In the past, Suzanne’s own struggles with IBS, made her give up a great job offer. Now she helps other sufferers to fast-track to an IBS-Free life.
In this episode, Nutritional Therapist and Coach, Suzanne Perazzini explains how she went from long-time IBS sufferer to IBS liberator, helping hundreds of people to successfully follow a low FODMAP diet and become IBS symptoms free.
In this episode, you’ll learn:
- How Suzanne struggled with IBS symptoms since childhood, but thought it was normal.
- How did IBS affect Suzanne’s family and work life?
- Why Suzanne had to give up a great job offer?
- What food Suzanne was able to re-introduce after being diagnosed?
- Suzanne tips to counteract constipation?
- Dealing with withdrawal symptoms on the low FODMAP diet.
- What are some travelling tips for IBS sufferers?
- How to deal with restaurant meals?
- The laminated card every IBS sufferer need to have.
- What to do when going on a cruise?
- What is Suzanne’s coaching program all about?
- Suzanne’s best selling low FODMAP cook books.
- Suzanne’s future book publication.
LISTEN OR DOWNLOAD THE LOW FODMAP DIET & IBS PODCAST EPISODE 21 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. My guest, Suzanne Perazzini, suffered from digestive issues most of her life, and for a long time, she did not know what it meant like to not feel sick after eating every single meal. That was until she learned about the low FODMAP diet, and finally her life changed. Nowadays, Suzanne is a nutritional therapist and a qualified teacher and coach. She thrives on helping people live an empowered life free of IBS, and in fact, she thinks of herself as an IBS liberator.
Suzanne is also the author of “The Low FODMAP Menus” and the “Low FODMAP Snacks” cookbooks, and she is also the creator of “The Inspired Life Low FODMAP Coaching Program” and “The IBS Recipe for Success” course. So, here you go, my guest, Suzanne.
LARAH: Hi, Suzanne.
SUZANNE: Hi, Larah, thank you very much for inviting me to your podcast.
LARAH: It is a pleasure to have you here. I’ve been following you for probably a couple of years, so I feel like I know a little bit about you through your blog, your journey and experiences, and also with your travels.
SUZANNE: Oh, it’s lovely to hear, I didn’t know that you were one of my long-time followers.
LARAH: Yes, definitely. And your story is also very interesting, I think a lot of IBS sufferers will be able to identify their stories and their struggles with yours. So would you like to tell us a little bit more about your story and your IBS issues and then the discovery of the low FODMAP diet and share it with the listeners, please?
SUZANNE: Sure. I’ve had IBS all of my life. I can remember as a child always waiting for everybody else to go to the toilet first because we only had one toilet. So I needed to spend time in there and I didn’t want somebody knocking on the door. I used to be so jealous of my sisters, who could run into the toilet, do their business and be out and gone. I didn’t understand it at all.
LARAH: Oh…Poor you.
SUZANNE: I know, I was the odd one out. Anyway, I went through my life not knowing any different, really. And it probably did take me a long time before I realised that I wasn’t normal in that sense. So I started going to doctors and dietitians and asking questions, and they’d all give the same kind of advice, which was eat more fruits, more vegetables, and more fibres — all of the things that we now know are exactly the wrong advice to give to an IBS sufferer. But, anyway, back then I kept doing it and kept trying. Then, a few years later, I would change doctors and go to someone else and they’d give me the same advice that I tried again. So what do they say about if something doesn’t work? Change it. Well, I didn’t. I kept trying the same thing over and over because I believed they knew what they were talking about.
SUZANNE: I now know they don’t know, of course, not where IBS is concerned. It’s simply just not their field. So I went through the years and the decades and suffered. And then, one day, it got particularly bad. My father died a decade ago and that kicked it up a notch, and a period of stress can do that for IBS and make it worse. And that’s what happened to me, so I really had to become more determined to find a solution. And now there was the internet which, of course, there wasn’t in the other decades. So I started Googling all my symptoms and the low FODMAP diet kept flitting across the horizon, but it looked so complicated that I’d just move on. And, in fact, I tried other diets including the Paleo diet, which made me worse because of the focus on lots of fruits and vegetables, on honey, coconut flour for baking and all the things that we can’t have.
SUZANNE: And anyway, about a year went by, and still I was Googling, and still, I was seeing the low FODMAP diet. One day I decided, “All right, just stop, Suzanne, and just read about this and see what’s involved.” And all the symptoms were the same of somebody who needed the diet. And so I started to research a little bit more. And I heard about the hydrogen breath test, which could tell us, in New Zealand, only about fructose and lactose, but it was a beginning. I rang up the doctor and got a nurse. And the nurse had never heard of the low FODMAP diet or hydrogen breath test, but she was a curious soul and so she said she would investigate and get back to me, which I’m very grateful for. And she did. She got back to me, and just down the road from where I worked there was a gastroenterologist centre where they did the hydrogen breath test. So I booked it and it was pretty expensive. You have to do it over three days, three hours each time, and my boss wasn’t exactly excited about this.
SUZANNE: Anyway, off I went. And the first test was the base test, and that was okay. Did that. The second time I went it was a fructose test and they gave me this really sweet horrible drink and I was as sick as a dog. They even had to put me in the recovery room. I was feeling so sick.
