Nutrition Therapy and Gastroparesis

What You Can and Shouldn't Eat

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Gastroparesis - often referred to as stomach paralysis - is one of the side effects of diabetes. Overtime excess sugar can damage the nerves in the stomach and delay how quickly the stomach passes contents into the small intestine. The result can be physically uncomfortable, causing nausea, vomiting and early satiety. Delays in gastric emptying can impact blood sugar control, too. A delay in digestion can cause blood sugars to be erratic, often resulting in hyperglycemia several hours after a meal.


Nutrition is Critical

If you've just been diagnosed with gastroparesis, you should meet with a Registered Dietitian or Certified Diabetes Educator. Medical nutrition therapy is the first form of treatment, because the timing of meals, size of meals and types of meals can all affect digestion. A Registered Dietitian can help to create an individualized meal plan that suites your likes, dislikes, maximizes essential vitamins/minerals/nutrients and adheres to diet restrictions necessary for other health issues.

What is the Diet?

While someone with diabetes is typically told to eat a high fiber diet, the opposite is necessary in the treatment of gastroparesis, often complicating blood sugar control. The problem is that fiber delays gastric emptying - something we now want to avoid. Fiber containing foods can also cause benzoar formation - a hardened mass of food which can result in nausea and vomiting and even stomach obstruction.

A benzoar forms when food remains in the stomach for extended periods of time. In efforts to prevent this from happening, you should eat small, frequent meals and choose foods that are lower in fiber and fat. For example, if you are following a consistent carbohydrate diet that allows you to eat about 200 g of carbohydrate for the whole day, you can break up the servings into six meals and eat about 30g of carbohydrate per meal.

The exact amount of carbohydrates per meal will rely on your post meal blood sugars. It is very important to try to be as consistent as possible with regards to the amount of grams of carbohydrate eaten at meals.

What Foods Should I Eat?

Refined breads (English muffins, white bread, dinner rolls), white rice, and white pasta, plus cooked vegetables and canned fruit because they’re better tolerated than fresh fruits and vegetables. If you are going to buy canned fruit, make sure it is in it's own juice as opposed to syrup. Canned vegetables should be washed thoroughly before eating to eliminate some of the sodium. Some people tolerate solid food better during the earlier hours of the day and may need to eat pureed or liquid foods towards the end of the day. Other foods that are well tolerated are low-fat or skim milk, instant breakfast beverages, low-fat yogurt, pudding, custard, smoothies, puréed foods, and soup. There’s a subgroup of patients who have more difficulty with solid foods. If this is the case, the optimal liquid food sources would be those with higher quantities of nutrients, such as low-fat milk.

What Foods Should I Avoid?

Foods high in fiber should be avoided.


  • Beans - dried, canned
  • Fresh fruit - blueberries, raspberries, blackberries, apples, orange, kiwi
  • Dried fruit - apricots, dates, figs, prunes, raisins
  • Vegetables - green peas, broccoli, Brussel sprouts, tomatoes with skin, green beans
  • Whole grains - shredded wheat, bran cereal
  • Nuts and Seeds: chunky or crunchy nut butters, pumpkin, sunflower seeds, almonds, cashews
  • Snack foods: popcorn
  • Full fat dairy - cheese, butter, milk (this may be tolerated in liquid form)
  • Carbonated beverages and alcohol - they can speed up gastric emptying

Sample Meal Plan: ~30 g Carbohydrate per Meal

Breakfast: 1 whole grain English muffin with 2 egg whites and 1 slice of low-fat cheese

AM Snack: 3/4 cup blueberries with 1 low-fat Greek yogurt

Lunch: 1 cup of low-sodium chicken noodle soup with celery and carrots with 5 unsalted saltines

PM Snack: 1 smoothie made with 1 cup low-fat milk or skim milk (whichever is tolerated better), 1/2 cup canned peaches (in their own juice) and 1 scoop of protein powder

Dinner: 3 oz of grilled chicken, 1 cup mashed sweet potato and pureed spinach

PM Snack: 1 low-fat pudding made with low-fat milk

What About My Diabetes Medicines?

Changes to your insulin timing will likely be necessary to regulate blood sugar control. Most people with gastroparesis need to take insulin more frequently and will need to monitor blood glucose levels before a meal or snack is eaten to adjust an insulin dose. If you are taking a mealtime insulin, instead of taking it before you eat, you may need to dose it after you eat. Keep a log of food and blood sugars and discuss it with your physician.


Jones, Jessica. Gastropareis. Today's Dietitian. Vol. 16 No. 7 P.16. Accessed on-line. July 25, 2014:

Parrish, Carrol & Keith-Ferris, Jeanne. UVA Nutrition Services. Diet Intervention for Gastroparesis. Accessed on-line. July 26, 2014:


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