Canadian Registered Dietitian Lauren Renlund proves that is possible to eat delicious foods when having food intolerances.

Lauren Renlund is a registered dietitian and nutrition coach from Ontario, Canada.  She is also a food lover and blogs about good food and digestive health issues under the name The Tummy Troubles Dietitian. She was diagnosed with IBS in 2014 and used the low FODMAP diet to improve her symptoms and identify her food intolerances. After that, she started a blog to share her experiences and suitable recipes. Lauren offers nutrition counselling and coaching sessions in person and remotely, both by telephone and Skype, and works with her patients to create a personally tailored nutrition plan.  Lauren’s key messages for her blog are:

1. You don’t have to be embarrassed of your tummy troubles;
2. You’re not alone in your struggles;
3. You can use nutrition to help manage symptoms and improve your health.

In this episode, you’ll learn:

• How Lauren came across the low FODMAP diet?
• How stomach bugs are connected to IBS symptoms?
• Why IBS sufferers shouldn’t be ashamed their issues?
• What was Lauren’s motivation for starting her blog?
• What are some tips for IBS sufferers to live a happier life?
• Why the re-challenge and reintroduction phase is so important.
• How Lauren’s passion for food came back after the initial disappointed of realising that many of her favourite foods would need to be restricted?
• What are the differences between traditional dietary recommendations and low FODMAP diet recommendations?
• What is gut microbiome and how important is it?.
• Why probiotics should not be taken during the elimination phase of the low FODMAP diet?
• Do juice cleanses and detox teas work?

LISTEN OR DOWNLOAD THE LOW FODMAP DIET & IBS PODCAST EPISODE 31 HERE

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Can’t listen to this episode right now? Read the transcript below!

LARAH: Hi Lauren.

LAUREN: Hi Larah. Thank you so much for having me on your podcast today. I’m a big fan.

LARAH: Oh, thank you. I’m very excited to have you here today. We’re going to discuss lots and lots of interesting things that listeners haven’t heard before. First of all, would you be able to tell the listeners a little bit more about yourself and how you came across the low FODMAP diet?

LAUREN: Yes, of course. So I’ve always loved food, and I first completed my undergraduate degree in Nutrition. During my undergrad I had some small tummy troubles as I call them, but they really weren’t too bad and so I never sought out help from my doctor or anyone else. I just really tried to manage it myself  — which now I know probably wasn’t the best way to go about things. But I really knew I wanted to be a dietitian and work in the area of public health and nutrition education, so I went on to do my Masters of Public Health and Nutrition and a dietetic internship at the University of Toronto. I graduated and became a dietitian more than half a year ago now, but unfortunately, at the start of my master’s degree, I actually started to experience worse digestive symptoms. I caught a really bad stomach bug just a month into my degree and my stomach was never the same afterwards. I was diagnosed with IBS and I did try a number of medications to manage my symptoms with the help of my doctor, of course. Since none of them were helpful for me, I did more research into nutrition for IBS. I learned about the low FODMAP diet from Stephanie Clairmont who is a great Canadian dietitian and she has a good book. She’s already been on your podcast. I decided to try it myself. It was really tough doing it by myself, especially because we don’t have a lot of information here in Canada about the low FODMAP diet. But eventually, I was able to figure it out and I was able to use the diet to identify which foods are my triggers and manage my symptoms. Overall though, I was really just frustrated with the information online and the small number of low FODMAP recipes that are out there. After I graduated, I decided to use my education in nutrition and public health to start my own website and food blog.  It’s fantastic because I get to talk about food and share my favourite recipes with people around the world.

LARAH: Perfect! Thank you so much, Lauren. And I’ve heard about people starting to have IBS symptoms after some type of stomach bug, so it seems quite common as a result of a stomach bug, to get IBS symptoms. Did you find that as well with some of your patients? Is that the way they started?

LAUREN: Yes. So, definitely with some of my clients it’s been quite clear that it was after they experienced some sort of stomach bug that then they developed their IBS symptoms. Of course, that’s not true for everyone, but that is a potential trigger for IBS.

