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Diet Modification for Fat Malabsorption

by in Digestion January 11, 2008

Fat Malabsorption occurs when fat is not digested and absorbed normally. Fat is excreted in the stools causing diarrhea. Stools are foamy, greasy, and malodorous.
Diagnosis is determined by a fecal fat assay from a stool sample which measures the amount of fat in the stool.
MCT Oil
• Absorbed easier by the body and supplies calories.
• Made from coconut oil.
• Lacks essential fatty acids.
• Limit to small quantities throughout the day: 3-4 tsp. at one given time.
• Incorporate into foods and recipes such as salad dressings, sauces, baked goods, sandwich spreads, milkshakes, and casseroles.
• Cook at low temperatures to prevent breakdown of the oil. Not to exceed 300-325 degrees F.
• Available at pharmacies and health food stores.
Symptoms of fat malabsorption
• Change of bowel habits
• Fatigue
• Apathy
• Smooth surface on lateral tongue
Nutrition Interventions
• Initially, restrict total fat and then generally add back to diet as tolerated.
• Use MCT oil to reduce symptoms and to help maintain weight by replacing long chain fats commonly found in food.
• Supplement with water soluble forms of the fat soluble vitamins (A,D,E and K) to ensure absorption.
• Supplement with calcium, magnesium, zinc, folic acid, B12, and iron. Fat, malabsorption may deplete these and possibly other nutrients by influencing their absorption, utilization, and/or excretion.
• Include high quality fats and essential fatty acids in the diet not attainable by MCT oil such as:
Flax seed/oil Canola Oil
Borage oil  Walnut Oil
Caution:
Kidney stone formation may be a risk of fat malabsorption. Normally, oxalates are bound to calcium in the urine and then excreted. When calcium is excreted in the stool due to unabsorbed fat, less is present in the urine. As a result, the potential of kidney stones increases with more unbound oxalates present in the urine.
Using MCT oil in the presence of liver disease and insulin dependent diabetics is not recommended because of the potential risk of inducing harmful conditions known as ketosis and acidosis.
PhotobucketDietary Guidelines
• Reduce the amount of high fat foods.
• Lower the amount of fat used in cooking and food preparation.
• Decrease intake of insoluble fiber such as raw salads, bran, seeds, and grain husks.
• Increase consumption of soluble fiber such as legumes, applesauce, oatmeal, and pears.
• Eat adequate protein: legumes and cereals, egg white, NF milk/dairy, lean cuts of meat.
• Choose the freshest, least processed food possible.
• Lactose may cause problems. If so, avoid dairy and foods containing dairy products.
• Avoid consuming alcohol and caffeine containing products.
Recipes
Congee
1c white rice
12c water
Boil for at least an hour.
Optional: add ground flax seeds, chopped walnuts, raisons, applesauce, pears, nutmeg, clove, or cinnamon to taste.
Hummus
2c cooked chick-peas
5T tahini
1/2t salt
1/3c fresh squeezes orange juice
3 cloves of garlic
3T MCT oil
1/4c filtered water
Place ingredients in blender and blend until smooth. Add water to desired texture. Refrigerate. Use as sandwich spread. Serve heated or cold as a dip.
Rice Pudding
4c congee
2 grated apples
3T maple syrup
1t Kuzu or arrowroot powder dissolved in 2T of cold water
Mix all ingredients together and blend for 30 seconds. Pour into bowls or dishes and refrigerate for 1 hour prior to serving. Sprinkle with cinnamon and top with chopped walnuts and maple syrup.
References:
Central Co-op News, Living with HIV, Dec. 1995
Escott-Stump, Nutrition and Diagnosis Related Cure, 3rd ed., 1992.
Lair, Feeding the Whole Family, 1994
Whitney, Cataldo, Fotfes, Understanding Normal and Clinical Nutrition, 4 ed., 1994.
Zeman, Clinical Nutrition and Dietetics, 2nd ed., 1991.

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