For many patients with digestive disorders, food can feel like both the problem and the solution. Few clinicians understand that balance better than Nancee Jaffe, MS, RDN, CSDH, founding registered dietitian for the UCLA Vatche and Tamar Manoukian Division of Digestive Diseases. Since joining UCLA in 2012, Jaffe has helped build a comprehensive GI Nutrition Program that supports patients with complex digestive conditions while educating fellows, gastroenterologists, and other health care professionals about the evolving role of nutrition in gastrointestinal care.
Beyond UCLA, Jaffe leads a growing private practice, Nancee Jaffe & Associates Nutrition Services, where she and her team counsel patients with conditions including celiac disease, inflammatory bowel diseases, disorders of gut–brain interaction, and gastrointestinal manifestations of long COVID and dysautonomia. A national speaker and leader in the field, she also helped formalize DIGID (Dietitians in Gluten and Gastrointestinal Disorders), a GI-focused dietitian group jointly housed within AGA and the Academy of Nutrition and Dietetics in 2020, and she serves as a committee lead for the Rome Foundation Diet and Nutrition Section.
In this spotlight, Jaffe reflects on her unexpected path into gastrointestinal nutrition, the growing role of dietitians on the GI care team and why helping patients rebuild a healthy relationship with food can be just as important as managing symptoms.
What first drew you to the field of gastrointestinal nutrition, and how did that path lead you to UCLA?
My deep interest in the digestive tract began in 2002 after I contracted a parasite during a study abroad program in Ecuador. The parasite remained in my body for about a year and a half and grew to roughly 1.5 feet long. After it passed, I began experiencing a range of unexpected and disruptive symptoms, including dizziness, fainting spells, extreme hunger, depression, bloating, weight loss, indigestion, and diarrhea.
After seeing seven doctors and spending six years searching for answers, I was finally diagnosed with celiac disease. Within two weeks of starting a strict gluten-free diet, all my symptoms disappeared.
Feeling so dramatically better — and remembering how long and difficult my diagnostic journey had been — motivated me to become a health care professional who could help others with gastrointestinal disorders. During graduate school, I completed one of my dietetic internships with the UCLA Division of Digestive Diseases, and I was fortunate that they later invited me to stay on as their first GI-specialized dietitian.
For gastroenterologists who may not work closely with dietitians, what does a GI-specialized dietitian bring to the care team that differs from general nutrition counseling?
Expert GI dietitians play many roles on the care team. In many ways, we act as detectives — listening closely to patients’ symptoms, reviewing their diet and eating patterns, and identifying potential food triggers without unnecessarily over-restricting their diets.
We also bring evidence-based knowledge that helps cut through the overwhelming amount of nutrition information available today. Both patients and providers are often exposed to conflicting advice, and GI dietitians help translate current research into practical strategies.
Another important role is serving as a bridge between medical recommendations and everyday life. We help translate clinical guidance into realistic and sustainable dietary approaches.
For many patients, food becomes something they fear. They worry that every bite may trigger pain, bloating, or an urgent trip to the bathroom. That fear can spiral into restrictive eating patterns or even disordered eating. A GI-specialized dietitian helps patients reclaim food as nourishment and enjoyment — not something to fear — while still managing digestive symptoms.
Nutrition is often one of the first things patients ask about when they receive a GI diagnosis. How do you help patients navigate the overwhelming amount of diet advice available online?
Much of my work involves helping patients filter through the noise. There is an enormous amount of diet advice online, and much of it is contradictory or unsupported by evidence.
I help patients understand what science shows, what might apply to their specific condition, and what is likely unnecessary or overly restrictive. My goal is to help patients build a balanced, sustainable approach to eating that improves symptoms without creating unnecessary fear around food.
What are some of the most common misconceptions about diet and digestive health?
One of the most common misconceptions is that food causes IBS, or that there is a "perfect" diet that can cure it. Patients often say, "If I avoid gluten, dairy, or fiber — or eat more fiber — maybe my IBS will go away."