LARAH: Yeah, that’s very interesting to understand what happened exactly. And we might be talking a little bit more about gut bacteria maybe later on, but now I would like to go back to quote number one. That’s really important to you, and it’s also very important to me, and that’s one of the reason why I’ve started this podcast, is really to share the message that you don’t have to, and we don’t have to be embarrassed by our tummy trouble. It is so true that a lot of people — and me included once upon a time —  feel really uncomfortable about talking to others about this condition of IBS. A lot of people may feel ashamed of that, and I look at our society where people share all sorts of things on social media — sometimes even too much. They share their lives; they share their pictures of themselves half naked on the beach, but they’re still ashamed and embarrassed to talk about their suffering of a condition like IBS, and the symptoms of IBS, so it is quite interesting. Digestive issues are still kind of taboo compared to other things that we share, so what’s your opinion on that and how can we convince other IBS sufferers like us that they should not feel embarrassed?

LAUREN: Yes, exactly. This is something that I’m really so passionate about and I really try to talk to so many people about this. To be honest, I was incredibly embarrassed of my digestive issues at first. I had trouble even talking about it with my mum, but over time I realised that my digestive issues are just a health issue and there’s no reason to be embarrassed. When I slowly told my friends and family about my tummy troubles, they were all so kind and accepting. I realised that I had been embarrassed for no reason, and once I let go those feelings, I really just felt so free. I do think it’s amazing that digestive issues are still quite taboo, even though we know so many people have IBS. It’s estimated to actually be about one in five people in Canada which is a lot.

I really think that one of the best ways to stop feeling self-conscious is to realise that everyone actually experiences tummy trouble sometimes, not just those with IBS. It’s a part of life, and gas and bloating is just a sign that your food is being broken down and absorbed by your body. I didn’t start my food blog just to talk about food.  I also really hoped to make it easier for others to talk about their digestive issues — I think very similarly to how you start your podcast — to help talk to other people about these types of issues. If you’re experiencing these kinds of digestive issues, you need to talk about it, at least with your doctor. And I really think that when people talk about their health issues, it really shows how strong they are. And I also believe that every time you talk about it, it does get easier.  I was also amazed at how many times I told someone about how I was on this special diet and I couldn’t eat this food — that type of thing — and they told me, “Oh, well, I actually do struggle with this type of digestive issue too, and these symptoms, but I never told anyone about it,” so I think it’s a lot more common than we realised.

LARAH: Yes, the more I talk to people, the more they recognise the same symptoms that they have. The only thing is that they could not associate that with IBS — and most of them do not even really know what IBS is. So by sharing it with others, I think it does help them to even pose the right question to their doctor the next time they go there, and see if that could be the case for them rather than just ignoring the fact that they’re constantly bloated after every single meal.

LAUREN: That’s so true.

LARAH: So you’ve mentioned already your blog, so did you have any other motivations for starting your blog?

LAUREN: Yes. So  I think it’s pretty obvious that I love food. I love to cook, and bake, and make new recipes. When I first started the low FODMAP diet, I was actually afraid of food. I knew some things were making me sick, but I didn’t know which ones.  And when I first looked up the diet, I saw the huge lists of foods  that are high in FODMAPs, I felt so sad thinking about all the foods I couldn’t eat, and I was just so focused on all the foods I missed. I actually had dreams about eating apples, which were my all time favourite food, and I just missed them so badly. I unintentionally started to lose some weight because I wasn’t eating enough and I’d really lost my passion for food.

LARAH: Yeah, it is so normal at the beginning when you get that long list of, “You can’t eat this, you can’t eat that.” It was the same for me. Everything on that list is what I ate on a daily basis, and it’s scary. But now, three and a half years later, I’ve adjusted completely — plus, I was able to reintroduce some of the foods, and that probably is the case for most people. But it makes me really sad as well when I see people who are just started on the diet, and because they don’t have the right support from a specialised dietitian, they just shut down and stop eating. I have people on my Facebook group say, “I skip breakfast most of the time, and even lunch, because I’m scared about being sick. I’m scared about feeling ill at work.” And this is really sad when, really, with some adjustment to their diet and their lifestyle, they might see great improvements. So I think they just need to be able to get the right help.

LAUREN:  Yes, that really is just so sad, and especially when we know there are things you can do. You can use nutrition, and food doesn’t have to be the enemy.

LARAH: Yes, perfectly so. So going back to what you were saying about feeling unhappy, now things seem to have changed for you and you seem much happier. What has changed?