SUZANNE: So I knew I had a problem with fructose. And then I did, about a week later, the lactose one and I had no problem at all. And, in fact, I don’t have an issue with lactose despite having been lactose-free for many, many years in my attempt to solve my own problem. So that was the beginning. And then the gastroenterologist set up an appointment with the dietitian, who knew something about the diet, but all she did was give me a list of good foods and bad foods like most of them do today. But it was a beginning. And so I started to feel better almost immediately, but it took a lot more than just that, of course, because it’s such a complicated diet and she hadn’t give me the information about amounts and combinations, etc., or how often you should eat, and how much at one time — all those bits and pieces of the diet that are essential to making it work. So over the next year, I kind of figured it all out and I changed my blog from being a blog about cooking to a blog about IBS and the low FODMAP diet, and still the cooking part, of course. And as soon as I did that, the blog just took off and more and more people started coming and subscribing. My subscriber list went sky high. Today I have over a quarter of a million page-views a month. These are all people with IBS who are trying to find a solution. And I was bombarded with emails of people needing help. I was working full time still, at that point, and I just couldn’t help them all. I answered everybody, but I was working late into the night to do that, and that’s where, eventually, the business developed out from. There you go.
LARAH: Oh, that’s great. And was that quite a long time ago that you found out about IBS and got introduced to the low FODMAP diet?
SUZANNE: I think it would be four or five years ago, I suppose, that I first started to do something about it, yes.
LARAH: Yes, so I guess there was a bit less knowledge than there is now. So the dietitian would have given you the list of the food not to eat, but then, was she able to help you, as well, with the reintroduction, or was that not really touched on?
SUZANNE: I went a second time, and she did touch on it, but the thing is, I wasn’t completely symptom-free at that point because I didn’t have all of the information I needed, and you can’t do the reintroduction unless you’re symptom-free or you’re not going to know if you’re reacting to the test food or something else…
LARAH: That’s right.
SUZANNE: … you’ve eaten. So I kind of was left to my own devices with that. And, yes, before, there was hardly anything on the Internet. It was just kind of random things that kept popping up, but I was one of the first major blogs on the low FODMAP diet. Now there are a lot of them, and some of them are wonderful and some of them are very inaccurate, still, which is unfortunate. But it’s becoming more mainstream, not quite yet, but much more available for people to at least hear about and learn something, hopefully, accurate.
LARAH: Yes, absolutely. And, for me, it was just over three years ago. And, again, I had the same thing. So the dietitian gave me the list, but then I was leaving for Italy so I never got to see her again. But one good piece of advice that she gave to me was to download the app from Monash University to help learn about the quantities as well as the food. But there is so much more now compared to three years ago. Even on the app, there is so much more food that has been tested. It’s great.
SUZANNE: I don’t think there was even the app back when I started. There really was nothing about the amounts and the combinations, and the app is absolutely essential for anybody with IBS.
LARAH: Yes, and it is so great that you were able to offer your experience and your knowledge to people so at least they had the basis to get some understanding of all of this. So that’s really good.
SUZANNE: Yes, it was brilliant, really. I mean, my very first program, I did as a group program. I decided I wanted six. It was going to be six weeks long with lots of personal attention, phone calls and live sessions etc., and I got the six almost immediately as soon as I put the word out there. And all six were, really quickly, symptom free. It was just a brilliant ride for that first group. And, of course, that was so encouraging for me that I repeated it and repeated, and eventually, I changed it into an individual program because everybody is so different on this.
SUZANNE: I was spending so much time anyway, and eventually, with each of these people, I stopped. And so many people wanted to start now and they couldn’t because I had a group going for six weeks, so they couldn’t start until later. Now they can start on any Monday, and it just sort of rolls over and I deal with each person individually. And that worked really well.
LARAH: Yeah, that’s perfect. And we are going to talk a little bit more about your coaching program in a little bit. I was also reading on your website that because of IBS, unfortunately, you missed precious moments with your family and friends. So can you just explain how IBS has affected the various aspects of your life, relationships, work? That’s before you discovered the low FODMAP diet, of course.
SUZANNE: Yes, so when you’re afraid all the time of what your gut is going to do and how it’s going to react to food, you make certain choices based around that discomfort. And one of the main ones that I made — a decision I made — was I turned down what looked like a really great job working in an architect’s office…and good money, good everything. But it was an office full of men and the toilet was right in the middle of this open plan office, so everybody would see me coming and going — and there wasn’t a lot of cushioning between the toilet and the main area either. And at that stage, it wasn’t something that I could imagine in my life because I would be so afraid to go to the toilet during the day, if I needed to because of those circumstances. And I turned down the job and other things back then. I still was travelling a lot and I was very brave about it; I even did a lot of camping in Africa. But it makes you think twice about certain things where it takes you out of your comfort zone — and that comfort zone involves a toilet being nearby that you can access without embarrassing yourself. So, these decisions get made based on the fact that you have IBS, and you miss out on things because of those decisions. That doesn’t have to happen today, and that’s a massive, massive improvement in the quality of my life.
LARAH: Yes, and I think there is also a little bit more understanding now of IBS and the symptoms and what it causes for people that, a few years ago, we would have all been worried about talking about. I see for me now, I have no issues with my close friends and colleagues talking about it and saying, “Okay, that’s the issue I have.” But, yes, it is still daunting. And I remember being at the office and looking to see if it was busy because it was, like, really embarrassing, so I always checked that no one was in the toilet. So I can kind of relate with you why you turned down that job.
SUZANNE: Yeah, absolutely. I mean, there was another job I had, and I took that job where the toilet was kind of central. People could see you coming and going. But what I used to do was, at lunch time, I would walk up to the shopping centre, which was about ten minutes away, and go to the toilet there so they couldn’t hear the noises. And that was my daily routine: walking up to the shops to go to the toilet rather than go to the office toilet.
