Two Parts Episode: Differences Between Dietitians and Nutritionists and Low FODMAP Diet Frequently Asked Questions
In this episode we’ll learn the differences between a dietitian and a nutritionist from Hollie O’Connor. We’ll also find out the answers to some of the most Frequently Asked Questions from listeners of the podcast and readers of the blog.
In this episode, you’ll learn:
- What is a nutritionist?
- How can a nutritionist helps IBS sufferers?
- What are the differences between a nutritionist and a dietitian?
- Who can diagnose and treat health issues?
- Why IBS sufferers are okay with some dairy products but not with cow’s milk?
- What milks are suitable for IBS sufferers?
- Is the gluten-free diet good for IBS sufferers?
- Will the Paleo diet reduce IBS symptoms?
- What can you eat, if you are following both a Paleo diet and low FODMAP diet (not much really!)
LISTEN OR DOWNLOAD THE LOW FODMAP DIET & IBS PODCAST EPISODE 22 HERE
Can’t listen to this episode right now? Read the transcript below!
LARAH: Hi, and welcome to the low FODMAP diet and IBS podcast. In today’s episode, I’m going to have my good friend and nutritionist, Hollie O’Connor. Hollie is going to explain what a nutritionist is and the differences between a dietitian and a nutritionist, specifically here in Australia, and how can a nutritionist help IBS sufferers. In the second part of this episode, I’m going to go through some of the most common frequently asked questions regarding the low FODMAP diet; some of the questions that I get asked, some of the questions that I see posted on my Facebook groups. So I hope you’ll find this useful. First of all, I would like you to welcome my friend and guest, Hollie.
LARAH: Hi, Hollie.
HOLLIE: Hi, Larah. Thank you for having me here. I’m excited to be here.
LARAH: Thank you so much for accepting to come on my podcast. I just want to ask you, what is a nutritionist?
HOLLIE: In the broad sense of the word, a nutritionist is basically someone who has studied, and like you said, is an expert in nutrition, or at least more of an expert than the average person. I certainly don’t know everything about food and how it works in the body, but the main role of a nutritionist is to help people reach their optimal health by giving advice or information and guidance regarding their health and food choices and their food habits and, basically just their eating environment.
LARAH: That’s great, thank you, Hollie. I was also wondering how many years you studied to become a nutritionist in Australia? Of course, we’re talking about Australia here, but it might be different in other countries. But what about in Australia? How many years did you study to become a nutritionist?
HOLLIE: In Australia, there are a few avenues that a person can go down to gain the title of a nutritionist, but one of the most credible is, indeed, a university degree, which is what I did, and it was three years’ full-time study.
LARAH: Wow! You must have learned so much. So now that you have a degree as a nutritionist, what can you do with it?
HOLLIE: So, as I’ve just touched on, nutritionists work with individuals, or even small communities, to achieve their optimal health levels through teaching and facilitating better food choices and just having healthier lifestyle habits. Most of what nutritionists deals with is weight loss, or healthy weight management, as well as maintaining healthy levels of nutrients, vitamins and minerals in their bodies. We work a lot with preventative health actually, teaching and encouraging people to what’s their best selves before the actual onset of disease or illness. In Australia, we might work with individuals, or even schools or communities, and explore the social and economical and environmental issues that might contribute to health and well-being. And then we work with those groups or individuals to make a plan for action towards their better health.
LARAH: That’s great information, Hollie. Now I was wondering if you could explain to the listeners the differences between a dietitian and a nutritionist?
HOLLIE: I’ll quickly touch on the differences because, surprisingly, they are two different things and it can be very confusing for people. Often, if I say I’m a nutritionist, they have no idea that there is a difference. And often dietitians do refer to themselves as nutritionists as well, but the biggest difference is in the scope of what they can lawfully practice. I’m speaking in Australia. So in Australia, a dietitian is more clinically trained and is therefore authorised to diagnose a diet-related disease and prescribe nutrition advice and eating plans for people with existing health issues such as diabetes, or cancer or health disorders, IBS and other GI tract diseases, just to name a few. Technically, in Australia, a person who is only trained to be a nutritionist, and not a dietitian, shouldn’t really be diagnosing and nutritionally treating any health issues other than weight loss or weight gain or weight maintenance in an otherwise healthy person.
LARAH: Thank you, Hollie, for clarifying that. During your study as a nutritionist were you able to learn anything about the low FODMAP diet for IBS sufferers? And if yes, what did you learn?