LAUREN: Yes, I am so much happier now, and I think it’s because of one pretty simple thing —  it is that I changed my mindset about how I viewed the diet. Instead of focusing on all the foods I couldn’t eat, I started focusing on foods that I could eat. There are so many delicious low FODMAP foods. Just simply focusing on what I could eat rather than what I was missing, sparked a huge change. I started experimenting with trying new low FODMAP recipes and then I even started making my own recipes.  I really think I fell in love with food again and now I prepare recipes that anyone can make and find delicious. I want to help others to realise that it’s possible to still eat tasty foods on the low FODMAP diet. It doesn’t mean that you have to eat bland foods for life, and hopefully I can help others fall back in love with foods, too.

Another thing I was able to figure out, similarly to you, is that I figured out what foods were causing my symptoms and I stopped being afraid of foods. I was also able to reintroduce some high FODMAP foods back into my diet while I’m still managing my symptoms — and those foods include ice cream. So for anyone who is afraid of doing the reintroduction out there, just think of all the potential amazing foods that you could be eating that might not even cause you issues. I am also so much happier now that I can include some ice cream in my diet, and really, I always talk about how the re-challenge and the reintroduction phase is just so important.

LARAH: Yes, that reintroduction phase that we’ve talked about it so many times is so important. We don’t want to stay on the low FODMAP diet elimination phase for too long. It is not what you’re supposed to do.

And another thing I found really interesting when I was reading your blog is that you recently  participated in the Gut Health and Microbiome Conference and you were able to present some of your research. You compiled a poster that is titled, “A Comparison of Traditional Dietary Recommendations for Irritable Bowel Syndrome versus the Low FODMAP Diet and Exploration Of The Role Of Dietitians in Symptoms Management”.  Could you elaborate a little bit more on what the differences are between traditional dietary recommendations, compared to the low FODMAP diet recommendations, and if one type of recommendation excludes the other one, or can they live together?

LAUREN: Yes. So that conference was a great experience. The title of my poster is so, so long that I can explain what it means. The poster was actually based off a literature review that I completed during my Masters degree as part of a directed reading course which was supervised by a gastroenterologist, Dr Johane Allard. There were two main parts to it. The first was comparing the simpler traditional dietary recommendations for IBS against the low FODMAP diet. The traditional recommendations include things such as limiting fatty foods, increasing fibre and water, having regular meals, and avoiding alcohol, caffeine, and carbonated beverages. I sort of took a look at all over the world to see what the average recommendations that people are saying by the doctors or dietitians are giving to their clients. Then, I also reviewed the research that has been conducted on the low FODMAP diet. So, while there is still, overall, a small amount of  research on the diet, most research has found that the diet is effective for about three out of four IBS sufferers which is higher than the traditional recommendations.

Also in this poster and paper, I discuss what dietitians are to do with all of this new research that’s coming out. I really emphasise that dietitians don’t have to choose between using the traditional recommendations and FODMAP. They can definitely use both. I use both in my practice. For example, a client could find that both certain FODMAPs, and greasy, fatty foods could trigger their symptoms. And, of course, FODMAP isn’t necessarily the right option for every client. Dietitians need to thoroughly assess each client and use their clinical judgement to choose the best path. This is a big reason why it is so important to see a dietitian —  especially one that, is of course, trained  in the low FODMAP diet — because they can help guide you to the right option for you because everyone is so unique. Everyone will have different food intolerances and will respond differently to various diets.

LARAH: Yes, that’s perfectly right, Lauren. We are all unique. We all have different types of intolerance. We have different tolerance levels, it’s about keeping yourself informed and seeking the right advice all the time. By going to a specialised dietitian, you have all these options; you’re being informed of what the low FODMAP diet is; you’re being informed of other ways for you and if it’s something else that triggers symptoms — if it’s the fat, if it’s the coffee or the alcohol, because we know that alcohol in small doses and some type of alcohol can be okay, and we know that coffee it is not a FODMAP, but again, it can be a gut irritant. So there are all these things that have to be taken into consideration and, really, the best thing is to go and see someone who is specialised which we say every time and in every podcast. This podcast is not a replacement or a substitution for the advice of a health professional. This is just to give you some ideas and some questions that you can ask, and to spread the message, really.

And did you notice that when you were talking to the other experts, a lot of them still hadn’t even heard about the low FODMAP diet?

