What does Low FODMAP mean, anyway? (+ Bonus Recipe!)
A low FODMAP diet is a 3 stage elimination diet used for those with Irritable Bowel Syndrome (IBS), and occasionally other conditions that similarly present with digestive complaints, such as Endometriosis.
FODMAP stands for:
Fermentable
Oligosaccharides (Fructans (FOS) and Galactans (GOS) )
Disaccharides (Lactose - Milk sugar)
Monosaccharides (Fructose)
And
Polyols (Sorbitol and Mannitol - common sugar alcohols)
For many with IBS, FODMAPs can be poorly digested, leading to gas, bloating, or pain. This is why a low FODMAP diet is often recommended as a first line treatment for those with IBS. Read on to find out what this diet actually looks like, and why I don’t typically use it as a first option…
How to follow a Low FODMAP diet:
There are 3 stages to a low FODMAP diet.
Stage 1: Elimination
For 2-6 weeks, swap any high FODMAP foods for those that are low FODMAP.
The list of foods high in FODMAPs is quite long, but includes foods like apples, garlic, mushrooms, dried fruit, onion, cow’s milk, wheat breads, honey, and pistachios (to name a few).
Stage 1 is the most difficult part of the diet, but should only be followed for up to 6 weeks, or until you see significant symptom improvement (whichever comes sooner). If you don’t notice any symptom improvement after 6 weeks, you should discontinue the diet explore other treatment options. If you do notice symptom improvement, you will move on to stage 2.
Stage 2: Reintroduction Challenge
Over 8-12 weeks, you will slowly re-introduce high FODMAP foods. This is a slow process, as you will try one FODMAP at a time, and one food at a time. For example, you might start with re-introducing Fructose (monosaccharides) - so you might first try a moderate serving of apple over 3 days, and if there is no symptoms, you would then try another high fructose food, such as mango, for another 3 days. You continue like this, increasing the serving size each day and monitoring for tolerance levels, as you go through each FODMAP category to identify any triggers.
Stage 3: Personalization and Maintenance
Eventually, you will learn which FODMAPs you can tolerate, and which you cannot. At this point, you will continue to avoid the triggers you have identified, while continuing to eat the foods that have been accepted without causing symptoms. This final stage is for life, so you want to relax the restriction as much as possible. You can also re-challenge any poorly tolerated foods periodically, to see if your tolerance has improved.
Should the low FODMAP diet be your first option for treatment?
The Low FODMAP diet can be quite effective, but approximately 1 out of 4 people with IBS will not find any symptom improvement by following the diet. It is also very restrictive, if even only for a short time, and so I often see disordered eating behaviours arising, or being aggravated, by following the diet. For these reasons, I typically won’t use a low FODMAP diet a first line treatment option, but will typically try other modifications first. Other options for managing IBS symptoms include optimizing fibre, stress management, yoga, and gut directed hypnotherapy - to name a few. In fact, researchers at MONASH university (the low FODMAP guru’s) have created an app called ‘Nerva’ which provides gut directed hypnotherapy sessions (similar to mindfulness or meditation apps) that has found similar effectiveness to the low FODMAP diet, without having to eliminate any foods.
It’s important to know that you do have options. It should also be noted, that during a low FODMAP diet it can be very challenging to meet optimal nutrition needs - so it’s best to have a dietitian monitoring you. It should also not be followed if you are trying to conceive or currently pregnant.
Now - if you are following a low FODMAP diet, here’s a recipe to include that will provide a little extra protein to your snacks, without being a trigger!
Recipe: Low FODMAP Peanut and Pumpkin Protein Bites.
Ingredients:
1/2 cup Peanut Butter
2 tablespoons Maple Syrup
1 teaspoon Vanilla Extract
1/4 cup pumpkin seeds
1/4 steel cut oats
2 tablespoons ground flaxseed
2 tablespoons Dark Chocolate Chips
Combine all ingredients until well mixed, add the chocolate chips in at the end. Form into 1 Tbsp sized balls and store in fridge or freezer!
Note: If you aren’t allowed peanut in your workplace or school, try making pumpkin seed butter by blending roasted pumpkin seeds with 1tbsp coconut oil and use that instead.
