BRAT Diet

[David]

The BRAT (banana, rice, applesauce, toast) diet is a common diet people with Crohn's Disease and other forms of IBD are told to go on during flares. I recently came across a great article by some doctors at the University of Virgina School of Medicine. Now, this article discusses the BRAT diet for children and specifically for acute diarrhea which obviously is merely a symptom (though usually chronic) of many cases of IBD and it's more complicated than that. So it is far from perfect and please take that into account. However, I feel it's still applicable, one, from a nutritional perspective since so many with IBD are deficient in various nutrients and two, it discusses a lot of the physiology that would be involved with IBD as well. Therefore I decided to share it here.

The article can be found here.

For those of you tired of reading already, here's the conclusion:

The selection of a single type of restrictive diet (e.g., the BRAT diet) during diarrhea can impair nutritional recovery and in fact lead to severe malnutrition. Dietary management during any acute illness should be balanced, providing all of the three major macronutrients, as well as meeting the DRI for micronutrients. Prompt feeding during an acute episode of diarrhea and avoiding unnecessarily restrictive diets is the recommended dietary therapy during acute diarrhea.

However, the entire article is well worth reading

 

[handle]

No sensible person ever suggests using the BRAT diet, or any other severely restrictive diet, for more than a day or two. Of course there will be problems if such a severely restrictive diet is used for any length of time!
Rehydration is the most important thing with acute diarrhea. Supplemental electrolytes and liquid feeds are preferred for any longer term dietary management of diarrhea, where a normal diet cannot be fully reintroduced.

 

[Rebecca85]

Reading the article, I cannot believe that children were kept on the diet for as long as 2 weeks! Personally, I have only ever used the diet for one or two days at most, during the first part of a stomach bug (the part where what goes in, must come out, quickly and violently!). Once the diarrhoea slows or I start to feel hungry, I reintroduce more foods.

 

[Silvermoon]

Exactly, handle!! As a health care professional, we were taught to use the BRAT diet in cases of acute diarrhea in children - bananas to keep potassium levels up, applesauce for sugar (energy), rice and toast for fiber to hopefully help lessen the diarrhea itself.

Today we use Pedialyte or Gatorade/Powerade for the same thing - keep elecrolyte levels up (drives me insane that ads promote these drinks as "healthy alternatives to juice and pop" - but I digress...)

As for other 'restricitve' diets I can think of (ie low fiber low residue, etc.), again, doctors should only be recommending these diets for short periods of time - during acute flares and such, not as a permanent alternative. We need fruits/veg/fiber to keep our bowels healthy when they are in a healthy state - like any other muscle: if you don't exercise it, you lose it!!

Great reading and interesting topic to bring up, David!