LARAH: Uh-huh. Yeah, yeah, you know it’s not something that we want to deal with, and if our experience can help someone else to deal with their issue, and to understand it, because there is lots of depression associated with it. Just imagine, you need a job, but you can’t accept it because of this reason, so that would put even more stress on your life, and it’s all like a catch-22, really.
SUZANNE: It is that whole anxiety thing and it is really so closely linked to IBS. And the choices that people have to make, dictate how they have to live their lives.
LARAH: Yes. In terms of food that you love that you had to give up, have you been able to introduce a few of the foods that you really, really enjoy?
SUZANNE: I was able to introduce all dairy food, despite having been off lactose for quite a long time, because of the fact that, if you have gut issues, the first thing people say is to go lactose-free, go gluten-free, etc. And in actual facts: only twenty-five percent of those with IBS have a problem with lactose, so it’s much lower than you would expect. And in my case, I didn’t have any problem with it at all. So one of the things that I loved was ice cream. So I’ve been able to add ice cream back into my diet, and I love ice cream. I can’t have a lot of it because I have the fructose issue; that’s my main trigger. So I can’t have a lot of sugar at any one time, but ice cream with one scoop on it, I can get away with it. Obviously I had to watch the ingredients, but I know that New Zealand’s main ice cream, Tip Top, does not use high-fructose corn syrup. In fact, they use a glucose syrup, which is the best for us. So I’ve been able to add that back in. I can have a dollop of cream, and I’ve always loved cream, being a daughter of a farmer. And that’s really the main thing that I had removed, that I could put back in, and that really has changed everything because so much has dairy in it…and cheese as well. Wonderful.
LARAH: Yeah, that’s good. I’m only mildly lactose-intolerant, so as long as I don’t have a big portion of it, then I’m usually good with that. I just don’t have a lot of dairy. I generally don’t have a huge amount. I’m happy with that because I do love dairy.
SUZANNE: Yes, so that’s a minor trigger for you.
LARAH: Yes, a minor one, yeah. What about fructose? You’re quite intolerant to fructose, so you definitely haven’t been able to introduce high-fructose fruits.
SUZANNE: No, I definitely can’t. And even the permitted amounts, I have maybe about half of that, so instead of twenty blueberries, I would have ten blueberries. And instead of, I think it’s ten, strawberries, I probably only have two strawberries at a time…that kind of thing.
SUZANNE: I cut it even further down. I mean that line between high FODMAP and low FODMAP is a moving line depending on what your main triggers are, and what your minor triggers are. And for me, fructose is way much further down than it is in the Monash app, for example.
LARAH: Yes, that’s why the diet is so individual, really. It is not a one size fits all.
LARAH: In that sense, the gluten-free diet is probably easier, even though it’s a more serious condition, because you eliminate gluten and it’s the same for everyone. But once you have, as you said, two strawberries or a couple of raspberries… and some others can have ten strawberries and they’re fine with that.
SUZANNE: Yes, and that is the variable for that. Yes, gluten-free, which means you are celiac, is simpler from the point of view that it’s black and white. You’re taking out anything with gluten in it. It’s definitely not an easy life because of the cross-contamination, but it is black and white. FODMAPs are not black and white because they’re in all fruits and vegetables, grains, lentils and legumes. If we cut them all out, we’d be left with protein, meats and fat. And you can’t live on that or you’d die, so it’s that’s what makes it so complex. And the same with dairy free products. Cut out dairy…done. But we can’t do that and we have to find our own level with everything.
LARAH: What about things like fructans, sorbitol? Are you okay with those?
SUZANNE: Sorbitol seems to be all right, but mannitol, the other polyol, is not so good for me. I have to be very careful on things like the amounts of sweet potatoes and so on. The fructans, of course, there’s a list of foods with fructans in them, and we have to test them all individually, and it’s not black. The fructose you can test one food and it tells you for the whole group, and the same with the lactose., but you can’t do that with the fructans, so it’s item by item.
As far as wheat is concerned, which contains fructans, it’s a minor trigger. I can have a slice of bread, not two. And how it affects me is, I’ve got IBS with constipation, is that the next day I’ll be more constipated, anything like bloating or gas, that’s how it affects my bowel movements that is not so satisfactory. So mainly, at home, I won’t have wheat, but if I’m eating out then I don’t bother about it too much. I’ll eat a bread roll and just have a good time and know that all that’s going to happen is I’ll be a bit more constipated and I’ll counteract that in other ways.
LARAH: Yeah, so how would you counteract that, for instance?
SUZANNE: Well, I take a hundred milligrams of magnesium citrate every morning for the constipation. And I would just increase that for the next day or make sure that I eat a good meal with quinoa in it. Quinoa has very good fibre for those with constipation, and it’s a good food for everybody. It’s called a grain, but it’s actually a seed and it’s got protein in it, as well as carbohydrate, and it’s a good fibre source. So I would make sure I get some quinoa that day and, if necessary, I would increase the magnesium.
LARAH: Okay, so what was it called, that magnesium that you’ve taken? It is just not simple magnesium is it?
SUZANNE: I use magnesium citrate.
LARAH: Okay, does it come in powder or tablets?
