Everything You Need to Know About FODMAP Diets

  1. What Does FODMAP Stand For?
  2. What Are FODMAPs?
  3. What Is a FODMAP Diet?
  4. What Are The Benefits Of a FODMAP Diet?
  5. What Can Happen If You Eat a Lot of High FODMAP Foods?
  6. Who Should Adopt a Low FODMAP Diet?
  7. Tips to Help You Start Your Low FODMAP Diet
  8. Things to Consider Before You Adopt a Low FODMAP Diet?
  9. Can Vegans and Vegetarians Follow a Low FODMAP Diet?
  10. What Can You Actually Eat On a FODMAP Diet?
  11. What Can You Do If Your Symptoms Don’t Improve?
  12. Summary

Although the debate on the benefits of a low FODMAP diet in relieving some of the effects of Irritable Bowel Syndrome (IBS) is still raging, there are indications that it can combat some symptoms of IBS. You cannot cure your IBS with FODMAP, but what you can do is take control of some of the more uncomfortable consequences, such as the pain and bloating.

No medication can treat all symptoms of chronic bowel conditions such as IBS or IBD (Irritable Bowel Disease) in their entirety. Therefore, low FODMAP can be used as dietary therapy to reduce some of the symptoms.

What Does FODMAP Stand For?

The Acronym FODMAP refers to a short-chain of carbohydrates that are not absorbed by the small intestine, and therefore leave food residue which then ferments in the gut. FODMAP stands for Fermentable oligo, di-, monosaccharides and polyols. According to Healthline, sensitivity to FODMAP is common for people suffering from IBS or IBD, and these foods have been known to exacerbate the symptoms substantially.

What Are FODMAPs?

FODMAPS has four main components, the first of which are the Oligosaccharides. Oligosaccharides, by definition, are carbohydrates that yield very few monosaccharide units upon hydrolysis. According to Chemistry Libretexts, the classification of these carbohydrates varies based on how many monosaccharides are formed when they are hydrolyzed, which is characteristically between 2 and 10.

Next, on the list are Disaccharides. Courtesy of the glycosidic linkage process, disaccharides are formed by combining two monosaccharide units. Among these carbohydrates are sucrose, lactose and maltose.

3rd on the carbohydrate hierarchy are the Monosaccharides. This is the simplest form of sugars, and this is by virtue of the fact that it cannot yield a simpler form upon hydrolysis. These simple sugars are considered the building blocks for all complex carbon sugar varieties, and they consist of glucose, fructose and galactose.

The last variation is Polyols. It is important to bear in mind that definitions of this compound differ substantially in food and science. In one they are organic compounds that contain two or more hydroxyl group, while in the other they are simply low-calorie sweeteners. There are naturally occurring polyols in some food types, but there are cases where they are synthesized as sweeteners to replace sugar as a low-calorie alternative.

This list makes up all the components of FODMAPs, which when combined results in an indigestible set of carbohydrates.

What Is a FODMAP Diet?

A low FODMAP diet is a form of dietary therapy that aims to relieve the effects of IBS by restricting foods known to have high concentrations of Fermented oligo-, di, monosaccharides and polyols. Research shows that specific foods attached to this FODMAP group are directly responsible for the onset or worsening of symptoms in up to 80% of patients who suffer from Irritable Bowel Syndrome.

The primary plan of action in a low FODMAP diet is to reduce intestinal water content, which is the leading cause of diarrhoea, to reduce the rate of absorption of active Short-chain Carbohydrates, to reduce the levels of faecal bacteria, and to effectively get rid of the fermentation that directly results in gas production.

Although the research is still not conclusive, there is a broad consensus indicating that a low FODMAP diet is indeed the best and most effective way to reduce the symptoms of IBS and IBD.

Compared to traditional approaches to the treatment of IBS, results by the National Institutes of Health indicates that a low FODMAP diet resulted in up to a 44% decrease in abdominal pain, a 32% decrease in bloating, and up to a 54% increase in stool frequency. This shows that a low FODMAP diet can be used to treat IBS, and it has a higher success rate compared to other forms of medication or dietary approaches.

What Are The Benefits Of a FODMAP Diet?

The low FODMAP dietary approach was initiated as a way to combat the effects of IBS. This is a dietary therapy that is mainly used to reduce the symptoms of IBS and so improve quality of life. This therapy is also used to treat Ulcerative Colitis and bring some slight relief to patients with Colorectal Cancer (CRC). Although there have only been a few studies into the impact of this approach, there have been some encouraging results for patients who experience a reduction in pain and discomfort.

Whether or not this dietary therapy will be more effective in the long-term is still a topic of debate, but what has been conclusively proven so far is that it does cause a significant reduction in diarrhoea, bloating, stomach pain, gas and constipation, which are all typical symptoms of IBS. The FODMAP diet has been known to also reduce symptoms of other digestive problems, as well as having the trickle-down effect of giving you peace of mind and reducing stress.

What Can Happen If You Eat a Lot of High FODMAP Foods?

It is important to note that the effects of FODMAP foods are restricted to individuals with certain gastrointestinal sensitivity, and the results themselves vary from person to person. That said, these short-chain carbohydrates (SCCs) are known to trigger and mostly worsen the effects of Irritable Bowel Syndrome; they cause high levels of colonic fermentation, which is the cause of gas symptoms.

