I think the difference in diet recommendations are likely a result of the physician's experience with the disease and what has and has not worked for their patients. A compromised pancreas makes it more difficult to digest all food and fat is the most difficult of the three types of food we consume to digest. If you have had no problems with consuming fat, I am envious. Even with digestive enzymes (I have also taken Zenpep at near the level you do as well as pancrealipase (sp?) and another generic enzyme before they were removed from the market), most of us with EPI are racked with pain after eating large amounts of fat. I don't try to get to zero grams, but something below 40 grams works best for me. I also try to avoid large meals instead opting for 4-6 of 300 calories or less. My total calorie goal is about 1600/day unless I have an unusually long exercise session or golf when I am losing lots of fluids.

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