SUZANNE: I get it in a tablet and each tablet is two hundred milligrams, so because it’s a tablet, I just snap it in half. You can take up to about four hundred milligrams, but don’t dive in a high amount because it’s a laxative, as well as having a good effect, it’s also good for the muscles; it’s good for sleep, for cramps and so on, but it has a laxative effect. The first time I took it, I took it for cramping muscles at night. It just said take four hundred milligrams, so I did, and I sat on the toilet at most of the rest of the day. I’ve got IBS constipation so it was pretty powerful. So each person has to find their own level with it. Start off low, and I would suggest the hundred milligrams and then build that gradually, day by day, until you get to the level that suits you. Not really any higher than four hundred, but if you get the capsules, they’re pretty hard to break apart. That’s why I suggest tablets.
LARAH: Okay, that’s good advice because a lot of people will be in the same situation and not know exactly what to do. Yeah, so that’s good. On your site, I was also watching one of your videos. You have lots of videos, so I would suggest for people to go and check out your site. And this particular video was talking about withdrawal symptoms and headaches when people start to follow a low FODMAP diet. Can you go a little bit more into detail and what people can do to help these cravings?
SUZANNE: A percentage of my clients who start the program, they go into a very clean eating program, because I supply the meal plans for them; with no processed food, and very little caffeine, and no excess of sugar. And this is a radical departure from how many of them have eaten before, and particularly, my clients in the US. They eat a lot of processed foods, and a lot of sugar as well. So when they go off that kind of eating, there are withdrawal symptoms. There’s withdrawal from the caffeine — from the coffee and the tea they’ve been drinking, and also from the level of sugar. If you cut the sugar quickly, you can end up with headaches as well as, of course, caffeine withdrawal. So, as I said, a percentage of my clients get, in particular, headaches. They can feel a bit kind of down and feel a little bit sick in that first week as they detox from the bad food that they’ve been eating. And, in fact, in the information that I send at the beginning, I include this fact so they’re already ready for it, that if they get a headache, not to blame the diet, but to blame the diet before.
SUZANNE: And the fact that they are now eating clean. But that can take up to a week for that to go away, but you know it’s a really good thing. And those who have the worst effects, it shows how bad their diet was beforehand.
LARAH: That’s excellent because if, in one week, you can get rid of those foods that are hurting you and get rid of the cravings you get from just withdrawing from that food, that’s pretty good. One week is not that long, really.
SUZANNE: Yes, it’s not too bad. I mean, obviously, the people who are going through it, think that it’s lasting forever and they have a very strong tendency to try and blame the low FODMAP diet for it, and that’s why I put it in the literature right at the beginning: “There’s a possibility this will happen and this is why it happens.” So you don’t give up on the diet because you’ve got a headache and feel off. You actually have to plow through that to get your body healthy.
LARAH: Yes, absolutely. It’s just really incredible the difference that you can make. That’s why it is so important for people to not go into the low FODMAP diet blind and get the support needed from an expert that guides you throughout because, as you said, yes, people might have cravings and say, “Oh no, this diet is not working for me. I’m feeling worse than I used to feel,” and, in fact, it’s because they’re making adjustments. And if they were just patient enough, they would see the benefits that they can get because, often, I wonder if they’re the twenty-five percent that said that the diet is not working for them if they’re doing it completely right.
SUZANNE: I strongly suspect they’re not doing it right. It’s incredibly hard to do this by yourself because there are so many moving pieces to it. If your only issues at the end of the day are FODMAPs, you’re probably going to manage it, to some degree, by yourself if you’ve got IBS with diarrhea because that can stop dead within a couple of days. With my clients, the bloating is gone, the gas is gone, and the diarrhea is gone. If you’ve got constipation, you’ve got a layer of protocol on top of that, to get rid of the constipation as well. It’s almost like a separate issue, the constipation, and much harder to do. And even though only thirty percent of people with IBS have it with constipation, about seventy percent of my clients have it with constipation, because they’ve failed trying to do it by themselves and they’re aware enough to know that it wasn’t the diet, it was them that failed and so they reach out for help. But how many people turn away from the diet thinking it’s wrong for them when it’s not that the diet that failed them, they failed the diet. And they didn’t do it right, and they turned away from the answer — and that’s just super, super sad.
LARAH: Yeah, this is just so important for people, and I hope that anyone listening to this podcast now can just give it another go if they’ve given it up because, yeah what you said is really true. Would you know if there is any statistics about percentage of people suffering from IBS-C and IBS-D because I’ve been asking that a little bit, but we don’t seem to find anything that we can refer to and say, “Okay, it’s about forty percent one way, sixty percent the other way or forty-forty and there is that twenty percent which is alternate or mixed?
SUZANNE: When I did the hydrogen breath test and they found I was a methane breather which is connected to the constipation. If you’re hydrogen breathing, you’ve got the diarrhea side. They told me that thirty percent of people have the methane, which means constipation. So that’s thirty percent with constipation, and then, I’d be guessing for the rest, and if I based it on my clients, I’d say it’s about fifty percent diarrhea and about twenty percent mixed would be what I get as clients. A surprising number have that mixed one. Now whether it’s a true mixed one, or it’s because they’re taking medications that swing them from one to the other, is unknown. I sometimes suspect that it’s because they have been taking a laxative and Imodium which is just pushing them from one extreme to the other and so it’s not possible to know what the natural tendency is. But that can be more or less, about thirty percent, for constipation and, certainly, the majority has diarrhea, which is the quickest one to sort. That’s the good news for those who suffer with diarrhea, which must be horrendous to have that. Even though when you get a solution, the diet, it’s much easier to have it with diarrhea.
LARAH: Yes,it’s quite interesting because what I notice for me, I was very much IBS-D, never ever IBS-C, but since adopting a mainly low FODMAP diet, which I’m now still on about eighty-five percent just to keep it on the safe side, I notice that I am one of those IBS mixed now. It’s quite funny because before I didn’t even know what constipation was.
