The low FODMAP diet is a diet specifically designed for people with IBS (irritable bowel syndrome). Those who follow the diet will go through three phases: elimination, reintroduction, and integration, where they will hopefully discover which foods may be triggering their IBS symptoms and which they can continue to eat without issue.
The low FODMAP diet eliminates or drastically reduces the intake of certain sugars, which tend to stay in our digestive system and ferment as we struggle to digest them. When our gut microbiota break them down, they produce gas, which can cause painful bloating and other uncomfortable symptoms.
IBS affects 7-15% of the general population, and many people experience bloating, gas, and stomach pain, as well as constipation, diarrhea, or a mixture of the two. These symptoms can range from mildly uncomfortable to debilitating, with one person with IBS experiencing the disease differently than the next.
Here, we’ll explain what FODMAPs are, what you can eat on a low-FODMAP diet, and how you can manage your IBS long-term. Additionally, find out about gut health and how to improve your digestion here at LiveScience.
What are FODMAPS?
FODMAP stands for “fermentable oligo-, di-, mono-saccharides, and polyols,” which are short-chain sugars that can trigger symptoms in people with IBS when consumed.
“FODMAPs are short-chain sugars found in a variety of grains, fruits and vegetables as well as added to some processed foods,” says Dr. Bridgette Wilson, a Doctify (opens in a new tab)-gut specialist and clinical and research dietitian. “Sugars are linked together in such a way that humans may not be able to digest them. These FODMAP sugars can be digested by gut microbes in a process called fermentation, which produces gas as a byproduct.
FODMAPs exist in a wide range of foods, according to a study by the Nutrients (opens in a new tab)journal, and people may find it difficult to avoid them properly or meet their nutritional needs enough while following a low-FODMAP diet, so support from a dietitian is essential for success.
What can you eat on a low FODMAP diet?
Dr. Wilson encourages people on a low-FODMAP diet to seek expert help, especially in the restriction phase. “You can eat foods from all food groups on a low FODMAP diet, it’s important to get expert advice to help you follow the diet accurately and maintain a good balance of nutrients while following the diet. restricted phase of the diet,” she says.
Some foods you can still enjoy on the low FODMAP diet include:
- Vegetables: Carrots, chives, cucumbers, eggplant, bamboo shoots, spinach, spring onions, ginger, lettuce, parsnips, potatoes and turnips.
- Fruits: Lemons, limes, oranges, grapefruit, bananas, strawberries, blueberries, cantaloupe and honeydew melons and kiwi. It’s important to note that some of these foods become high in FODMAPs when under- or over-ripe, so you need to check at what stages you can eat.
- Meat and fish: Most unprocessed meats are fine, but beware of processed meats like salami which sometimes contain garlic.
- Dairy products and dairy substitutes: Lactose Free Milk, almond milk, oat milkmilk rice, coconut milklactose-free yogurt and hard cheeses.
- Cereals: Oats, rice, gluten free pasta, quinoa and corn flour. Check the label of anything listed as “gluten-free” to make sure it doesn’t contain other trigger ingredients. Note: It’s not gluten that you avoid on the low FODMAP diet, it’s the sugars in wheat. However, since gluten-free products are also wheat-free, you can usually eat them.
Dr Tariq Mahmood, physician and medical director at Diagnostic concept (opens in a new tab), notes that although the low-FODMAP diet may seem restrictive at first glance, it is possible to stay healthy and full while eating low-FODMAP. “There are a lot of foods that are absolutely fine to eat. For example, eggs, fish and meat,” he says. “There are also a lot of fruits, grains and vegetables – grapes , oranges, strawberries, cucumbers, potatoes, tomatoes, oats, quinoa and rice to name a few.
“Common beverages like tea and coffee can also be consumed on a low FODMAP diet, but no more than three cups a day.”
How to Follow a Low FODMAP Diet
Dr. Mahmood lists some foods to avoid on a low FODMAP diet: “Foods to avoid in excess on a low FODMAP diet include fruits like apples and watermelon, dairy products like cream cheeses and soft cheeses, ice cream and milk, vegetables like broccoli, mushrooms and onions as well as wheat products like cookies, bread and pasta,” he says. Once you’ve eliminated all high-FODMAP foods, you can try slowly reintroducing them one at a time to see which ones do or don’t cause digestive symptoms.
“Another thing to consider is that when changing your diet, it can be difficult to ensure your body is getting all the nutrients it needs. As such, multivitamins and supplements are your friends. omega-3s, vitamin D, vitamin B6, and calcium are just a few of the most important vitamins and minerals you’ll need to stay on top.
A study in the Journal of Gastroenterology and Hepatology (opens in a new tab)encourages people wishing to try the low FODMAP diet to do so under the supervision of a dietitian. He also recommends that the initial elimination phase should last no longer than 4 to 6 weeks, as following the diet long-term can have negative effects on the gut microbiome.
The stages of the low FODMAP diet
“The low-FODMAP diet is a process of short-term elimination of foods high in fermentable sugars (FODMAPs) followed by a precise reintroduction process to identify the specific group of foods that may be triggering symptoms,” says Dr Wilson. . “The final step in this process is personalization where the diet is expanded to include all non-trigger FODMAP foods,”
In this phase, all foods high in FODMAPs are cut out for a period of 4-6 weeks. The elimination guide made by Monash University (opens in a new tab) (where the low FODMAP diet was developed) reminds us that the low FODMAP diet is not an elimination diet, but a replacement diet. While it may seem difficult to swap foods with very distinct flavors like onions and garlic, a dietitian can point you towards low-FODMAP alternatives, like chives or garlic-infused oil. , which can facilitate this phase.
Reintroduction involves strategically testing each FODMAP subgroup (fructose, lactose, sorbitol, mannitol, fructans, and galactans) to see if you can digest them without experiencing symptoms. You will maintain the low FODMAP diet in the background and test each subgroup individually and in increasing amounts over a few days, pausing for a few days before attempting another re-introduction. You may find that you can tolerate some foods in small amounts, while others can be completely incorporated into your diet without restriction. It’s important to have the support of a dietitian for this step, as they can give you advice on the best foods to test your tolerance to each subgroup.
In the integration phase, you work with your dietician to take the results of the reintroduction phase and apply them to your diet. If certain FODMAPs still trigger you after elimination, they will be avoided in the future, but you can test your tolerance every few months as our response to FODMAPs tends to change over time.
These 5 ways to improve gut health might offer some tips to help you improve your gut health after the integration phase.
Benefits of a low FODMAP diet
According to Dr. Mahmood, “Digestive problems are also linked to anxiety, depression and stress, which makes a low FODMAP diet worthwhile if you’re battling IBS.”
He also says that avoiding all FODMAPs is a serious challenge that borders on the impossible, as some of the most common FODMAPs include fructose (found in most fruits and vegetables), fructans (found in grains), and lactose (found in dairy products). However, research has shown that bloating, pain, and passing wind were also reduced in IBS patients who followed a low-FODMAP diet.
A study in the Nutrients (opens in a new tab) journal also found that the low-FODMAP diet significantly reduced bloating and pain in the subjects. As these are two of the main symptoms of IBS, cutting out the foods responsible for these symptoms could help alleviate some of the burden of IBS.
“The low FODMAP diet has been clinically proven to significantly reduce IBS symptoms,” adds Dr. Wilson. “It’s a process of identifying specific dietary triggers of IBS symptoms. By knowing exactly which foods are triggers, people with IBS can regain their confidence, freeing them from food and social anxiety..”