LAUREN: Yeah, well, I think a lot of dietitians I talk to said that, “Oh, I’ve heard about this, but I don’t know if there is enough research about this,” or “I don’t feel that I have enough education on it yet to be able to use it with my clients, and can you teach me more,” that type of thing. So a lot of dietitians were vaguely familiar with it. And some other health professionals or researchers came up to talk to me at the end and asking me, “What is this? FODMAP? What does that mean?” So, yes, a bit of a mix.

LARAH: Wow, that’s incredible. I don’t know if you have a place in Canada. For instance, in Australia, dietitians can do a course, I think via Monash University. Maybe there are other ways as well. In London, they go King’s College London. So there isn’t a place in Canada where dietitians can do a course on the low FODMAP diet?

LAUREN: No, not yet. Stephanie Clairmont,  who I mentioned before, is a Canadian dietitian. She does offer some education on the low FODMAP diet. She sometimes offers free webinars about the low FODMAP diet for health professionals, so that’s really great. I really hope in the future that there’s a lot of really great universities in Canada who do a lot of nutrition research. I would love to see if we could make our own training program here because as I said before, one in five people with IBS is a huge number and we really need more dietitians, who are trained in digestive health.

LARAH: Yeah, that’s fantastic — hopefully in the near future.

LAUREN: Yeah.

LARAH: So,going back to the conference you attended, you talked a lot about the gut microbiome. Would you be able to explain a little bit more about what that is? Just explain it to us because we’re not in that specialised field exactly. What is the importance of the gut microbiome?

LAUREN: Yes. And so this conference was fantastic because it was all about the microbiome in a gut. And basically, what the gut microbiome means is just the various microbes that are located in our gastrointestinal system. All the researchers discussed the latest research in this area, and I did write a recap about it on my blog.

One of the first presenters discussed why there is so much research in this area, especially right now. Of course, we’ve only just started to learn about the importance of the microbiome for many areas of health, but technology is actually a big factor. The gut microbiome contains many more microbes than we have cells in our body. That is an enormous amount of data we need to store, and only recently technology has become advanced enough to be able to manage that much data. I thought that was really interesting, and part of the reason why there is a boom of research into this area now.

Something else that was discussed is the importance of fibre and prebiotics, they are so important for our gut health, and really, for me, reintroduction is so important for the low FODMAP diet to learn your tolerance level.  And as I said before, you don’t want to be avoiding healthy foods that you’re actually fine with. There’s so much fascinating research being done, but there’s also so much we still don’t know.  For example, we don’t know the effect that the trendy detoxes and cleanses have on our gut microbiome and what the long term side effects of that are. I really don’t recommend them for anyone, and our bodies organs are perfectly capable of detoxing itself.

LARAH: Well, that’s quite interesting considering all the detoxes that there are around for sale. I have heard that before, that actually, doctors and dietitians do not really promote those detox. They’re saying that our body is able to provide all the detoxing that we need for the functioning of our organs, but it is still a big business. I think it’s human nature to be looking for the magic pill, the quick solution, and hoping that will work.

LAUREN: Yes, of course. And I feel like there’s just so much money to to be made in that area to be honest. I mean, you see all these like detoxes. There are juice cleanses or detox teas, and they’re so pricey. And, of course, people see them and say, “Oh. If they’re that much money, it must be doing something good for me.” But, I mean, it might seem a lot easier to say, “Oh. I just drink juice this one day then actually to focus on eating more nutritious food in my diet.”  Overall, I definitely don’t think they’re worth the money, and actually, for a lot of them, for example, the detox teas, most of them include laxatives, which is not great for our digestive system. If you use them a little bit long term, your gut will actually become reliant on the laxatives, and that’s not really great. So, overall, I really recommend just talking to your dietitian and getting some help with making practical long term positive changes in your diet. That’s what’s really going to help  improve your health.

LARAH: Yeah. So, yes, adjusting the quantity of food you eat to the fibres and the right nutrients that you need. It’s always like a tweaking thing, isn’t it? It’s never like smooth sailing and saying, “Okay, I found my optimal now if I stay with that, and then I eat that forever.” It’s always like seeing it and adjusting. What I notice, even to keep my IBS at bay, it’s not always like, “Oh, okay. If I only eat this type of food, I’ll be fine,” even when I have reintroduced it because sometimes, it may just step me over the border so I have to readjust the quantity.  It’s almost like on a daily basis you need to make these changes.

