A BEGINNER’S GUIDE TO GOING FODMAP-FRIENDLY

One of the most effective ways we can make a real change in our health is through diet but having the motivation to change your diet is one thing, knowing which diet is right for you is another. While it can be difficult to cut through the noise on what is the best diet to follow, one thing we have learnt in recent times is that there is no such thing as a one-size-fits all approach to healthy eating. 

There are many factors that can affect your individual dietary needs, some of which include age, pregnancy, genetics…even your unique microbiome plays a role. [1]  Another important factor to consider is your current state of gut health, as this can greatly affect your ability to digest, absorb and tolerate the different foods you eat.  One such gut condition that can affect your response to specific foods is known as medically diagnosed irritable bowel syndrome (MD-IBS).

MD-IBS is a common condition affecting up to 1 in 5 Australian guts, resulting in symptoms such as gas, bloating and abdominal discomfort.  While researchers are yet to identify the cause, approximately 70-89% of sufferers report that certain foods worsen symptoms.[2]  While classically rich foods such as alcohol and fats are well known for their ability to upset the guts of those with MD-IBS, there are also some foods that we typically view as healthy that can also act as triggers.  These foods are collectively known as FODMAPs

If you have MD-IBS, chances are you have heard of the low FODMAP diet but perhaps you have been wondering what it all means?

Allow us to break down the science for you, so that you can weigh up the pros and cons and, with the help of your medical practitioner, decide whether the low FODMAP diet might be the right diet for you.

 

WHAT ARE FODMAPS?

Firstly, let’s answer the question - what does FODMAP stand for?

FODMAP is an acronym for Fermentable Oligo-, Di- and Mono-saccharides and Polyols, which describes a group of short chain, fermentable carbohydrates and sugar alcohols. [3] 

In simpler terms, FODMAPs are a specific group of carbohydrates that are poorly digested and absorbed in the digestive tract.  Their presence in the gut leads to 3 main changes, including:

  • Increased gut movements
  • A build-up of fluid in the small intestine
  • Increased production of gas[2],[4]

*Cue the stretchy pants!

It is thought that these changes contribute to the symptoms associated with MD-irritable bowel syndrome, however the reasons why are not yet fully understood.  Similar changes can also occur in those without symptoms of MD-IBS, leading researchers to propose that symptoms may be due to an increased ‘sensitivity’ to these foods rather than directly caused by the foods alone.[2]

 

WHAT ARE THE BENEFITS OF A LOW FODMAP DIET?

Several studies have shown an association between a short term low FODMAP diet and a reduction in MD-irritable bowel syndrome symptoms, such as abdominal pain and bloating.[4] It is believed that reducing dietary FODMAPs can assist with improving the health of the gut microbiome as well as gut barrier integrity, both of which are altered in MD-IBS.[4]  However, like with most diets, evidence suggests these benefits do not apply to everyone with MD-IBS and therefore individual professional advice is recommended.

 

WHAT CAN YOU ACTUALLY EAT ON A LOW FODMAP DIET?

Foods to enjoy

Foods to avoid

  • Eggs and meat
  • Certain dairy, such as low-lactose or lactose free varieties
  • Almond milk
  • Grains such as rice and oats
  • Nuts and seeds
  • Vegetables like potatoes, tomatoes, carrots, cucumbers and zucchini
  • Fruits such as grapes, oranges, strawberries, blueberries and pineapple

     

    • Wheat based foods – such as biscuits, cereals and breads
    • Full lactose dairy – including regular cow’s milk and cheese
    • Some fruits – such as apples and pears
    • Some vegetables – including garlic and onions
    • Legumes

     

     

    It is important to remember that everyone is different when it comes to the FODMAP diet.  For instance, you may tolerate some FODMAPs and not others, or you may be able to have a small amount of all FOMDAPs.  This is why it is so important for you to seek advice from a medical professional, to avoid any unnecessary restrictions.

     

    REASONS WHY A LOW FODMAP DIET MAY NOT BE FOR YOU:

    A low-FODMAP diet can be difficult to follow, after all it is quite the list of foods to avoid!  In addition to this, many of the foods to be avoided belong to highly nutritious food groups including lactose-containing dairy products, wheat and legumes, and a variety of fruits and vegetables. Some restricted foods are also high in ‘prebiotic fibres’ – an important food source for the beneficial bacteria that live within your gut.  Restriction of such a large number of food groups can increase the risk of nutritional deficiencies and can have unknown consequences on the health and balance of your gut microbiome.

     

    SO, WHERE TO FROM HERE?

    If you have medically diagnosed irritable bowel syndrome, and your diet is currently high in FODMAP containing foods, the current evidence suggests that you may benefit from following a short-term, low FODMAP diet.

    Due to the challenging nature of balancing nutritional intake with a reduction in MD-IBS symptoms, it is best to consult your medical practitioner or dietician for a low FODMAP plan that is right for you and caters to the unique individual that you are.

    For more specific advice on the FODMAP diet or MD-IBS, please consult your medical practitioner.

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    [1] Matusheski N, Caffrey A, Christensen L, Mezgec S, Surendran S, Hjorth MF, McNulty H, Pentieva K, Roager HM, Seljak BK, Vimaleswaran KS. Diets, nutrients, genes and the microbiome: recent advances in personalised nutrition. British Journal of Nutrition. 2021 Jan 29:1-24.

    [2] Staudacher HM, Whelan K. The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS. Gut. 2017 Aug 1;66(8):1517-27.

    [3] Gibson PR, Shepherd SJ. Evidence‐based dietary management of functional gastrointestinal symptoms: the FODMAP approach. Journal of gastroenterology and hepatology. 2010 Feb;25(2):252-8. Include financial sponsor)

    [4] Ooi SL, Correa D, Pak SC. Probiotics, prebiotics, and low FODMAP diet for irritable bowel syndrome–What is the current evidence?. Complementary therapies in medicine. 2019 Apr 1;43:73-80.