SUZANNE: No, what happens is that your natural tendency is IBS with diarrhea. When you’re on a low FODMAP diet and you stop putting those foods and that bypass the small intestine going into the bowel and fermenting and causing your diarrhea, then the diarrhea stops, and that’s why it’s so quick to stop. It’s fairly common for people then to swing to the constipation side if you’re not putting a protocol in place to stop that from happening, which I have to do with my clients. Otherwise, they do swing across. So it’s not that you’ve changed to mix or you’ve changed the constipation or anything; you have IBS with diarrhea, but because you’re taking away what causes it, you’re actually bringing yourself closer to the norm, but just swinging slightly too far, that’s all.
LARAH: So it will have to be a balance of what gets me to the right point.
SUZANNE: Getting you to the right point is about fibre levels.
LARAH: Yes, sure.
SUZANNE: Yeah, but getting more fibre, you’ve got to be very careful. It’s a gut irritant and we have to just get exactly the right level for you and then you’ll be, on the Bristol stool chart, you’ll have a lovely number three or four bowel movement.
SUZANNE: The perfection.
LARAH: I know. Which type are you?
SUZANNE: I know, exactly. All of my clients know all about that. Every day, they have to report the number to me.
LARAH: It means they have to look at it.
SUZANNE: Yes, everybody does with IBS.
LARAH: Okay, I also wanted to ask you about soy products that I saw mentioned in one of your videos on your website. Which ones are low FODMAP and are okay to consume for people with IBS?
SUZANNE: There’s a lot of confusion about soya because most people think of it as bad. It’s high FODMAP, but that’s not completely the way it is overall. I mean if you get some soy beans and try to eat them, then that’s high FODMAP. But if you look at, for example, tofu, we can have a cup of tofu and that’s because when tofu was made, all of these liquids come out of it, and a lot of FODMAPs go out into the liquid and are discarded. So what’s left in the tofu doesn’t have a lot of the galacto-oligosaccharides which is the FODMAP that’s in tofu, and that allows us to eat up to one cup. With soya milk, it’s based on the whole to stay away from soya milk because the majority of it is made from the whole soya bean and that’s not okay. That’s high FODMAP. But if you were to find one that was made from the soya protein then, of course, that’s okay because proteins are not our problem. It’s FODMAPs and carbohydrates, not proteins. And the other one to mention is soya sauce. There is so little in that that’s going to hurt us. There’s a little bit of wheat and we only have small quantities that we can use soya sauce. But the soybeans themselves, or any product made from the soybeans, apart from tofu and tempeh, you have to avoid.
LARAH: Yeah, and going back to the tofu, on the Monash app now they make a difference between the firm one and the silken one with one being low (FODMAP) and the other one being high. So it’s a bit what you said, that the firm one has drained all the liquid and the silken one has still too much liquid in it?
SUZANNE: Exactly, that’s exactly right. That’s what make it soft. The liquid retains the FODMAPs.
LARAH: That’s good. That’s interesting because, obviously, there are lots of vegetarian people following the low FODMAP diet so they have to be able to eat something.
SUZANNE: Yes. I have at the moment two vegetarians in my program and we have to feed them protein. It’s one of the three macronutrients so they have to have it, but they can have tofu, tempeh, chickpeas in small amounts, lentils in small amounts as long as they’re canned, rinsed and drained. There are certainly things that we can do to get the protein into the diet, but it is much harder than somebody who’s not a vegetarian.
LARAH: Yeah, understandable. Okay, let’s say that I’ve been following you for quite a while and I’m subscribed to your newsletter and often I read about your travels around the world, which sound really fantastic. So how do you find following the low FODMAP diet while you’re travelling — including going on a cruise? Do you have any useful tips?
SUZANNE: Yes, I travel a lot. I always have, and now I don’t suffer. And it’s about knowledge and standing up for yourself and putting a few strategies in place. For example, on the plane trips — and to go anywhere from New Zealand is a long way and a long flight. I don’t order a gluten-free meal because gluten-free does not mean low FODMAP and could easily have high FODMAP ingredients. I get a normal meal. We always get on the plane two choices, so I choose the simplest one which would be something like chicken and mashed potatoes, so that’s the one I get. I open it up and scrape off any any sauce that’s on it and I eat what I know is safe which will be the lump of chicken and the mashed potato and there might be a few beans and a few carrots there, and I eat that. Anything I can’t eat, I hand it to my husband, and if he’s got anything at his meal, he always chooses the other one. If he’s got anything at his meal that I can eat, I grab it. I have never gone hungry on the plane yet. I do take some snacks with me because, sometimes, there’s far too long between meals on the long flights to Europe. Especially when they turn the lights off and think you’re going to sleep which doesn’t happen that easily and we have to eat three hours apart. So that’s not going to work on a plane, so I always take my own snacks to fill in those gaps in between meals.
LARAH: Which snack would you advise to people to bring? Something easy on the plane.
SUZANNE: Well, just cut up some vegetables — some carrots, zucchini, fennel, radish. Cut them up into little pieces and put them in a little Tupperware container and take, perhaps, some peanut butter with you, or tahini. In many countries, when you land, you can’t have that food with you, but you can eat it before you get off the plane. These days there is more firms creating low FODMAP snack bars as well. I’ve actually just been sent some from a new company in the US. The lady who created them is actually a gastroenterologist.
LARAH: She is going to be on my podcast in a couple weeks.
LARAH: Dr. Michelle O’Brien from True Foods.
