Table 10.
Hydration: if all else fails, go for liquids | On days when symptoms are worse, try taking just liquids to maintain hydration and to rest the stomach |
Meal volume/portion size: multiply frequency and divide the portions | Eat smaller, more frequent meals |
Meal consistency: If you can not chew, blenderize |
Chew the food thoroughly and take 20–30 min to finish the meal Try solid meals in the morning, switch to semi-liquid and liquid meals over the course of the day Any food can be blended with water, vegetable juice or broth to make a puree When symptoms worse, prefer liquid vs solid meals |
Glycemic control: match meals with medicines | Modify meal timing, form of carbohydrate (simple, complex) according to the diabetes treatment regimen and vice versa |
Fat: less is more | Fat in liquid is well-tolerated; maintain an intake of 20–30% of calories from fat |
Fiber: watch for fur balls |
Identify the high-fiber foods that worsen upper GI symptoms, and individualize the sources of fiber Delaying GI transit may modulate the biome and alleviate the symptoms If bezoar formation is a concern, avoid foods causing bezoar, such as fruits with peelings, berries, coconut, legumes and fiber supplements Treat bacterial overgrowth if suspected/symptomatic |
Address micronutrient deficiency: bones and blood |
Eat nutritious foods first before filling up on “empty calories” Replace iron, B12, vitamin D and calcium deficiency |
Weight/body mass index: keep moving |
Check body weight twice a week, if the weight is decreasing, increase the amount of liquid supplements. Lose weight if you are overweight Physical activity may improve gastric emptying [90] (Consult your medical team) |
Miscellaneous: do not miss the bottom line |
Avoid foods that lower esophageal sphincter pressure: pepper-mint, chocolate, fat, and caffeine Avoid caffeine, alcohol, tobacco and stress Avoid chewing gum, which increases air swallowing High-fiber foods should be avoided as they may be more difficult on the stomach and may cause bezoar formation Chew well and eat slowly (30 min meals) Do not lie down immediately after eating. Consult dental/oral health team to improve oral hygiene |