells it by the Pike Place Market) because she has a sweet tooth sometimes. She doesn't like the taste of the soy products that well (I'm still working on that on - any suggestions)? I can never thank you enough for all your help, it is truly appreciated!!!!!! Thanks, Lisa


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## Heather Van Vorous (Oct 2, 2001)

Hi - I didn't realize you're in Seattle. I am too! I'm actually teaching a class on managing IBS through Discover U in Northgate tomorrow (Saturday) from 9-noon. You can call them at (206) 365-0400 if you're interested. It's course # GS448A. Seattle is a wonderful place to get all the health food alternatives for IBS foods (especially Whole Foods), plus Pike Place and Chinatown have great stuff too.It is really hard to keep all the guidelines in mind at first when you're cooking, so don't be too hard on yourself. It will very quickly become routine and you won't even have to think twice. A scrambled egg white sandwich is actually a good bet (just scramble it in a nonstick skillet with Pam instead of frying it in oil or butter). You can also get something called Tofu Scrambler by Fantastic Foods. It's seasoning that you add to mashed tofu and scramble like eggs. It's delicious (health food stores carry it). You can sautee in some finely diced veggies with it too to add nutrition. For a change of pace wrap the scramble in a toasted flour or corn tortilla, or serve it with baked corn chips (like Tostitos) for scooping up.Fructose and lactose frequently cause problems for IBS. Fructose can cause cramps, diarrhea, and gas (though it tends to be the only sugar that does so - sucrose, or plain table/baking sugar, doesn't usually cause problems.) Lactose is just one of the many components of dairy that can trigger an IBS attack. Dairy is very high in fat, and fat is a trigger, and dairy proteins such as casein and whey are difficult to digest. This is why I strongly recommend that people eliminate dairy altogether, even if they're not lactose intolerant. Fructose can be managed in several ways. You can't eliminate fruit for health reasons, but you can make it safer. Avoid processed fruit juices (especially apple and grape). Cook with fruit purees (banana bread, pumpkin bread, etc.). Add diced, peeled fresh fruit to high soluble fiber foods like oatmeal or cream of rice cereal. Watch out for high fructose corn syrup in prepared foods (it's a common commercial sweetener). Remember that the insoluble fiber in fruit can trigger IBS attacks too, which is why it's important to peel, dice, or puree the fruit and not eat it alone - always have a soluble fiber base.Your daughter's food preferences make things pretty easy for IBS cooking. "Shrimp Scampi, Pizza, Pasta dishes, Fish, Lean Chicken, Burgers, Salads and some sandwiches"Scampi is great - sautee it in a wee bit of olive oil (not butter), the garlic is fine if it's very finely diced, and make sure you serve a soluble fiber base (rice, pasta, white bread). Shrimp is super low fat and a great safe IBS food. Pizza is also easy, especially if you make it. The crust is a good soluble fiber base, you can eliminate the tomato sauce (or try just a thin layer of a non-fat one), use a bit of shredded soy cheese, shredded chicken breasts, roasted veggies, vegetarian "pepperoni" or veggie "sausage", even shrimp on pizza is really good. At restaurants make sure their crust isn't oily, and just get a no-meat no-cheese option.Pasta is wonderful - virtually anyting on top of it that's non meat, non dairy, and low fat will work great for her. If she's really touchy, a plain bowl of noodles will be very stabilizing.Fish of all kinds is great. Lean chicken is perfect - use white meat only, no skin. If barbecue isn't an option, try brushing the breasts with any low-fat marinade (low fat salad dressings work well) and baking them. For burgers, she'll have to stick to Gardenburgers or Boca burgers, or some other veggie variety. Red meat is just a huge universal trigger.Salads, if they're green salads, are difficult. They're very high in insoluble fiber from the greens and salad dressings are usually very high fat. Don't let her eat a salad on an empty stomach. Instead, have a small portion at the end of the meal, following a good soluble fiber base from rice, pasta, potatoes, etc. And use only fat-free, non-dairy dressings. No cheese or fried croutons or bacon bits.Sandwiches can easily be safe too. Veggie meats, soy/rice cheeses, mustard, fat free mayo, and thinly sliced veggies work well, and a white bread gives a soluble fiber base. Use a sturdy loaf with thick slices, or some kind of bun. You want the bread as the base of the meal, so don't use really thin slices.For soy, try a different variety of brands and flavors for the milk and cheese. They vary a LOT. Some are great, some pretty awful. VitaSoy and Silk are pretty well-liked brands for the milk. Try the vanilla and the chocolate and see what she likes. For cooking, if you just substitute plain soy milk for dairy you can't taste the difference so the brand won't really matter.If she has a sweet tooth, try the peppermint fudge cake from the book. Children (and adults) adore it, it's totally safe, and she'll get a real treat without getting sick. I always bring this cake to classes and seminars and such because it is so safe and because literally everyone loves it.The cooking show is coming soon. It's been an enormous project, but we hope to go live by May. It will run on the website and the local cable access tv station. I'm going to see if the local PBS station is interested as well.Hope this helps.Best, Heather


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