Bland diet

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A bland diet is a diet consisting of foods that are generally soft, low in dietary fiber, cooked rather than raw, and not spicy. It is an eating plan that emphasizes foods that are easy to digest. [1] It is commonly recommended for people recovering from surgery, diarrhea, gastroenteritis, or other conditions affecting the gastrointestinal tract. Such a diet is called bland because it is soothing to the digestive tract; it minimizes irritation of tissues. It can also be bland in the sense of "lacking flavor", but it does not always have to be so; nonirritating food can be appetizing food, depending on preparation and individual preferences.

Contents

Uses

Bland diets are often recommended following stomach or intestinal surgery, or for people with conditions such as ulcers, acid reflux (GERD), gastritis, heartburn, nausea, vomiting, diarrhea, gastroenteritis and gas. [2] A bland diet allows the digestive tract to heal before introducing foods that are more difficult to digest.

A bland diet is designed primarily to help patients recover from gastrointestinal conditions or other medical circumstances in which improved digestion would be essential. [2] It is not especially effective as a long-term weight loss diet. Many people find a bland diet to be very difficult to maintain, although some find the use of acceptable spice alternatives does make it easier. Most patients slowly return to a more normal diet once their medical issues have been resolved.

Diet

Fried and fatty foods, strong cheeses, whole grains (rich in fiber) should be avoided while on a bland diet.

Medications such as aspirin, ibuprofen, and naproxen should be avoided, because they can irritate the stomach. [3]

Many milk and dairy products may be permissible on a bland diet, but there are a few exceptions. Chocolate-flavored dairy products are discouraged, as well as any strongly spiced cheeses or high fat dairy products such as heavy cream or half-and-half. Mild dairy foods may soothe irritated linings, but excessive fats, cocoa and spices can have the opposite effect. [2]

Most canned fruits and vegetables are fine, with the exception of tomatoes. [2] Tomato-based sauces on pasta are avoided. Bananas are good; however, higher fiber and acidic fruits should be avoided. [2] Baked potatoes and sweet potatoes are very easily digested, but it is important to avoid high fat toppings like butter. Vinegar based foods such as pickles are to be avoided as are sour fermented foods like sauerkraut.

Perhaps, the most difficult adjustment for some to a bland diet may involve meats and proteins. In a strict bland food diet, softer protein sources such as smooth peanut butter, eggs and tofu are encouraged over any type of fibrous or seasoned meat. [2] Certain meats such as poultry or fish are permitted, as long as they are not heavily fried, breaded or processed like sandwich meats. Steamed poultry breast served with a salt substitute would be a typical protein serving while on a bland diet. [2]

Specific bland diets

BRAT diet

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2020-03-27 19 36 25 A pot of white rice after cooking in the Franklin Farm section of Oak Hill, Fairfax County, Virginia.jpg
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The BRAT diet: banana, rice, apple sauce, and toast

The BRAT diet consists of only bananas, rice, apple sauce, and toast.

As of the 21st century, the BRAT diet is no longer recommended. [4] [5] The diet was first discussed in 1926 and was once recommended for people, particularly children, with gastrointestinal distress like vomiting, diarrhea, or gastroenteritis.

However, modern research has shown that the BRAT diet is unnecessarily restrictive. [5] [4] The American Academy of Pediatrics states that most children should continue a normal, age appropriate diet. The foods from the BRAT diet may be added, but should not replace normal, tolerated foods. Sugary drinks and carbonated beverages should be avoided. [6] The BRAT diet is no longer routinely recommended to those who have had stem cell transplants and have diarrhea due to graft-versus-host disease, as long-term use can lead to nutritional deficiencies.

Adding rice, bananas, or pectin to the diet while suffering from diarrhea may be beneficial, but physicians Debora Duro and Christopher Duggan point out that the diet is not nutritionally complete and may be deficient in energy, fat, protein, fiber, vitamin A, vitamin B12, and calcium. Duro and Duggan also say that food restriction does not alleviate diarrhea and actually causes individuals to have diarrhea for longer periods, according to randomized clinical trials. [7]

BRATT diet

The BRATT diet consists of bananas, rice, applesauce, toast, and tea. [8]

BRATTY diet

The BRATTY diet consists of bananas, rice, applesauce, toast, tea, and yogurt. [9]

CRAM diet

The CRAM diet consists of cereal, rice, applesauce, and milk.

