This Doctor’s Complete Guide to the Low FODMAP Diet

This Doctor’s Complete Guide to the Low FODMAP Diet.

While most of this month’s recipes were created for hormonal health & fertility I couldn’t let ‘IBS awareness month’ pass by without a post on the FODMAP diet. Irritable bowel syndrome is an extremely common gastrointestinal disorder that presents with symptoms like bloating, intermittent pain, diarrhea, gas and even constipation. It’s defined as a pattern of bowel symptoms that manifest without any evidence of underlying damage to the GI system. When your doctor hands you a diagnosis of IBS it essentially says that they’re not entirely sure why you’re having so many digestive issues. There’s not 1 ’cause’ of IBS, and symptoms can be triggered by things like stress, food sensitivities, travel and even hormone imbalances. This unfortunately means that there are very standardized treatments for IBS since the cause is poorly understood and can be different for each patient.

When it comes to improving your gut health, there’s nothing more important than the foods that you eat. Diet changes are critical when managing symptoms of IBS, and the low FODMAP diet is an excellent place to start. There is more than sufficient evidence to suggest that this diet should be considered a legitimate first-line therapy in the treatment of IBS. Quite a few well-designed studies have already shown that a low FODMAP diet improves IBS symptoms in the majority of patients. One study, published in the Journal of Gastroenterology, even found that 76% of IBS patients following the diet reported improvement with their symptoms.

FODMAP is an acronym referring to foods that contain Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. FODMAPs are carbohydrates and sugar alcohol that are poorly absorbed in the digestive tract. Since they are slowly digested FODMAPs act as a fuel source for the bacteria of the intestines. The bacteria in your gut ferment these FODMAP-containing foods leading to excess production of gas and other byproducts of fermentation. FODMAPs also increase the amount of fluid in the bowels, leading to bloating and loose stools. By removing these foods from the diet for a short period of time you can “starve” the gas-producing bacteria of the digestive system leading to a more balanced gut microflora.

FODMAP Foods to avoid:

• Excess Fructose: Honey, Apples, Mango, Pear, Watermelon, High Fructose Corn Syrup, Corn Syrup Solids
• Fructans:  Artichokes, Asparagus, Beetroot, Chicory, Dandelion leaves, Garlic (in large amounts), Leek, Onion (brown, white, Spanish, onion powder – onion is one of the greatest contributors to bloating and therefore strict avoidance is recommended.), Raddicio lettuce, Wheat, Rye (in large amounts), Inulin, Fructo-oligosaccharides.
• Lactose: Milk, icecream, custard, dairy desserts, condensed and evaporated milk, milk powder, yoghurt, margarine, soft unripened cheeses (eg. ricotta, cottage, cream, marscarpone).
• Galacto-Oligosaccharides (GOS): Legume beans, Lentils, Chickpeas
• Polyols: Apples, Apricots, Avocado, Cherries, Longon, Lychee, Nectarines, Pears , Plums, Prunes, Mushrooms, Sorbitol (420), mannitol (421), xylitol (967), maltitol (965) and Isomalt (953).

FODMAP Diet Resources:

• Pintrest: Pintrest has a ton of recipes and resources to make your FODMAP elimination as easy as possible. Check out my curated FODMAP diet Pinterest board for the best resources.
• The Low-FODMAP Diet Step by Step: A Personalized Plan to Relieve the Symptoms of IBS and Other Digestive Disorders: this cookbook is an excellent resource if you want to learn more about the FODMAP diet, it also includes 130 delicious recipes.
• Monash University has developed an app for patients with IBS. This app contains the largest database of FODMAP tested foods in the world, with regular free updates as new foods are tested. It uses an easy to follow “traffic light system” to classify foods low FODMAP (green), moderate FODMAP (amber) or high FODMAP (red) foods.

Since the FODMAP diet can be fairly restrictive and difficult to navigation it’s important to meet with a registered Naturopathic doctor or dietician with additional training in FODMAP elimination if you are considering this diet. Your practitioner will help you safely eliminate FODMAPs from your diet and help your monitor your symptoms as you add them back in one at a time. They also prescribe food sensitivity testing to help you further narrow down which foods are causing your problems.

Looking to connect with a Naturopath in Oakville to discuss the FODMAP diet & develop a personalized gut-health plan? Book your appointment here.

References:

• Krogsgaard LR, Lyngesen M, Bytzer P. Insufficient evidence of the effect of the low FODMAP diet on irritable bowel syndrome [in Danish] Ugeskr Laeger. 2015;177(18):1503–1507.
• Does a low FODMAP diet help IBS? Drug Ther Bull. 2015;53(8):93–96.
• Camilleri M, Acosta A. Re: Halmos et al, A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology. 2014;146(7):1829–1830.