What is a Low FODMAP Diet?

by admin | Jul 20, 2015 | Doctors Perspective

Do you eat the same foods every day?  
Health problems such as: digestive, headaches, low energy, depression, skin irritations, joint aches, difficulty losing weight and more may be related to a specific food or foods you eat frequently.

Many people with food sensitivities don’t even realize how awful they feel until the “trigger” foods are removed from the diet. Food reactions are a frequently overlooked cause of chronic health issues. Some reactions occur immediately after eating the food (called “food allergy”), but in other cases, symptoms may be delayed by several hours or even days (referred to as “food sensitivity” or “food intolerance”). Removing specific foods from your diet will allow your body to recover and begin to function efficiently again.  

So what is FODMAP?
FODMAP stands for Fermentable Oligo, Di, and Mono-saccharides, And Polyols. The acronym is used to describe a specific group of carbohydrates that are poorly absorbed in the small intestine and often cause symptoms such as excess gas, bloating, and diarrhea in certain individuals with irritable Bowel Syndrome (IBS) and other functional bowel disorders.

What carbohydrate foods are FODMAPs?
FODMAP carbohydrates include:

• Certain sugars (lactose and fructose) found in foods such as mile and dairy products, fruit, honey, and high-fructose corn syrup.
• Artificial sweeteners (polyols), especially sweeteners containing sorbitol and mannitol.
• Certain types of fiber (fructans and galactans) found in wheat, beans, and some vegetables.

FODMAP tolerance:
All FODMAPs have the potential to cause unwanted symptoms. Yet, the degree in which FODMAPs are tolerated varies from person to person. An individual’s physical response to certain FODMAPs depends on their own person level of sensitivity. Therefore, some FODMAP groups may trigger symptoms while others might not.

Think of the small intestine as a bucket. Each person has their own size bucket, or unique tolerance for FODMAP carbohydrates. FODMAPs have a cumulative effect. That is, the amount, not just the type of FODMAP consumed matters. When FODMAP intake exceeds the amount the “bucket” can hold (the small intestine’s capacity for digestion and absorption), it overflows into the large intestine. This may lead to gas, bloating, and diarrhea.

The FODMAP approach:
It is important to understand that IBS and other functional bowel disorders are not caused by eating FODMAPs, therefore eliminating FODMAPs from the diet will not cure the disease. However, removing certain FODMAPs from the diet may greatly improve symptoms.

The FODMAP approach takes into consideration tolerance to all FODMAP carbohydrate groups, not just specific foods. Often times in an attempt to ease symptoms, individuals tend to be overly restrictive with their diet. This leads to nutritional deficiencies. The goal of the FODMAP approach is to manage symptoms while allowing for the most varied and nutritious diet possible.

Low FODMAP diet:
A low FODMAP diet aims to minimize gastrointestinal symptoms by removing common high FODMAP foods and replacing them with low FODMAP alternatives. It is intended to be a short-term diet and is usually followed for six weeks or less. It is not to be used as a permanent diet solution. After symptoms improve, high FODMAP foods are gradually added back into the diet in smaller amounts.

FODMAP Elimination diet:
A more aggressive approach is a FODMAP elimination diet. It should not be attempted without the help and supervision of either a Registered Dietitian or healthcare provider. An elimination diet is a temporary learning diet that is used to identify troublesome FODMAPs. It consists of three phases:

• Elimination phase: all FODMAPs are eliminated from the diet for approximately 3 weeks.
• Challenge phase: the body is challenged by reintroducing FODMAPs into the diet in an organized way. Symptoms are observed and problematic FODMAPs are identified.
• Final phase: problem FODMAPs are incorporated back into the diet as tolerated.

Rather than excluding all FODMAPs from the diet, the goal of both diet methods is to eliminate only the FODMAPs that are problematic. With proper management, few, if any foods must be removed from the diet permanently.

Is a low FODMAP diet right for you?
A low FODMAP diet may not be appropriate for everyone. Before beginning a low FODMAP diet, first consult your healthcare provider to eliminate other causes of your symptoms. Low FODMAP diets have shown to be most successful for persons who have:

• An official diagnosis of Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disease (IBD) or other functional bowel disorder with symptoms of excess gas, bloating, abdominal pain, diarrhea/constipation, etc.
• Tried and failed standard therapy (high-fiber diet, increased fluid intake, increased exercise, etc.)
• Ruled out celiac disease as a possible diagnosis. This is important as restriction wheat from the diet will affect the accuracy of future celiac testing.
• Regular or irregular intake of high FODMAP foods.
• The desire and ability to modify their diet.

**Additional testing such as lactose and/or fructose breath tests is helpful (bot not essential) prior to beginning a FODMAP diet.

Enlist the help of a Registered Dietitian:
If it is determined that a low FODMAP diet would be beneficial to you, consulting a Registered Dietitian (RD) who specialized in gastrointestinal nutrition can increase the likelihood of your success. The RD will help to identify major FODMAP culprits in your diet and develop an individualized diet plan centered around your eating habits and food preferences to improve both symptoms and quality of life.

Try these low- FODMAP foods

Avoid these foods containing FODMAPs

More information about FODMAP can be found here.