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:
- Foods that need to be peeled or husked – like tomatoes, corn, peas, sprouts and cabbage;
- Stringy food – such as stalks of cauliflower and broccoli, asparagus and leeks;
- Foods with “membranes” like orange, grapefruit and lemon;
- Grains and nuts like bread, nuts and almonds;
- 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.