Manual of Clinical Nutrition Management D- 1 Copyright © 20 13 Compass Group, Inc.
FIBER-RESTRICTED DIETS
(Low-Fiber*)
Description
The Low-Fiber Diet restricts dietary fiber and provides less than 10 grams a day (1). Foods that have been
defined in qualitative terms as having tough fibers are also eliminated. Animal products, refined grain
products and cereals (providing < 2 g/serving), and selected fruits and vegetables are included. Previously
this diet had also been titled the “low residue diet”. Due to no scientifically acceptable definition of residue and the
lack of widespread availability of resources to provide this information, the term is no longer used by the Academy
of Nutrition and Dietetics (1,2). Since fiber content of the diet can be estimated from food composition tables, “low
fiber diet” is the preferred title of this diet and used throughout this manual (1,2).
Indications
To prevent the formation of an obstructing bolus when the intestinal lumen is narrowed.
To delay intestinal transit time in conditions of diarrhea.
To reduce (not eliminate) the fiber in the colon pre- and postoperatively.
To allow the bowel to rest during acute exacerbation of inflammatory bowel disease (ulcerative colitis,
Crohn’s disease) , acute phases of diverticulitis, or radiation enteritis.
For patients with acute episodes of ulcerative colitis, Crohn’s disease, or diarrhea the low fiber diet may
need further modifications for individual symptom management. The avoidance of caffeine, lactose and
excess fat may improve tolerance in patients with acute exacerbations of ulcerative colitis and Crohn’s
disease (3). The low-fiber diet is intended for short-term use. The goal of nutrition therapy is to establish
tolerance to a wider variety of foods and to make a transition to a regular diet.
Contraindications
A fiber-restricted diet is contraindicated when a soft stool is desired, as in individuals with diverticulosis. A
low-fiber intake may aggravate the symptoms of irritable bowel or constipation. In these cases, a high-fiber
intake is recommended. (See Section ID: High-Fiber Diet.). If a soft texture is desired, as in the case of a
patient with esophageal narrowing, a mechanical soft diet may be ordered.
Nutritional Adequacy
The Low-Fiber diet can be planned to meet the Dietary Reference Intakes (DRIs) as outlined in Section IA:
Statement on Nutritional Adequacy. At least one serving of citrus fruit juice is recommended for daily vitamin
C.
How to Order the Diet
Order as “Low-Fiber Diet.” Milk and other lactose-containing foods will not be restricted unless ordered.
Milk is fiber-free; therefore, it is not necessary to eliminate it (2). However, for individuals with inflammatory
bowel disease who present with a primary or secondary lactose deficiency, a low-fiber, low-lactose dietary
restriction may be appropriate. In addition, caffeine may also need to be limited or avoided in individuals
with IBD, or diarrhea to decrease intestinal transit time (1,3).
Planning the Diet (1):
- Select cereals, grains and bread products, and vegetables that are low in fiber (< 2 g fiber/serving)
- For patients with a lactose intolerance, dairy products may need to be avoided or limited
- For patients with IBD and diarrhea limit or avoid caffeine per individual tolerance (1,3).
- Clean, prepare and store foods using proper sanitation techniques
Reference
- Low Fiber Nutrition Therapy. Gastrointestinal Diseases. In: The Academy of Nutrition and Dietetics Nutrition Care Manual. Updated
annually. Available at: http://www.nutritioncaremanual.org. Accessed January 25, 2013. - Cunningham E. Are low-residue diets still applicable? Journal of Academy of Nutrition and Dietetics. 2012; 112:960.
- Brown AC, Rampertab SD, Mullin GE. Existing dietary guidelines for Crohn’s disease and ulcerative colitis. Expert Rev Gastroenterol
Hepatol. 2011;5:411-425.