Fiber Restricted Diets

FIBER-RESTRICTED DIETS
(Low-Residue/Low-Fiber)

Description
The Low-Residue/Low-Fiber Diet restricts dietary fiber and provides less than 10 grams a day. Foods that have been defined in qualitative terms as having tough fibers are also eliminated. Animal products, refined grain products, and selected fruits and vegetables are included.

Indications

To prevent the formation of an obstructing bolus when the intestinal lumen is narrowed.
To delay intestinal transit time in conditions of diarrhea.
To reduce (not eliminate) the residue in the colon pre- and postoperatively.
To allow the bowel to rest during acute exacerbation of inflammatory bowel disease, acute phases of diverticulitis, or regional enteritis (Crohn’s disease).

The diet is intended for short-term use. The goal of nutrition therapy is to establish a tolerance to a wider variety of foods and to make a transition to a regular diet.

Contraindications
A fiber-restricted diet is contraindicated when a soft stool is desired, as in individuals with diverticulosis. A low- residue/low-fiber intake may aggravate the symptoms of irritable bowel or constipation. In these cases, a high-fiber intake is recommended. (See High-Fiber Diet.)

Where a diet soft in texture is desired, as in the case of a patient with esophageal narrowing, a mechanical soft diet may be ordered.

Nutritional Adequacy
The Low-Residue or Low-Fiber Diet can be planned to meet the Dietary Reference Intakes (DRIs) as outlined in the Statement on Nutritional Adequacy. At least one serving of citrus fruit juice is recommended for daily vitamin C.

How to Order the Diet
Order as “Low-Residue Diet” or “Low-Fiber Diet.” Milk and other lactose-containing foods will not be restricted unless ordered. Milk is fiber-free and a medium-residue food; therefore, it is not necessary to eliminate it. However, for individuals with inflammatory bowel disease and a lactose deficiency, a low-fiber, low-lactose dietary restriction may be appropriate.

Planning the Diet (1):

Limit foods and beverages that contain added sugar, lactose, fructose, high-fructose corn syrup, and sorbitol
Limit intake of fat to < 8 teaspoons each day
Select cereals, grains and bread products that contain < 2 g fiber/serving
Avoid beverages with caffeine
Eat small meals, or snack every 3 to 4 hours
Clean, prepare and store foods using proper sanitation techniques

Reference

Meal Plans, Gastrointestinal Diseases. In: Nutrition Care Manual. American Dietetic Association; 2007. Available at: http://www.nutritioncaremanual.org. Accessed January 28, 2008.

