Small Particle Size Diet

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20 Jan 2020 | By Amanda Gonzalez Pegorer | 10 minutes read

What is a small particle size diet?

A small particle size diet is a diet based on foods of small particle size or foods that can be easily processed into small particles. Foods that can be easily mashed with a fork, such as potatoes, are your best friends in this diet.

This diet restricts the intake of:

  1. Foods that need to be peeled or husked – like tomatoes, corn, peas, sprouts and cabbage;
  2. Stringy food – such as stalks of cauliflower and broccoli, asparagus and leeks;
  3. Foods with “membranes” like orange, grapefruit and lemon;
  4. Grains and nuts like bread, nuts and almonds;
  5. Foods that are poorly digested by our bodies are also not part of this diet, like pasta, rice, cheese slices, meat, grated vegetables and raw vegetable salad.

However, some of these foods from above can be consumed as long as they are processed into smaller particles. For example, nuts like almond and cashews can be consumed in the form of flour and peas, and onions and corn can also be eaten if they are mixed by a food processor.

The more your food looks like mashed potato, the better!

How does it help with gastroparesis?

Gastroparesis is a condition defined by delayed gastric emptying without any local obstruction, which means that the stomach releases its food contents into the small intestine later than it should. This causes food to stay in the stomach for too long, increasing the sensation of early fullness, nausea, vomiting and bloating.

The stomach plays a big role in accommodating, grinding foods into smaller particles and emptying its food contents into the small intestine. However, gastric emptying only occurs if food particles are smaller than < 2mm in diameter, which explains why a small particle size diet has a great potential of helping individuals with gastroparesis. This means that the symptoms mentioned above should improve when this diet is implemented in their lives.

What does the research say about it?

Until now, only one study was conducted analysing the role of this new promising diet. It was a randomized double-blinded controlled trial – which means it is an experimental study of a high level of evidence – analysing how a small particle size diet can help patients with diabetes mellitus which developed gastroparesis as a complication. In this study, 56 participants were split into two groups that would follow two different diets to see if one of them would change some symptoms individuals with gastroparesis experience, such as bloating, sense of fullness after eating a small amount of food, nausea and vomiting.

Group one (intervention group) followed a small particle size diet and group two (control group) followed a standard diet recommended for patients with diabetes – such as fruit, vegetables, pasta and whole grain bread; they were also allowed to eat large particle components such as meat, cheese, nuts and bread. Their diet did not include small particle size foods like milkshakes, berry and fruit compote, mashed potato, smooth soups and mashed turnips.

Both groups were advised to eat only 25-30% of their calories from fat and to eat a maximum of 15g of fibre per 1000kcal consumed – which is the general advice given to patients with gastroparesis.

The study was conducted for 20 weeks and at the end five patients in group two left the study due to worsening of some of their symptoms and one patient from group one passed away of a heart attack, which means that 50 participants stayed until the end of the study. The participants that followed a small size diet (group one) related improvement of gastrointestinal symptoms like fullness, bloating, vomiting and nausea, except for abdominal pain which was rated the same between group one and two. Group two did not show any improvement in these symptoms.

Group one also showed an overall decrease in anxiety, which group two did not show. Both groups showed similar levels of depression rates and quality of life.

To summarise, this study showed that a small particle size diet was superior to a standard diabetes diet – which includes large particle size foods – on managing symptoms of gastroparesis in patients with diabetes. On the other hand, further studies should be conducted to see the role of a small particle size diet in patients with gastroparesis with and without diabetes. Maybe this new exciting diet will change our current guidelines and we will have a new way of managing gastroparesis!

Have you ever tried small particle size diet and did it help manage your gastroparesis? We would love to hear about your experiences and thoughts on this diet. Please leave a comment below for Amanda.

  1. I started this today based on MD recommendation. I have high hopes that it will help, however difficult it will…

  2. So, without realising this is a thing, small particle diet is basically what I have been doing. My symptoms…

  3. For me, though my Gastroparesis doesn’t seem to act like other people’s’, it has also been a matter of how…

  4. Thank you for doing this study. When I could eat after my Botox injections i was able to get back…

  5. As my condition deprecated, I was on liquids and schmolids (soft solids) in which I would blend and then sieve.…

5 thoughts on “Small Particle Size Diet

  1. As my condition deprecated, I was on liquids and schmolids (soft solids) in which I would blend and then sieve. This took out all the fibre that wasn’t broken down which made the food go down the best it had ever in my condition. I was able to survive like this for two years before I had to go on a feeding tube. To this day anything with flour, that bulks together ie bread, anything with a skin or seeds, or powder that doesn’t quite dissolve causes me issues. I’m great with anything that doesn’t have bits in it like water, some soy milks, broth or stock. Would love more information on foods to include and avoid into the small particle diet. I really do think this diet is key to not only survival but a quality of life

  2. Thank you for doing this study. When I could eat after my Botox injections i was able to get back to a normal diet but just very small amounts of even beef and gravy with veggies including peas. But after having a couple of months on cortisone I went into a big GP flare and had alot of trouble getting back on to just a liquid diet of two boxes of Isosource and 6 scoops of sustagen and that gives me Diarrhea everyday. I can eat one plain sweet biscuit but it will also give me Diarrhea. Potatoes was my safe food but not anymore. I tried mashed potatoes a few weeks back but me nauseated and diarrhea again. I need to get back on to food but my gut just won’t let me. If I have more than 2 boxes of Isosource I get worse diarrhea. Feel free to contact me on messenger or email any time if you have any questions.
    Regards Hope Davis.☺️

  3. For me, though my Gastroparesis doesn’t seem to act like other people’s’, it has also been a matter of how broken down the food is in terms of enzymatically. Ie even if it is pureed, I struggle to empty complex starches and proteins. When the food has already been broken down (often to a semi-elemental state or by natural enzymes (like cheese) I actually have a much higher chance some of it will empty. I’ve found that complex starches like potato for me tend to actually slow motility.

  4. So, without realising this is a thing, small particle diet is basically what I have been doing. My symptoms have mostly decreased and I find when I eat a “real meal”, symptoms tend to flair again.

    My doctor put me on a low residue diet and I have been on it for nearly 18 months. I have lots of food allergies and intolerances, but these fit with what you are saying to avoid (ie pork seafood eggplant mango gluten dairy soy onion legumes) I am also very careful with fat and fibre.
    And you are right…mashed potato is my very best friend!

  5. I started this today based on MD recommendation. I have high hopes that it will help, however difficult it will be since I try to be plant-based, though for protein purposes I have relaxed my principles in that area. I am happy to share my information with you if it helps your research. I am NOT diabetic, 47 y/o female with no significant physical issues (except low BMI thanks to my tummy troubles). I am looking forward to more physical stamina, being able to regain some muscle and one day being able to run again.

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