The CRAM diet has more protein and fat content than the BRAT diet. [10]

According to John Snyder, M.D., professor of pediatrics at the University of California at San Francisco Medical Center and a member of the American Academy of Pediatrics subcommittee on treating acute diarrhea, the CRAM diet seems to ease the diarrhea symptoms faster.

Controversy

Even though milk and other dairy products are permissible in a bland diet, consumption may interfere with the homeostatic processes involved in digestion; prominently for peptic ulcer patients. In an early study, milk was found to have a short-lived gastric acid neutralising effect; which may lead to milk-alkali syndrome and eventually arteriosclerotic heart disease if dietary intake is excessive and uncontrolled. [11] Further research by McArthur, Hogan & Isenberg demonstrated a link between milk consumption and an increase in gastrin production almost equivalent to that of pentagastrin, which may be detrimental to the patients requiring a bland diet as an increased gastric acid output is induced and acts as an overcompensation to the increased (neutralised) pH. [12]

Need for hydration

Due to severe dehydration caused by both diarrhea and gastroenteritis, bland diets should be combined oral rehydration therapy to replace the depleted electrolytes and avoid salt imbalance. [13] Severe, untreated salt imbalance can result in "extreme weakness, confusion, coma, or death." [14] [15] [16]

Continued diarrhea while on a bland diet

Immediate medical attention is necessary if the diarrhea symptoms remain severe or if the child exhibits symptoms of dehydration, such as dry mouth, lack of urination, listlessness, or rapid heart rate.[ citation needed ]

Medical attention is required when on a bland diet if any blood or mucus is present in the diarrhea, if the diarrhea is severe, or if it lasts longer than 3 days. [17]

Related Research Articles

<span class="mw-page-title-main">Dairy product</span> Food product made from milk

Dairy products or milk products, also known as lacticinia, are food products made from milk. The most common dairy animals are cow, water buffalo, nanny goat, and ewe. Dairy products include common grocery store food around the world such as yogurt, cheese, milk and butter. A facility that produces dairy products is a dairy. Dairy products are consumed worldwide to varying degrees. Some people avoid some or all dairy products because of lactose intolerance, veganism, environmental concerns, other health reasons or beliefs.

<span class="mw-page-title-main">Apple sauce</span> Purée made from apples

Apple sauce is a purée made of apples. It can be made with peeled or unpeeled apples and can be spiced or sweetened. Apple sauce is inexpensive and is widely consumed in North America and some parts of Europe.

<span class="mw-page-title-main">Diarrhea</span> Loose or liquid bowel movements

Diarrhea, also spelled diarrhoea or diarrhœa, is the condition of having at least three loose, liquid, or watery bowel movements in a day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin with loss of the normal stretchiness of the skin and irritable behaviour. This can progress to decreased urination, loss of skin color, a fast heart rate, and a decrease in responsiveness as it becomes more severe. Loose but non-watery stools in babies who are exclusively breastfed, however, are normal.

<span class="mw-page-title-main">Dietary fiber</span> Portion of plant-derived food that cannot be completely digested

Dietary fiber or roughage is the portion of plant-derived food that cannot be completely broken down by human digestive enzymes. Dietary fibers are diverse in chemical composition and can be grouped generally by their solubility, viscosity and fermentability which affect how fibers are processed in the body. Dietary fiber has two main subtypes: soluble fiber and insoluble fiber which are components of plant-based foods such as legumes, whole grains, cereals, vegetables, fruits, and nuts or seeds. A diet high in regular fiber consumption is generally associated with supporting health and lowering the risk of several diseases. Dietary fiber consists of non-starch polysaccharides and other plant components such as cellulose, resistant starch, resistant dextrins, inulins, lignins, chitins, pectins, beta-glucans, and oligosaccharides.

<span class="mw-page-title-main">Food pyramid (nutrition)</span> Visual representation of optimal servings from basic groups

A food pyramid is a representation of the optimal number of servings to be eaten each day from each of the basic food groups. The first pyramid was published in Sweden in 1974. The 1992 pyramid introduced by the United States Department of Agriculture (USDA) was called the "Food Guide Pyramid" or "Eating Right Pyramid". It was updated in 2005 to "MyPyramid", and then it was replaced by "MyPlate" in 2011.

