Diet modifications for Pancreatitis

As mentioned in my previous post, I already have a very good diet (everything that I can purchase or makes sense purchasing is organic, I cook my meals, if I eat out I choose for most of the part wholesome ingredients with known macronutrients and ingredients list).

But after this pancreatitis (I am not completely convinced its that, since I do have gastritis symptoms too, much more than pancreatitis…more on another post after I go talk with my GP on monday), I was advised to go on a high carb, high protein, low fat diet.

So what does this mean?

Well…the accepted definition of ‘Low fat’ diet is anything between 20 to 30% of your daily caloric intake in fat.

Anything under 20% and is extremely low fat and for longer periods of times might be detrimental to health since hormones, neurons and cells among others require fats (and essential fatty acids; which cannot be manufactured by your body but has to be coming from an external source aka food) to properly function.

I personally stick between 20 to 30% fat most of the year. I have done 40-80% fat in the past for ketogenic diets (maybe more about this in a future post 😉 ).

So for reference…what does it look like to have 20% of fat vs. 30% of fat?

Let’s use a reference caloric intake: 1500 cal / 2500 cal / 4000 cal

For someone needing to consume 1500 cal it would mean 33 grams to 50 grams.

For someone needing to consume 2500 cal it would mean 55 grams to 83 grams.

For someone needing to consume 4000 cal it would mean 89 grams to 133 grams.

As you can see, it depends on what your caloric needs are ; which is comprised of your Basal metabolic rate / resting metabolic rate + thermic effect of food + daily activity (like moving, walking, doing chores etc…) + (post exercise oxygen consumption or EPOC if you are someone training hard)  + other unknown factors which are too complicated to measure or go into detail here. (I promise I’ll do a post on metabolism soon).

So for someone needing less calories, low fat means certain amount of grams of fat whereas for someone else it might be entirely different quantity.

Now onto a bit of Q&A:

  • Do you NEED to follow a low-fat diet if you are healthy? NO. A wholesome diet that provides all of the essential macro and micro nutrients is what one would need (aka meeting their caloric needs in the most complete way). Some people feel better on lower fat nutrition plans while others don’t. In this case it is a medically prescribed diet for a condition.
  • What types of fats should be prioritized when eating a low-fat diet? Prioritize more unsaturated sources (like fish, olive oil, avocado) and add a bit of saturated fats (animal fats, cocoa butter).
  • What is the difference between saturated and unsaturated? The number of hydrogen that is associated in the carbon chain. Saturated has no double bonds in the chain.
  • What is pancreatitis? It is an inflammation of the pancreas. It causes an impaired function, usually impared fat digestion and consequently absorption. It can also affect the regulation/release of insulin if severely damaged and the other enzymes released.
  • Why are pancreatitis diets low in fat? Because when you have an inflammation of the pancreas, the ability to effectively release Lipase – the enzyme that digests fats- is decreased or you need to give a rest to pancreas.
  • How is the process of fat digestion? When you consume fat , it is first digested by lingual lipase (which is why it is important to properly masticate your food, since digestion begins at the mouth), it is then digested by the stomach/duodenum and then finally reaches the small intestine, which is where the emulsification takes place using bile. This will sort of de-condensate the fat into larger droplets which allow the pancreatic enzyme lipase to hydrolyse the triglyceride :: This means that it separates the fatty acid from the glycerol which forms the triglyceride. When they have been hydrolised, they can finally diffuse the intestinal mucosa and be repackaged (with a protein, to form something known as a chylomicrons) for appropriate distribution into the body. If you are still feeling curious, these chylomicrons are sent to the lymphatic system and they are slowly released. But it doesnt stop there; they are still further processed by another lipase enzyme…this time lipoprotein lipase which is NOT from the pancreas but found in the endothetial cell lining the small capilaries in your body. Once they transverse that they are oxidized and either transferred for energy usage or …wait for it….ONCE AGAIN converted and repackaged for storage as a triglyceride. Phewwww >_<
  • What is a triglyceride? It is basically a chain of fatty acids joined together via a glycerol molecule.
  • What about exogenous enzyme supplementation? You can get these both RX (Pancrease, usually from pig origin) or mix of digestive enzymes OTC. The difference is that one (RX) is regulated (that means the FDA or the appropriate health inspection in each country makes sure that 1) It is what it is claiming to be inside, 2) it has the potency it is claimed to be 3) efficacity remains throughout) and one is not regulated. Some good brands to look for OTC is Solgar.
  • What if I need to gain weight due to weight loss from pancreatitis? You could try MCT oil since it does not require Lipase (see study) to digest it, so it is an easy way to increase fat consumption.

So what will my diet look like? I had my resting metabolic rate measured a while ago via indirect calorimeter method. This method is within 10% of accuracy of the gold standard: Direct calorimeter (or basal metabolic rate measurement). Problem with Direct calorimeter is that you have to stay 24hrs in a barometric chamber that will measure all your gas exchange and is basically unpractical.