The high levels of water content that they produce are also directly responsible for the diarrhoea experienced in most IBS patients, as well as the pro-inflammatory interleukins that are responsible for stomach swelling, and in some cases, the stomach pain that comes with it. The increased water content in your intestines and inflammation are also key indications that you may be suffering from IBD, which in some cases is more severe.

FODMAP foods are indigestible, and when they fuse with bacteria in your stomach, they produce hydrogen, which in turn will give you that bloated feeling and cause some stomach pain. A low FODMAP diet seeks to reduce the effects of these osmotically active SCCs, and ultimately relieve these symptoms.

Who Should Adopt a Low FODMAP Diet?

The low FODMAP diet is suitable for people with dietary complications. Based on several studies, it has been found that people suffering from Irritable Bowel Syndrome, Irritable Bowel Disease and Colorectal Cancer benefit the most from this dietary therapy.

Tips to Help You Start Your Low FODMAP Diet

There isn’t enough proof as to the long-term effects of a low FODMAP diet, but it is estimated that you should be able to notice some substantial improvements to within about 18 months after beginning this dietary therapy. Below are some steps to help you get started with your low FODMAP diet.  It may also be possible for your GP to refer you to a dietician to be guided through this dietary programme if they feel this will be of benefit to you.

Step 1

The first action plan would be to eliminate all FODMAP foods from your diet for a prolonged period. This will gradually improve your IBS symptoms, and you should notice most or all of your symptoms reducing significantly. The first and most crucial step is to figure out which foods exacerbate your digestion problems, and slowly phase them out of your diet.

After identification, try and establish a list of other foods that have high FODMAP content and try to work around them. It may be challenging to develop a routine at first, which is why it is recommended that you consult your GP to get some professional input on the kind of foods you can eat to supplement your diet.

Step 2

This initial stage is perhaps the most challenging, as you will probably have to cut back on some of your favourite foods. Fortunately, after the 8-week mark, you can gradually begin to reintroduce these foods into your diet and gauge how your body responds to the changes. It is recommended that you do this in small increments, as this will give you a more precise, more sustainable way to evaluate your progress.

Step 3

The final stage mostly depends on the results of the first two stages. This stage varies from one person to another and is a matter of individual tolerances. You will need to keep a close eye on which foods affect you negatively, and which ones have no adverse effects. This way, you will be able to pinpoint which of these SCCs your body rejects, and which ones you can live with.

Things to Consider Before You Apot a Low FODMAP Diet?

IBS is still one of the most misdiagnosed conditions today. It is essential that you have seen your GP, and they have excluded any other conditions. Your GP needs to be satisfied that there are no underlying causes for your symptoms and that IBS is the most likely cause.

There are, as well, cases where a low FODMAP diet may not be suitable for you, which is why you need to pay close attention to the following:

  • Which FODMAP foods are always in your diet plan?
  • What you can and can’t eat.
  • The FODMAP concentration of foods you constantly eat.
  • Which foods have adverse effects on your health and which ones have no impact?
  • Finally, does your GP recommend a FODMAP diet, or is there an alternative?

Can Vegans and Vegetarians Follow a Low FODMAP Diet?

Vegetarians and vegans may struggle to find foods that are permitted, as many of their chosen diets consist of high FODMAP content. There is a solution, however. The challenge is to keep your protein count up. This can be done with soybeans, soy milk or any of the various soy-based products. Vegetarians can also substitute their diets with nuts, grains, almonds, peanuts, hazelnuts, etc. You can also go for seeds – pumpkin, sesame and sunflower seeds all qualify as great dietary substitutes.

What Can You Actually Eat On a FODMAP Diet?

It is virtually impossible to get rid of all FODMAP foods in your diet. The key is to reduce them to a level where they cease to be harmful to your digestion. There is an extensive list of food items you can eat on a low FODMAP diet, including the following:

Food Type Food
Fruits Avocado
Banana
Lemon
Lime
Orange
Papaya
Passion Fruit
Pineapple
Strawberry
Sweeteners and Spreads Artificial Sweeteners
Brown Sugar
Glucose
Maple Syrup
Powdered Sugar
Sugar (Sucrose)
Chocolate
Dairy and Dairy Substitutes Almond Milk
Coconut Milk
Butter
Certain Cheeses
Vegetables and Legumes Beetroot
Broccoli
Carrots
Common Cabbage
Corn
Collard Greens
Courgette
Cucumber
Green Beans
Green Peppers
Ginger
Kale
Karela
Lettuce
Grains, Cereals, Bread, Biscuits,Pasta, Nuts, and Cakes Brown Rice
Bulgur Wheat
Oats
Gluten-Free Products
Quinoa
Spelt Products
Wheat-Free Products
Rice
Nuts
Seeds
Protein Sources Beef
Chicken
Eggs
Fish (Particularly Fresh Fish)
Drinks Beer (One Drink Limit)
Clear Spirits (Such As Vodka)
Gin
Whiskey
Wine (One Drink Limit)
Coffee

What Can You Do If Your Symptoms Don’t Improve?

There are scenarios where, after completing a low FODMAPs dietary period, your symptoms don’t show any significant improvement. This may indicate that you may have an underlying condition, or you didn’t have IBS to begin with. You will have to consult your physician to get a conclusive answer.

Summary

Many top researchers have supported a low FODMAP diet, and many people are beginning to realise the invaluable benefits of having a well laid out plan of action towards improved gastrointestinal health. It is for this reason that it is recommended that if you are suffering from IBS, IBD or CRC, you should consider this as a potential solution.

Foods High In FODMAP infographic

References

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