People living with chronic gut conditions such as irritable bowel syndrome (IBS), coeliac disease and inflammatory bowel disease (Crohn’s and Colitis) are being cautioned against a new trend called ‘diet stacking’, where people follow multiple diets at the same time.
New research published in JGH Open medical journal said that while diet therapies played an important role in managing gut conditions – combining two or more diets without proper guidance can increase the risk of nutritional deficiencies, disordered eating and poorer long-term health outcomes.
Diet stacking occurs when patients follow multiple dietary approaches at once, such as a gluten-free diet alongside a low FODMAP*, dairy-free, low-histamine or elimination diet, for example.
The research was led by a team of gastroenterologists, psychologists and dietitians, including Dr Alice Day from the Queen Elizabeth Hospital and Basil Hetzel Institute’s Inflammatory Disease Group, which is supported by The Hospital Research Foundation Group.
Dr Day, an advanced gastroenterology research dietitian, said diet therapies can be highly effective in managing gastrointestinal disease, but ‘diet stacking’ needed expert guidance.
“We are seeing many patients grapple with trying to follow multiple different diets, too afraid to let go of certain dietary restrictions for fear symptoms might get worse, but also finding it increasingly hard and restrictive to follow multiple diets,” Dr Day said.
“Diet and food seemingly appear to be a low-risk way to help manage symptoms or treat an illness, however without the correct advice and support, people can become confused and nutritionally, medically, socially and psychologically compromised.”
The research found that more than half of patients with IBS were following two or more diets at the same time, often without support from a dietitian.
Many continued restrictive diets even when they were no longer helping, increasing the risk of poor nutrition and anxiety around food.
Dr Day said diet was just one part of managing chronic gastrointestinal conditions and that diet therapy should be personalised and regularly reviewed by an experienced dietitian.
“This research highlights the important steps in correctly applying diet therapy to manage gastrointestinal disease and disorders – and being supported and monitored by a dietitian with expertise in managing gastrointestinal issues with diet, along with other members of the multidisciplinary team.”
*FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polys – types of carbohydrates that can cause digestive distress in some people.
