{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T14:04:48Z","timestamp":1788876288944,"version":"build-2803163510"},"reference-count":71,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Dietary therapy has an established role in managing gastrointestinal disorders, as a short\u2010term induction therapy (e.g., exclusive enteral nutrition for Crohn's disease), a long\u2010term monotherapy (e.g., gluten\u2010free diet for coeliac disease and a personalized FODMAP diet) or adjunct therapy (e.g., Mediterranean diet). As use of dietary therapies rises, it is becoming increasingly common for gastroenterologists and dietitians to encounter patients who are simultaneously following two or more dietary therapies to achieve optimal symptom control, to manage multiple concurrent medical issues, or for social or religious reasons. This practice is termed \u2018diet stacking\u2019. The aim of this review is to clarify the principles behind the safe and effective combination of dietary interventions with specific attention to potential risks, mitigation of risk and practical application. For gastroenterologists, awareness of current dietary practices of their patients prior to advising dietary therapy is warranted and, in those who are diet stacking, risk assessment is essential. Validated screening tools to evaluate risks, particularly of disordered eating, are limited. The management of those who currently or are at risk of diet stacking is best directed toward gastrointestinal dietitians who offer time, appropriate skills for assessment, and the delivery of pragmatic patient education to safely implement appropriate dietary interventions, and assess for the need for engaging psychological primary management or co\u2010management. In conclusion, diet stacking is common, and requires awareness and often multi\u2010disciplinary management to ensure it is implemented safely.<\/jats:p>","DOI":"10.1002\/jgh3.70314","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T06:02:24Z","timestamp":1765346544000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Diet Stacking \u2013 An Expanding Challenge for Gastroenterologists and Dietitians in Managing Chronic Gastrointestinal Disorders"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5043-7946","authenticated-orcid":false,"given":"Sarah L.","family":"Melton","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, School of Translational Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8000-1000","authenticated-orcid":false,"given":"Simon R.","family":"Knowles","sequence":"additional","affiliation":[{"name":"School of Health Sciences Swinburne University of Technology  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4813-0053","authenticated-orcid":false,"given":"Kok\u2010Ann","family":"Gwee","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9108-1712","authenticated-orcid":false,"given":"Peter R.","family":"Gibson","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, School of Translational Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5343-7842","authenticated-orcid":false,"given":"Caroline J.","family":"Tuck","sequence":"additional","affiliation":[{"name":"School of Health Sciences Swinburne University of Technology  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4905-5056","authenticated-orcid":false,"given":"Alice S.","family":"Day","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology The Queen Elizabeth Hospital  Adelaide South Australia Australia"},{"name":"School of Medicine, Faculty of Health Sciences University of Adelaide  Adelaide South Australia Australia"},{"name":"Basil Hetzel Research Institute  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.04.014"},{"issue":"1","key":"e_1_2_11_3_1","first-page":"23","article-title":"Patient and Community Health Global Burden in a World With More Celiac Disease","volume":"167","author":"Gatti S.","year":"2024","journal-title":"Gastroenterology"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-065186"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2023.06.005"},{"issue":"10","key":"e_1_2_11_6_1","first-page":"2258.e3","article-title":"A Low FODMAP Diet Reduces Symptoms in Treated Celiac Patients With Ongoing Symptoms\u2010A Randomized Controlled Trial","volume":"20","author":"Megen F.","year":"2022","journal-title":"Clinical Gastroenterology and Hepatology"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13730"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jhn.70134"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.70116"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu11123038"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12328-015-0611-x"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001029"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(22)00351-X"},{"key":"e_1_2_11_14_1","volume-title":"Feeding and Eating Disorders","author":"American Psychiatric Association","year":"2013"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.15018"},{"key":"e_1_2_11_16_1","volume-title":"Handbook on Diet and the Gut","author":"Knowles S. 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