WHAT ARE FODMAPS?

FODMAPs are a group of small chain carbohydrates (both sugars and fibres) that are commonly malabsorbed in the small intestine. FODMAPs are abundant in our diet and can be found in foods such as: wheat, barley, rye, apples, pears, mango, onion, garlic, honey, beans, cashew nuts, agave syrup and some medicines, to name only a few.

Up to 75% of those who suffer with irritable bowel syndrome (IBS) will benefit from dietary restriction of FODMAPs. Research has shown the low FODMAP diet improves gastrointestinal (GI) symptoms (gas, bloating, pain, change in bowel habits) related to IBS. (Staudacher 2011)

A low FODMAP diet was developed based on the hypothesis that impaired carbohydrate absorption allows excess undigested carbohydrates to reach the large intestine. There, undigested carbohydrates stimulate the growth of pathogenic microbes, leading to excess gas, diarrhea, and constipation (Ostgaard 2012). Theoretically, the restriction of fermentable foods deprives the dysbiotic microbes of their energy source and results in decreased symptoms

FODMAPs is an acronym that stands for:

Fermentable

Oligosaccharides (fructans and galacto-oligosaccharides)

Disaccharides (lactose)

Monosaccharide (Fructose)

And

Polyols

What is a FODMAP Elimination diet?

The low FODMAP diet is a 2-6 week elimination diet that involves removing high FODMAP foods from the diet to assess whether FODMAP rich foods are triggering your GI symptoms.

 The low FODMAP diet is what I like to call a “learning” diet rather than one that you stay on forever. The goal of the diet is to help you determine your personal dietary triggers and threshold. After the low FODMAP elimination diet phase, it is imperative to re-introduce FODMAPs, in a methodical manner, to assess your tolerance to various FODMAP containing foods. Many people will find they can liberalize their FODMAP diet restrictions and only need to restrict some high FODMAP foods. The low FODMAP diet should be implemented with the help of a FODMAP knowledgeable nutritionist to help you navigate the many nuances of the diet and to help you develop a personalized, well-balanced eating plan. I typically recommend such a dietary elimination diet with other foods you may be sensitive or allergic too rather than by itself.

This combination approach is more likely to produce symptom relief and to identify symptom-evoking foods, because many are also sensitive to gluten and other common allergens or food sensitivities. The combination approach also minimizes the number of different diets the patient must try, and therefore improves compliance.

Foods typically avoided on a low FODMAP diet include: fructo-oligosaccharides (eg, wheat, rye, onions, garlic, artichokes), galacto-oligosaccharides (eg, legumes), lactose (eg, milk), fructose (eg, apples, pears, watermelon, mango), sorbitol (eg, apples, pears, stone fruits, sugar-free mints/gums), and mannitol (eg, mushrooms, cauliflower, sugar-free mints/gums). In one study, IBS sufferers assigned to a low FODMAP diet experienced significant improvement in their symptom response (ie, bloating, abdominal pain, and flatulence) relative to a standard diet group (Barrett 2012; Staudacher 2011). These results are supported by a later study showing that IBS patients who were guided to eat a low FODMAP diet experienced a significant decrease in abdominal pain (Ostgaard 2012).

Why do FODMAPs trigger symptoms for individuals with IBS?

Because FODMAPs are very small carbohydrates, they can pull water into the small intestine. This can contribute to diarrhea in an individual with a fast motility in their intestine. For the individual prone to constipation, bloating will likely be the main symptom together with the constipation. But also because FODMAPs are food for your gut microbes. These bacteria, yeast and single cell organisms can help you digest your food, help with nutrient intake, produce vitamins and help keep your immune system healthy. When microbes ferment FODMAPs, the gas they produce fills up and stretches your intestine; this can contribute to bloating, abdominal pain, and cramping in individuals with a sensitive GI tract. The combination of gas and water in the intestine can alter the motility of the intestine and contribute to diarrhea or constipation.

Who Should Follow a Low-FODMAP Elimination Diet?

A low-FODMAP elimination diet is not for everyone! This is because most FODMAPs are prebiotics, meaning they support the growth of good gut bacteria.

Consider this diet only if you:

• Have ongoing gut symptoms.

• Haven’t responded to stress management strategies.

• Haven’t responded to first-line dietary advice, including restricting alcohol, caffeine, spicy food and other common trigger foods.

• Have been diagnosed with IBS or SIBO (Small Intestinal Bacterial Overgrowth)

• Preferably, you are consulting a health care practitioner.

It is important to be aware that this elimination diet is a process. Therefore, it’s not recommended to try it for the first time while traveling or during a busy or stressful period.

A Low-FODMAP Elimination Diet Can Be Flavourful and Delicious

Garlic and onion are both very high in FODMAPs. This has led to the common misconception that a low-FODMAP diet lacks flavour. While many recipes do use onion and garlic for flavour, there are many low-FODMAP herbs, spices and savoury flavourings that can be substituted instead.

It is also worth highlighting that you can still get the flavour from garlic using strained garlic-infused oil, which is low in FODMAPs. Others are Chives, chili, fenugreek, ginger, lemongrass, mustard seeds, pepper, saffron and turmeric

Which is why we have created a Flavourful FODMAP Elimination Menu Plan for you. Check out our Shop under Menu Plans!

We recommend that you consult with a knowledgeable practitioner if you decide to begin an FODMAP elimination diet.

References:

Staudacher HM, Whelan K, Irving PM, Lomer MCE. Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome. J Hum Nutr Diet 2011;24:487–495.

Halmos EP, Power VA, Shepherd SJ, et al. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology 2014;146:67–75.e5.

De Roest RH, Dobbs BR, Chapman BA, et al. The low FODMAPs diet improves gastrointestinal symptoms in patients with irritable bowel syndrome: a prospective study. Int J Clin Pract 2013;67:895–903.

Staudacher HM, Lomer MCE, Anderson JL, et al. Fermentable carbohydrate restriction reduces luminal bifidobacteria and gastrointestinal symptoms in patients with irritable bowel syndrome. J Nutr 2012;142:1510–1518.

Marsh A, Eslick EM, Eslick GD. Does a diet low in FODMAPs reduce symptoms associated with functional gastrointestinal disorders? A comprehensive systematic review and meta-analysis. Eur J Nutr. 2016;55(3):897-906. doi:10.1007/s00394-015-0922-1

Disclaimer

Information on my website and this blog post is for education and entertainment purposes only. It is general information and should not be taken as medical advice. Consult your physician before you change your diet, supplement or exercise program. Any changes you make are at your own risk based on your own judgment. I am trained in nutrition and am not acting as a medical doctor or naturopath. I provide services as a certified nutritionist and that should not be construed as providing medical advice. Any testimonials provided are examples of happy clients, and I cannot guarantee results.