HOLLIE: So in my undergraduate degree, or while I was doing it, the low FODMAP diet was fairly new research coming through. But surprisingly, during my undergraduate degree to become a nutritionist, we didn’t touch on that at all. Like I said, a lot of it was just to do with the maintenance of healthy weight and healthy levels of nutrients. It wasn’t until I started my master’s degree, actually, to become a dietitian, that we touched a lot on what they call therapeutic diets, or diets to treat different diseases like IBS. So during my Master’s program we did a lot concerning IBS. We were in the kitchens altering diets and planning recipes. So, yeah, we covered that a lot in the dietetics’ program.
LARAH: That’s great. Thank you, Hollie. As a nutritionist, are you able to give dietary advice to IBS sufferers at all?
HOLLIE: I have no doubt that most nutritionists would certainly know about IBS, and also the low FODMAP diet, but again, and I’m talking in Australia, it might be best to first go to a dietitian and to be properly introduced to the low FODMAP diet and the elimination diet. But once you’re aware of the diet, however, I do believe a nutritionist could be very beneficial in helping an IBS sufferer to alter their diet and still maintain their healthy weight. They could be a great companion and guide to go grocery shopping with and also to help you come up with new low FODMAP recipes so that this new relieving health journey that you find yourself on isn’t too confusing or bland or boring for you.
LARAH: Great! I understood what a nutritionist does and what the differences are between nutritionists and dietitians. And I can definitely see that there is a place for a nutritionist when you’re an IBS sufferer following a low FODMAP diet. So, I just wanted to thank you for being a guest on my podcast and clarifying these questions that I had.
HOLLIE: Thank you, Larah, for having me. I do hope that I was somewhat helpful for any people out there wondering about the differences between nutritionists and dietitians.
LARAH: Thank you, Hollie, for being here.
LARAH: I hope you have enjoyed the first part of this is episode with my friend Hollie O’Connor, and that you found the content useful and you got to understand a little bit more about the differences between a nutritionist and a dietitian. This is a question that I’ve seen quite often from people not knowing if they should see a dietitian or another health practitioner, and that kind of gave you an example of a health practitioner that could assist you with following the low FODMAP diet.
In the second part of this episode, I would like to go through some of the Frequently Asked Questions from podcast listeners and my blog readers. These are some of the questions that I get asked the most. Again, I am not a dietitian or a nutritionist, or a health professional. This is my experience; it’s my knowledge from the research I have done.
So the first one is regarding lactose-free dairy products and what is suitable on a low FODMAP diet. The second one is about gluten-free. Is the low FODMAP diet like a gluten-free diet? So we’ll be talking about that. And the third one we’ll be talking about is the Paleo diet.
Okay, so the first question that a lot of my listeners and readers seem to be confused about is why, on the low FODMAP diet, it’s okay to have some dairy products such as hard cheeses, but it is not okay to have animal milk, like cow’s milk? First of all, what is important to understand is that the low FODMAP diet is about keeping FODMAPs low. So lactose, it’s a FODMAP. It’s a natural sugar that is present in milk and most dairy products. Our intestine produces an enzyme called lactase which is meant to help us to digest that sugar — that lactose. For some people, this is easily done. They produce the enzyme, lactase, and their system can break down lactose. For others, it is harder because maybe they don’t produce enough lactase. So, for the low FODMAP diet, it’s important to consider that milk, like cow’s milk and other animal milk, contain quite high levels of lactose, and, therefore, not suitable for IBS sufferers, while cheeses, especially hard cheeses, are okay for IBS sufferers because they contain very little lactose. So for IBS sufferers, usually, it is okay to have products that are low in lactose.
So another question I get asked is, what milk is suitable? So there are lactose-free milks which could be naturally lactose-free. Or there can be the animal milk in which the enzyme, lactase, has been put in and they are also called lactose-free. So those animal milks that are lactose-free milk are okay for IBS sufferers, but animal milk that is not lactose-free, is high FODMAP, and therefore, not suitable.
Regarding milks that are nut-based or plant-based… let’s see what is okay to have in the low FODMAP diet. For instance, soy milk is quite popular, but the majority of soy milk that can be bought from the store is made from soybean, and therefore, not suitable in the low FODMAP diet. Soy milk made from soybeans is high FODMAP, but soy milk made from soy protein is actually okay. It has been tested and it’s safe, up to one cup or 250 ml.
Another milk that has been tested is coconut milk. If you get the coconut milk from a can or long-life, UHT (ultra high temperature) milk, that’s low FODMAP up to half a cup or 125 ml. These are the safe quantities that have been tested, and for this, half a cup of coconut milk is low FODMAP. Almond milk is also a milk that has been tested low FODMAP for up to 250 ml, or one cup. Hemp milk is also suitable. It’s another plant milk and it’s suitable for up to one cup or 250 ml. Personally, I haven’t found hemp milk. I think you can possibly find it in health food stores. I haven’t been able, really, to see it anywhere. Rice milk, it’s also okay up to 200 ml. That’s just a bit short of a cup, so it’s about 4/5 of a cup, so rice milk is low FODMAP up to that quantity. Oats milk, unfortunately, has been tested high FODMAP, so, I guess, it’s only about 30 ml that is low FODMAP. So a couple of tablespoons, no more than that, as it becomes high FODMAP.
