The term “FODMAP” is an acronym that refers to “fermentable oligo-, di-, and monosaccharides and polyols”. These are types of short-chain carbohydrates that cannot be fully broken down during the digestive process, and they have an osmotic effect that causes water to be drawn into the digestive system.
Furthermore, since FODMAPs cannot be digested, they are metabolized by your gut microbes, which leads to escalated production of short-chain fatty acids and gas. As a result, FODMAPs have a reputation for instigating digestive issues like bloating, stomach pain, excessive gas, and fluctuations in bowel movements that could involve constipation, diarrhea, or both.
By excluding certain carbohydrates, the low-FODMAP diet offers temporary relief from discomforting symptoms and allows your digestive system to recuperate. The elimination of irritating substances facilitates the healing of your gut lining and promotes the restoration of a healthy gut microbiome. If you experience positive results, the low-FODMAP diet can assist you in determining which foods to curtail in the long run.
Approximately 60% of individuals suffering from IBS have stated that these carbohydrates can induce or intensify their symptoms. Different quantities of FODMAPs are present in a diverse array of foods, with some containing only one type and others possessing multiple. The principal sources of the four FODMAP groups in one’s diet are:
Foods such as wheat, rye, nuts, legumes, artichokes, garlic, and onion are converted to gases through fermentation by your gut bacteria, as they feed on oligosaccharides.
Prebiotics, which are plant fibers that dissolve in water, are called disaccharides and function to nourish the advantageous bacteria in your gastrointestinal tract. Oligosaccharides are comprised of various wheat items as well as onions, garlic, and beans/lentils. The sensitivity towards oligosaccharides might contribute to the elucidation of particular instances of non-celiac gluten sensitivity.
Due to the reduced fermentable sugar content in gluten-free grains compared to gluten-containing grains, there is a possibility that individuals who believe they are gluten-sensitive may be reacting to the oligosaccharides present in wheat-based products. These may include dairy items that contain lactose, such as yogurt, milk, soft cheese, whipped cream, buttermilk, and condensed milk.
In the group of monosaccharides, fructose is the type of sugar found in fruits that can be fermented. However, not all fruits are affected by fructose in certain quantities and proportions. Foods that contain fructose are fruits such as apples, pears, watermelon, and mango, as well as sweeteners like honey, agave nectar, and high fructose corn syrup.
Polyols are sugar alcohols utilized as artificial sweeteners and can also be found naturally in certain fruits. Apples, pears, cauliflower, stone fruits, mushrooms, and snow peas contain mannitol and sorbitol, while low calorie sweeteners such as sugar-free gum and mints may contain xylitol and isomalt.
Fermentable carbohydrates known as FODMAPs contribute to gut symptoms in susceptible individuals and are present in a variety of foods.
Consuming FODMAPs regularly or in high amounts typically involves consuming 15-30 grams (0.5-1 ounce) of these carbohydrates per day.
On the other hand, if you follow a low FODMAP diet, you will be required to restrict your consumption to 0.02 ounces (0.5 grams) during a meal, which is a highly restricted quantity that equals 0.08–0.1 ounces (2.5–3 grams) per day if small, frequent portions are consumed as recommended.
Fortuitously, numerous foods are innately deficient in FODMAPs. Provided below is a compilation of foods which are permissible to consume while adhering to a low FODMAP regimen:
- Proteins: beef, chicken, eggs, fish, lamb, pork, prawns, tempeh, and tofu
- Whole grains and starches: white and brown rice, lentils, corn, oats, quinoa, cassava, and potatoes
- Fruit: blueberries, raspberries, pineapple, honeydew melon, cantaloupe, kiwi, limes, guava, starfruit, grapes, and strawberries
- Vegetables: bean sprouts, bell peppers, radishes, bok choy, carrots, celery, eggplant, kale, tomatoes, spinach, cucumber, pumpkin, and zucchini
- Nuts: almonds (no more than 10 per sitting), macadamia nuts, peanuts, pecans, pine nuts, and walnuts
- Seeds: pumpkin, sesame, and sunflower seeds, as well as linseeds
- Dairy: lactose-free milk, Greek yogurt, and Parmesan, Colby, cheddar, and mozzarella cheeses
- Oils: coconut and olive oils
- Beverages: peppermint tea and water
- Condiments: cumin, saffron, cinnamon, paprika, coriander, cardamom, soy sauce, fish sauce, some chile-based products, ginger, mustard, pepper, salt, white rice vinegar, and wasabi powder
Although coffee, black, and green teas are all low FODMAP products, individuals with IBS are typically advised to avoid caffeinated beverages on the low FODMAP diet as caffeine often aggravates symptoms.
