Help a foodie survive a bland diet!

December 30, 2010 12:07 PM

Bland Diet -- tips and recipes for surviving. My sweetie has severe acid reflux -- about as bad as acid reflux can get. So he has to stick to a bland diet for the foreseeable future. This is particularly hard on him because he is a real foodie and enjoys eating out. The doctor did not give him really specific instructions for what or what not to eat. Somethings are obvious -- no citrus, no alcohol, no chocolate. But some things are less obvious -- since it's meant to be low fat is butter okay?

Some of the stuff on the web about bland diets is contradictory. The best sites I found on bland diet were here and here. Anyways, I did a general amazon search for a bland diet recipe book and didn't find anything.

For breakfast, he'll have a bagel with lowfat cream cheese and for lunch another bagel or maybe a low-fat turkey sandwich. We're struggling for dinner.

So far the ideas I've come up with are:

1. grilled cheese with lowfat cheese assuming a little butter or olive is okay

2. Oven baked chicken -- I've got one recipe that just uses lowfat yogurt, chicken, and breadcrumbs/cornflakes. Another recipe which sounds much better uses paprika and a tablespoon of butter (but not sure if either of these is okay).

3. Chicken and dumplings (but this uses butter Crisco -- so I'm not sure that's okay)

So any ideas about things to cook, recipe books, and how to survive eating out would be much appreciated. Fish and sushi would be great suggestions normally but I can't eat them for medical reasons right now so it makes going to sushi/fish restaurants difficult and also would require cooking two meals.

Any help is appreciated

posted by bananafish to Food & Drink (18 answers total)

The recipes on Dr Gourmet have tags for which ones are usually GERD friendly. There's some foods that are common triggers, but some are going to be individual and one is going to have to work with cooking and figure it out piecemeal if there's anything less common that tends to aggravate his more. I usually just pull recipes from here, but there is a 2-week planner that you can use, entering in your no fish restriction and his GERD restriction.
posted by cobaltnine at 12:30 PM on December 30, 2010

When I went on my "bland diet" for acid reflux that meant not frying anything, so grilled cheese is out (actually, cheese is out, there's acid in dairy products). Basically, it was rice, chicken, turkey and bread for a week, oh, and eggs, boiled or poached with some salt but not too much. For drinks it was tea (no sugar) and water. Seriously, I wanted to find out what was causing my heartburn and eliminate it. I did and no longer suffer from acid reflux.
posted by patheral at 12:31 PM on December 30, 2010

Here is some advice on the subject.
posted by lazydog at 12:32 PM on December 30, 2010

When looking at link #2 (drpstokes.com) are you looking at the diet labeled "bland diet?" Because that one is meant for bowel irritation, not reflux. Scroll down for the reflux diet, it's the fifth section down labeled GERD/Weight loss diet. If he doesn't need to lose weight, ignore the serving sizes except for the fats which you are trying to limit.
posted by Serene Empress Dork at 12:32 PM on December 30, 2010

If it's,meant to be low fat then butter or oil isn't OK, they're made of fat. Pretty much any fat or oil is my main reflux trigger and either of those things will make me sick, so I haven't eaten butter in many years (not even a tiny smear on toast). Low fat hard cheese is also often enough to set it off, I really have to avoid any fat at all not just cut back. Low fat yoghurt is OK because it really is very low in fat, same goes for low fat soft cheese like ricotta.

But reflux triggers are different for everyone and I can eat as much spicy food or caffeine as I like. Your sweetie needs to find his triggers and avoid those, rather than arbitrarily cut out big swathes of food in the hopes it has an effect. His best bet is to work with a dietician and probably do some kind of elimination diet (despite what the internet will tell you this needs to be done under supervision, just cutting stuff out on his own is pointless). He should start keeping a food and symptom diary right now and make an appointment - note that he needs a registered dietician rather than a 'nutritionist' because literally anyone can call themselves the latter. I presume his doctor has also been working to rule out other causes (H. pylori, hernia) and to treat the reflux itself. Most people with reflux have dietary triggers so it's worth figuring out that side, but even then it may be something that just happens regardless of what he eats (or it may be that he has other triggers, e.g. stress, that happen on top of the food triggers too).
posted by shelleycat at 12:35 PM on December 30, 2010

I don't know if it's still true, but many doctors routinely graduated from med school with NO courses on nutrition or diet, because they weren't required. (!) So I'd recommend doing your own research and/or consulting a registered dietician or other nutrition specialist.
posted by cyndigo at 12:39 PM on December 30, 2010

Oh, also a food/symptom diary may be enough to figure out his triggers on his own. That's basically what I did (mine are fat and acidic foods like citrus and tomato, plus sometimes alcohol). Some foods triggers the actual reflux, some irritate my stomach so it hurts (which can lead to reflux), and some set off my IBS. Keeping careful track for a while was enough to generally figure out which is which. But it sounds like he needs to get on top of the symptoms now rather than mess around trying things, so a dietician should be able to help do this more efficiently.

