Healing Ibs: Vegan Diet For Gut Health

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that affects 10-15% of people worldwide. It is characterised by abdominal pain, diarrhoea, and constipation, with 25% of sufferers reporting severe symptoms. A low-FODMAP diet is often recommended to ease IBS symptoms. FODMAP is an acronym for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols, which are short-chain carbohydrates that are poorly digested and can cause gas and an uncomfortable feeling of distension.

A low-FODMAP diet can be challenging for vegans, as it initially eliminates many plant foods, and vegan pantry staples tend to be high in FODMAPs. However, a vegan diet can help manage IBS symptoms, and there are ways to ensure sufficient protein intake while following a low-FODMAP diet. This involves including moderate servings of beans and lentils, as well as firm tofu and tempeh, nuts and seeds, and grains such as quinoa, corn, and wheat-free breads.

The FODMAP approach: Eliminating certain fermentable short-chain carbohydrates from your diet

The FODMAP approach is an evidence-based diet therapy that helps manage symptoms in about 70-75% of people with IBS. It involves limiting certain fermentable short-chain carbohydrates from your diet, known as FODMAPs, for several weeks to see if IBS symptoms improve. FODMAP is an acronym for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. These are all short-chain carbohydrates that are not bad for you in general and even have prebiotic effects that may lower the risk of colon cancer. However, for people with IBS, these carbs may be poorly digested or not digested at all, leading to gas production and an uncomfortable feeling of distension.

The FODMAP approach involves eliminating the following foods during the initial elimination phase:

• Galactans: Oligosaccharides found in beans that no one can digest due to the lack of appropriate enzymes.
• Fructans: Oligosaccharides found in artichokes, garlic, onions, leeks, wheat, rye, and barley.
• Lactose: A disaccharide found in milk and other dairy products.
• Fructose: A monosaccharide found in fruits and sugars. The ratio of fructose to glucose is important, as it affects absorption.
• Polyols: Sugar alcohols found in some fruits like apples, apricots, avocados, cherries, nectarines, pears, plums, prunes, and mushrooms, as well as sugarless gums and candies.

During the elimination phase, it is important to ensure adequate protein intake, as vegan protein sources can be limited. Some low-FODMAP vegan protein sources include:

• Legumes in moderate portions: 1/2 cup of garbanzo beans, 1/4 cup of black beans, 1/3 cup of cannellini beans or kidney beans.
• Lentils: 2-3 tablespoons of red, green, or Le Puy lentils, or up to 1/3 cup of green lentils.
• Tempeh and firm tofu: Processed from soybeans, these are low in FODMAPs.
• Nuts and seeds in small portions: Avoid pistachios and cashews. 2 tablespoons of peanut butter is also low in FODMAPs.
• Grains and grain products: Quinoa, corn, wheat-free breads, sourdough breads, and cereals.
• Pea protein isolate: According to Monash University, pea protein isolate is low in FODMAPs.

After the elimination phase, the reintroduction phase involves gradually adding foods back one at a time to determine which type of fermentable carbs are responsible for your symptoms. This helps identify which carbs can be comfortably eaten without triggering IBS symptoms.

Vegan protein sources: Ensuring you get enough protein from vegan-friendly foods

Protein is an essential part of our nutrition, making up about 17% of the body's weight. It is the main component of our muscles, skin, internal organs, eyes, hair, and nails. Our immune system requires protein to make antibodies to fight infections, and protein also plays a role in blood sugar regulation, fat metabolism, and energy function.

Protein is made up of long chains of smaller units called amino acids. There are 20 amino acids in total, nine of which are essential, meaning the body cannot make them, and they must be obtained from your diet.

Animal foods like meat and fish are often referred to as 'complete' sources of protein, meaning they contain all nine essential amino acids. However, several plant sources are also complete proteins, while others may be lacking in sufficient amounts of some essential amino acids.

How to get enough protein as a vegan

If you're not eating enough protein, you may notice this in the condition of your hair, nails, and skin. Other signs might include wounds and injuries that take longer to heal, frequent colds and infections, and muscle weakness.

As a vegan, getting all your protein needs is possible, but the key is variety. This means mixing up your food choices and eating a range of beans, legumes, grains, and nuts while trying to avoid ultra-processed substitute products such as vegan cheese.

