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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

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