<span class="mw-page-title-main">Low-carbohydrate diet</span> Diets restricting carbohydrate consumption

Low-carbohydrate diets restrict carbohydrate consumption relative to the average diet. Foods high in carbohydrates are limited, and replaced with foods containing a higher percentage of fat and protein, as well as low carbohydrate foods.

<span class="mw-page-title-main">Malabsorption</span> Abnormality in absorption of food nutrients across the gastrointestinal tract

Malabsorption is a state arising from abnormality in absorption of food nutrients across the gastrointestinal (GI) tract. Impairment can be of single or multiple nutrients depending on the abnormality. This may lead to malnutrition and a variety of anaemias.

<span class="mw-page-title-main">Gastroenteritis</span> Inflammation of the stomach and small intestine

Gastroenteritis, also known as infectious diarrhea, is an inflammation of the gastrointestinal tract including the stomach and intestine. Symptoms may include diarrhea, vomiting, and abdominal pain. Fever, lack of energy, and dehydration may also occur. This typically lasts less than two weeks. Although it is not related to influenza, in the U.S. and U.K., it is sometimes called the "stomach flu".

<span class="mw-page-title-main">Cat food</span> Food for consumption by cats

Cat food is food specifically formulated and designed for consumption by cats. As obligate carnivores, cats have specific requirements for their dietary nutrients, namely nutrients found only in meat or synthesized, such as taurine and Vitamin A. Certain nutrients, including many vitamins and amino acids, are degraded by the temperatures, pressures and chemical treatments used during manufacture, and hence must be added after manufacture to avoid nutritional deficiency. Cat food is typically sold as dry kibble, or as wet food in cans and pouches.

<span class="mw-page-title-main">Oral rehydration therapy</span> Type of fluid replacement used to prevent and treat dehydration

Oral rehydration therapy (ORT) is a type of fluid replacement used to prevent and treat dehydration, especially due to diarrhea. It involves drinking water with modest amounts of sugar and salts, specifically sodium and potassium. Oral rehydration therapy can also be given by a nasogastric tube. Therapy can include the use of zinc supplements to reduce the duration of diarrhea in infants and children under the age of 5. Use of oral rehydration therapy has been estimated to decrease the risk of death from diarrhea by up to 93%.

Abdominal bloating is a short-term disease that affects the gastrointestinal tract. Bloating is generally characterized by an excess buildup of gas, air or fluids in the stomach. A person may have feelings of tightness, pressure or fullness in the stomach; it may or may not be accompanied by a visibly distended abdomen. Bloating can affect anyone of any age range and is usually self-diagnosed, in most cases does not require serious medical attention or treatment. Although this term is usually used interchangeably with abdominal distension, these symptoms probably have different pathophysiological processes, which are not fully understood.

<span class="mw-page-title-main">Milk substitute</span> Alternative substance that resembles milk

A milk substitute is any substance that resembles milk and can be used in the same ways as milk. Such substances may be variously known as non-dairy beverage, nut milk, grain milk, legume milk, mock milk and alternative milk.

A low-residue diet is a diet intended to reduce certain constituents of the bowel, often with consequence for functional behaviour of the bowel. It may be prescribed for patients with ailments or functional gastrointestinal disorders mitigated by fewer and smaller bowel movements each day.

The Montignac diet is a high-protein low-carbohydrate fad diet that was popular in the 1990s, mainly in Europe. It was invented by Frenchman Michel Montignac (1944–2010), an international executive for the pharmaceutical industry, who, like his father, was overweight in his youth. His method is aimed at people wishing to lose weight efficiently and lastingly, reduce risks of heart failure, and prevent diabetes.

<span class="mw-page-title-main">Sports nutrition</span> Study and practice of nutrition to improve performance

Sports nutrition is the study and practice of nutrition and diet with regards to improving anyone's athletic performance. Nutrition is an important part of many sports training regimens, being popular in strength sports and endurance sports. Sports nutrition focuses its studies on the type, as well as the quantity of fluids and food taken by an athlete. In addition, it deals with the consumption of nutrients such as vitamins, minerals, supplements and organic substances that include carbohydrates, proteins and fats.

