PEN eNews 12(11) November 2022 - What is the Latest on IBD and the low FODMAP Diet?

What is the Latest on IBD and the low FODMAP Diet?

Should a low FODMAP diet be recommended to individuals with inflammatory bowel disease (IBD)?

Recommendation

Limited evidence suggests that for adults with IBD in remission and experiencing functional-like gastrointestinal symptoms (FGS), following a low FODMAP diet may improve quality of life (QoL); however, no consistent beneficial effect has been reported for symptoms (e.g. stool frequency and consistency, abdominal pain, flatulence) compared to following a normal diet.

Evidence Summary

A systematic review of four RCTs in 236 adults with IBD in remission and experiencing FGS reported that while following a low FODMAP diet the QoL improved; however, there were no significant changes or inconsistent findings found for FGS, including stool frequency, consistency, abdominal pain, bloating and flatulence.
Grade of Evidence C

No studies were retrieved that examined the effect of a low FODMAP diet in individuals with IBD who do not have FGS.
Grade of Evidence D

Remarks

See Additional Content:  What are the nutrition and safety challenges and considerations for individuals follow the low FODMAP diets?

To see the full practice question, including the Evidence Statements, Remarks, Comments and References, click here.

Check out the other new IBD practice questions on IBD added to the PEN System:

• Is there a specific diet that individuals with inflammatory bowel disease (IBD) should follow?
• Should a dairy-free diet be recommended to individuals with inflammatory bowel disease (IBD)?
• Should nutrition support be offered as a primary therapy to individuals with inflammatory bowel disease (IBD) to induce or maintain remission?
• Should nutrition support be offered as a supportive therapy to individuals with inflammatory bowel disease (IBD)?
• Are omega-3 fatty acids or vitamin D supplements recommended as a treatment for inflammatory bowel disease (IBD)?

Knowledge Pathway Alert: Fibromyalgia

The Musculoskeletal/Connective Tissue Disorders - Fibromyalgia Knowledge Pathway has been updated. Check out these new and updated practice questions:

• Does weight loss help to reduce symptoms of fibromyalgia?
• Can specific dietary patterns (e.g. vegetarian, Mediterranean-style, low FODMAP, gluten-free) help to relieve the symptoms of fibromyalgia?
• Do any dietary supplements help relieve symptoms of fibromyalgia?
• Can the elimination of food additives such as monosodium glutamate (MSG) or aspartame help to relieve the symptoms of fibromyalgia?
• Can eliminating caffeine help to relieve the symptoms of fibromyalgia?

Sign up for PEN Content Alerts to find out when the new and updated content is added.

Nutrition Assessment: Are you Up to Speed?

Three nutrition assessment practice questions and a background have been updated! 

• What is the most accurate way of estimating height in adults when it cannot be measured directly?
• How can body composition and nutritional status be assessed in individuals with amputations?
• What dietary assessment tools can be used to measure dietary behaviour change as an outcome of nutrition intervention in adults?
• Nutrition Assessment - Adult Background

There are also 28 related Tools and Resources that have all been recently reviewed.

Do you want to help shape PEN content on gallbladder disease and GERD/GORD?

We want to share a fantastic opportunity to help shape PEN content to ensure it is relevant to dietitians in everyday food and nutrition practice.

Are you a researcher or practitioner who specializes in the gastrointestinal system? The following PEN Knowledge Pathways are being updated:

• Gastrointestinal Disease - Gallbladder disease
• Gastrointestinal System - Gastroesophageal/Gastro-oesophageal Reflux Disease (GERD/GORD).

Contact the PEN Content Manager (coordinator@pennutrition.com) to learn how you can contribute.

When developing new or updating existing PEN content, we look for input on practice questions that make up a knowledge pathway. Specifically, this will look like:

• Providing input on the existing practice questions that reflect the everyday practice situations faced by dietitians in the specific topic area.
• Providing direction on any practice guidelines, national policy documents or reports that would be important for authors to include in their work.
• Recommending reviewers for content review once it's been written.

This is a 1:1 request. Meaning it's a one-time request which requires about one hour of your time (you are not committing to writing or reviewing content). 

With your permission, you will be acknowledged for your role as a Topic Advisor. You can also download a letter of contribution signed by PEN's Director of Knowledge Translation acknowledging your contributions to the PEN System once the content is published.

Are you interested? That’s great! Reach out to our PEN Content Manager by November 30th, 2022. Your input will be required by early January.

How do I… Customize and Send PEN^® Client Handouts?  

The PEN Client Handouts are one of the most popular features of the PEN System, but did you know you can customize the handouts and email them directly to your clients from the PEN System? You can add your organization/company logo to the handout, add a personalize note to your client and/or remove the additional resources section. 

The customize and share features on the PEN System are not available with site licenses but if you have an individual account with your Dietetic Association, read the steps below to become a PEN Client Handout aficionado!

How do I customize the “Distributed by” box in PEN Client Handouts?

*Skip to Step 4 if your logo is already uploaded or if you do not want your logo included.

Step 1: Click on ‘My Profile’.

Step 2: Under “My Handout Distribution Preferences”, click on “Upload New Photo” and find the logo you want to add. If desired, add a distribution message.  

Step 3: Click “SAVE & UPDATE” at the bottom right-hand side of the page.

Step 4: Navigate to the PEN client handout you wish to customize.

Step 5: Click on “Customize and Share this Resource” phrase or the  icon.    

Step 6: On the Share this Resource pop-up page, make sure that the “Include” bubble corresponding with “Distributed By” is checked.

Step 7: Text in the “Distributed By” box can be added or edited. The “Distributed By” box will not accept images.

Step 8: Click "PDF PREVIEW" to view this content on the last page of the handout. Make sure the “Include” bubble is checked if you want your logo displayed.

Step 9: A hard copy of the handout including your “Distributed By” information can be printed from the PDF preview, or click SEND to e-mail a copy to your client or yourself.

How do I customize the editable "Notes" feature in PEN Client Handouts?

Step 1: Access a PEN handout from the Search, or the Related Tools and Resources section within a Knowledge Pathway, or from the PEN Client Handout Collection.

Step 2: Click on “Customize and Share this Resource” phrase or the  icon.

Step 3: A Customize and Share this Resource pop-up window will appear that will allow you to enter a message in the “Notes” section (up to six lines of text). Make sure that the ‘Include’ bubble corresponding with the “Notes” section has been checked.

Step 4: Once you have entered the information, you can click ‘PDF Preview’ to check that information is correct, and then you can click "Send". If you want to provide a hard copy to your client, you can e-mail the handout to yourself, and then print.

How do I suppress the Additional Resources, Notes and/or Distributed By section from displaying in a Handout?

Step 1: Access a PEN Handout using the Search, or the Related Tools and Resources section within a Knowledge Pathway, or from the PEN Handout Collection.

Step 2: Click on the ‘Customize and Share this Resource’ phrase or the  icon.  

Step 3: A Customize and Share this Resource pop-up window will appear. To exclude any of the “Additional Resources”, “Notes” or “Distributed By” sections, make sure that the corresponding bubbles are cleared of check marks.

You can click the PDF PREVIEW button to view the handout and print a hard copy, or click the SEND button to e-mail a copy to your client or yourself.

How do I send a PEN^® Handout to a client via email?

Step 1: Click on “Customize and Share this Resource” phrase or the  icon

Step 2: Fill in your e-mail address, your client’s e-mail address, the message you wish to send to your client to accompany the handout and press Send.