Any 'bland diet' books being sold as the answer to reflux or GERD or more about making money than being a real cure, because the triggers are so individualised between people. Plus it sounds kind of like a hold over from the days when spicy foods etc were thought to cause ulcers.
posted by shelleycat at 12:42 PM on December 30, 2010 [1 favorite]

My go-to chicken breast recipe uses no added fat, and almost no added anything: take bone-in/skin-on chicken breasts (I think organic chicken tastes better, but that may be all in my head), sprinkle with sea salt, bake at 350 for 45 minutes or so until cooked through, and then let them rest for ten minutes. You can remove the skin before serving the meat--leaving the skin on during cooking keeps the meat from drying out. I can't find online nutrition info for chicken that was cooked skin-on and then had the skin removed, but I doubt the fat increase is significant (most of the fat ends up pooled in the pan or still in the skin). The meat is juicy and flavorful, and the leftovers are great for sandwiches.

You can also make homemade applesauce, which is delicious but very simple and mild. Peel and coarsely chop a few apples, add them to a saucepan and pour in enough water to cover, then sprinkle in some sugar (I usually do, oh, about half a tablespoon per apple). Gently simmer until the apples are soft and most of the water has evaporated, then crush the apples a little with a potato masher. You can add cinnamon if he's allowed it, but I don't think it's essential.
posted by Meg_Murry at 1:21 PM on December 30, 2010

Another approach to investigate may be looking into a low carbohydrate diet. Studies (1, 2) and my own experience have shown that restricting carbohydrates leads to significant improvement in reflux, heartburn and other tummy troubles. Personally, I haven't had a single bout of heartburn in six months since going low-carb, and I was popping antacids pretty regularly before that.

Unfortunately the classic "bland diet" approach is usually extremely high in carbs, so it's a bit of a catch 22. Do some research and definitely talk to a nutritionist about exploring his options, including cutting out the sugar and wheat-based products from his diet as an alternative to focusing on the spicy, fatty or other "non-bland" foods.
posted by platinum at 1:23 PM on December 30, 2010 [1 favorite]

Ah, I suffer from the same problem. Make sure he avoids dairy, I know that I have a problem with cheese for example. Homemade yogurt is OK for me. As somebody said before some triggers are personal, so he should keep an eye out for things that give him acid (tomato paste, onion and garlic are my favourite things but they kill my stomach!).

Suggestions for dinner: maybe a rice bowl with steamed fish and veggies or a nice chicken noodle soup with only carrots and a few bits of shredded chicken breast. A cup of bulgur with chicken. Key here is some carbs and protein (minimal fat). Make sure the veggies are cooked. No tomatoes! Lamb shank soup with boiled potatoes and carrots. That's all I can think of for now.
posted by kuju at 2:02 PM on December 30, 2010

Response by poster: I agree that he should see a dietician or nutritionist and I'll encourage that. Identifying trigger foods right now is impossible because his acid reflux is constant. As I said, his situation is extreme. The doctors are looking into possible other causes but for right now they want him to stick to a bland diet while they try and figure out other possible causes/treatments.

Thanks for all the suggestions so far!
posted by bananafish at 2:15 PM on December 30, 2010

As somebody said before some triggers are personal,

Actually, ALL triggers are personal. For example, high starch foods are the only things that stop a really bad reflux attack for me so platinum's diet would be a disaster. There's a lot of research backing this up too by the way, the aetiology of functional bowel disorders is multi-factorial and can be complicated to sort out.
posted by shelleycat at 2:15 PM on December 30, 2010

Make sure you find out how registration etc works where you are, if you're in the US or UK then you want Registered Dietician, not a nutritionist (which, again, can be anybody with any level of expertise). What they should be aiming to do is get his diet sorted asap so his reflux is reduced, then introduce foods back in carefully to see which ones are the a trigger. I agree that you won't be able to figure it out as things stand, and I know how much reflux sucks so I hope you get it sorted!
posted by shelleycat at 2:19 PM on December 30, 2010

I spent time in the hospital last year having growths removed from my esophagus and stomach and spoke with a gastroenterologist about my own acid reflux problems that helped cause the growths. She gave me a pamphlet that basically is the same as what's here. I love the format - it says what's bad and what's good, relatively speaking, so you get an overview instead of a strict diet without understanding the reasoning behind it.

Some things are more painful/obvious than others; I can drink beer but not spirits, frozen yogurt but not ice cream, coffee hurts but tea doesn't, etc.

