As you can imagine, I see a lot of clients with digestive issues in my clinic.
They have often been struggling for a very long time with their symptoms, and have usually done a lot of their own research already.
Quite often clients ask me about FODMAPs, usually because they have cut out loads of foods and are wondering what to do next.
In this blog I delve into what FODMAPs are, how they affect our digestive system, and how avoiding FODMAPs can be an effective strategy for managing irritable bowel syndrome (IBS).
Before we start
If you have digestive symptoms your first port of call must be the GP because there are many digestive conditions with similar symptoms, for example celiac disease, inflammatory bowel disease (IBD), and even cancers. Unless the GP has seen you for your digestive symptoms, you shouldn't start to reduce your FODMAPs.
If you've received an IBS diagnosis and need a strategy to manage your symptoms, reducing FODMAPs could help. But, bear in mind that there are other diet and lifestyle changes that you should try first, namely eating home-cooked meals, eating a balanced diet, getting enough exercise, relaxing or doing things you enjoy, drinking plenty of water, and mindful eating.
If you've done all that, or are just interested in getting ahead, read on!
What are FODMAPs?
FODMAPs stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. These are short-chain carbohydrates and sugar alcohols that are poorly absorbed in the small intestine.
Let's break these down:
Fermentable: Carbohydrates that are fermented by gut bacteria in the large intestine, producing gas.
Oligosaccharides: Found in foods like garlic, wheat, beans, onions.
Disaccharides: Lactose, found in dairy products.
Monosaccharides: Fructose, found in fruits, honey and high-fructose corn syrup.
Polyols: Sugar alcohols like sorbitol and mannitol, found in some fruits and vegetables (sweetcorn, avocado, apricot) and used as artificial sweeteners.
How do FODMAPs affect digestive health?
When FODMAPs reach the small intestine, they attract water via osmosis, and the increase in water causes distension, bloating and discomfort. When they reach the large intestine, they are fermented by gut bacteria, leading to the production of gas, which again causes bloating, flatulence and discomfort. These actions can also cause diarrhoea and constipation.
People with sensitive digestive systems are more likely to experience these symptoms.
Figuring out which FODMAP affect you
Cutting out (or reducing) FODMAPs that you know negatively affect you can be effective in managing such symptoms.
You can do this in three phases.
Elimination: Remove all high-FODMAP foods from your diet for 4-6 weeks. This helps to reduce symptoms and allows the gut to settle.
Reintroduction: Gradually reintroduce FODMAPs one at a time. This helps to identify which specific FODMAPs are triggering symptoms.
Personalisation: Based on the results of the reintroduction phase, create a tailored diet that avoids only the FODMAPs that cause symptoms, allowing the inclusion of as many foods as possible without triggering discomfort.
Benefits of cutting out FODMAPs that affect you
Research has shown that avoiding the FODMAPs that negatively affect you can significantly improve symptoms in about 70% of people with IBS. The benefits include:
Reduced bloating and abdominal pain
Improved stool consistency and frequency
Enhanced quality of life.
Common low-FODMAP foods
Proteins: Plain-cooked meats and fish, eggs, tofu and tempeh (despite being made from soy beans, these are low FODMAP because the FODMAPs have been removed during processing), nuts, seeds.
Grains: Rice, quinoa, oats, buckwheat, corn/polenta.
Fruits: Berries, grapes, oranges, bananas, strawberries, honeydew melon, kiwi, tomatoes, lemons, limes, oranges, papaya (all of these contain the FODMAP fructose in low levels, so you need to be especially wary of FODMAP stacking - see below).
Vegetables: Carrots, spinach, courgette, potatoes, rocket, green beans, bok choy, spring onion, potatoes, aubergine, bean sprouts, lettuce, turnips, rhubarb
Dairy alternatives: Lactose-free milk, almond milk, coconut milk.
Common high-FODMAP foods
Protien: Pulses (beans, lentils and peas).
Grains: Wheat.
Fruits: Apples, apricots, figs, pears, watermelon, peaches, plums.
Vegetables: Garlic, onions, asparagus, Brussel sprouts, fennel, leeks, butternut squash, mushrooms, globe and Jerusalem artichokes, cauliflower.
Proteins: Dairy products, e.g. milk, yoghurt, ice cream; legumes, pulses.
Soy milk (most in the UK is made from soya beans, as opposed to soya bean extract, which makes it high in FODMAPs).
FODMAP stacking
FODMAP stacking occurs when multiple low-FODMAP foods that contain the same type of FODMAP are consumed together or in close succession.
While each food might be within the acceptable serving size, their combined FODMAP content can exceed your tolerance threshold, leading to symptoms.
For example eating a moderate portion of berries (low in FODMAPs) followed by a banana (also low in FODMAPs) might stack up the fructose content.
You can avoid FODMAP stacking by:
Understanding FODMAP categories: Familiarise yourself with the different types of FODMAPs (earlier in this blog) and know which foods contain each to better plan your meals.
Monitoring serving sizes: Stick to recommended serving sizes for low-FODMAP foods. Use resources like the Monash University FODMAP Diet app to check the FODMAP content of foods and their serving sizes.
Planning your meals: Eat balanced meals that spread out different types of FODMAPs rather than concentrating one type in a single meal.
Eating a diverse diet: Ensure variety to prevent overconsumption of any single type of FODMAP.
Spacing out FODMAP-containing foods: Leave a gap between eating different FODMAP-containing foods.
Snacking wisely: Be cautious with snacks that might add to your overall FODMAP intake.
Tracking your symptoms: Keep a detailed food diary to identify patterns between what you eat and your symptoms. Use your diary to adjust your diet and avoid combinations that cause symptoms.
I can help
If you're considering reducing your FODMAPs to manage your digestive symptoms, then please do get in touch - I can help guide you through the process. I'll also help you to understand what else might be going on that's contributing to how you're feeling.
You'll get:
An in-depth health analysis that helps you to understand why you're feeling how you're feeling
A plan with manageable nutrition and lifestyle actions, personalised to you
Specific meal and snack suggestions and recipes
Supportive accountability to keep you on track
Lots of opportunities to ask questions
Book a free 15-minute chat with me to find out more.
Disclaimer
The information and advice I provided here is of a general nature and should never replace individual health or medical advice provided by your doctor or other healthcare professional involved in your care.
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