Digestive Issues? Low FODMAP Diet May Help
You may have heard about some of the new research being done on what is known as the FODMAP diet as a potential treatment for IBS (irritable bowel syndrome).
Although research is still limited, data from several short-term (less than 6 week) clinical trials suggest that a low FODMAP diet can reduce uncomfortable digestive symptoms such as abdominal pain, bloating and excessive gas in up to 75 per cent of individuals with IBS.
What are FODMAPs?
FODMAP stands for Fermentable Oligosaccharides Disaccharides Monosaccharide Polyols. FODMAPs are certain types of sugars and fibres that are found in many common foods such as fruits, vegetables, legumes, grains, milk products and sweetening agents.
Oligosaccharides: short chain fibres such as fructans, galacto-oligosaccharides and inulin found in foods such as wheat, rye, certain vegetables, certain fruits, dried peas/beans, nuts/seeds and chicory root.
Disaccharides: two single carbohydrate sugars linked together. Most important to consider is lactose found in dairy foods such as milk, yogurt, ice cream and some cheese.
Monosaccharides: single carbohydrate units. The most important to consider is excessive fructose found in fruit juice, honey, agave, high-fructose corn syrup, sugar and large volumes of fruit.
Polyols: sugar alcohols found in certain fruits and vegetables as well as in certain sugar-free and diet foods containing sorbitol, mannitol, xylitol, maltitol and isomalt.
It should be noted that most people can eat FODMAPs without any digestive issues and following a low FODMAP diet is unnecessary.
However some individuals with sensitive digestive systems or with IBS can experience less digestive symptoms by following a low FODMAP diet. This is because for some people FODMAPs may be poorly absorbed in the small intestine and when they travel to the large intestine they can draw water. Also in the large intestine, fermentation (digestion) occurs by bacteria that live naturally in the gut that can create gas and other byproducts. Research has established there are individual differences in tolerance for FODMAPs with some foods causing more symptoms than others.
What does a low FODMAP diet look like?
Partial list of high FODMAP foods to limit:
- Regular milk, yogurt, cottage cheese, ricotta cheese, ice cream and soy milk
- Apricots, apples, blackberries, dried fruit, cherries, fruit juice, nectarines, pears, peaches, plums, mango, watermelon
- Asparagus, avocado, beets, Brussels sprouts, cauliflower, celery, garlic, mushrooms, onions, peas and tomato paste
- Wheat, barley, rye (as well as cereals, pastas, bars or baked goods made of these items)
- Sugar-free candy and gum; honey and high fructose corn syrup
- Baked beans, refried beans, chickpeas, kidney beans, edamame and hummus
- Pistachios, cashews
Partial list of low FODMAP foods to enjoy:
- Lactose-free dairy foods or certain hard cheese like cheddar, Parmesan, Swiss and mozzarella
- Strawberries, blueberries, banana, cantaloupe, grapes, honeydew, kiwi and oranges
- Bell peppers, carrots, chives, cucumber, kale, lettuce, grapefruit, raspberries, spinach, fresh tomatoes, scallion greens, white potatoes and zucchini
- Cornmeal, quinoa, rice and spelt (as well as cereals, pastas, crackers or baked goods made of these items)
- Meat, poultry, eggs, seafood, firm tofu as well as small handfuls of nuts such as peanuts, pumpkin seeds and sunflower seeds
Where should I begin?
If you are experiencing digestive issues it is essential to visit your physician to have a proper medical assessment to be sure the diagnosis and treatment is correct. If your physician has diagnosed you with a functional bowel disorder such as IBS, work with a Registered Dietitian, the only university trained and regulated nutrition professional. A dietitian that specializes in nutrition for IBS can first help you understand the overall nutrition and lifestyle strategies important for IBS and other digestive issues.
Then if the traditional lifestyle and nutrition recommendations have not provided relief of uncomfortable symptoms, your dietitian can help you explore the low FODMAP diet. Since this is a complicated and restrictive diet to follow, your dietitian can help ensure you are getting enough good nutrition. Since this diet is not meant for the long-term, dietitian support can help you understand the re-introduction phase of individual foods to assess your personal tolerance.