Low Residue Diet Foods
A low residue/low fiber diet should contain a maximum of 10g of fiber per day and includes white bread, white rice, refined pasta, low-fiber cereals (Rice Krispies, corn flakes), lean meats (chicken breast, lean beef, fish, eggs), and smooth nut butters in small amounts. 1, 2, 3
Defining Low Residue vs. Low Fiber
The terms "low residue" and "low fiber" are used interchangeably in clinical practice, with both referring to diets containing less than 10g of total fiber daily. 1, 3 The quantitative definition of <10g fiber/day represents the accepted standard based on ESPEN guidelines and research consensus. 1, 3
Recommended Foods
Grains and Starches
- White bread (not whole grain) 2
- White rice 2
- Refined pasta (not whole grain) 2
- Low-fiber cereals such as Rice Krispies and corn flakes 2
- Pancakes made with refined flour 1
Protein Sources
- Lean meats including chicken breast, lean beef, fish, and eggs 2
- Smooth nut butters in small amounts (avoid chunky varieties) 2
- Cheese and yogurt in moderate amounts 1
Beverages and Other Items
- Pulp-free juices (such as pulp-free orange juice) 1
- Jello and dairy desserts/mousse 1
- Golden syrup and honey in limited amounts 1
Foods to Avoid
While the guidelines focus on permitted foods, a low residue diet inherently excludes:
- Whole grains and whole wheat products 2
- High-fiber cereals 2
- Raw vegetables and fruits with skins 1
- Nuts and seeds (except smooth nut butters) 2
- Legumes and beans 1
Clinical Applications
The primary evidence-based indication for a low residue diet is colonoscopy preparation, where it should be consumed solely on the day preceding the procedure to achieve better colon cleansing and reduce patient discomfort. 1 This recommendation carries a Grade B strength with 94.3% consensus. 1
Additional Uses
- Pre-competition or high-intensity training in athletes to reduce gastrointestinal complaints 2
- Post-colorectal surgery (day one postoperatively) where it is associated with less nausea, faster return of bowel function, and shorter hospital stay compared to clear liquid diets 1
- Weight management in weight-division sports 2
Important Caveats
Low residue diets are NOT recommended for long-term use as they lack essential nutrients and adequate fiber for overall health. 2 Long-term fiber restriction may negatively impact gut microbiome diversity. 2
There is insufficient evidence to recommend low residue diets for management of diverticulitis, acute colitis, Crohn's disease, or ulcerative colitis. 1, 2 In fact, historical recommendations to avoid nuts, seeds, corn, and popcorn in diverticular disease have no supporting evidence. 4 One prospective controlled study in Crohn's disease showed no difference in outcomes between low residue and normal diets over 29 months. 5
Practical Implementation
For colonoscopy preparation, patients should follow the low residue diet until lunch the day before the procedure if they have no risk factors for poor preparation. 1 Compliance with dietary restrictions improves when patients understand that the low residue diet combined with cathartic agents achieves better colon cleansing and is better tolerated than clear liquid diets alone. 1, 6