9 Fatty Foods to Include in an EPI Diet
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Why Healthy Fats Are Important for EPI
Although you might think to avoid foods high in fat to prevent uncomfortable digestive symptoms from exocrine pancreatic insufficiency (EPI), adequate amounts of fat, along with protein and other nutrients, are essential to a healthy diet. “Every part of the body needs fat to function,” says Kelly Scheller, RD, LD, a dietitian at Fairview Health Services in Minneapolis.
People with EPI can and should eat moderate amounts of fats from healthy sources – about 35 to 40 grams of fat throughout the day, says Scheller. This falls in line with national nutrition recommendations from the Department of Agriculture (USDA) for 20 to 35 percent of daily calories to come from fat.
If you have EPI, Scheller advises eating fat in small amounts over the course of the day and taking prescribed pancreatic enzyme replacement therapy (PERT) with meals as needed to prevent the abdominal pain, bloating, or fatty stool that can result from too much fat. Here are some of the healthiest foods that are high in fat.
A quarter-cup of avocado provides about 9 grams of monounsaturated and polyunsaturated fats, according to the USDA. “Dietary fat plays a crucial role in providing energy to the body, maintaining body temperature, protecting vital organs, and allowing for the intestinal absorption of fat-soluble nutrients,” says Kristen M. Roberts, PhD, RD, a dietitian and an assistant professor of clinical medicine at The Ohio State University Wexner Medical Center in Columbus.
In addition to healthy fats, avocados offer fiber and nutrients such as vitamin E, vitamin C, magnesium, iron, folate, potassium, and beta-carotene.
“In terms of animal sources of fat, fish is the best," Scheller says. "Some fatty fish may actually be higher in fat than some beef, but it’s easier to digest." Salmon offers about 5.4 grams of fat in 3 ounces. Salmon, swordfish, and tuna also provide fat-soluble vitamin D that helps keep bones healthy, according to the Office of Dietary Supplements at the National Institutes of Health. People with EPI have an increased risk of osteoporosis and related changes in bone density because of malabsorption of nutrients, according to research published in the January 2015 issue ofJournal of the Pancreas.
Snacking on shredded coconut or coconut meat can give you a little boost of fat (and flavor) when adding it to fruit, cereal, or smoothies. A quarter-cup of shredded coconut contains 7 grams of fat, according to the USDA. For variety, try other forms of coconut. Coconut oil, at 4 grams of fat per teaspoon, can be a healthier alternative to cooking or baking with butter, and coconut milk, at about 3 grams of fat per tablespoon, is a smart option for people who are lactose intolerant or vegan.
When choosing foods with fat, high-fiber options like chia seeds are good choices for weight management because the fiber helps you feel full longer. What’s more, fiber promotes healthy digestion and may help prevent constipation, according to the Academy of Nutrition and Dietetics. An ounce of chia seeds has nearly 9 grams of fat, 5 grams of protein, and 10 grams of fiber, according to the USDA. Chia seeds also contain omega-3 fatty acids, an essential fat that may help reduce the risk of heart disease. Chia seeds can be sprinkled on yogurt, hot cereal, or rice or added to drinks, such as smoothies.
One of the best types of oil for cooking is olive oil because of its monounsaturated fatty acids, Roberts says. The USDA recommends that adults include the equivalent of 5 to 7 teaspoons of oil in their daily diet, depending on age and gender, and limit saturated fat (found in butter and lard) to less than 10 percent of your calories – making it wise to use olive oil, which has 4.5 grams of fat per teaspoon. Canola, flaxseed, and soybean oils are also beneficial. Since certain vitamins such as A and K are fat-soluble, a small amount of oil drizzled on veggies enables your body to better use the vitamins in them.
Many people with EPI who have symptoms when they eat fatty meals often don’t have a problem with nut butters, Scheller says. Nuts and nut butters are nutrient-rich, high-calorie foods and can be great additions to a healthy EPI diet, especially if you’re trying to gain weight. A quarter-cup of mixed, dry-roasted nuts contains 18 grams of fat and 8 grams of protein, with nutrients such as vitamin E, iron, folate, selenium, and calcium. The 2015-2020 Dietary Guidelines for Americans recommends incorporating 2 to 4 ounces of nuts a week into your diet, depending on your daily calorie needs.
Greek yogurt offers healthy fat along with protein and probiotics that can aid your digestion. Eat it with fruit, in a smoothie, or even as a replacement for sour cream. It typically has 5 grams of fat and 9 grams of protein per 100 grams, according to the USDA. Roberts recommends dividing your total recommended daily fat intake over six small meals in the day. So if your goal is 45 grams of fat for the day, boost the fat in your yogurt snack to 7 to 8 grams by sprinkling on a few nuts or seeds. Work with a dietitian to determine a daily goal that’s best for you.
Most people find eggs relatively easy to digest, unlike fatty meats, Scheller says. “The yolk is the source of fat, and eggs are a good source of protein,” she says. An egg offers 6 grams of protein and 5 grams of fat, according to the USDA. People with EPI are at risk for some malnutrition because their digestion isn’t working well, she adds, so it's essential to find healthy sources of protein and fat that are easy to eat and prepare. When eating meals that include fat and protein, take your enzymes to make sure your digestion works well.
Scheller says it’s okay to allow yourself some sweet treats. People with EPI are advised to cut down on refined sugars, but that doesn’t mean you can’t indulge a little. Of all your options, Scheller says that dark chocolate might be among the best.
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