Ordinarily, of course, I’d say “no” to dieting. Diets don’t work and they make us feel bad about ourselves. But a low FODMAP diet is actually a tool to help you discover what foods might be triggering certain gastrointestinal symptoms. It is not designed to be followed long-term. And it is not a tool for weight loss or weight maintenance.
What is a low FODMAP diet?
A low FODMAP diet has been proven effective in individuals with irritable bowel syndrome (IBS). In particular, it helps individuals with IBS- diarrhea predominant subtype (IBS-D). A low FODMAP diet eliminates foods high in FODMAPs which are fermentable oligo-, di-, and monosaccharides and polyol. These are unabsorbed, osmotically active carbohydrates which increase the water content of the small intestine. This leads to intestinal distension, causing symptoms such as bloating and discomfort. The increased distension also leads to faster orocecal transit, which impairs absorption in the small bowel. FODMAPs reach the colon unabsorbed, where they are rapidly fermented by colonic bacteria, causing gas, bloating, and discomfort. Individuals will experience symptoms differently, so not everyone is affected by FODMAPs in the same way.
How do I follow a low FODMAP diet?
A low FODMAP diet should be done with the support of a registered dietitian. The dietitian can help explain the diet and support you as you eliminate foods and begin the re-introduction period. A dietitian can help ensure your diet remains nutritionally balanced and address any feelings of restriction or deprivation that may come up for you.
The following table is a guide, but not a complete list.
|Food||Permitted Foods||Foods to Avoid|
|Grains||Rice, oats, quinoa, tapioca, millet, amaranth, buckwheat, gluten free bread and cereal, potato flour||Foods made with wheat flour, kamut, barley, rye, couscous|
|Dairy||Lactose-free milk, rice milk, soy milk, oat milk, lactose-free yogurt, soy yogurt, Greek yogurt||Cow’s milk, goat’s milk, fresh cheeses, ice cream, cream, yogurt with lactose|
|Nuts||Almonds, hazelnuts, walnuts, pine nuts||Pistachios, cashews|
|Vegetables||Carrots, pumpkin, Chinese cabbage, celery, lettuce, spinach, potatoes, tomatoes, zucchini, eggplant, green beans, red pepper, olives, bamboo shoots, fresh herbs||Asparagus, cauliflower, garlic, onion, shallots, mushrooms, leek, chicory, fennel, artichokes, Brussels sprouts, broccoli, radishes, peppers, turnips|
|Legumes||Peas||Beans, chickpeas, lentils, soybeans|
|Fruit||Banana, blueberry, strawberry, raspberry, grape, melon, grapefruit, kiwi, oranges, lemons, limes, pineapple, passion fruit||Apple, pear, watermelon, mango, apricot, avocado, cherries, peaches, plums, persimmon, lychee, fruit juices|
|Sweeteners||White sugar, brown sugar, maple syrup||Agave, honey, fructose, xylitol, maltitol, mannitol, sorbitol|
Foods in the “avoid” column should be avoided for 4-6 weeks. The goal is for you to be feeling better without these foods in your diet. If you are feeling better, it’s time to re-challenge some high FODMAP foods. You will begin challenging foods one at a time to determine if your symptoms return. If symptoms return, you will need to determine if you need a lower serving of the food or if you need to avoid it completely. The re-introduction phase can be tricky which is why having a dietitian to help guide the process can be extremely helpful.
How do I know if a low FODMAP diet is right for me?
If your symptoms of IBS are interfering with your life and you’ve already tried fiber supplementation, exclusion diets, low-carbohydrate diets, low-fructose diets, and gluten free diets and nothing has given you consistent symptom relief, it may be time to try a low FODMAP diet. The low FODMAP diet is more effective in people with IBS-D, but if your symptoms are mixed, it is worth trying the diet as well.
What should I do if I’m currently recovering my healthy relationship with food?
Any type of diet can be difficult when you’re learning how not to diet. It can easily trigger certain thoughts and feelings. This diet is not necessary. If trying a low FODMAP diet would be too triggering right now, you can always discuss other options with your doctor. However, with the help of a registered dietitian, you may be able to find certain foods that you cannot tolerate and achieve symptom improvement and increased quality of life.