The next best is the Resting metabolic rate measurement. The more precisely you follow the instructions on the days preceding the measurement, the better the results.

I had mine measured at 2750 calories. On top of that you add non-exercise activity and exercise activity. My maintenance caloric needs range between 3400 to 4200 depending on how active / how much exercise I have done.

My personal nutrition for recovery / assesment of digestive capacity

I aim to start at around 2500 calories for the first week  since I have not had solid foods for 3 days and I need to assess my capacity to digest. I start at 20% fat, since again – I need to assess my capacity to digest.

  • 2500 calories (it is close to my resting metabolic rate, so it will not be damaging for my lean mass and it will still support the basic processes of the body and all the rest that is required can be tapped from bodyfat).
  • 40/40/20 Breakdown of macronutrients : Carbs/Protein/fat, which turns about 250 grams carbohydrates / 250 grams protein / 55 grams fat. It is not set in stone, but a starting point for me.
  • Spread into 6 meals – One of the imperatives from the doctor was to eat smaller meals but much more frequently.
  • For me, 4:1 ratio of fruits to vegetables on each meal. Unprocessed and starchy carbohydrates for the rest of carbs. Emphasis on dark leafy greens and dark fruits for antioxidant factor.
  • 1-2 meals per day with legumes for protein source.
  • Supplementation with R-Alpha Lipoic acid and Co Q10 at bedtime.
  • Digestive enzyme at every meal.
  • VSL-3 every day.
  • Multivitamin.
  • If I exercise, I add a direct sugar drink during/after weight training.

What does this look like?

  • 7 oz of protein sources per meal uncooked (lean meat cuts, lean fish, salmon)
  • 4 oz of veggies and 1 oz of fruit ratio = this is approximately 13-16 grams of carbs per portion. Depending on how many portions I consume, I can add some starches.
  • 0-5 oz of easily digested cooked grains / 7oz of potatoes / Legumes
  • Supplement with extra fat if it has not been met

 

SAMPLE MEAL (Both Animal based protein and Veggie based protein)

  • 4oz grilled chicken breast
  • 4 oz shredded kale
  • 1 oz apple / blueberries
  • 1/2 oz sunflower seeds
  • 1 oz goat cheese
  • Fat free vinagrette

This totals to 42 grams of protein / 40 grams carbs / 11 grams fat – and a good blend of saturated:unsaturated fats.

  • 0.5 cup cooked Lentils
  • 0.5 cup cooked Black beans
  • 0.5 cup cooked Quinoa
  • 2 oz Fat free feta cheese
  • 1 oz Cranberries / blueberries
  • 1 cup Steamed Broccoli
  • 1 tbsp Tahini

This has 40 grams of protein / 53 grams carbs / 11 grams fat and 21 grams of fiber 🙂

I shall report back how it works 🙂 I am excited to nutrify myself to feel better and heal this.

I hope this was anyhow a helpful post. I consider my blog to be part diary / part education. If you have any questions / need help, don’t hesitate to drop a message.

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Hello, I have Mast Cell Disorder

This is the excerpt for your very first post.

Hello 🙂

I am Nora and I have a Mast Cell disorder.

I am too tired (mentally and physically) to talk about my story or background right now. I was 2 days ago on ER because I was suffering from heart palpitations, weird gurgling sounds in my upper (mid and left) gastric area, pain/stuffed feeling when eating and out of breath feeling. Oh and a stabbing sensation.

I was this time diagnosed with Pancreatitis. Which is completely puzzling since I do eat predominantly healthy, have never drank alcohol, do not smoke, exercise regularly and my blood lipids are in good range.

I am afraid it has been caused by Xolair, which is an antibody that binds to IgE in order to prevent it to bind in mast cells thus ‘cutting’ a part of the link necessary for degranulation process. This is one of the many treatments I have gotten across my 28 (soon 29) years of life.

After my second injection that was overdue (on the 28th of November), I started to feel ill in my thorax. I was not sure if it was my imagination, heart burn (I have Hiatal hernia and have had episodes of gastritis from unknown origin) or what.

I went to see my Immunologist/Allergist and after examining me she concluded I had to go to ER.

10 hrs later and I am told I have Pancreatitis and my thyroid hormone levels are low (despite high dosages of the thyroid medication – more on that in a future post).

So here I am…following a 72hr ‘Clear Fluid Diet’ to give my pancreas and digestive system a rest and after that I’ll have a ‘High carb, High protein, Low fat’ diet (more on that in future post).

Right now my leg is aching (from lack of protein, always happens to me, muscular pain when my protein intake is insufficient) and I have 1 more day to go before I can eat.

I am anxious as to what is really going on with my body since symptoms come and go but they are there and I am just confused at every signal that I receive from my body. Adding hunger to the list doesn’t help.

I also noticed that now I am randomly having my face flushing a lot while on this clear liquid diet.

24hrs….only 24 to go…..

Nighty Night folks :*