FODMAP Everyday® Chats with Dietitian Joanna Baker
Joanna Baker is a Registered Nurse, an Accredited Practising Dietitian based in Australia and received FODMAP training at Monash University. She first came on my radar when I stumbled upon Alana Scot’s website, A Little Bit Yummy, where Joanna was listed as part of the team of dietitians who monitor the content.
As Robin and I began to build FODMAP Everyday®, we reached out to Joanna to chat about her practice and interest in the diet. We got to meet in person at FNCE 2017 (the Food & Nutrition Conference and Expo put on by the Academy of Nutrition and Dietetics) and have continued to foster our relationship. We thought it was time to introduce all of you to Joanna!
Dédé: Joanna, thank you so much for agreeing to chat with us. First, tell us about your company, Everyday Nutrition (we love the name!). We understand you have three locations in Melbourne, Australia. Tell us about your offerings in general and also how you particularly help those with IBS.
Joanna: Hi Robin & Dédé, thanks for having me. Marnie & I are gut health expert dietitians who love food. We now work exclusively in Gastrointestinal nutrition, with a particular interest in IBS and food intolerance. Our work is quite varied and never boring. We get to work alongside food manufacturers to develop low FODMAP products, lecture internationally on the Low FODMAP diet and work privately with patients. In all of these roles, we aim to help people manage their tummy symptoms and begin to enjoy food again. Everyday Nutrition actually got its name because we believe that good food doesn’t need to be complicated, instead it should be simple to prepare and good to eat, everyday
We think alike! Our use of the word “everyday” for our company was quite deliberate as well. We should note that you have been public about the fact that you are living with both IBS and celiac disease. Did your personal medical issues encourage you to be a dietitian?
Yes, I’ve had gut problems for as long as I can remember! In fact, my mum first took me to the doctor about it when I was only 12 months old! He told her to take me off milk and that I was just a gutty baby and would grow out of it. Well I never grew out of it, and actually it wasn’t until I went back to University to study nutrition after my son was born that I discovered the low FODMAP diet. I tried it to get an idea of what people went though on a restricted diet and within 2 days, for the first time in my life, my tummy settled. Prior to this, I actually thought it was normal to be bloated and everyone walked around feeling like that. Needless to say, it changed my life and absolutely inspired me to work in this field once I graduated as an Accredited Practising Dietitian (this is the Australian title for a Registered Dietitian).
It is fascinating for me to hear this as it was my case as well that even after 24 hours on the diet, I could detect a positive change.
In terms of Coeliac Disease, I had started a gluten-free diet prior to being tested properly. It was another 7 years before I worked up the courage to do a gluten challenge, and in this time I didn’t know if I had coeliac disease or not, so I had to assume worst case scenario. It was July 2017 that I finally completed a gluten challenge and got the great news, that although I have a gene for coeliac disease, I don’t actually have the condition. I recently wrote a blog about my experience with the hope of encouraging people to make sure they are tested properly.
Also tell us about when you first learned about FODMAPs and what that meant to you, both personally and as someone who helps others. Was it a significant new tool for you in your practice?
Of course, I actually first learned about FODMAPs from Dr. Sue Shepherd when I was doing my Master of Dietetics degree. At this point, I knew I had a sensitive gut, but I had lived with it all my life and thought it was just me and I had to put up with it. Being a mature age student I was super conscientious and decided to trial the low FODMAP diet myself to get a really good idea of what my patients would go through when I used it in the future. Well, I was only on it 3 days and I was blown away by what a difference it made to my tummy! I took myself to the doctor to ensure that it was the right approach for me and this became the beginning of my FODMAP journey. Not having a swollen & painful tummy gave me more energy, made me less self-conscious and meant I didn’t have to worry about where all the toilets were when I wanted to take my toddler to the park! It made such an enormous difference to my quality of life, that I became really passionate about it and helping others get their life back as well.
Do you feel that the diet has had a positive impact on your health beyond your IBS?
It has certainly improved my personal relationships and made home life more settled. Because I’m not always uncomfortable, I’m much more relaxed and less stressed! My husband even noticed this, and like a lot of men, he is usually quite unobservant. The other thing is that I now get out and enjoy life more. In the past my gut would get in the way of me going out with friends, swimming with my family and exercising. I’m much more ready to go now, which is really great. So I guess from this, the biggest improvement has been in my mental health and my personal relationships.