LAUREN: Yes it’s really not a simple thing, and I think a lot of people just try to simplify it and try to sell the easy thing that’s going to fix everything. And I think any time you see that, you sort of know that’s probably actually not going to work very well because I feel like if we did have that amazing thing that could just fix your diet and makes us feel great, doctors and dietitians would be promoting it all the time. We would be loving it because we want our clients to be healthy and happy, but in reality, what we know right now is that eating nutritious food takes effort. It takes time, but it’s what really pays off in the long term for health.

LARAH: Yes, that’s right. Thank you, Lauren. And I’m wondering what your opinion is or if you know much about it, what do you think about probiotics? Nowadays they do sell some probiotics that are IBS friendly and they don’t contain prebiotics or other things that can actually give you IBS symptoms instead of helping you. There are some brands that cater for IBS as well. Is this something that you tend to give to your patients, to people that come and see you, and do you believe in it?

LAUREN: Yes. So this is really a great question because we’re seeing ads for probiotics everywhere nowadays. I want to start off with saying that during the low FODMAP diet when you’re on elimination or re-challenging and reintroducing foods, it’s actually not recommended to start a probiotic. The whole point of the low FODMAP diet is that we really want to isolate to see if these certain foods are triggering our digestive symptoms. If we start a probiotic during the low FODMAP diet and we see a change in our symptoms, we’re not going to know if that change is coming from the diet or the probiotic. So, before I start talking about probiotics, I just wanted to say that. Perhaps after you have finished the low FODMAP diet and you know which FODMAPs are your triggers, if you’re still dealing with symptoms, then that would be a really good time to talk to your doctor or dietitian and see if probiotics might be right for you.

Overall, just like a lot of area of gut health, I think the research into probiotics is very new and there’s a lot of research going on. There are a few probiotics that have been found that can help manage IBS symptoms, but practically, when people try them, it’s often that some people find that they really help; some people find they really do nothing; and some people might even find that it makes it worse. So just like the low FODMAP diet, you’re not going to know if the probiotic will help you until you try it. Also, with the probiotic, I think the downside of it is that the probiotics don’t colonise in your gut. What that means is that if you stop taking the probiotics, they’re not going to stay in your intestines.  You have to keep taking that probiotic on a regular basis to get any of the beneficial effects. This can get very pricey over time. Basically, when it comes to probiotics, I think it’s just something to talk to your doctor about — talk to your dietitian.  There are so many options out there for gut health, and you really just want to talk to an expert to figure out what’s right for you.

LARAH: Yeah, thank you for the clarification, Lauren. And it’s very interesting because I didn’t know that when you took probiotics they would not colonise. I thought they would just live happily in your gut forever, but that’s not the case.

LAUREN: Yeah, that’s a really common misconception, actually.

LARAH: Yeah, that’s interesting. So they eventually die off, and if your body is not able to replace them by itself which is one of the issues that we have, then you have to keep on taking them. That’s kind of interesting.

LAUREN: Yeah, and so that’s why it can really get pricey over time which is why, even though maybe the low FODMAP diet might increase our grocery bill a bit, I think you’ll save money because you’re not eating out in restaurants as much and you might not need a probiotic.

LARAH: Yes, that’s so very true. And also, I think it’s pricey at the beginning when you’re a bit lost and you don’t know what to eat. But what I noticed, like when I got over my mourning period from not being able to eat what I was eating before…

LAUREN: I love ‘mourning period’. That’s a great way to put it.

LARAH: I know. It’s like the shocking reality of seeing black on white because you kind of understand, already,that there’s some food that is not really doing any good for you, but it’s hard to admit it. But when you see it there and you say, “ I can’t have this. But I’m having avocado every day on my wheat toast and now I can’t have it. I’m having mango smoothies everyday…”  That’s a big thing in Australia and why I’m eating this type of food. Like growing up in Italy, it was all about pasta and bread…and lots of tomato sauce.

LAUREN: Yeah. Here in Canada we have the best apples, and they’re just so delicious. And I just knew that if I were to eat a whole of an apple that I was going to feel so miserable afterwards,  and it takes a while to really sink in.

