The Low FODMAP Diet
Researchers Susan Shepard, Peter Gibson, Jacqueline Barrett, and Jane Muir at Monash University and Box Hill Hospital in Australia coined the acronym FODMAP. They discovered that a low FODMAP diet provided symptom relief for 75% of patients with IBS (irritable bowel syndrome). FODMAPs are a groups of carbohydrates, sugars and fibers found in many foods that can cause digestive issues such as bloating, excessive gas, abdominal pain, constipation, and diarrhea after consumption for those with IBS. Why? These carbohydrates are often poorly absorbed, quickly fermented by your gut bacteria, and often cause intestinal fluid shifts which all contribute to IBS symptoms. When gut bacteria breakdown FODMAPs the byproduct is gas (hydrogen, carbon dioxide and methane) which contributes to increased intestinal pressure resulting in abdominal pain, bloating, and flatulence. The high osmotic effect of FODMAP digestion causes fluid shifts which can lead to diarrhea or constipation. Many FODMAPS are malabsorbed which affects gut motility which again can lead to all the IBS symptoms. Symptoms can occur soon after a meal or many hours later based on your gut transit time and which FODMAPs are consumed. By consuming a diet low in FODMAPs most of those with IBS see impoved digestive health.
Examples of FODMAPs include:
FODMAP stands for the following:
F = Fermentable - Quickly broken down by gut bacteria in the large or small intestine producing excessive gas
O = Oligosaccharides - Found in many cruciferous vegetables, legumes, fruits, wheat, onions, garlic, cashews, pistachios, chicory root, and herbal teas
D = Disaccharides (Lactose) -Also called milk sugar which is found in cow's milk and many dairy products.
M = Monosaccharides (Fructose) - Found in some fruits, vegetables and sweeteners such as honey and agave.
A = And
P = Polyols (Sugar Alcohols) - Found in may stone fruits, vegetables, low carb protein bars, and sugar free, no sugar added products.
It is important to remember that the low FODMAP is a three part diet journey.
- The first part is the elimination stage which can last 3-6 weeks.
- The next part is the rechallenge or reintroduction stage where one adds back FODMAP groups in a slow, methodical process with the goal of determining which FODMAP groups they are intolerant to and hopefully learning safe thresholds of these foods.
- The last part is learning how to live on a modified low FODMAP diet forever to keep IBS symptoms in control.
It is not recommended to remain on the elimination diet forever and in some situations this may not be the best first approach. It is highly recommended to work with a registered dietitian who specializes in the low FODMAP diet. The end goal is to have the most varied diet one can tolerate. Many high FODMAP foods are rich in prebiotics which play an important role in gut health