As a foodie, simply switching to the low-fat or baked version of something he loves will help immensely. I was shocked that things like gum and sparkling water (two things I enjoyed daily) were hurting me, but I only chew gum now when I'm out somewhere drinking and drink still water at my office. A bland diet's not going to be enough if it's actually GERD and not something else.

Everyone's triggers ARE different, but for now doubling up on Protonix or whatever meds he's recommended and amazingly, eating smaller amounts also helps too. It doesn't all have to be low fat or whatever, but if it's high fat or spicy, eat a SMALL amount. Don't eat before bed, don't work out after eating, etc. are just as important as the bland diet thing because of the way it pushes acid into your esophagus.

I seldom feel pain now, and when I do, I double up my meds for a few days and cut back on fatty foods and eat smaller portions more frequently. Things like peanut butter can seem bland, but the high fat content is the culprit - and possibly more triggering than, say, a jalapeno would be. I'm sorry he's hurting and wish him a speedy recovery!
posted by Unicorn on the cob at 2:40 PM on December 30, 2010

I should add, I was in pain every day for many years even while taking prescription medication. Turns out Tagamet was not good for GERD, but it was good for IBS, and when I switched to Omeprazole I stopped taking 1-2 pills every 4-6 hours and now only take one or two on my worst days. If he's taking lots of antacids and/or pepto, please have him eliminate that from his diet as well if he can tolerate it. Ibuprofen can also trigger stomach pain - I know this isn't diet-related, but if it goes in his mouth, he's technically eating it and it can affect his pain / discomfort levels.
posted by Unicorn on the cob at 2:47 PM on December 30, 2010

I know someone with GERD and IBS. Trigger foods are highly individual, of course, but some of the things that don't often work well for this person include:

• Tomato
• Orange juice
• Ibuprofen
• Mint
• Anything with curry in it
• Hot peppers, jalapeños, etc.

Things that are sometimes OK, sometimes not:

• Hot dogs
• Salad with dressing
• Broccoli
• Pizza
• Chips and dip
• Chips and salsa
• Pasta with tomato sauce
• Low-acid orange juice
• Pomegranate juice
• Cranberry juice
• Hamburgers
• Heavily fried food
• Heavily spiced Indian food
• Highly acidic salad dressing
• Vodka
• Tonic
• Lemon anything
• Beer
• Most fast food

Things that are generally OK:

• Cheese and crackers
• Carrots
• Grilled cheese
• Lean Pockets
• Cereal with milk
• Quaker Oats granola bars
• Chicken
• Bread with I Can't Believe It's Not Butter
• Deli-meat sandwiches
• Pie
• Mustard
• Stuff with garlic in it
• Grapes
• Raspberries
• Blackberries
• Apples
• Salt and pepper
• Uncle Ben's Chicken-Flavored Rice
• Stubb's Chicken Marinade
• Spinach
• Pasta alfredo
• Peanuts
• Dried fruit
• Fruit leather
• Eggs
• Olive oil

And then there's Tums, which can be good in moderation, but can cause problems with excessive use—like Unicorn on the cob points out, some "antacids" can actually make acid problems worse for people with GERD.

Look at the lists starting on p. 188 and p. 62 of this book on Amazon to see more foods that are common triggers, along with their respective pHs. (You should be able to see those pages and a few others via the Look Inside! feature.)
posted by limeonaire at 5:08 PM on December 30, 2010 [1 favorite]

Oh oh oh—forgot two other completely forbidden foods for this person: Grapefruit and pineapple. Heh. That's how rarely those foods ever even come up in conversation, I guess.

Bananas are OK; iced tea seems fine; the occasional Cherry Coke or Arizona green tea with ginseng isn't problematic. And this person drinks coffee every day, despite warnings to the contrary.

All of that said, this person is also on meds for GERD. So that may influence which of these foods work OK, too.
posted by limeonaire at 5:13 PM on December 30, 2010

If it's low-fat, I think he'll want to just be really strategic about when he uses it -- so if he can use small amounts of butter, it should be wherever he'll enjoy it most.

Is parmesan cheese okay? If so, that will help a lot and make risotto an option.

Lots of soups can be made creamy through pureeing instead of through heavy cream, and that's usually what I do anyway. So potato soup, maybe carrot soup.

I'm sure he's sick of them already but poached eggs are great and you can also throw them on a salad. There are some sauces that are egg-based, too, there's a Greek one that I think is mainly bread and pureed hard cooked egg and water. I think with lemon. Is citrus okay in small amounts? It would be good on vegetables.

Looking at some Vegan cookbooks might help with ideas, but he'll want to look for ones that really focus on deliciousness. The Millenium cookbook is good.

I wonder if he could do some interesting things with wonton wrappers, some kind of steamed dumpling with some vegetables.
posted by A Terrible Llama at 11:12 PM on December 30, 2010