It is crucial to inspect the ingredient lists of packaged goods for extra FODMAPs. Producers sometimes incorporate FODMAPs into their products for various purposes, such as prebiotics, fat substitutes, or low calorie sweeteners.
Although numerous foods have low levels of FODMAPs by nature, it is important to be cautious of processed foods while adhering to a low FODMAP diet as they can have additional FODMAPs.
Limiting high FODMAP foods is a essential aspect of a low FODMAP diet, which has been proven through scientific research to potentially improve symptoms in individuals diagnosed with IBS.
May reduce digestive symptoms
The symptoms of IBS can differ greatly, ranging from stomach pain, bloating, and reflux to flatulence and urgent bowel movements. These symptoms can have a significant impact on a person’s quality of life. It has been observed that a diet low in FODMAPs can effectively reduce both stomach pain and bloating.
Four high quality studies have provided evidence that adopting a low FODMAP diet increases the likelihood of reducing stomach pain and bloating by 81% and 75%, respectively. Furthermore, numerous other studies support this view and propose that the diet is also effective in controlling flatulence, diarrhea, and constipation.
Many parts of the world now view a low FODMAP diet as the primary dietary treatment for IBS.
May improve your quality of life
Individuals who suffer from IBS frequently state that their severe digestive symptoms diminish their quality of life. As a result, social interactions and their ability to work may be influenced. Research has shown that adhering to a low FODMAP diet can greatly improve the quality of life by significantly reducing symptom severity.
Studied benefits of a low FODMAP diet for individuals with IBS include an improvement in digestive symptoms and an overall increase in quality of life, potentially leading to reduced fatigue, depression, and stress, and an overall boost in happiness and vitality.
There are three stages involved in following a complicated low FODMAP diet.
Restriction
During this phase, individuals must eliminate all high FODMAP foods from their diet. Although some individuals may believe that they must eliminate all FODMAPs permanently on this diet, this phase should only extend for a maximum of 4-8 weeks. This is because FODMAPs contribute significantly to maintaining gut health.
While some individuals experience relief from their symptoms within the initial week of adopting this diet, others may require the full 8-week period. About 75% of individuals adhering to this dietary regimen have indicated an enhanced symptom alleviation within a time frame of 6 weeks.
The elimination phase is advised by healthcare providers to last for a minimum of two weeks and a maximum of six weeks. It may take some time for this phase to be effective for the alleviation of your symptoms. If you are experiencing SIBO, you may initially feel worse before feeling better due to detox symptoms resulting from the gut bacteria starvation process.
Although you may feel wonderful during the elimination phase, it is not intended to be a lasting solution. It is crucial to determine which foods you can reintroduce into your diet without adverse effects. A less restrictive diet will be more manageable in the long term, and for optimum nutrition, a diverse range of foods is always recommended to ensure adequate micronutrient intake.
Once your digestive symptoms are adequately relieved, you can move on to the next stage.
Reintroduction
During this phase, individuals gradually reintroduce high FODMAP foods in a methodical manner. The duration of this stage may differ from person to person, but usually falls within the range of 6 to 10 weeks. The objective of this phase serves two purposes:
- to identify which types of FODMAPs you tolerate, as few people are sensitive to all of them
- to establish the amount of FODMAPs you can tolerate — also known as your “threshold level”
During this stage, it is recommended that you try out small portions of particular foods individually for a duration of three days. To prevent additive or crossover effects, it is best to adhere to a strict low FODMAP diet while testing each food and to wait for 2-3 days before reintroducing a new one.
