here and also something I hope to post more about in the near future.
OK, so moving on to The Gastroparesis Cookbook, written by Karen Frazier. As stated on the cover it includes "102 Delicious, Nutritious Recipes for Gastroparesis Relief." The first thing I noticed was how professional it looked, from the photograph on the cover to the binding to the organization, something nice to see and shows that gastroparesis is getting more attention not only in research but in the publishing world. In fact, the author doesn't actually have gastroparesis herself but specializes in cookbooks for special need diets. Karen shares in the introduction that she lived most of her life with celiac disease which caused severe GI symptoms and malnutrition, going undiagnosed for 20 years. Just like us she has been through numerous doctors, testing and what sounds like similar worry of what hours, days, even weeks of symptoms the next meal may result in. Sound familiar?
This cookbook goes beyond recipes and I enjoyed the fact that it shared stories and experiences as well as tips from actual real people living with GP. They are dispersed throughout the first section and also included at the end of the book in more details. A few of them even shared their own recipes, which like all food with GP, may or may not work for you.
Part One - Basics of Eating Well with Gastroparesis
You will probably find that a lot of this information has been shared over the years by some medical professionals, bloggers who have experienced it first-hand like myself and others, and books that Crystal Saltrelli has released. The author went over in brief detail about possible causes, symptoms and treatment. She then moves on to the basics of a GP diet with tips for low-fiber, low-fat, peel and cook, chew chew chew, puree and so on, all excellent reminders. What I LOVED and respected is her focus on eating small, nutrient-sense meals which you will see emphasized in the recipes. The use of mostly whole foods, quality protein and methods of cooking to get the most out of each bite.
Laying in bed late one evening while reading through the section Alleviating Gastroparesis with Smart Eating, I came across the section Consider FODMAPs and read the following: "According to health coach Stephanie Torres in a blog interview by Kate Scarlata, a registered dietitian and FODMAP and IBS expert, some people with gastroparesis may also benefit from a low-FODMAP diet." What?! I ran out to T and yelled "my name is listed in the book.!" This was completely unbeknownst to me and left a feeling of pride and also confusion. So, while I'm excited she used that blog post as a reference I have to share that I had no part in how it was presented in the book itself. But yes, I do agree that giving this diet a try may help relieve or at least lessen some of the symptoms such as pain, bloating and nausea. I say that from my own experience and talking with others who have done the same.
At the end of Part One Karen creates a 2 week meal plan using recipes throughout the book. She focuses on small, nutrient dense portions every 2-3 hours which includes a combination of solid meals, smoothies, soups and snacks. When looking at the recipes you will find each provides the nutrition information - calories, fat, carbohydrates, sugar and fiber. Portion sizes average about 2-4 oz with 5 portions recommended a day. *Important to note, this can vary from person to person as some do better with slightly larger and less frequent or smaller and more frequent, something to experiment with and find out what works best for you.*
What concerned me were the total calories per day with the meal plan mostly being under 1000. Karen was kind enough to answer this question and her response made sense.
"The small size of servings makes calories an issue, particularly in the meal plans. I’m all for people adding bigger servings or having more meals/snacks as they can tolerate. I’m certainly not advocating for an 800 calorie per day diet, which isn’t nutritionally sustainable long-term, but from what I’ve heard from people with severe symptoms, eating a high-calorie diet is virtually impossible when symptoms are at their worst. Therefore, while I don’t think an 800 calorie a day diet is sustainable, during severe symptoms eating fewer calories will provide nutrition while hopefully soothing the digestive system and easing people with gastroparesis back into being able to eat more. The goal is soothing the system, and then working their way back up to more nutrient-dense foods that also have more calories to a more sustainable level of 1400-2000 calories per day. I understand, however, that in some cases, this may not be feasible. Individuals need to do what works best for them and work with a nutritionist or health-care professional to find a way to improve nutritional status."
Part Two - The Recipes
The recipes are labeled for specific dietary needs, a huge bonus for those with a ridiculous number of sensitivities like myself, yay! They include the following: gluten-free, dairy-free, low-FODMAP, low-carb, low-sugar, SIBO friendly and GERD-friendly.
*I will note to still make your own judgements on what works best for you when trying these out. For example, orange juice and zest used in some of the recipes are listed as GERD-friendly due to the small amounts per serving. Personally, even a tiny amount can cause pretty bad reflux so I completely avoid citrus foods. Some I know with GP do great with it though and will love the added flavor combinations! As for dairy-free there are suggestions for substitutes like almond and/or coconut milk or yogurt, a great alternative to those with lactose intolerance. Be cautious however that the dairy free yogurts often have added ingredients such as inulin or chicory increasing fiber content to 3 or more grams and also tested as high in FODMAPs by some. So again, make your own decisions on whether this might work for you.
Plenty of variety is offered ranging from eggs and egg-free dishes, fish, chicken and turkey to vegetarian recipes as well as soups, stews, dips, desserts and smoothies. I love that she incorporated scallops, shrimp and crab, something we get a lot of here in the Pacific Northwest! That said one of the first things I made were scallops and Roasted Root Vegetable Soup. For the scallops it was more of an inspiration to try again (a benefit of this cookbook may be to simply encourage you to mix things up a bit!) but did modify recipe to exclude the orange juice. The soup turned out AMAZING, with a combination of roasted sweet potato, carrot and parsnip as well as some dried thyme to compliment the sweet earthiness of the veggies. This made enough for dinner, leftover lunch and freezer portions. I pureed the soup for a thick, creamy texture as recommended and this will definitely be a staple in my diet!
Every recipe has either an ingredient, substitution or cooking tip in the lower right corner and found them to be helpful for ideas in making it individual to specific needs. Who knows, this might spark some creativity to share some recipes of my own again soon after a long time of avoiding anything new. If you have a chance to check out this book, which you can purchase here on Amazon, be sure to let us know what you think!
Oh, and don't forget to check out Appendix B towards the end called, Stories From the Front Line. This includes a series of Q&A's with "Gastroparesis Veterans" where they share their own stories and tips about living with gastroparesis.
Addition thoughts for those who really struggle to eat period...
Getting in enough calories has always been my biggest challenge and personally I will be experimenting again with smaller, more frequent meals with the idea of working back up again. Some of us have higher metabolisms that require more and some of us unfortunately just have a severe case where, no matter what we try, our bodies cannot take in enough. Working with these severe cases through ThriveRx is a reminder that not everyone out there can eat and some may require the extra nutrition support. They might laugh at the idea of a cookbook for gastroparesis and I totally get that. With such a variety of struggles out there I would like to acknowledge these tough situations and will continue to share not only food posts but also stories and ideas from all spectrum's of GP.