A BEGINNER’S GUIDE TO GOING FODMAP-FRIENDLY
One of the most effective ways we can actually improve our health is through diet, but changing your diet is one thing and knowing which diet is right for you is another. While it can be hard to figure out what the best diet is, one thing we've learned recently is that there is no one-size-fits-all approach to healthy eating.
There are many factors that influence your personal dietary needs, some of which include age, pregnancy, genetics...even your unique microbiome plays a role. [1] Another important factor to consider is your current gut health, as this can greatly affect your ability to digest, absorb and tolerate the different foods you eat. A bowel disorder that affects your response to certain foods is called medically diagnosed irritable bowel syndrome (MD-IBS).
MD-IBS is a common condition that affects the bowels of up to one in five Australians, causing symptoms such as gas, bloating and abdominal discomfort. While researchers have yet to determine the cause, approximately 70-89% of patients report that certain foods make symptoms worse.[2] While classically rich foods like alcohol and fat are known for their ability to disrupt the guts of people with MD-IBS, there are also some foods that we typically consider healthy that can act as triggers. Collectively, these foods are called FODMAPs.
If you have MD-IBS, you've probably heard of the low FODMAP diet, but maybe you've always wondered what it means?
Let us break down the science for you so you can weigh the pros and cons and, with the help of your doctor, decide if a low-FODMAP diet is right for you.
WHAT ARE FODMAPS?
First, let's answer the question - what does FODMAP stand for?
FODMAP is an acronym for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols, which describes a group of short-chain, fermentable carbohydrates and sugar alcohols. [3]
Simply put, FODMAPs are a specific group of carbohydrates that are poorly digested and poorly absorbed in the digestive tract. Their presence in the gut causes 3 major changes, including:Increased gut movements
A build-up of fluid in the small intestine
Increased production of gas[2],[4]
*Cue the stretchy pants!
These changes are thought to cause symptoms associated with MD irritable bowel syndrome, but their reasons are not fully understood. Similar changes can occur in people without symptoms of MD-IBS, leading researchers to suggest that these symptoms may be due to increased "sensitivity" to these foods rather than directly caused by the food itself.[2]
WHAT ARE THE BENEFITS OF A LOW FODMAP DIET?
Several studies have shown an association between a short-term low-FODMAP diet and a reduction in MD IBS symptoms such as abdominal pain and bloating.[4] Reducing dietary FODMAPs is thought to help improve gut microbiome health as well as gut barrier integrity, both of which are altered in MD-IBS.[4] However, as with most diets, there is evidence that these benefits do not apply to all patients with MD-IBS, so personal professional advice is recommended.
WHAT CAN YOU ACTUALLY EAT ON A LOW FODMAP DIET?
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Foods to enjoy |
Foods to avoid |
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Eggs and meat Certain dairy, such as low-lactose or lactose free varieties Almond milk Grains such as rice and oats Nuts and seeds Vegetables like potatoes, tomatoes, carrots, cucumbers and zucchini Fruits such as grapes, oranges, strawberries, blueberries and pineapple
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Wheat based foods – such as biscuits, cereals and breads Full lactose dairy – including regular cow’s milk and cheese Some fruits – such as apples and pears Some vegetables – including garlic and onions Legumes
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It's important to remember that everyone is different on the FODMAP diet. For example, you might tolerate some FODMAPs but not others, or you might be able to have a small amount of all FOMDAPs. This is why it is so important to seek advice from a medical professional to avoid any unnecessary restrictions.
REASONS WHY A LOW FODMAP DIET MAY NOT BE FOR YOU:
A low FODMAP diet can be difficult to follow, after all this is a list of foods to avoid! In addition to this, many foods to avoid belong to the high-nutrient food group, including lactose-containing dairy products, wheat and legumes, and a variety of fruits and vegetables. Some restricted foods are also rich in "prebiotic fiber" -- an important food source of good bacteria that live in the gut. Restricting so many food types increases the risk of nutrient deficiencies and has unknown effects on gut microbiota health and balance.
SO, WHERE TO FROM HERE?
If you have been medically diagnosed with IBS and your diet is currently high in FODMAP foods, current evidence suggests that you may benefit from a short-term low-FODMAP diet.
Because balancing nutritional intake and reducing MD-IBS symptoms can be challenging, it is best to consult with your doctor or dietitian to develop a low-FODMAP plan that is right for you and meets your unique individual.
For more specific advice on the FODMAP diet or MD-IBS, talk to your doctor.
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[1] Matusheski N, Caffrey A, Christensen L, Mezgec S, Surendran S, Hjorth MF, McNulty H, Pentieva K, Roager HM, Seljak BK, Vimaleswaran KS. Diets, nutrients, genes and the microbiome: recent advances in personalised nutrition. British Journal of Nutrition. 2021 Jan 29:1-24.
[2] Staudacher HM, Whelan K. The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS. Gut. 2017 Aug 1;66(8):1517-27.
[3] Gibson PR, Shepherd SJ. Evidence‐based dietary management of functional gastrointestinal symptoms: the FODMAP approach. Journal of gastroenterology and hepatology. 2010 Feb;25(2):252-8. Include financial sponsor)
[4] Ooi SL, Correa D, Pak SC. Probiotics, prebiotics, and low FODMAP diet for irritable bowel syndrome–What is the current evidence?. Complementary therapies in medicine. 2019 Apr 1;43:73-80.