Nutrition on Fasano Diet for DH

[Alaskaguy]

Hello All,

I wanted to share with you some information that I have learned about my nutrition while on the Fasano Gluten Contamination Elimination Diet (https://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-13-40) for alleviation of my dermatitis herpetiformis.

Because I have started on this diet not for any gut-related problems, but specifically for DH, I am not only adhering to the strict guidelines of the diet as laid out by Dr. Fasano and his team, but am also avoiding or severely restricting any foods high in iodine as well, which can aggravate DH.  So I am therefore ALSO eliminating all dairy products (which I already did six or seven months ago), all seafoods of any kind (both fish and, above all, seaweeds), and will be restricting my egg consumption to two or three a week, along with eliminating my multivitamin (which, like almost all of them, contains 100% of the US RDA for iodine, 150 ug.)  In addition, I am choosing to avoid all dried beans, peas and lentils, although they are allowed on the Fasano Diet, due to the potential for cross-contamination with gluten-containing grains.

So, this leaves me with not an awful lot of foods to chose from.  My starches are white potatoes and sweet potatoes, with lesser amounts of white rice, yuca (cassava root), and plantains (cooking bananas).  My proteins are limited to (lean) unprocessed beef, chicken, turkey and pork.  And with vegetables (which must be fresh, whole and unprocessed), I need to totally avoid asparagus, spinach, rhubarb, broccoli and cauliflower (due to high iodine content), and carefully limit my intake of green leafy vegetables.  All fresh fruits are OK, as are nuts in the shell.  Avocados are a particularly good source of a number of otherwise limited nutrients --- don't overlook them!

Well, after eight days now on this diet, I was curious just how it might stack up nutritionally, as I could imagine that I might be missing some important nutrients.  So for three days I actually recorded the weight and type of each food that I ate, representing what I expect would be a good cross-sectional sample of my diet going forward, then added up all the nutrients in those foods, as listed on the very useful website NutritionData.Self.com --- https://nutritiondata.self.com/facts

For most nutrients, I am actually not doing bad at all.  Despite eating meat every day (which was not my norm before this), my protein intake is not at all high, but I seem to be getting just marginally enough protein.  The same goes  for fats, although it almost feels like I am using MORE in the last week than before.  But where I am falling noticeably low is in a few key vitamins. Most of them are good to very good (A, C, K, Thiamin, Riboflavin, Niacin), but my Vitamin K intake is around 65% of the RDA, and both my Vitamin E and Folic Acid intakes are only around 50% of the RDA.  The bad ones are Vitamin D intake, now exactly zero (as it is admittedly for many people), and Vitamin B12, where I hover around 10% of the RDA.  Calcium and Magnesium are also low --- about 75% for magnesium, but only 26% for calcium.

I realized that on this restricted diet I would be low on Calcium, Magnesium and Vitamin D, so I did already buy and start using a supplement from Costco that contains each of those three nutrients.  I would have thought with the daily meat intake that I'd be fine for Vitamin B12, but while that vitamin is only found in animal products, it is not very high in lean meats --- more so in eggs, dairy products, organ meats and seafood.  So I may have to take a supplement for B12 as well, although it is true that most people store several years worth of B12 in their liver, which however diminishes with age.

The upshot here is that I would HIGHLY recommend for anyone going on the Fasano Elimination Diet to seek out the assistance of a dietician in formulating a properly balanced diet, particularly if they are also further restricting certain foods that are allowed on the Fasano Diet for other and more individual-specific reasons,   The work and effort I put in just to analyze my three days diet was rather extensive, and I don't know how many others would have the patience and wherewithal to do that.  But even as a rather nutritionally aware person, I was still surprised by a few of the nutritional 'holes' that my current diet contains.

[RMJ]

Very interesting, thank you for posting.

[Iiv]

Thanks, I don't know if I have DH.. I just know that my rashes goes hand in hand with gluten/ grain derived things. But I'm definitely gonna mind iodine a lot more! 

Just a thought for you on vitamins. I cannot eat solid D-vitamins on pills, if they contain dextrin (derived from barley or wheat, but no need to tell on label). That is enough to evoke my rash on some patches. Not as bad as pure wheat, but still very annoying. 

So, perhaps you ought to mind your vitamins too? 

I'm guessing that you are having issues getting rid of your rashes, hence severe rashes and worse than mine. So, I'm thinking that if I cannot, perhaps you can't either?