Nutrition-Feature

Gastroparesis Diet

Purpose

Gastroparesis is the medical term for delayed stomach emptying. During the process of digestion, the stomach must contract to empty itself of food and liquid. Normally, it contracts about three times a minute. This empties the stomach within 90-120 minutes after eating. If contractions are sluggish or less frequent, stomach emptying is delayed. This results in bothersome and sometimes serious symptoms, as well as malnutrition, because food is not being digested properly.

Gastroparesis may be caused by various conditions such as diabetes mellitus, certain disorders of the nervous system, or certain drugs. Often however, no cause can be found although a viral infection is suspected in some. Usually, the physician prescribes medication to stimulate the stomach to contract. The purpose of the gastroparesis diet is to reduce symptoms and maintain adequate fluids and nutrition. There are three steps to the diet.

Step 1 Diet- consists of liquids, which usually leave the stomach quickly by gravity alone. Liquids prevent dehydration and keep the body supplied with vital salts and minerals.

Step 2 Diet- provides additional calories by adding a small amount of dietary fat — less than 40 gm each day. For patients with gastroparesis, fatty foods and oils should be restricted, because they delay stomach emptying. However, patients at the Step 2 level are usually able to tolerate this amount.

Step 3 Diet- is designed for long-term maintenance. Fat is limited to 50 gm per day, and fibrous foods are restricted, because many plant fibers cannot be digested.

Nutrition Facts

The Step 1- Gastroparesis Diet is inadequate in all nutrients except sodium and potassium. It should not be continued for more than three days without additional nutritional support. STEP 2 and STEP 3 Gastroparesis Diets may be inadequate in Vitamins A and C, and the mineral iron. A multi-vitamin supplement is usually prescribed.

Special Considerations

1. Diets must be tailored to the individual patient. This is because the degree of gastroparesis may range from severe and long-standing to mild and easily corrected. Patients may also have various medical conditions to be considered. For example, diabetes patients with gastroparesis are allowed sugar-containing liquids on the Step 1 diet, because that is their only source of carbohydrate. On the Step 2 and Step 3 diets, these patients should avoid concentrated sweets. These are noted with an asterisk (*) on the food lists.

2. On all of the diets, liquids and food should be eaten in small, frequent meals. This helps to maintain nutrition.

Step 1 Food Groups

Groups Recommended Avoid
Milk & Milk Products none all
Vegetables none all
Fruits none all
Breads & Grains plain saltine crackers all others
Meats & meat substitutes none all
Fats & Oils none all
Sweets & Dessert
none all
Beverages Gatorade and soft drinks (sipped slowly throughout the day) all others
Soups Fat-free consommé and bouillon all others

 

Sample Menu Step 1

 Breakfast Lunch Dinner
  • Gatorade 1/2 cup
  • ginger ale 1/2 cup
  • bouillon 3/4 cup
  • saltine crackers 6
  • Gatorade 1/2 cup
  • Coke 1/2 cup
  • bouillon 3/4 cup
  • saltine crackers 6
  • Gatorade 1/2 cup
  • Sprite 1/2 cup
  • bouillon 3/4 cup
  • saltine crackers 6

This Sample Diet Provides the Following

Calories Fat Protein
790 90 mg 11 gm
     
Sodium Carbohydrates Potassium
3531 mg 156 gm 244 mg

 

Step 2 Food Groups

Groups Recommended Avoid
Milks & Milk Products skim milk, products made with skim milk, low-fat yogurt, low-fat cheeses whole milk products, creams (sour, light, heavy, whipping), half & half
Soups fat-free consommé & bouillon, soups made from skim milk, & fat-free broths containing pasta or noodles and allowed
vegetables
soups made with cream, whole milk, or broths containing fat
Breads & Grains breads & cereals, cream of wheat, pasta, white rice, egg noodles, low-fat crackers oatmeal; whole grain rice, cereal, bread
Meats & meat substitutes eggs, peanut butter (maximum 2 Tbsp/day) beef; poultry; fish; pork products; dried beans, pea, & lentils
Vegetables vegetable juice (tomato, V-8); well-cooked vegetables without skins (acorn squash, beets, carrots, mushrooms, potatoes, spinach, summer squash, strained tomato sauce, yams) all raw vegetables; cooked vegetables with skins; beans (green, wax, lima), broccoli, Brussels sprouts, cabbage, cauliflower, celery, corn, eggplant, onions, peas, peppers, pea pods, sauerkraut, turnips, water chestnuts, zucchini
Fruits apple juice, cranberry juice, grape juice, pineapple, prune juice, canned fruits without skins (applesauce, peaches, pears) citrus juices, all fresh and dried fruits, canned fruits with skins (apricots, cherries, blueberries, fruit cocktail, oranges, grapefruit, pineapple, plums, persimmons) 
Fats & Oils any type of fat, but only in small amounts none
Sweets & Dessert
hard candies, caramels, puddings & custards made from skim milk, frozen yogurt, fruit ice, gelatin, ice milk, jelly, honey, syrups high-fat desserts (cakes, pies, cookies, pastries, ice cream), fruit preserves
Beverages Gatorade*, soft drinks* (sipped slowly throughout the day)