The Reference Nutrient Intake (RNI) for an average adult is set at 0.75g of protein per kg of body weight per day. This means an adult weighing 60kg needs 45g of protein per day, while an adult weighing 74kg would need 55g. The RNI is a minimum amount based on the needs of an average, sedentary adult. As a vegan, aim for three plant-based protein sources per day, spread evenly throughout the day to optimise your body's use of protein.

Vegan protein sources

• Hemp seeds: Hemp seeds provide all nine essential amino acids and are a rich source of protein. About 25% of the calories supplied by hemp seeds come from protein, and weight for weight, they provide similar amounts to beef or lamb. They also provide a highly digestible form of protein, making it easy for us to break down and absorb.
• Peanuts: Peanuts are a rich source of plant protein, providing 25.8g of protein per 100g. Like other legumes, they are low in certain essential amino acids, including lysine and methionine. However, as part of a balanced, plant-based diet, they can be a useful contribution due to the digestibility of their protein.
• Pumpkin seeds: Pumpkin seeds are a useful protein source, providing 24.4g of protein per 100g. Combine them with oats and soy milk for a complete protein dish.
• Tempeh: Tempeh is made from cooked, fermented soybeans and is a useful source of plant protein, providing all nine essential amino acids. Of all the soy products, tempeh is the richest in protein content, with 20.7g of protein per 100g.
• Cashew nuts: Cashews contribute a good level of protein, with 17.7g of protein per 100g, and are a useful source of minerals like iron and zinc, making them an excellent choice for those following a plant-based diet.
• Soya mince: Typically made using concentrated sources of soy protein and processed to resemble meat mince, soya mince provides 16.6g of protein per 100g. The digestibility of the protein in soya is good and may even be comparable to that of animal protein.
• Tofu: Tofu, or bean curd, is another soy product that is a good source of protein, with 16.5g of protein per 100g. It can be cooked in many ways, including baking and stir-frying.
• Chia seeds: Just one tablespoon of chia seeds will provide about 2g of protein. They can be sprinkled onto dairy-free yoghurt for breakfast, blitzed into smoothies, or enjoyed as a protein-rich dessert. They also work as an egg replacer in vegan cooking as they soak up water and help bind ingredients together.
• Lentils: Different lentil varieties can contain up to 18g of protein per cooked cup, and they're also a great source of fibre. They may also reduce your risk of heart disease, diabetes, excess body weight, and certain types of cancer.
• Chickpeas: Chickpeas, also known as garbanzo beans, are a useful source of protein, with 7.2g of protein per 100g, and work well in dishes like curries and salads. They can also be blended with tahini to make hummus.
• Baked beans: Haricot beans are used to make baked beans, which are an affordable source of plant protein, providing 5g of protein per 100g. Just watch out for any added salt and sugar.

Stress reduction: Exploring ways to minimise stress, such as yoga and meditation

Stress is a common trigger for IBS symptoms, so finding ways to minimise stress is an important part of managing the condition. Yoga and meditation are effective tools for stress reduction, and can complement a vegan diet as part of an IBS management strategy.

Yoga

Yoga is a mind-body practice that combines physical postures, breathing techniques, and meditation or relaxation. It has been shown to have physical and mental benefits, including stress reduction. The physical postures promote flexibility, relieve tension, and alleviate pain. They also promote the release of endorphins, which are hormones that positively affect how you handle stress.

Yoga can also help you to focus on the present moment, enhancing your awareness and concentration. This can make it easier to let go of attachments to positive, negative, and neutral experiences. You may also find it easier to cultivate feelings such as love, joy, and serenity.

There are many different types of yoga, but one style that has been specifically shown to reduce stress is Hatha yoga. In one study, women who practiced Hatha yoga three times a week for four weeks experienced significant reductions in stress, depression, and anxiety.

Meditation

Meditation can be practiced on its own or as part of a yoga routine. It can be done sitting, standing, walking, or lying down. Yoga nidra, or "yogic sleep," is a form of guided meditation that promotes deep relaxation, stress relief, and improved sleep quality. In one study, people who practiced yoga nidra for 11 minutes a day for 30 days reduced their stress levels and enhanced their overall well-being. These benefits were still present at a follow-up six weeks later.