FOOD GUIDE - LOW-RESIDUE/LOW FIBER DIET (1)
FOOD GROUP	FOODS ALLOWED	FOODS EXCLUDED

Beverages (0 gm fiber/serving) No limit of allowed foods	Decaffeinated coffee, caffeine-free teas, soft drinks without caffeine, rehydration beverages	Beverages with added sugar or high-fructose corn syrup, fructose or sorbitol. Avoid caffeine-containing beverages.
Milk Products (0 gm fiber/serving) No limit of allowed foods	Choose yogurt with live, active cultures, evaporated skim, and low-fat milk, soy milk, powdered milk, cheese, low-fat ice cream (1)	Milk is avoided only when lactose intolerance is present (1). Yogurt with berries, orange or lemon rind, or nuts. Whole milk, half and half, cream, sour cream, regular ice cream
Breads and Starches, Pasta, Rice (0.5 gm fiber/ serving per allowed foods) No limit of allowed foods	All breads and crackers made from white flour or choose grain foods with less than 2 grams dietary fiber per serving (1) Graham crackers Corn and flour tortillas Cornbread Pasta, noodles, white rice	Whole-wheat, rye, pumpernickel or bran breads, crackers, muffins Buckwheat pancakes Rye wafers Breads and crackers containing fruit, nuts, or seeds Brown rice; barley
Breakfast Cereals (0.5 gm fiber/serving) No limit of allowed foods	Farina, cream of rice, grits, oatmeal Ready-to-eat cereals from corn, rice, or white flour or others providing < 2 g fiber per serving (1)	Wheatena, rolled wheat, and other whole-grain cooked cereals Ready-to-eat whole-grain, oat and bran cereals including bran flakes, granola, Grape-Nuts, oat bran, 100% bran, puffed wheat, shredded wheat, wheat bran, wheat flakes, wheat germ
Fruit Juices (0 gm fiber/serving per allowed foods) No limit of allowed foods	Fruit juice without pulp (except for prune juice). Ripe banana or melons. Canned, soft fruits packaged in water or natural juices. Peeled apples.	Limit juices that contain added sugars, high-fructose corn syrup, and sorbitol
Fruits (2.0 gm fiber/serving per allowed foods) Count in 3-6 servings of allowed fiber containing foods/day	Banana, applesauce Canned: peeled apricots, Royal Anne cherries, peeled citrus sections, peaches, pears, peeled plums, fruit mix without grapes, pineapple	All fresh fruits except banana and soft fresh fruit from which the peel and seeds have been removed
Desserts (2.0 gm fiber/serving per allowed foods) Count in 3-6 servings of allowed fiber containing foods/day	Fruit and vegetable pies without skins or seeds, eg, apple, pumpkin, banana, All others except those excluded	Cakes, pies, cookies, pudding containing dried fruit, fruit with skins or seeds, coconut, nuts, or seeds
Meat, Fish, Poultry,Cheese, Eggs (0 gm fiber/serving) No limit of allowed foods	Tender, well-cooked meats, poultry, fish, eggs, and soy prepared without added fat. Smooth nut butter	Avoid fried meat including sausage and bacon. Luncheon meats, such as bologna or salami, hot dogs, tough or chewy cuts of meat, fried eggs, all dried beans, peas, and nuts, Chunky nut butters.

Legumes None allowed	None	All legumes: chickpeas, lima beans, black-eyed peas, kidney beans, pinto beans, etc Peanut butter Baked beans
Soup (2.0 gm fiber/ serving per allowed foods) Count in 3-6 servings of allowed fiber containing foods/day	Meat, rice, noodle soups Soups made from allowed vegetables	Minestrone soup Bean, pea, and lentil soups
Fats (0 gm fiber/serving) No limit of allowed foods	Limit fats to < 8 teaspoons per day(1) including bacon, butter, cream, cream substitutes, margarine, mayonnaise, oils, shortening, salad dressing, sour cream	Nuts, seeds
Sugar and Sweets (0 gm fiber/serving) No limit of allowed foods	Cranberry sauce, seedless, sherbet	Candy containing fruits, nuts, or coconut Jam, marmalade, relishes containing seeds, or skins
Vegetables and Vegetables Juices (2.0 gm fiber/ serving per allowed foods) Count in 3-6 servings of allowed fiber containing foods/day	Mushrooms (cooked) Tomato/vegetable juice Tomato sauce Cooked asparagus, beets, carrots, spinach, green and wax beans, zucchini, white potatoes without skins	Raw or fried vegetables Broccoli Corn Mixed vegetables Skin of potato Beets Brussel Sprouts Cabbage Cauliflower Succotash (also see legumes) Collard, mustard, and turnip greens
Miscellaneous (0 gm fiber/serving) No limit of allowed foods	Catsup, spices, herbs, seasonings	Pickles

SAMPLE MENU (less than 10 g fiber)
Breakfast	Noon	Evening
Orange juice Grits Soft-Cooked egg White toast Margarine Grape jelly Milk Coffee Sugar	Chicken rice soup Roast beef sandwich on white bread Mayonnaise Tomato juice Orange sherbet Coffee and tea Sugar	Baked chicken with gravy Whipped potatoes Green beans Dinner roll Margarine Canned peaches Milk Tea Sugar