Those are really powerful statements! The fact is that when we feel good physically, our whole lives can be positively affected. We know that you spent quite a bit of time on the road internationally this year. As you speak to people working with the low FODMAP diet, what common denominators do you see for everyone?
The big thing I notice is the impact IBS has on mental health and quality of life. The physical symptoms are no fun, but the flow on effect of these really destroys quality of life. It’s so wonderful and incredibly rewarding seeing people begin to enjoy life again.
Are there any particular aspects that are specific to location? I would imagine since the diet is so much better known in Australia that our Aussie friends have an easier time at the market and at restaurants, but we’d love to hear what you have to say with first-hand experience.
Yes, I think it is easier to follow here in Australia, simply because it is becoming quite well known and we have so many options that are increasing all the time. In terms of getting professional support, dietitians in Australia and especially Melbourne have access to training and education, so it tends to be much easier to find professional support to implement the diet.
One of the things I have noticed on social media and while traveling is that many people internationally, even if they wanted to see a dietitian there isn’t one near them that is familiar with the diet. This was the motivation for me to write my two ebooks. I figured that with these, anyone living could get guidance through Elimination & Challenges from a FODMAP trained dietitian regardless of where they live.
Speaking of things specific to location, are most gastroenterologists in Australia on board with the diet? Do you find that they are supportive?
Yes, I think all the gastroenterologists in Australia have heard of FODMAPs and most are on board with it. The literature and evidence for it is just so compelling by now, that there is very little dispute for its efficacy. Certainly the Gastroenterologists that I work closely with are very supportive and happy to have a solution to offer their patients with IBS.
What is the most common complaint that you hear from patients in regards to following the diet?
Label reading, of course finding suitable products and eating out seems to be the hardest part.
What are your favorite tips for helping those just starting on the Elimination phase?
1. Don’t be afraid to experiment in the kitchen, even if it doesn’t work out it’s a learning experience
2. Learn to adapt some of your favourite recipes
3. Use herbs, spices & infused oils to add flavour and excitement back into food.
We have something called FODMAP IT!™ where we take favorite recipes and convert them and love teaching folks how to do this themselves. Any favorite tips for the Challenge phase and beyond?
- It’s not a game of perfect. FODMAPs do not cause damage or long-term health complications, so it’s about finding the balance between your life, your food and your personal symptoms. This is a very subjective judgment and there is no right or wrong answer.
- We know that variety is good for long-term health and well being and that tolerance changes over time, so don’t be afraid to push the boundaries occasionally.
- If you get symptoms, you can always return to the safety of the Elimination phase, at any time, until they pass.
What do you think is the biggest impediment to more people trying the diet?
I think the idea of it is worse than the reality. Emotionally and psychologically it’s hard to change the meal patterns that you have spent years developing. It means that you have to think about every time you eat, something that in the past that has just been intuitive. I like to reassure people that the first week is the hardest and I am there to support them and help them find some yummy and satisfying foods to eat. Everyday, they find new foods and it becomes easier and easier.
What do you see for the future of the low FODMAP diet? Certainly, we all know that more and more food products are being certified, making it easier for IBS sufferers to make decisions at the market.
I agree we will see more food options and eating out options as awareness increases. I think that we will also see it become a bit of a trend, I already see people saying they are using it to lose weight or eat healthier, rather than what its designed for. In terms of research, I think science will find out more about the long-term impact of FODMAPs, this will be fueled by and contribute to our knowledge of gut microbiome. So I’m excited to see what we learn about here. I also think we will also find other medical conditions that it is helpful for and what the limitations are as well.
Speaking of which, tell us about how you help manufacturers bring low FODMAP products to market.
I consult to FODMAP Friendly, a low FODMAP certification program, as a FODMAP expert dietitian. This involves working with manufacturers to modify their products or develop new products that are low in all FODMAP groups. Once the product is ready, it goes to DTS Food Assurance – Australia’s largest accredited food testing laboratory to be scientifically tested for FODMAPs. If the product passes testing, we then work on getting the product to market and letting FODMAPers know that they have another option that is laboratory proven to be low FODMAP.
Joanna, thank you so much for your time with this interview and for all the hard work you do for those with us with IBS and those working with the low FODMAP diet.
It’s been a pleasure Robin & Dédé, and I look forward to seeing lots more yummy low FODMAP recipes and tips from FODMAP Everyday.