Kate Scarlata,RD,LDN is a registered and licensed dietitian with private practice offices in Boston and Medway, Massachusetts. Kate provides individual and group consultations as well as interactive nutrition workshops. As a digestive health expert,particularly in the area of FODMAPs, Kate has authored The Complete Idiot’s Guide To Eating Well With IBS. Her health writing also includes Real People Real Food: A Guide To Healthy Eating For Families Living In A Fast Food World, a family nutrition book she co-authored as well as numerous articles for Today’s Dietitian and local Boston media publications including The Boston Herald and Bay State Parent Magazine. Kate has been interviewed by Fox News, Fitness Magazine, Christian Science Monitor, and Spa Magazine sharing her wide range of nutrition expertise. She is the author of Irritable Bowel Syndrome: Fodmaps, Fat, Fiber, and Flora, an eight credit CPE self study course for nutrition professionals (available from Wolf Rinke Associates, Inc. and CDR approved). LIDA had the pleasure of recently interviewing Kate for this blog.
LIDA: How and why did you become interested in gastrointestinal nutrition and particularly the FODMAP diet approach?
Kate: When I researched current therapies for IBS in writing my Complete Idiot’s Guide: Eating Well With IBS, I stumbled upon the research for the low FODMAP diet and IBS symptom management. This approach made such sense to me from a dietitian perspective that I started to use it right away with my clients. One by one, the vast majority of my client’s symptoms improved – dramatically!! I found helping IBS patients feel better and regain their lives back to be so rewarding. It has become my life’s work ever since.
LIDA: What do you want other registered dietitians to know regarding IBS and the low FODMAP diet approach?
Kate: Please get trained in the FODMAP diet! IBS symptoms impact millions of Americans -quite significantly-and understanding the diet specifics will help your clients while they attempt this dietary approach. There are many nuances with the diet so take the time to read the literature and get up to date with this new and evolving diet. Also, I have seen just how helpful this diet can be to people who suffer from IBS symptoms; it has therefore become a serious mission for me to get other registered dietitians on board with the FODMAP diet approach.
LIDA: The Monash University in Australia seems to be at the forefront with research regarding IBS, gastrointestinal symptoms, and FODMAPs. Why do you think this is so and what about research here in our own country?
Kate: Quite honestly, I think it has a lot to do with funding – most US studies are pharmaceutical driven and Australia has government support. But certainly, since the Australian’s researchers defined this dietary approach, it makes sense that they remain at the forefront as it continues to evolve.
LIDA: What do you think of the high fiber diet approach for IBS?
Kate: For some patients, simply adding fiber does the trick for their IBS symptoms but despite the fact that adding fiber seems to be the universal first line therapy, the research supporting the efficacy for use of fiber in IBS patients is limited.
LIDA: You address small intestinal bacterial overgrowth (SIBO) in your self study guide. Do you have any suggestions regarding raising awareness about SIBO among registered dietitians?
Kate: I wrote an article for Today’s Dietitian – and since then there have been other articles in this publication. Registered dietitians are an integral part of the healthcare team for their patients and they should be reading up on digestive health and be aware of these conditions such as SIBO. In too many cases to count, I was the first healthcare professional to push for small intestinal breath testing (a test for diagnosing SIBO) for my clients. And I would have to say, that the majority test positive for SIBO. I am a firm believer of advocating for my clients!
LIDA: Could you comment on why a totally gluten free diet is not indicated with the low FODMAP diet approach.
Kate: The low FODMAP diet approach focuses on small chain carbohydrates and their aftermath when not absorbed in the small intestine. FODMAPs are rapidly fermented by gut bacteria and have an osmotic effect, drawing water into the bowel contributing to common IBS symptoms. Gluten, of course, is a protein. In a recent study by Jessica Biesiekierski and other Monash researchers – gluten had no impact on gut symptoms in individuals with non-celiac gluten sensitivity (NCGS). It was likely the FODMAPs that trigger gastrointestinal symptoms. Please refer to http://www.ncbi.nlm.nih.gov/pubmed/23648697. The study conclusion: In a placebo-controlled, cross-over rechallenge study, we found no evidence of specific or dose-dependent effects of gluten in patients with NCGS placed diets low in FODMAPs.
For additional information, you can visit Kate’s website at www.katescarlata.com her blog at http://blog.katescarlata.com and also follow Kate on twitter https://twitter.com/KateScarlata_RD.
About the Author
Lisa Samuels is a Long Island native who is currently a Dietetic Intern at LIU Post. She has a B.A. in Art History from Ithaca College, a B.S. in Nutrition from LIU Post & was also a practicing baker for two years. Lisa has finally found her calling. Combining her love for food, writing, and nutrition, she strives to bring you the latest news in the field.
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