* Concentrated Sweets

all others, except allowed juices

 

Sample Menu Step 2

Breakfast Lunch Dinner
  • skim milk 1/2 cup
  • poached egg 1
  • white toast slice
  • apple juice 1/2 cup
  • mozzarella cheese 2 oz
  • saltine crackers 6
  • chicken noodle soup 3/4 cup
  • Gatorade 1/2 cup
  • peanut butter 1 Tbsp
  • saltine crackers 6
  • vanilla pudding 1/2 cup
  • grape juice 1/2 cup
Morning Snack Afternoon Snack Evening Snack
  • ginger ale 1/2 cup
  • canned pears 1/2 cup
  • skim milk 1/2 cup
  • cornflakes 1/2 cup
  • sugar 2 tsp
  • frozen yogurt 1/2 cup
  • saltine crackers 6

This Sample Diet Provides the Following 

Calories Fat Protein
1343 35 gm 52 gm
     
Sodium Carbohydrates Potassium
2639 mg 206 gm 1411 mg

 

Step 3 Food Groups

Groups Recommended Avoid
Milks & Milk Products skim milk, products made with skim milk, low-fat yogurt, low-fat cheeses   whole milk products, creams (sour, light, heavy, whipping), half & half
Soups fat-free consommé & bouillon, soups made from skim milk, & fat-free broths containing pasta or noodles and allowed soups made with cream, whole milk, or broths containing fat
Breads & Grains breads & cereals, cream of wheat, pasta, white rice, egg noodles, low-fat crackers oatmeal; whole grain rice, cereal, bread
Meats & meat substitutes (Tbsp/day), poultry, fish, lean ground beef fibrous meats (steaks, roasts, chops), dried beans, peas, lentils 
Vegetables vegetable juice (tomato, V-8); well-cooked vegetables without skins (acorn squash, beets, carrots, mushrooms, potatoes, spinach, summer squash, strained tomato sauce, yams)  all raw vegetables; cooked vegetables with skins; beans (green, wax, lima), broccoli, Brussels sprouts, cabbage, cauliflower, celery, corn, eggplant, onions, peas, peppers, pea pods, sauerkraut, turnips, water chestnuts, zucchini
Fruits fruit juices, canned fruits without skins (applesauce, peaches, pears) citrus juices, all fresh and dried fruits, canned fruits with skins (apricots, cherries, blueberries, fruit cocktail, oranges, grapefruit, pineapple, plums, persimmons) 
Fats & Oils any type of fat, but only in small amounts none
Sweets & Dessert
hard candies, caramels, puddings & custards made from skim milk, frozen yogurt, fruit ice, gelatin, ice milk, jelly, honey, syrups high-fat desserts (cakes, pies, cookies, pastries, ice cream), fruit preserves
Beverages

Gatorade*, soft drinks* (sipped slowly throughout the day), coffee, tea, water (note: non-caloric beverages should be limited if patient cannot maintain adequate caloric intake)

*Concentrated Sweets

all others, except allowed juices

 

Sample Menu Step 3

Breakfast Lunch Dinner
  • skim milk 1/2 cup
  • cream of wheat 1/2 cup
  • sugar 2 tsp
  • orange juice 1/2 cup
  • white toast 1 slice
  • margarine 1 tsp
  • jelly 1 Tbsp
  • tuna fish 2 oz
  • low-fat mayonnaise 2 Tbsp
  • white bread 2 slices
  • canned peaches 1/2 cup
  • Gatorade 1.2 cup
  • baked chicken 2 oz
  • white rice 1/2 cup
  • cooked beets 1/2 cup
  • dinner roll 1
  • skim milk 1/2 cup
  • margarine 2 tsp
Morning Snack Afternoon Snack Evening Snack
  • low-fat yogurt 1/2 cup
  • Sprite 1/2 cup
  • chocolate pudding 1/2 cup
  • ginger ale 1/2 cup
  • ice milk 1/2 cup
  • pretzels 2

This Sample Diet Provides the Following

Calories Fat Protein
1822 42 gm 75 gm
     
Sodium Carbohydrates Potassium
2234 mg 286 gm 2467 mg