SUZANNE: I just received some snack bars. I’ve only tried one and it was great so I’m going to try the other flavours. There’s more and more of those kind of snack bars, so I would definitely stock up on those. They’re packaged so you’re going to be able to get them into the country as well, and you can use them while you’re on the ground in the country.
I always prepare before I go to a country, a laminated card in the language of the country, and I put all of my big triggers on that. My big triggers are garlic and onion. I don’t have the lactose one; otherwise you’d put that. And I have only a minor problem with wheat so I don’t put that. But for my clients. I always tell them to have the card that says no lactose, no gluten — and we use the word gluten because the public understands it, even though it’s not strictly our problem — and no onions, no garlic because they are major triggers. But those four, are things that can be hidden in food. Everything else we can see on the menu or on the plate. So my card just says no garlic and no onions. And when we’re looking for a place to eat, the first thing is we go to the district where there’s a lot of restaurants and cafes and I’ll look at all the menus, which are on the outside and choose a place that seems that seems to have the most likely food. I go and I wave my laminated card around. Everybody gets used to it. If I’m in a group tour, they all know I’m going to wave my card around and insist that it gets taken into an account. Even here in New Zealand you should never go anywhere without your laminated card because even though you can verbally tell the waitress or waiter, they don’t necessarily convey that information accurately to the chef, so you want the waitress to take that card to the chef and show them and then bring it back to you. The other thing is — and this is not just abroad, but even in your own country — you take that precaution beforehand. Your meal arrives and you look the waitstaff in the eye and you say, “So this meal has got no garlic or onions because if it has, I’m going to be sick right here in the restaurant.” You’d be surprised by how many times the waitress or waiter takes the meal, goes back to the kitchen and checks, and it comes back just a little bit different. So that’s a double check because I’ve been caught with that before where they make mistakes between you telling them and the meal arrived, so you double check afterwards.
The only other little tip I want to say is that if you’re staying in a hotel and you got the breakfast in the hotel, it’s normally a big buffet and you’ll find something you can eat. I always take something from the breakfast buffet for a snack for that day, so I have either a little Tupperware container, or just tin foil, that I take with me, and I wrap a little something up and that goes into my purse. And that’s my snack during the day.
LARAH: That’s a good idea. What about in terms of cruises?
SUZANNE: Okay, so the cruise that I went on, I’ve only done that one, and I got in touch with the cruising company beforehand and they didn’t know what I was talking about with the low FODMAP diet. And so, in the end, it was agreed that when I got on board I went and talked to the Maitre d’ as soon as I arrived which I did, and he was absolutely wonderful from that moment on. He supervised all my meals in the kitchen and brought them to me himself, every single day. At each meal, he’d give me the menu for the next meal and told me to choose something that was the most likely and he would make sure, personally, that there was no garlic or onions in it. I was not sick at all on that cruise. I had fairly bland food, I do have to say, because everybody else had all this wonderful stuff,. but I didn’t get sick. And, yeah, they were wonderful. So don’t take a no or confusion or anything like that. Stick to your guns. The cruise companies especially — I’ve heard from other clients — they really look after you. But get to the Maitre d’; he’s in charge.
LARAH: Yeah, absolutely, The first time I went on a cruise, I was saying that because they didn’t have, obviously, low FODMAP and I didn’t know the tip you just gave, I said, okay, maybe I should tell them gluten-free. And then they were making such a big fuss about having to cook it. It’s not they didn’t want to; they were willing to do it, but I thought, why I am putting them through having to cook my food all separate, all not contaminated when gluten is not my issue? So after the first day, I said don’t worry about it; I’ll find something to eat. And being able to pick from the buffets, there is so much choice and I didn’t go starving, let’s say. But, yeah, now that I know what you do — and I heard that from other people as well. That’s excellent. And I have to say, they’re pretty accommodating on cruises. They really want to give you the best experience you can possibly have.
SUZANNE: Well, on that particular cruise I went on, they have very special area for gluten-free — for coeliacs. It was a little bit separate from the restaurant, so, obviously, it’s a big thing with them. It was Costa Cruises. But I had a wonderful cruise from that point of view and so I can only recommend them.
LARAH: Yeah, that’s good. Let’s now talk a little bit about — and you mentioned those before — your coaching programs, your courses and the challenges. But if you want to just go through them in a little bit more detail and how can they help people following a low FODMAP diet.
SUZANNE: Sure, I’ve got three main programs. One is the personal coaching, which is a six-week program, and I create the customised meal plans for everybody, they fill out diary pages, etc. And in that six weeks, we go through the elimination diet, get them symptom-free and do a complete reintroduction diet so that by the end of the six weeks they’ve got their own personal diet that’s perfect for them. It will be different from my diet, your diet, and the next person’s diet. But it’s their diet that keeps them symptom free, and that becomes a lifetime diet — or at least until they find a cure for IBS, which I don’t think is going to happen anytime soon.
So that’s the kind of the main part of the program, but we also look at the whole lifestyle issues of sleep and exercise and stress because we know how much that affects IBS. So it’s a very personal program; we talk weekly and we communicate daily. They send me the diary pages and I’m making tweets and suggestions all the time.
