What are FODMAPs?
FODMAPs are a group of short-chain carbohydrates that are not completely digested or absorbed in our small intestine. This can cause increased gas production and draw water into our gut during digestion. All of this contributes to possible feelings of bloating, gas, pain, and discomfort when consuming these foods.
FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. They can be found in various fruits and vegetables, dairy products, legumes, nuts, and artificial sweeteners.
To break down this ‘FODMAP’ term a bit further, ‘fermentable’ describes the quality of these short-chain carbohydrates that allow our gut bacteria to break them down for food, producing gas as a byproduct. Oligosaccharides include foods like onions, garlic, rye, and wheat. Disaccharides consist mainly of dairy products. Monosaccharides include foods like honey, apples, or high fructose corn syrup. Polyols are found in small amounts in fruits and vegetables and higher amounts in artificial sweeteners.
What is the Low FODMAP diet?
The low FODMAP diet is used in those with IBS who have symptoms of frequent bloating, abdominal pain, gas, or related stool issues. It is a fairly restrictive diet that eliminates high FODMAP foods, monitors for symptom improvement and then reintroduces them back into the diet as tolerated.
By understanding some foods that fall under these ‘FODMAP’ categories, we can better understand what the Low FODMAP diet is. Low FODMAP fruits and vegetables include oranges, kiwi, pineapple, green beans, bell peppers, carrots, and cucumbers. Low FODMAP dairy products consist of common alternatives like almond or soy-based products or lactose-free products. As for bread and cereals, it is recommended to choose products like sourdough bread, rice cakes, or quinoa-based pasta instead of wheat-based products. Low FODMAP options for sweets include dark chocolate and maple syrup. As for nuts and seeds, it is generally recommended to stay away from cashews and pistachios while the rest are considered safe.
It is highly recommended that those who are considering following the low FODMAP diet do so under the guidance of a registered dietitian. There are some great resources available to help build your understanding of the Low FODMAP diet, including those from Monash University, which coined the term FODMAP in 2005 and has done a lot of significant research in this area. Kate Scarlata is a registered dietitian specializing in food intolerances and the Low FODMAP diet and has a lot of great resources on her website as well.
When understanding the FODMAP diet, it is also essential to consider its proper implementation. The Low FODMAP diet is implemented in three stages: elimination, reintroduction, and personalization. Elimination typically lasts 2-6 weeks and requires swaps from high FODMAP foods to low FODMAP foods. At the end of this 2–6-week period, changes in GI symptoms should be assessed to see if there was true success with FODMAP elimination. If you find symptom relief with elimination in stage 1, then it is warranted to move on to stage 2. If you do not find symptom relief with stage 1, it is important to consider other possible explanations for your gastrointestinal symptoms.
Stage 2 is reintroduction, lasting up to 8-12 weeks. This stage involves small tests and trials to reintroduce high FODMAP foods into your diet. For example, let’s say someone starts their reintroduction phase with a dairy trial. They would start with small portions (1/4-1/3 of the amount typically consumed) of a food like yogurt into their diet for 2-3 days, slightly increasing the portion each day, with a 3-day rest before beginning the subsequent trial. This methodology limits any side effects or symptoms as much as possible. This stage is designed to test one’s tolerance of high FODMAP foods and see if certain foods or food groups are better tolerated. At the end of this stage, tolerance is assessed to help inform decisions made in the personalization stage. Stage 3 is personalization, when those high FODMAP foods best tolerated in stage 2 are reintroduced for the diet to be as expansive as possible. The end goal is not to be on the restrictive low FODMAP diet indefinitely but to use it as a strategic method to determine your individual dietary triggers and ease gastrointestinal symptoms as much as possible.
The FODMAP ‘gentle’ approach has also been designed to make this diet a bit more accessible and less demanding when eliminating so many foods from one’s diet. Instead of total elimination in stage 1, the ‘gentle’ approach advises using a food diary to track the high FODMAP foods that you tolerate the least and making low FODMAP swaps for those foods. One can still move through stages 2 and 3 after this preliminary stage, but this approach offers a much less restrictive option than the traditional low FOMDAP approach.
How do I know if the Low FODMAP diet is right for me?
Low FODMAP diets are typically beneficial for people with IBS who experience frequent bloating, abdominal pain, gas, or related stool issues. Because FODMAPs can exacerbate these symptoms, and people with IBS are more sensitive to these feelings of pain and discomfort, high FODMAP foods have been targeted as dietary triggers for this condition.
Not everyone with IBS may need to follow a Low FODMAP diet, and not everyone who follows a Low FODMAP diet has IBS. It is best to consult with a registered dietitian to learn about this diet and its proper implementation and allow them to assess if the low FODMAP diet is something that could be beneficial for you.
Written by: Carolyn McHugh, Dietetic Intern
Resources:
https://www.monashfodmap.com/about-fodmap-and-ibs/
https://www.monashfodmap.com/ibs-central/i-have-ibs/starting-the-low-fodmap-diet/
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