The Low FODMAP Diet Made Simple

In a world where digestive issues are becoming more and more prevalent by the day, diets that address symptoms of digestive stress are worth talking about. One such diet is the Low FODMAP Diet. While you may have heard the term “FODMAP” before, you may not know exactly what it means. Even if your doctor has recommended you try it out, it can be overwhelming to get started- not to mention tricky to follow. Which is where this week’s blog post comes in! In addition to providing you with some user-friendly resources, I do my best to simplify the Low FODMAP Diet and explain who may benefit from it.

What are FODMAPs

The term “FODMAPs” stands for Fermentable Oligosaccarides, Disaccarides, Monosaccarides, and Polyols. In simple terms, these are forms of carbohydrates that humans are unable to digest. Instead they are broken down (fermented) by the bacteria in our intestines and hydrogen gas is produced as a by-product. While all of this may not seem relevant to you, it can actually have a significant impact on those individuals who suffer from digestive symptoms, whether it be gas, bloating, loose stool, or pain.

Patients with IBS (Irritable Bowel Syndrome), Crohn’s Disease, Ulcerative Colitis, and bacterial overgrowth tend to be particularly, but not always, sensitive to foods high in FODMAPs (aka “high-FODMAP foods”). The Low FODMAP Diet is actually considered to be one of the first-line treatments in the management of IBS (1,2) and may also have applications in the management of IBS-type symptoms (ie. gas, bloating, pain) in those with Inflammatory Bowel Disease (such as Crohn’s and Ulcerative Colitis) (3,4).

While it is far too much to go through all of the high- and low-FODMAP foods in this one blog post, below is a short list of a few commonly consumed foods that are high in FODMAPs. You may look at this list and think “Wait, I thought some these foods were GOOD for me and are supposed to support healthy digestion?” While that is absolutely true, they still may aggravate symptoms in those individuals with any of the GI conditions that I alluded to above. And while the end goal is always to consume a whole food, plant-based diet rich in a variety of fruits and vegetables, there are certain times and certain situations that call for a (hopefully) temporary reduction in these potential trigger foods- even healthy ones. You also may recall our post about prebiotics a few weeks ago. Many prebiotic rich foods are also high in FODMAPs- which makes sense considering they serve as food for our friendly bacteria.

With all of that being said, here are some common high-FODMAP foods.

Fruits: apples, cherries, mangoes, pears, watermelon, ripe bananas, dates, figs, nectarines/peaches, plums, prunes, blackberries, apricots 

Vegetables: Jerusalem artichokes, asparagus, garlic, onions, mushrooms, cauliflower

Grains: wheat, barley, ryeLegumes: soybeans (including soy products), black beans, kidney beans, navy beans, split peas

Sweeteners: artificial sweeteners such as sorbitol, agave, honey, high fructose corn syrupDairy: soft cheeses (ricotta, cottage), yogurt, cow milk 

Nuts: cashews, pistachios

Who Should Try the Low-FODMAP Diet

First off, let me clarify that this is NOT a weight loss diet, rather it should be considered an elimination diet. The utility of the Low FODMAP Diet lies in its potential ability to reduce symptoms in those who struggle with digestive issues. It is meant to be done for a period of 2-6 weeks, after which higher FODMAP foods are reintroduced one at a time to determine individual tolerance. Ideally this should be done in collaboration with a dietician, physician, or other health practitioner with experience in elimination diets.

I also want to clarify that not everyone with the below conditions and/or symptoms will benefit from the Low FODMAP Diet. In fact, it may not be appropriate in certain circumstances- another reason why it is important to work with a qualified practitioner, especially if you suffer from Inflammatory Bowel Disease or another chronic health condition. Individuals with a history of an eating disorder should also be careful as elimination diets can trigger disordered eating patterns and behaviors- which is far less healthy than a little bit of bloat after consuming a high FODMAP food!

Although the Low FODMAP Diet is used as a way to reduce symptoms and help individuals identify possible trigger foods, it also has potential in the treatment of SIBO, aka Small Intestinal Bacterial Overgrowth. I will be describing this condition in more detail in a future blog post, but it is worth mentioning that a significant percentage of patients with IBS actually have SIBO. In fact, one study found that 78% of IBS patients also had bacterial overgrowth in their small intestine (5). Given that high-FODMAP foods feed the bacteria in our gut, it makes sense that limiting their consumption will, in a sense, “starve” the bacteria and reduce their numbers. This is a bit of a double-edged sword, especially considering that diversity in your microbiome is a vital component to overall gut health. But in situations where a temporary reduction in bacteria numbers may be beneficial, ie. in SIBO, following a Low FODMAP Diet for a period of time may aid in treatment. This has yet to be proven by vigorous studies, but this certainly makes sense on an intuitive level and the Low FODMAP Diet is a component of many effective SIBO treatment protocols.

Keeping all of this in mind, individuals who suffer from the following conditions and symptoms may benefit from trying the Low FODMAP Diet.

Irritable Bowel Syndrome (IBS)

Small Intestinal Bacterial Overgrowth (as noted above, often overlaps with IBS)

Crohn’s Disease (a type of Inflammatory Bowel Disease, or IBD)

Ulcerative Colitis (another type of IBD)

Excessive gas and/or bloating

Chronic diarrhea

Chronic constipation

As I alluded to above, please discuss any dietary changes and treatment protocols with your health care provider before trying them, especially if you suffer from any chronic medical conditions. Even potentially beneficial diets may have a negative impact in certain individuals. If you are interested in learning more about the Low FODMAP diet, Kate Scarlata, a registered dietician, has a wonderful website that provides a great set of resources- everything from food lists to meal plans and workshops. The FODMAP app from Monash University is another great resource that you can download on your phone and makes following a low FODMAP diet much less stressful!

And, as always, be sure and reach out to us if you have any questions!

Continue to Follow Your Gut,

Erin

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