<span class="mw-page-title-main">Protein (nutrient)</span> Nutrient for the human body

Proteins are essential nutrients for the human body. They are one of the building blocks of body tissue and can also serve as a fuel source. As a fuel, proteins provide as much energy density as carbohydrates: 17 kJ per gram; in contrast, lipids provide 37 kJ per gram. The most important aspect and defining characteristic of protein from a nutritional standpoint is its amino acid composition.

A diabetic diet is a diet that is used by people with diabetes mellitus or high blood sugar to minimize symptoms and dangerous complications of long-term elevations in blood sugar.

High performance sport dogs are those bred and trained to compete in various athletic events. Events include but are not limited to, agility trials, hunting and racing. These events are physically and metabolically demanding. As a result, canine athletes require specialized nutrition in order to perform at high levels during events and for maintenance and recovery. The main nutritional concern for sport dogs is adequate energy. A well-balanced diet, containing the appropriate amounts of protein, fat, carbohydrate, fiber and micronutrients is essential to meet these energy requirements.

<span class="mw-page-title-main">Vegetarian and vegan dog diet</span> Adequate meat-free or animal-free nutrition

As in the human practice of veganism, vegan dog foods are those formulated with the exclusion of ingredients that contain or were processed with any part of an animal, or any animal byproduct. Vegan dog food may incorporate the use of fruits, vegetables, cereals, legumes including soya, nuts, vegetable oils, as well as any other non-animal based foods.

References

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  4. 1 2 Mackell, S (1 December 2005). "Traveler's diarrhea in the pediatric population: etiology and impact". Clinical Infectious Diseases. 41 (Suppl 8): S547-52. doi: 10.1086/432950 . PMID   16267717.
  5. 1 2 King CK, Glass R, Bresee JS, Duggan C (November 2003). "Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy". MMWR Recomm Rep. 52 (RR-16): 1–16. PMID   14627948.
  6. Kyle, Terri (2008). Essentials of pediatric nursing. Lippincott Williams & Wilkins. p. 685. ISBN   978-0-7817-5115-5.
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  8. "BRATT Diet Phase 1 | Memorial Sloan Kettering Cancer Center". www.mskcc.org. Retrieved 2 December 2024.
  9. "BRATTY Diet: Solid Meals To Help Relieve Diarrhea".
  10. Cenzon, Matthew. "What Is The BRAT Diet?". symptomfind.com. Archived from the original on 15 December 2013. Retrieved 5 December 2013.
  11. Ippoliti, Andrew F. (1 March 1976). "The Effect of Various Forms of Milk on Gastric-Acid Secretion: Studies in Patients with Duodenal Ulcer and Normal Subjects". Annals of Internal Medicine. 84 (3): 286–289. doi:10.7326/0003-4819-84-3-286. ISSN   0003-4819. PMID   946584.
  12. McArthur, Katherine; Hogan, Daniel; Isenberg, Jon I. (1 July 1982). "Relative Stimulatory Effects of Commonly Ingested Beverages on Gastric Acid Secretion in Humans". Gastroenterology. 83 (1): 199–203. doi: 10.1016/0016-5085(82)90175-5 . ISSN   0016-5085. PMID   6896312.
  13. Duggan, C; Santosham, M; Glass, RI (16 October 1992). "The management of acute diarrhea in children: oral rehydration, maintenance, and nutritional therapy. Centers for Disease Control and Prevention". MMWR. Recommendations and Reports. 41 (RR-16): 1–20. PMID   1435668.
  14. McLaughlin, Eileen (24 July 2000). "salt imbalance". Archived from the original on 2 July 2007. Retrieved 8 April 2007.
  15. Mayo Clinic Staff. "Gastroenteritis: First aid". Mayo Clinic . Retrieved 6 March 2011.
  16. "Gastroenteritis". MedlinePlus . United States National Library of Medicine . Retrieved 18 November 2022.
  17. "BRAT diet: What is the BRAT diet?". C. S. Mott Children's Hospital. University Of Michigan. Archived from the original on 20 February 2007. Retrieved 8 April 2007.