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What is the low FODMAP diet? Dietitian explains the role of the low FODMAP diet in IBS

What is the Low FODMAP diet? What does the word FODMAP stand for, and what is involved if I would like to follow this diet?

Thank you for joining me for the third episode of my series “Gut Time”. In this post series, we will explore all things gut. In my last 2 posts, we looked at the causes and symptoms of IBS, and we discovered 17 surprisingly simple ways to improve your IBS symptoms. Today we will turn our eye to the complex but often life-changing world of the low FODMAP diet.

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What is the low FODMAP diet?

What is the Low FODMAP diet? What does the word FODMAP stand for, and what is involved if I would like to follow this diet? Today we will turn our eye to the often life changing low FODMAP diet.

I first heard of the low FODMAP diet while I was in university studying my Dietetic degree. At this stage it appeared to still be in the early phases. We heard of a university in Australia named the Monash University doing lots of research. And Ireland was slowly starting to take notice of the result from this research. Over time, the more I was learning about this diet, the more interested I became.

Having IBS myself, I was interested at first to try out the low FODMAP diet for myself.

Thankfully I was able to gain a place on a low FODMAP diet course run in the South of Ireland. I was my own first guinea-pig and started following the diet while following the course. After lots of learning, some patient practical work and a final course discussion, I completed the course and could then bring my clients through the Low FODMAP diet also.

I myself have found the low FODMAP diet incredibly useful for three main reasons:

Firstly, it has helped me to know which foods I need to avoid in order to keep my symptoms under control.

Secondly, I have been able to reintroduce foods that I had been avoiding for many.

I have become more aware about portion sizes that may lead to symptoms. And I have found ways to reduce the chances of these foods causing symptoms in the first place. For example, I had been avoiding lentils since lentils were invented. Well – since I first ate them at quite a young age and had some nasty gut effects – you know what I mean… But through the Low FODMAP diet, I have learnt that I get much milder symptoms if I eat just a smaller portion of lentils. The diet also taught me that it helps if they have been canned in water and then rinsed before cooking. Hurrah for the vegan proteins that I can now eat again!

And thirdly, I now get caught out less.

As in, I am more in control of my symptoms. As in, I can choose to very carefully avoid foods that I will react to if I know that I have a quiet event to attend the next day. This has significantly improved my ability to not outvoice the speaker with my digestive noises at said quiet events. But also, it allows me to prepare in advance if I know that I will be eating a food that will cause gut problems. For example, I can prepare by taking an anti-cramping tablet or an immodium. Because my goodness I love hummus, and no – I don’t always want to stick to minute amounts of it.

So what does the low FODMAP diet stand for?

  • Well the F is for fermentable. This means that bacteria can act on these foods to create gas.
  • O stands for Oligo-saccharides. There are two types of these: Fructo-oligo saccharides (also known as FOS or Fructans) and Galacto-oligosaccharides (also known as GOS or galactans). FOS is a type of sugar found in foods such as wheat, rye, onions and garlic. GOS is found in pulse vegetables such as beans and chickpeas.
  • The D stands for Di-saccharides. Lactose is a disaccharide for example that is found in milk.
  • M stands for Mono-saccharides such as fructose, which is found in several fruits and in honey.
  • The A just stands for the word “and”.
  • And the P stands for Polyols, which are sugar alcohols used as artificial sweeteners, but can also be found naturally in some vegetables and fruit.

How can these FODMAP foods cause my symptoms?

Well as the F at the start of the word FODMAP explains, the various types of sugars we just discussed can be easily fermented in the gut by bacteria. When they are being fermented, they cause problems such as wind, bloating and pain. This can also cause constipation, or diarrhoea for some people.

When we eat these FODMAP foods, we can react to some of these types of sugars, but rarely do we respond to every single one of them. Whether you react to each sugar or not can be influenced for example by your gut bacteria and the various factors that may be causing your specific type of IBS. I go into some of those possible causes in my post “What is IBS”.

What is involved in following the Low FODMAP diet?

Well there are three main steps in this diet.

The first is known as the elimination phase.

Here you try to avoid foods that contain high levels of the various FODMAP sugars.

The next phase then is known as the reintroduction phase.

During this phase you gradually reintroduce each of the groups of FODMAP foods, in a careful and graded way. This will then help you to see which exact FODMAP sugars you may be reacting to.

The final phase is known as the maintenance phase.

This involves going back to eating as normally as possible, and only avoiding FODMAPs that you have discovered during the elimination phase that you react to. And it is a good idea to continue to challenge these foods that you are avoiding. Over time, some people can eventually go back to eating a fully normal diet.

Before starting on the Low FODMAP diet, you are asked to fill out a symptom evaluation form.

This will help you to rate how bad your symptoms are, and how often your symptoms are occurring. At the end of the elimination phase, you will fill out the same form again to see if your symptoms have improved. Then you will continue to monitor your symptoms carefully as you reintroduce the FODMAP sugars to see if you may be reacting to that particular FODMAP.

It is recommended that you see a dietitian to help you through the two phases of this diet.

There are some studies coming out that show that you may be at an increased risk of nutritional deficiencies when you follow this diet without a dietitian’s help. Also, a dietitian can help you to make sure that you follow the diet correctly to help you get the most out of its effects.

Will the low FODMAP diet work for me?

The FODMAP diet works for many with IBS, with one study showing improvements in symptoms for up to 86% of people with IBS. However there are several suggested reasons why some people with IBS may not respond to the low FODMAP diet. For example, some people may have IBS that is more strongly linked to stress and anxiety than others. These people may therefor be less responsive to diet strategies.

There is also some emerging evidence in using the Low FODMAP diet for people with other functional gastrointestinal disorders, and even inflammatory bowel diseases such as Crohn’s disease and Ulcerative Colitis. However, the majority of research into the use of the Low FODMAP diet has been around IBS.

So are you already following the low FODMAP diet? And if so, how have you found it so far? Or have you tried all first-line IBS strategies and are thankfully getting enough relief from these? Let me know in the comment section below. And find my video on this topic below!

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