That’s my main program, and the one I started off with, and I still continue doing that. But then there are people who couldn’t afford the personal program so I created the “IBS Recipe for Success” course with just a twenty-two day self-study program that people do by themselves. They still get the meal plans, the diary pages, and all the same information, but it’s not personalised. They don’t have me, but they do have me and the associated Facebook group that is specifically for my clients and they can ask me questions there. And just this year, I started a third program, which is a two-week group program. I’m about to start the next one on Monday, actually, and that will be the third one for the year. And there’s just small groups under twenty-five people for two weeks doing the elimination stage and we have four live sessions in that; very interactive. We’ve got a really good Facebook group that we interact on. People report there every day and I’m very active in that. So that one’s been going really well for those. It’s kind of an in-between program. I have just started a reintroduction program, as well, specifically for those who’ve done the elimination diet, are symptom-free and they are too afraid to do the reintroduction by themselves. They can come and do a three-week program with me on that. So that’s all the progress, but my main one remains the one-on-one because it’s so individual…the diet.
LARAH: Yes, and all those are explained on your website. And if I link on the show notes to your specific page, they will be able to get all the information they need and contact you, yes?
SUZANNE: Yes, I think it’s StrandsOfMy Life.com/coaching programs. I’m sure you will find it. And there you can see each of the programs and you can click into more information for each one.
LARAH: Okay, that’s great. I will do that. So now, as you’ve had so much experience with all the different clients with all different issues, what are the main issues that your clients complain about before going through your programs?
SUZANNE: All the common symptoms of IBS, either the diarrhea, or constipation, or the mixture of the two. I have had some with the fourth kind of IBS which isn’t talked about very much, but that’s when bowel movements are normal, but they still have the bloating, and the gas, and the discomfort, and the tiredness that goes with that. Tiredness is a really big one because people are basically malnourished and are not absorbing the foods that they’re eating. It doesn’t matter how healthy they think it is, if they’re not absorbing it, then they’re going to be malnourished, and that creates really heavy tiredness and lack of energy. On the program, once you’re eating well on the low FODMAP diet, that energy comes back quickly. Really quickly. The body bounces back fast. Within a few days the energy levels go up. So the bloating and the gas are really disconcerting for a lot of people. So what they found in a research study was that we don’t have any more gas than anybody else, but it’s distributed differently in our gut. So the person without IBS — everybody passes wind fifteen to twenty five times a day, which is already a wide range — with men passing more often by the way. And the person without IBS passes that in small little lots throughout the day so you often don’t hear it or know it, although you might smell it, but it’s gradual. Whereas the person with IBS, it accumulates in pockets in the digestive system and in the colon so you’ve got these big pockets of gas that cause pain and cramping and discomfort and so when it comes out, it can be quite explosive and seem like we have a whole lot more gas than the other person. But the quantity, when they tested it, was exactly the same — always between fifteen and twenty-five times a day of little passings. We just do it a lot less often. I’ve had clients actually monitor this and they were really surprised that they don’t actually pass wind that often — maybe not as often as their spouse, but it’s a bit more explosive when it happens. It’s just an interesting titbit for you.
LARAH: Yes, and I think it’s also harder to hold it. We obviously grow up in a society where it is not okay just to…
LARAH: We’re trying to hold them when we are with people, and when you have IBS, sometimes they just fall out because of the pressure.
SUZANNE: Yes, the pressure is so great because there’s a big pocket of it. But also remember that other people are letting it out and it’s just that you don’t hear it. It’s not explosive. So everybody’s letting it out, but for us, because we’ve got very sensitive gut –and that’s one of the things they know about us — it’s so over-sensitive to everything that when we feel that accumulation of gas. It’s so much more painful than for somebody else, as well. So someone else with a bit of wind, it’s nothing. It’s part of life, Boom! It’s gone. But for us, it’s all dramatic.
LARAH: Yeah, in Italian we say that there’s more space outside than inside. Something like that.
SUZANNE: Yes. So let it out. Exactly. My brother-in-law always said, “Keep it in and feel the pain; better to let it out and feel the shame.” Something like that.
LARAH: Oh, yeah, yeah. That make sense.
SUZANNE: Yeah, and he does as well, he doesn’t care.
LARAH: Yeah, I know. It’s just that for females, it’s different. Men are a little gross in general, but, yeah, we try not to inform everyone about our issues.
SUZANNE: Oh no-no. Not the done thing at all.
LARAH: Okay, let’s talk about your cookbooks now. So you published a few cookbooks on the low FODMAP diet. Can you tell us what they are and where they can be found, and if you want to share one of your favourite recipes that can be found in those books?
SUZANNE: Yes. Near the beginning when I was doing this, I made two cookbooks. One is called The Low FODMAP Menus and it’s divided into menus — like a menu for picnic, menu for a formal dinner party, menu for brunch. And for all different scenarios, I create menus, and there’s a whole lot of photos in there too. It was a lot of fun, putting it together.
The second one was The Low FODMAP Snacks with sweet and savory snacks and lots of photographs. I do my own photography; I learned how to do it from my son who did a degree in photography. Again, really enjoyable. So there are these two cookbooks you can buy on Amazon for the hard copy, or on my website for the pdf version of it. I’ve also got an IBS daily journal. It is really, really important to make sure you are journaling every day with IBS — what you’ve eaten, what your bowel movements are, the amount of water, exercise, and all those kinds of things.
I have another book hopefully, being published in the traditional way. And I’ve got a literary agent at the moment and she’s put my book idea, which is for a plan for people who need to do the low FODMAP diet — a six-week plan exactly the way I do my program with my one-on-one clients. She has that out with publishers at the moment, and we’ve already got some interest. With the traditional publishing world, that can take a year or more before anything is actually seen in the book shop. So that’s just a little in anticipation that should happen, but at the moment, I’ve got my two cookbooks that I’m proud of, and you can buy those on Amazon or my website.
