#09: A/Professor Emma Halmos & Dr CK Yao - Food is Medicine.. or is it?

Today we welcome two world-leading dietitians to talk all things diet in IBD and IBS....

A/Prof Emma Halmos is a senior research dietitian at Monash University and the Alfred Hospital. Her scientific achievements have had a major impact in clinical practice nationally and internationally. The most notable was the pivotal feeding study that demonstrated the low FODMAP diet was efficacious in patients with IBS. A/Prof Halmos has been elected onto the D-ECCO (Dietitians of European Crohn’s and Colitis Organisation) committee and is a leading coordinator for the first ECCO guidelines on nutrition in IBD. Her current role at Monash University is leading research on novel dietary therapy to treat IBD and IBS.

Dr CK Yao is a senior research dietitian at Monash University and the Alfred Hospital, and recent NHMRC emerging leader. In 2017, CK completed her PhD investigating dietary manipulation of gut microbial function and the application of gaseous biomarkers in patients with functional and inflammatory bowel disease. Dr Yao currently leads a research programme looking at optimising dietary strategies for patients with ulcerative colitis and those with an ileoanal pouch.We discuss the critical role of diet in managing inflammatory bowel disease (IBD), particularly Crohn's disease and ulcerative colitis.

We explore various dietary patterns, the impact of emulsifiers and ultra-processed foods, and the importance of personalized dietary advice. We talk about the significance of dietitians in guiding patients towards healthier choices. This conversation delves into the complexities of dietary recommendations for various gastrointestinal conditions, particularly focusing on the Mediterranean diet, Crohn's disease, and IBS. We discuss cultural influences on diet, the importance of personalized nutrition, and the emerging trends in dietary therapy. Finally we touch on the new ECCO Diet in IBD guideline that is set to be published soon.

As always comments, questions and feedback please send to: X: @2guystalkingit

Email: 2guystalkingit@gmail.com

Chapters

00:00 Introduction with J & J

4:20 On to our guests... Diet and IBD

05:50 Dietary Patterns for Disease Prevention

08:53 Therapeutic Diets and Active IBD

11:58 Controversies in Dietary Recommendations

15:02 The Impact of Emulsifiers and Ultra-Processed Foods

18:07 Practical Dietary Advice for Patients in IBD

21:02 Cultural Considerations in Dietary Recommendations

23:57 Food as Medicine: A Discussion

27:03 Exploring Diverse Dietary Patterns

30:13 Conclusion and Future Directions

32:26 Cultural Influences on Diet and Health

34:40 Dietary Recommendations for active Crohn's Disease

37:22 Understanding Pouch Patients

38:11 Initial Assessment for IBS Patients

44:25 Screening for ARFID

48:03 Emerging Dietary Trends in IBS

51:40 New Guidelines in IBD Nutrition

Papers discussed

Fitzpatrick JA, Gibson PR, Taylor KM, Anderson EJ, Friedman AB, Ardalan ZS, Smith RL, Halmos EP. Clinical Trial: The Effects of Emulsifiers in the Food Supply on Disease Activity in Crohn's Disease: An Exploratory Double-Blinded Randomised Feeding Trial. Aliment Pharmacol Ther. 2025 Apr;61(8):1276-1289.  https://pubmed.ncbi.nlm.nih.gov/39967287/

Fitzpatrick JA, Gibson PR, Taylor KM, Halmos EP. Development of Novel High and Low Emulsifier Diets Based upon Emulsifier Distribution in the Australian Food Supply for Intervention Studies in Crohn's Disease. Nutrients. 2024 Jun 18;16(12):1922. . https://pubmed.ncbi.nlm.nih.gov/38931276/

Halmos EP, Gibson PR. Controversies and reality of the FODMAP diet for patients with irritable bowel syndrome. J Gastroenterol Hepatol. 2019 Jul;34(7):1134-1142. https://pubmed.ncbi.nlm.nih.gov/30945376/

A FODMAP Gentle approach: https://www.monashfodmap.com/blog/gentle-fodmap-diet/

The SCOFF Questionnaire: https://ceed.org.au/wp-content/uploads/2024/05/SCOFF.pdf