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Are you familiar with FODMAPs?
If not, don’t worry, by the time you’ve finished reading this post, you’ll be armed with all the info you need to know, and all of your burning questions will have been answered.
Let’s get stuck in, shall we?
What are FODMAPs?
FODMAP is an acronym and it stands for:
They are fermentable carbohydrates and sugar alcohols that are poorly absorbed in the intestines and can trigger IBS symptoms.
What happens when you eat FODMAPs?
There are two mechanisms by which FODMAPs can trigger IBS symptoms:
- They draw water into your small intestine, leading to diarrhoea.
- They are rapidly fermented by your gut bacteria in the large intestine, which causes the intestines to stretch and stimulates nerves in the gut, leading to pain and discomfort. An increase in fermentation can also slow down the movement of food through the intestines, leading to constipation.
FODMAPs don’t cause any physical damage to your intestines, but up to 80% of IBS sufferers are sensitive to theses effects.
It’s worth noting that most healthy people (and the remaining ~20% of IBS sufferers) can consume FODMAPs without any issues at all.
This video provides an excellent visual animation of what happens inside your guts when you eat FODMAPs.
What foods contain FODMAPs?
FODMAPs are found naturally in a number of foods and drinks.
- Oligosaccharides – Fructans and GOS are oligosaccharides. Fructans are found in cereals such as wheat and rye, dried fruits, onions, garlic, and some other fruits and veggies. GOS is found in beans, lentils, some nuts, and green peas.
- Disaccharides – Lactose is a disaccharide. Lactose is found in dairy products, including milk, yoghurt, and cheese (in varying amounts).
- Monosaccharides – Fructose is a monosaccharide. Fructose is found in some fruits and veggies, including apples, pears, mango, asparagus, sugar snap peas and fruit juice, as well as honey, and the sweetener, high fructose corn syrup.
- Polyols – Sorbitol and mannitol are polyols. Sorbitol is found in avocados and other stone fruits, blackberries and coconut. Mannitol is found in mushrooms, sweet potato, cauliflower, celery and mangetout. Polyols are also used as artificial sweeteners (i.e. xylitol).
These lists are not exhaustive by any means – I’ve just given a few examples of foods high in FODMAPs here.
Are FODMAPs bad for you?
No, quite the opposite! It’s a bit of a paradox, but FODMAP-containing foods are mostly beneficial for health.
As you can see, most foods that are high in FODMAPs are plant foods; fruits, vegetables, whole grains, legumes, nuts and seeds. These are the healthiest foods on the planet, thanks to their vitamin, mineral, fibre and phytochemical content.
Long-term avoidance of FODMAPs can upset the balance of bacteria in your gut – your gut microbes thrive on the fibre found in FODMAP-containing foods. The ‘good’ microbes living in your gut provide a vast range of health benefits, including training your immune system, ensuring effective communication between the brain and the gut, and maintaining the lining of your colon.
The gut microbiota is a fascinating and emerging area of scientific research, which is still in its infancy, but what we do know so far is that diversity of this ecosystem living in your gut is a biomarker for health.
In short, FODMAPs contribute to a healthy microbiota, which, in turn, means better health outcomes both inside and outside of the gut.
Learn how you can ensure you get adequate fibre on the low FODMAP diet here.
Should I avoid FODMAPs if I have IBS?
If you have IBS, your doctor may recommend the low FODMAP diet to you. This is an elimination process to help you identify your personal trigger foods.
The good news is that people who are sensitive to FODMAPs are rarely sensitive to all FODMAP groups.
You may find that you can tolerate fructose just fine, but fructans and GOS trigger your symptoms, or visa versa.
Everybody has different triggers which is why you should never cut foods, or food groups, out of your diet based on generalist advice, or what triggers other people.
What is the Low FODMAP Diet?
As I briefly touched on above, the low FODMAP diet is a three-phased process of elimination. Here’s how it works:
- Phase 1 – Elimination (2-8 weeks): you eat mostly low FODMAP foods and avoid high / moderate FODMAP foods during this phase. The aim is to induce symptom control.
- Phase 2 – Reintroduction (6-12 weeks): high FODMAP food groups are challenged, one-by one, to check for tolerance. The aim is to identify FODMAP sensitivities.
- Phase 3 – Personalisation (ongoing): well-tolerated FODMAPs are eaten freely and poorly-tolerated FODMAPs are limited. The aim is establish a minimally restrictive, personalised FODMAP diet for the long-term.
What are the benefits of the Low FODMAP Diet?
In a number of high-quality clinical trials, the low FODMAP diet has been shown to:
- Reduce pain and discomfort
- Reduce bloating and distension
- Improve bowel habits (reduce diarrhea or constipation)
The low FODMAP diet isn’t a cure for IBS, but it can help many people reduce their symptom frequency and severity, and improve their overall quality of life.
Three important things to know about the Low FODMAP Diet
- Think of the process as a diagnostic tool, rather than a therapeutic diet.
- It’s vital not to skip the reintroduction phase. Find out why this is so important here.
- Many online resources for the low FODMAP diet are not up-to date, so be careful where you take your information from.
Can I do the Low FODMAP Diet if I’m plant-based?
The low FODMAP diet process can be adapted for vegans, vegetarians and other plant-based eaters, but it is fairly complex and should be overseen by a nutritionist or dietitian trained in the implementation of the protocol.
This is true for everyone – it was never intended to be a DIY solution – but this is especially important if you’re plant-based to ensure you meet your nutritional requirements.
I’ve tried the Low FODMAP Diet before and it didn’t work. What should I do now?
There are a few reasons why you may not have found success with the low FODMAP diet:
- You are one of the ~20% of IBS sufferers who are not sensitive to FODMAPs and you need to explore reduction of gut irritants and stimulants, modifying your fibre intake, adequate hydration, stress and the gut-brain axis, or other lifestyle factors such as movement and sleep.
- You didn’t follow the process correctly by yourself (it’s not your fault – this is very common!). As I’ve touched on already, many online resources for the low FODMAP diet are outdated because food testing is ongoing and many foods are being re-tested. Many people also struggle with interpreting the results of their food challenges in the reintroduction phase without the help and support of a FODMAP-trained health professional. Lastly, you may have been accidentally stacking FODMAPs, meaning you hadn’t reduced your intake low enough to see any change.
- You don’t actually have IBS. While it is rare to be misdiagnosed if you have been assessed under current medical guidelines, it does happen occasionally.
Is the Low FODMAP Diet right for you?
The low FODMAP diet isn’t suitable for everyone. Although it is a short-term diet, it is very restrictive and should not be attempted by pregnant women, older adults and children, and those with a history of disordered eating.
The low FODMAP diet can be adapted and simplified based on your existing intake of FODMAPs and lifestyle requirements. A thorough assessment is needed to make personalised recommendations – there is no one-size-fits-all approach!
I’ve worked with many clients who have successfully reduced their IBS symptoms and normalised their bowel habits without the low FODMAP diet, so it shouldn’t be considered a first-line therapy.
If you’d like to learn more about whether the low FODMAP diet may be right for you, book a complimentary discovery call with me to discuss further.