There you go. So you’ve got some options for lactose-free milks. So, either the lactose- free animal milk, or these plant and nut-based milks — those products that we’ve just discussed. I hope this helps.
The next question is about gluten-free food and the gluten-free diet. So is the gluten free diet good for IBS sufferers?
In short no, the gluten-free diet is for people who cannot have gluten. The low FODMAP diet is for people who cannot have a lot of FODMAPs. It’s a low FODMAP diet, so it’s for people suffering from IBS. So the things that the low FODMAP diet and the gluten-free diet have in common is the fact that, in the low FODMAP diet, we need to stay away from wheat, barley and rye. The same as the gluten-free, but for us, the problem is not the gluten, which is a protein, but other sugar in the wheat, barley and rye. And that’s about the only thing that there is in common between the low FODMAP diet and the gluten-free diet. Therefore, if you are an IBS sufferer and you want to have safe products, you may not necessarily find it in the gluten-free section of the supermarket, because a lot of those products may actually contain high FODMAPs ingredients. So gluten-free, you’ve got to be careful. Some products will be fine, other products are not fine. You really have to look at all the ingredients within that gluten-free product. So unless you are celiac as well as suffering from IBS, you don’t need to avoid gluten. Some people may not be celiac, but they might be suffering from non-celiac gluten sensitivity and, therefore, they need to avoid gluten as well. So two different things. And again, if you consume products that are gluten-free, you really need to look at the package and look at the ingredients list for high FODMAP ingredients. It could be all sorts of things: fructans, fructose, lactose, polyols — all sorts. Recently, in the health section of the supermarket, we’ve started to see here in Australia, especially, some products that are certified FODMAP Friendly. In those cases you would know that those products have been tested to be okay for IBS sufferers because they are low FODMAP, therefore, FODMAP Friendly. So check them out. There are muesli bars, cereals, biscuits, different sauces, and even chicken stock and things like that, if you live in Australia. In America, they’re starting to come up as well. There are a few FODMAP Friendly products, as well, that can be found. So, there you go!
The third question that I see asked quite a bit is regarding the Paleo diet, and specifically, using the Paleo diet in the hope to reduce IBS symptoms. Okay, well we know that the best diet to reduce IBS symptoms is the low FODMAP diet. It has been proven successful for seventy five percent of the people that have tried it. So according to the founder of the Paleo diet, on his website, the idea is to cut out any food that wouldn’t have been available back in the time of our Stone Age ancestors. So the general idea is that if it has an ingredient list, it’s off the menu for the Paleo diet.
I’m not going to go into details of whether the Paleo diet is a good diet or a healthy diet; that’s not my place. Really, you should see a dietitian, a nutritionist or a health professional. What I’m just trying to point out is that for those that are thinking that they can do a Paleo diet instead of a low FODMAP diet, or a low FODMAP diet that is also a Paleo diet, well, I have a very clear diagram regarding that. Pretty much, if you are trying to follow a low FODMAP diet and a Paleo diet at the same time, all you would be able to eat is the food in the middle of the diagram: grass-fed meat, fish and seafood, eggs, only the low FODMAP vegetables (excluded potatoes), only the low FODMAP fruits and only the low FODMAP nuts, except peanuts, because those are not Paleo. Healthy oils, spices and herbs are okay. Without being someone that is a health expert, you can realise that that is a very restricted diet. So in a low FODMAP diet we can have all types of meat, potatoes, rice, low FODMAP grains, low FODMAP seeds, low FODMAP nuts included peanuts, low FODMAP dairy, sugar, low FODMAP processed food… Again, I’m not saying that this is a good thing, but it’s allowed. Tofu, tempeh, quorn, coffee and chocolate, in small quantities. Alcohol, which is low FODMAP in small quantities, some type of alcohol. Anyway, I just wanted to address this question because I’ve seen it asked quite a lot, and I thought it would be interesting to put it out there.
Well that’s it for now. I hope you have enjoyed this episode that has been a little bit different from the usual ones. And if you have any questions that you would like me to answer, or you would like me to ask any of the health professionals I’m interviewing next, please contact me on my website. Let me know what you would like to have answered, and I will do my best.
I would really like to thank those of you who have sent me feedback on the podcast and also that have let me know how much this podcast has helped them. I really appreciate those people sending those in. It makes all the time I’m spending to create this podcast well worth it, as I love to be able to help and spread the message and to spread the word on the diet. For now, I wish you all the best. Take good care, keep healthy, keep safe, be happy and until next time, goodbye.