LARAH: That’s great. I’ve seen the photographs of your books and they’re very beautiful. You are very talented in taking food photographs.
SUZANNE: Thank you. I do love doing that. It’s the creative side of me that needs a release, and photography’s a good way to do that.
LARAH: That’s good. And one of your favourite recipes just very quickly?
SUZANNE: Obviously, lots of them are my favourites. I’ve got a wonderful carrot cake and banana cake. They are very soft and moist. A lemon potato cake made with potatoes, believe it or not. For a savoury one, I have a zucchini-salmon stack — so easy to make. It looks great and I use it often when I have guests that I want to impress. I cook some polenta and I let it harden on a board and then, just with a stamp, I cut out perfectly round slices of polenta. On top of that, I just cook up some zucchini with a bit of cottage cheese, salt and pepper, put them on top of the round, and then layer some smoked salmon on top of that. I make a little sauce with just bit of sour cream –and if you can have a little bit, you can get away with it -and some capers mixed into that and that just decorates the top. It’s so simple to make and it looks spectacular with the green, orange, yellow and white.
LARAH: Mmmm… beautiful. Sounds delicious, too. And in some countries, like in Australia, you can find that lactose-free sour cream because I buy that when I make Mexican. So if anyone has got a lactose problem, not a dairy problem, maybe they can try that.
SUZANNE: Yeah, sounds excellent.
LARAH: Okay, well that was awesome. That was a really good informative interview, Suzanne, I thank you so much for that. Was there anything that we haven’t covered?
SUZANNE: Oh, for sure. There’s a million things we haven’t.
LARAH: I know.
SUZANNE: It’s such a complicated diet. I mean, I could talk for twelve hours which is what I do in the workshop with my clients. I talk and talk and give them as much information as I can and they ask questions. But for now, I think we have put a lot of information out there and I hope that it’s really helpful to those people who are trying to get on top of the low FODMAP diet at a moment.
LARAH: Yes, I’m sure it has been very informative, and every week, at least once a week, I do get an email or a message from someone that has listened to the podcast and just said how much it has helped them because sometimes it’s even harder to tell your family about it and get them to understand it. And one of them specifically said, “I got my wife to listen to your podcast and now she understands I have a real issue.”
SUZANNE: Oh, fantastic. It is really very difficult. It’s not like a broken arm where you can see a cast and see that something is wrong and everybody’s got sympathy for you. But, I mean, even the doctors still tell people that it’s in their heads and to go away. So it’s very isolating for a lot of people, and if your family’s not understanding how more isolating is that?
LARAH: Yes, that’s right. And I think that what we do, in different ways, is to bring awareness so that people don’t have to feel different and don’t have to feel worried. And for the majority of us, the low FODMAP diet does really help us. It would be wonderful for them to find out about it and at least they have a choice to try it or not.
SUZANNE: Exactly, and that’s why I want to get my book out there with the program in it, because not everybody can afford to have personal individual coaching. And so I’m not reaching as many people as I want to, because my program’s constantly full and I can’t fit any more people in. So this book is like twenty dollars or whatever it will sell for. Get this, do it and get well. All the information you need will be in there and I’m not advertising the book, it’s not even done yet, but that’s why I want to get this book done and out there — to reach these people who shouldn’t be suffering. They just shouldn’t. We’ve got a solution. So let them find it and get well. I’ve had it for decades and I don’t want any other people having that. Now let them get help.
LARAH: Okay, so I’m going to put all the links in the show notes, but if you want to just tell people where they can find you if they want to get in touch with you? What’s the best way?
SUZANNE: Well, there’s a few different ways, but mainly through my blog. You can go to the ‘contact me’ page, or if you want to fill out the application form, for the personal coaching you would just go to the ‘coaching’ page and there’s a button to fill out the application form, because for the personal coaching, they fill out the application form and then I phone them and we talk for thirty minutes. I need to be sure that they’re going to be a good fit for the program before I accept them into it. So there’s a bit of a procedure for that one, not for the other ones. So you can contact me that way. If you ever put a comment on my blog, I answer every single comment that’s ever been put it on there. Or you could email me at Low FODMAP Coach as well.
LARAH: Okay, that’s great. So all those links will be on the show notes so that it will be easy to find them. Well, what should I say? Thank you so much for your time, Suzanne.
SUZANNE: Well, thank you for having me on it. As you can see, I can talk forever on this subject. It’s my subject.
LARAH: Yes, I can see you have a real passion for it.
SUZANNE: Yes. Oh gosh, yes. It’s made such a change in my life and I want that for everybody else. As I said, it drives me nuts that people haven’t found answers and they still have IBS.
LARAH: I agree with you. Goodbye and thank you, Suzanne.
SUZANNE: Thanks very much, Larah. This has been very enjoyable and goodbye.
LARAH: Another great episode today which I really hope you have also enjoyed and found useful. You may be able to identify with Suzanne’s ordeals with IBS symptoms and her struggles, especially at work, due to those symptoms. Hopefully this episode should also reassure you that there is a light at the end of the tunnel. And in the case of Suzanne, how she could now help a lot of other sufferers. The low FODMAP diet works for the majority of IBS sufferers and I am very grateful that it was created and personally for the relief that I have benefited from following this diet. Well, keep on listening, keep on sharing the word about the diet. Send me your questions if you have any and go to my blog for the show notes and for all the links.
As usual, my best wishes to you for the next week, I wish you great happiness and health and take good care and goodbye.
Links and resources mentioned in this episode:
Suzanne’s Customised Meal Plans