Breathing Techniques

Breathing exercises, or pranayama, teach you to relax, regulate your breath, and breathe deeply. This helps to reduce stress and calm your body and mind. They can also enhance your sleep quality and encourage mindfulness.

There are many different types of pranayama, including:

• Alternate nostril breathing (nadi shodhana)
• Breath of fire (kapalabhati)
• Lion's breath (simhasana)
• Humming bee breath (bhramari)

Tips for Using Yoga and Meditation for Stress Relief

• Release negativity during your practice by practicing awareness, acceptance, and detachment. This can help you have fewer negative thoughts and be less affected by them.
• Learn to focus on the present moment and bring your attention to your thoughts as they arise and pass. This helps you recognize their fleeting nature.
• Each time you find yourself getting lost in your thoughts, bring your awareness back to your breath and body.
• Take a look at your schedule and lifestyle to see where you can make changes to manage stress off the mat. This may include allowing yourself more free time, developing a healthy eating plan, or spending more time in nature.
• Talk to an instructor if your yoga practice creates more stress in your life. They can help you develop a routine tailored to your needs.
• Always talk to your doctor before starting any yoga routine, especially if you have any health conditions or take medications.

Plant-based protein options: Finding suitable alternatives to animal-based proteins

A common concern about vegan diets is that they may lack sufficient protein. However, vegans can get protein from various plant sources, though some may be better than others.

Legumes

Legumes are a great source of protein for vegans. Examples include beans, lentils, and chickpeas. Canned beans are preferred over dry beans, as they have lower FODMAPs. A quarter cup of canned chickpeas or half a cup of canned lentils per meal is a good portion size.

Soy-based foods

Soy-based foods such as tofu and tempeh are good sources of protein. Tofu, also known as bean curd, is made by coagulating soy milk and then pressing the resulting curds into soft white blocks. Tempeh, on the other hand, is made by a natural culturing and controlled fermentation process that binds soybeans into a cake form. It is important to note that silken tofu is high in FODMAPs and should be avoided.

Nuts and seeds

Nuts and seeds are excellent sources of protein and can be included in a low-FODMAP diet in small portions. Examples include peanuts, almonds, pumpkin seeds, and chia seeds. It is best to avoid pistachios and cashews, as they are high in FODMAPs. Nut and seed butters, such as peanut butter and almond butter, are also good options.

Grains

Grains such as quinoa, corn, wheat-free breads, and cereals contribute to your protein intake and are suitable for the elimination phase of a low-FODMAP diet.

Meat alternatives

There are now many meat alternatives available that are made from plant-based proteins. Examples include "meat" balls, burgers, crumbles, "chicken" tenders, and "fish" fillets. However, it is unclear if these processed plant-based meat alternatives provide the same health benefits as whole-food, plant-based protein options.

Food journaling: Keeping a record of what you eat and how it affects your IBS

Food journaling is a crucial part of managing your IBS. Keeping a record of what you eat and how it affects your IBS can help you identify patterns and trigger foods, and create an effective long-term IBS diet plan. Here are some tips for food journaling:

• Be consistent: Record everything you eat and drink, including portion sizes, timing, and any condiments or ingredients. Inconsistent recording can lead to inaccurate conclusions about trigger foods.
• Detail your symptoms: Note the date, time, and any IBS symptoms you experience after eating. Include details such as the intensity and duration of symptoms, and any other factors that may be relevant, such as stress levels or physical activity.
• Be specific: Instead of generalising, be as detailed as possible. For example, instead of simply writing "bread", specify the type of bread (e.g., whole wheat bread) and the amount consumed.
• Consider a food journal app: There are apps available that can make food journaling more convenient and help you track your progress over time. Some apps even have barcode scanners that provide nutritional information for packaged foods.
• Include non-food factors: In addition to what you eat and drink, consider including other factors such as sleep patterns, stress levels, and physical activity. These factors can impact IBS symptoms, and including them in your journal can help identify patterns and triggers.
• Be patient: Give it time! It may take a few weeks or even months to identify patterns and trigger foods. Don't make drastic dietary changes without consulting a healthcare professional.
• Work with a professional: Consult a registered dietitian or a gastroenterologist to help you interpret your food journal and create a safe and effective diet plan. They can provide guidance and ensure your diet is nutritionally adequate.

Frequently asked questions