How to Stick to an FCS-Safe Diet in the Real World

But even before you see a nutrition specialist, you can take charge of your familial chylomicronemia syndrome diet with the tips below and lessen stress around eating. “While FCS does require strict dietary management, it is possible to enjoy flavorful meals while keeping triglycerides at a safe level,” says Erin Sheehan, RDN, a cardiovascular dietitian at Wellstar Health System in Atlanta.

• Alcohol
• Fatty meats or fish
• Pastries
• Nuts
• Sodas and fruit juices
• Bread, tortillas, and rice (even brown or whole-wheat options)
• Mashed potatoes

“The ‘avoids’ on the list can seem overwhelming,” says Simpson. “[But] our experience in the Lipid Clinic is that these diets are palatable, help with weight control, and can improve a sense of one’s well-being, as well as limit the complications of triglyceride associated syndromes.”

• Protein 10 to 35 percent

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• Carbohydrates 45 to 60 percent
• Fat Between 2 and 15 percent

Diet preferences vary substantially by cultural background, and some cultures have strong preferences for specific foods, so the foods above provide only general tips. “Culturally specific food guidance should be provided by a trained nutritionist,” says Simpson.

If going to the grocery store is overwhelming, you’re not alone. All those aisles of food choices may feel like too much to deal with, but by focusing on a planned list and menu, you can cut out a lot of the noise.

“Instead of relying on processed ‘diet’ foods, focus on naturally low-fat foods,” says Sheehan. Examples are:

• Fruits
• Vegetables
• Whole grains
• Legumes
• Egg whites
• Skinless chicken breast
• 98 percent fat-free ground turkey
• Shrimp
• White fish
• Low-fat dairy

Sheehan also recommends keeping herbs, spices, and vinegars on hand to add variety and flavor to meals without adding fat.

Unprocessed, whole foods will always give you more say over how much fat you eat, but if you need anything in a box or bag, you can see on the label how much fat each serving will give you. “Look for foods labeled ‘fat free,’ or check the nutrition label for foods that have as close to zero grams of fat as possible,” says Sheehan.

With each trip to the grocery store, you’ll feel more confident about your choices, and may be able to branch out to new flavors and options.

Even if you have reached expert label-reading levels, going out to eat can pose its own set of difficulties. How can you know the fat levels of each dish? In general, Simpson recommends avoiding alcohol, fruit juices, salad with dressing, potatoes, or fatty meat and fish. Instead, he suggests looking for fresh vegetables and low-fat fish like grilled or broiled cod.

“Avoid menu items with words like ‘au gratin,’ ‘creamy,’ ‘crispy,’ ‘fried,’ or ‘sautéed,’ which usually indicate high-fat foods,” says Sheehan. She recommends choosing safer options, like grilled or baked entrées, steamed vegetables, shrimp cocktail, plain baked potatoes, fresh fruit, and broth-based soups. “Just be sure they're made without added fats, sauces, or cheese,” she says.

• Stretch your advocate muscle. You have every right to ask for what you need. Ask your waiter to pass on to the chef that they can’t cook your dish with butter or oil.
• Don’t overexplain. You don’t need to explain FCS to your waiter. A simple, “I can only eat a small amount of fat because of a medical condition,” will work.
• Look ahead. Many restaurants post their menus on their websites, so you can plan your choices and special requests ahead of time.

When you have FCS, sharing a meal with extended family or a group of friends may spark anxiety, but you can still enjoy these gatherings with some preparation. If you see people in the group often, try to educate them about your condition and dietary restrictions ahead of time. “Talk, talk, talk about your diagnosis and requirements as listed above,” says Simpson.

For family members and friends you see infrequently, keep it simple on the day. Some loved ones may feel hurt that you don’t want to try their dish, but stand firm in your boundaries and gently remind them that eating too much fat can hurt your body.

“Invite them to try new FCS-friendly recipes with you to make adjusting to your new lifestyle more enjoyable while helping them understand how to support you,” says Sheehan.

• The extreme fat restrictions in a familial chylomicronemia syndrome diet can feel overwhelming, but with preparation, you can navigate the grocery store, restaurants, and family gatherings with ease.
• When grocery shopping, focus on fresh foods, and look for fat content on all food packaging labels to stay under your limit.
• When eating out or sharing a meal on holidays, educate your loved ones and advocate for yourself — you deserve to enjoy the outing and your meal.