LARAH: Yes, and now that you kind of balanced it out, can you manage a slice of apple pie here and there, or is it still a no-no?

LAUREN: Actually, I can. It’s amazing. My parents make the best apple pies and the best apple crisps, and for quite a while, I did know that apples are a trigger for me, but I decided you know what, like on a day when I was very careful about all the FODMAPs I ate, I did have a very, very small serving of apple crisp and I was fine. It was really great, so I think that shows the importance of serving size on the low FODMAP diet. I think if it had been a day when maybe I was also eating ice cream or some other high FODMAP foods, and some portion sizes, then I might have reacted poorly to the apple crisp. But, yeah, having a small amount — as long as I’m careful with the other things I’m eating —  it’s okay!  It’s a really great feeling.

LARAH: Yes, absolutely.  And you feel almost like that child that has found the jar of, I don’t know, Nutella. That what it was once upon a time for me as a kid. It could be jam or the lolly or the candy that you find and you eat it like, “Is anyone seeing me?” I totally understand. It’s the same for me, and here and there I am allowed to eat high FODMAP food, and it’s just balancing it out, really.

LAUREN: Yeah, exactly. It’s all about finding your own personal balance.

LARAH: Yeah. And you were talking about ice cream — so were you tested as lactose-intolerant or mildly lactose-intolerant like I am?

LAUREN:  So do you mean tested by like having a breath test?

LARAH: Yeah, like a breath test, yeah.

LAUREN: So here in Canada we don’t have as easy access to breath tests as I think there are in Australia, so my doctor never suggested for me to go get a breath test or anything like that. I just did the low FODMAP diet. And during reintroduction, I found that I could tolerate moderate amounts of lactose, but not high amounts, so I can’t go drinking like cups of milk. I buy lactose-free milk still, but I am fine if I have smaller amounts of lactose which is a bit of ice cream or something like that.

LARAH: Yeah, that’s identical to me as well. I’ve noticed that if I have a lot of milk, yes, I get symptoms. But if I just have a little dash or a little bit of ice cream here and there, not often, I can do that.

That’s great.Thank you so much Lauren for participating to this podcast. I’m just going to ask you the last question about could you share with the listeners how they can find you and get in touch with you? Social media, website address?

LAUREN: My website is laurenrenlund.com and you can subscribe to my weekly email/newsletter which is used to update all my recipes and blog post. My website also has information about my nutrition counselling and coaching services. For social media you can find me on Facebook, Twitter, Google Plus and LinkedIn under @LaurenRenlundRD and my Instagram is @Tummytroublesdietitian and Pinterest is tummytroublesRD. I really love connecting with people all around the world.

LARAH: Perfect. It sounds great! And as usual, those links will be in the show notes on my website so that you can get in touch with Lauren and ask her a question or see how to start a consultation with Lauren. So, that’s great.  And whoever is in Canada, you have another dietitian there ready to listen to you and to help you as much as she can. So, thank you Lauren for participating to this podcast. I had lots of fun interviewing you. I hope you enjoyed it and I hope the listeners have enjoyed it too.

LAUREN: Yes, thanks so much for having me. I had lots of fun too.

LARAH: Great. Yeah, thank you so much for all you do for spreading the word about the diet as well.

LAUREN: Yeah, and thanks to you too. I think you really do a great thing in your podcast.

LARAH: Thank you so much.  Goodbye!

LAUREN: Bye!

Thank you for listening to this episode with Canadian dietitian Lauren Renlund, where we also talked about not feeling embarrassed about our condition and that in fact by talking to our family and friends about it, we may be able to help some of them, who may be suffering just like we do, and don’t even know it’s IBS and don’t have a way to manage their symptoms.

Lauren also mentioned how much happier she is feeling since changing her mindset and focusing on the food that she can eat rather on the food she cannot eat because that food can cause her IBS symptoms.

If you are finding this podcast useful, and would like to help me share the word on IBS and the diet, I would really appreciate if you would leave a review on iTunes or Stitcher.

Thanks again and have a great and fabulous day, I wish you great happiness and health. Take good care and until next time goodbye.

Links and resources mentioned in this episode:

• Lauren’s Website
• Lauren’s Facebook Page 
• Lauren’s Google+
• Lauren’s LinkedIn
• Lauren’s Pinterest
• Lauren’s Twitter
• Lauren’s Instagram