The duration of the reintroduction stage may differ from person to person, though it usually lasts for approximately eight weeks. Throughout this period, you will continue to follow the low-FODMAP diet plan while progressively reintroducing one high FODMAP food item from each FODMAP category, singularly. Each food will be tested for a few days with a gradual increase in consumption in order to determine your level of tolerance.
After each test, you will follow the strict elimination diet for a few days to prevent crossover effects. When you determine which food suits you and which does not, you and your healthcare provider can create a nourishing, long-lasting diet plan that you can follow permanently unless you want to repeat the test.
After determining your minimum tolerance, you can assess your ability to consume greater amounts, more often, and mix high FODMAP foods – just make sure you pause for 2-3 days after each trial.
To properly navigate the suitable types of food, it would be ideal to seek the assistance of a licensed dietitian. It should be noted that individuals with IBS are able to handle limited amounts of FODMAPs, unlike those with common food allergies who need to entirely steer clear of certain allergens.
Personalization
During this phase, referred to as the “modified low FODMAP diet”, certain FODMAPs are still limited while others that are well-tolerated are reintroduced to your diet. Essentially, the amount and selection of FODMAPs are customized based on the individual tolerance identified in stage 2.
The low FODMAP diet is neither a one-size-fits-all approach nor a lifelong diet. The ultimate goal is to reintroduce high FODMAP foods at your personal tolerance levels. It’s essential to progress to this final stage to increase diet variety and flexibility. These qualities are linked to improved long-term compliance, quality of life, and gut health.
What to do before starting the low-FODMAP diet
Seek guidance from a dependable healthcare professional. If you are experiencing symptoms that may be related to a gastrointestinal (GI) disorder or have already received a diagnosis, contacting a registered dietitian or GI specialist can offer assistance in determining the most effective remedies.
Before attempting the diet, they could suggest other ideas to consider. Additionally, they offer assistance in navigating the specifics of the diet, furnish recommendations for shopping and menu planning, and offer solutions when issues or inquiries emerge.
To succeed in following this diet, one must keep track of various quantities and portion sizes for different foods. Having a knowledgeable guide can make the process easier.
To ensure the success of the temporary elimination diet, it is important to plan ahead and allocate adequate time for its completion without any interference from other crucial events or duties. Cheating on the diet would render the entire experiment useless. Therefore, it requires a significant investment of time and effort.
Ensure that you make a conscious decision to see the entire process through before commencing. Take careful steps in getting ready – clean out your refrigerator and pantry of high-FODMAP items and create menus ahead of time. Guarantee that you have the necessary ingredients for a few effortless standby meals that you can easily prepare and savor.
Are FODMAPs bad for everyone
Our digestive tracts are actually built to handle certain foods that we are unable to fully digest, such as dietary fiber. This fiber is crucial to maintaining good digestive health.
And feeding the bacteria in our gut is part of our symbiotic arrangement with those bacteria. But some people with sensitive guts experience a level of indigestion from these foods that significantly impacts their quality of life.
These individuals experience persistent gas, bloating, abdominal pain, and distension due to the byproducts of fermentation. If the small intestine draws too much water, it can lead to excessive diarrhea, while insufficient water can result in constipation.
Who will benefit from a low-FODMAP diet plan
The low-FODMAP diet is typically recommended for a temporary period to individuals with irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO), with research indicating that most people with these conditions experience positive results from the diet.
For individuals experiencing digestive issues, the low-FODMAP diet can serve as a brief exclusionary regimen to pinpoint the specific foods that trigger their discomfort. By removing common problematic foods and gradually reintroducing them, individuals are able to monitor their body’s response. As one of numerous elimination diets available, the low-FODMAP diet offers a means of identifying food sensitivities.