Exocrine pancreatic insufficiency (EPI) affects nutrient absorption. People with EPI need to ensure they eat a varied, balanced diet that provides carbohydrates, fats, and protein.
It is best for people living with EPI to carefully select their foods so they eat enough calories and nutrients to prevent deficiencies.
This article explains how diet affects EPI and its role in managing it. It also provides tips on which foods to eat and avoid with EPI and how to prevent malnutrition.
EPI happens when the pancreas does not produce enough exocrine pancreatic enzymes.
The lack of these enzymes causes the body difficulty breaking down food and absorbing nutrients.
Issues with digesting and absorbing food
- malnutrition
- deficiencies in fat-soluble nutrients, such as vitamins A, D, E, and K
- low bone mass, called osteopenia
- osteoporosis
- slowed or stunted growth in children
EPI can occur in people living with other health conditions,
People with these conditions often need a tailored diet, but EPI may require further dietary changes. Alongside treatment with nutrition supplements and enzyme replacement therapy, dietary changes can help manage EPI.
Fat intake is a very important consideration for people with EPI. These individuals
Due to this, a person living with EPI must also ensure they are getting enough fat. However, there is mixed evidence on whether someone with EPI should increase their fat intake beyond the Daily Value (DV) of around 78 grams daily.
The authors of a
Conversely, they state that a high fat diet can benefit people with cystic fibrosis and EPI.
A person with EPI can consult a doctor about which dietary approach is right for them. They should aim to eat foods with monounsaturated or polyunsaturated fats and fatty acids and limit foods high in saturated and trans fats.
Most people with EPI need to eat a varied, balanced diet full of carbohydrates, fats, and protein to maintain well-being. A person can prioritize minimally processed, fresh foods whenever possible.
Lean proteins
Lean proteins, such as chicken, turkey, eggs, lentils, and fish, can provide energy while also being low in trans and saturated fats.
Healthy fats
When choosing foods high in fat, it is
Foods rich in healthy fats include:
Small meals
It is
Dietary supplements
Dietary supplements may help increase the nutrients a person with EPI can absorb.
Taking supplements for fat-soluble vitamins, such as A, D, E, and K, can be beneficial.
A person with EPI can aim to avoid:
- high fiber foods
- heavy meals
- alcohol
High fiber foods
For
A
According to some guidelines, people with EPI can avoid very high fiber diets of more than
Heavy meals
Eating larger meals can make it more difficult for the pancreas to secrete enough enzymes to adequately break down food.
People with EPI can avoid eating larger meals. Instead, they can aim to eat smaller meals more frequently throughout the day.
Alcohol
It is best for a person with EPI to
Heavy and prolonged alcohol consumption is the
Alcohol also further disrupts the production of pancreatic enzymes, which can worsen EPI symptoms.
People living with EPI have a high risk of developing malnutrition, which involves deficits in vitamins, minerals, and calories.
Symptoms of malnutrition may include:
- weight loss
- skin rashes
- mouth sores
- hair loss
- behavioral changes, in some cases
A doctor or nutritionist will likely prescribe or recommend a combination of vitamin and mineral supplements as part of a person’s treatment.
In addition to dietary changes and supplements, a person
PERT works by replacing the defective or insufficient enzymes that the pancreas typically supplies. A person needs to take PERT with each meal to help aid digestion.
People living with EPI and those at increased risk of developing it can also avoid smoking. According to a
Some other tips a person can follow to help manage EPI include:
- finding or creating a support group to help with implementing and adhering to dietary changes
- getting regular physical activity
- keeping track of what foods work best to manage symptoms
- eating frequent, smaller meals throughout the day
- making sure to take the correct dosage of medication before each meal
Dietary changes can play a large role in treating and managing EPI. Healthcare professionals also recommend other lifestyle strategies, such as avoiding smoking and drinking alcohol.
Additionally, treatment with vitamin and mineral supplements and PERT is important to help ensure the proper absorption of nutrients into the body.
A person with EPI can work with their doctor, dietitian, or healthcare team to develop a diet and treatment plan to help them get the necessary nutrients and maintain their well-being.