low-FODMAP

Food Friday: Tom Kha Gai Soup

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This recipe is adapted from a recipe out of The Defined Dish Cookbook. I just recently was introduced to her blog and cookbook and love it. They are easy, healthy meals for those nights you don't want something heavy or for those who are following a #Whole30 plan.

Now onto this recipe! This soup is creamy (without the cream, thanks to coconut milk) and full of flavour. It isn't too heavy on the veggies so I make sure to get those in during other meals. It is a great meal if you are sick (think Thai chicken soup, bonus is that the mushrooms are immune boosters), if your digestion is off (coconut milk if a low-FODMAP food, and the soup is low in fibre), or great for a light brothy meal anytime.

Ingredients:

  • 2 tbsp extra virgin olive oil or coconut oil

  • 1/2 cup finely diced shallots

  • Salt & Pepper

  • 2-in piece fresh ginger, grated

  • 2 garlic cloves, minced

  • 2 cans unsweetened full-fat coconut milk

  • 1 cup chicken broth (or bone broth!)

  • 2-3 tbsp fish sauce

  • 8 keffir lime leaves (or 1/2 lime grated)

  • 2 tbsp lime juice

  • 1 tbsp coconut sugar

  • 2 red thai chilis, very thinning sliced

  • 1/4 tsp ground coriander

  • 2 stalks lemongrass (white and light green parts), cut into 2-in pieces

  • 2 lbs boneless, skinless chicken thighs, trimmed and thinly sliced

  • 2 cups thinly sliced mushrooms (button, cremini, shitaki etc)

  • 1/4 cup fresh cilantro leaves, optional (I omit since my other half says its a “vile weed”!)

Directions:

  1. In a large pot of Dutch oven, heat the oil over medium heat. Add the shallots and a pinch of salt and pepper. Cook until the shallots are tender, about 2-3 minutes.

  2. Add the ginger and garlic and cook until fragrant, being careful not to burn, about 1 minute.

  3. Add the coconut milk, chicken/bone broth, fish sauce, keffir lime leaves, lime juice, coconut sugar, chilis and coriander. Stir to combine, then add the lemongrass. Bring the soup to a gentle simmer.

  4. Add the sliced chicken and simmer until the chicken is just cooked through, 6-7 minutes. Add the mushrooms and simmer for another 3 minutes. Stir in the cilantro if using.

  5. Remove from heat and discard the lemongrass and keffir lime leaves, if desired. Top with cilantro (or basil is good) and serve with an extra squeeze of lime. Delicious!

Enjoy!

In health & happiness,

Dr. Karen

IBS Diet - Why A lowFODMAP Diet Is Not Advised Long-Term

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More and more digestive patients of mine tell me that it has been suggested they go on a low-FODMAP diet (easily fermentable foods) to help/cure their IBS symptoms. Sometimes they are even told to stay on it longterm despite not seeing a big benefit. Unfortunately this is not the best suggestion and can actually cause some long-term side effects leading to worse digestive issues. Only a few digestive condition warrant a low-FODMAP diet, including something called SIBO, small intestinal bacterial overgrowth, and only for a short amount of time. To simplify, SIBO basically means that bacteria have ascending up from the large intestine into the small intestine where they are not supposed to be and cause symptoms such as diarrhea or constipation, bloating, gas, and pain. Yes, many patients with IBS do have SIBO, however it is important to accurately test and properly treat, instead of staying on a restricted diet long-term. We want to treat the root cause, not just decrease symptoms.

A low-FODMAP diet keeps symptoms of SIBO under control simply by starving the bacteria in your small intestines. When they don’t have food, they aren’t able to ferment that food and produce unwanted gas. It doesn’t always solve the problem however. Longterm, this can starve the bacteria in your large intestines that have a beneficial role in our gut and overall health as well as potentially set patients up for reoccurrence of SIBO. Studies have shown that a long-term low-FODMAP diet can reduce the diversity and quality of beneficial bacteria in the large intestine.  

Yes this diet can reduce symptoms IF you have IBS/SIBO, however dietary changes alone are often not enough to treat. We want to actually eliminate the bacteria vs starve them into a dormant state. A low FODMAP diet (or similar low carbohydrate diet) is only one portion of my SIBO protocol and should only be used for about 6-8 weeks in the final phase, or short term at the beginning to lessen symptoms. As mentioned, my main goal is to eliminate the unwanted microbes with antimicrobials. This phase does not happen for long as well, only about 6-8 weeks typically.

In the long term, we want to eat FODMAP foods to feed the beneficial bacteria in the large intestines. We also want to keep our diet as diverse as possible to allow greater nutrient density and get a wider variety of nutrients. 

My last point is that SIBO is often a symptom of a deeper digestive problem, therefore after properly treating this condition we then address the root cause, which could be low stomach acid, gallbladder issues, intestinal motility issues, scar tissue, stress and so on. 

Therefore if you have been advised to start a low FODMAP diet, or have been on it for even a few months already, please consider seeing a Naturopathic Doctor like me to consult on whether this is the right treatment path for you, to get tested for SIBO, or to help get to the root cause of your digestive concerns. 

Any questions? I'm happy to help!

In health & happiness,

Dr. Karen