The truth is that food does not cause IBS, and there is not a single cure-all diet. However, nutrition can play an important role in managing symptoms and improving quality of life.
Many patients also believe they need allergy testing, food sensitivity panels, or extreme elimination diets to control symptoms. Digestive issues are complex. Food can certainly act as a trigger, but symptoms often arise from a gut that is already hypersensitive.
This means the same food may feel fine one day and trigger another. Helping patients understand this variability can take pressure off their food choices and allow for a more balanced, flexible approach to diet.
Where do you see nutrition therapy having the greatest impact on patient outcomes or quality of life?
Patients often want diet to play a role in managing their disease because it is something they feel they can control. Helping patients find the right balance between dietary changes and acceptance of the role diet plays in their condition can be incredibly powerful.
When patients understand the evidence and learn how to use nutrition to improve their quality of life, they feel empowered. At the same time, recognizing that diet is rarely a cure-all can relieve pressure and reduce unnecessary food restrictions.
Instead of labeling foods as "good" or "bad," we can help patients think about foods as everyday choices, special-occasion foods, or foods that may be better tolerated in smaller portions or with evidence-based tools like digestive enzymes.
The role of GI-focused dietitians has grown significantly in recent years. What factors do you think are driving that shift?
As more research emerges demonstrating the impact of diet on digestive symptoms and quality of life, interest in nutrition as a component of treatment has grown.
At the same time, patients have always wanted guidance on diet. We all eat every day, and our relationship with food plays a significant role in our health and well-being. Creating a diet that is balanced, adequate, enjoyable, and supportive of healing can make a meaningful difference for many GI patients.
In addition, increased attention to the gut microbiome and the role of prebiotics and probiotics has brought even more focus to the relationship between food, gut health, and overall wellness.
What barriers still exist to integrating GI dietitians into clinical practice, and what changes would help make this type of care more widely available?
One major challenge is the limited number of dietitians with specialized expertise in GI disorders, which restricts access for patients who could benefit from targeted nutrition therapy. Misconceptions about insurance coverage also play a role; many patients and providers assume that nutrition services are not covered.
At the same time, certain insurers — including Medicare — do not reimburse medical nutrition therapy for many GI conditions. Additionally, misinformation from social media influencers and other media sources can undermine evidence-based dietary guidance and create confusion for patients.
Finally, some health care providers still underestimate the value of including a dietitian as part of the multidisciplinary GI care team. Expanding specialized training opportunities, improving insurance coverage and reimbursement, addressing misinformation, and increasing provider awareness could all help make GI dietitian services more widely accessible.
When should a gastroenterologist consider referring a patient to a GI-specific dietitian?
The short answer is almost anytime diet comes up in a clinical visit.
Whenever dietary concerns are discussed, a referral to a GI-specialized dietitian can be valuable. A brief conversation or a one-page handout is rarely enough to address patients’ diet-related questions.
There’s a reason dietitians often spend 60–90 minutes during an initial consultation. Diet is complex, personal, and emotionally significant. Patients benefit from a thorough, individualized discussion rather than quick recommendations delivered during a busy clinic visit.
Lightning Round
What are you excited about working on right now?
Building my private practice with two expert dietitian associates and serving as a board member on the UCLA Integrative Digestive Health Program Education Committee.
Favorite quote or words to live by?
The Voltaire quote: "Perfect is the enemy of good."
Biggest misconception about your career?
That dietitians just tell patients to eat more vegetables — or that discussing diet is easy. We act as detectives, understand pathophysiology, and provide evidence-based, yet practical, guidance.
Best way to unwind after work?
Exercise. I love to dance and take long walks.
Favorite AGA memory?
Helping build the alliance between AGA and the Academy of Nutrition and Dietetics in 2020.
Describe your dream retirement.
Living in a small forest town with lots of rain and plenty of time for reading and making art.
Favorite hobby?
Bookbinding. I apprentice once a month with a master bookbinder in Hollywood, CA.