By Felicia Newell

You may have heard buzz around the internet about the ‘Low FODMAP Diet’ being the next ‘in’ diet for weight loss and overall health.

My job as a health professional is to clear things up so that you have all the facts. The low FODMAP diet is not a weight loss diet, or a diet that will promote overall wellbeing for the general public. It is a diet that has been scientifically proven to help many people who suffer from medically diagnosed irritable bowel syndrome (IBS) to improve and better manage their symptoms.

Irritable bowel syndrome is a common disorder of the gastrointestinal (GI) system. Typical IBS symptoms include abdominal pain, bloating, constipation and/or diarrhea. Ten to 20% of the adult population suffers from IBS, which is twice as frequent among women ⁽¹⁾.

So what are FODMAPs?

FODMAP stands for:

– Fermentable
– Oligosaccharides
– Disaccharides
– Monosaccharides,
– And
– Polyols

Basically, they’re a bunch of long words that represent short-chain carbohydrates/sugars which are poorly absorbed in the small intestine. As FODMAPs reach the large intestine, they are fermented by bacteria, which leads to gas production and increases the osmotic load in the intestine. This means more water particles are attracted to the intestine, which results in bloating and other digestive symptoms.

Why Low-FODMAP Diet works for people with IBS

Many IBS sufferers attribute their ‘tummy troubles’ to carbohydrates in general, or to gluten. However, carbohydrates are not the culprits of all digestive issues, and you don’t need to eliminate all carbohydrates to manage symptoms. FODMAPs are only one group of carbohydrates, and many of these types of carbohydrates also happen to contain gluten (which is why some people understandably make that connection).

Most of us can consume foods high in FODMAPs with little to no discomfort. However those with IBS tend to be more sensitive to the process mentioned above, and symptoms such as such as gas, bloating, pain, constipation and/or diarrhea are worsened when foods high in FODMAPs are consumed.

The low FODMAP diet is an evidence-based approach to identify and eliminate potential trigger foods. Many studies have emerged over the past several years, showing that a low FODMAP diet for IBS patients leads to a significant reduction in digestive symptoms ^{(2, 3, 4)}.

How to Get Started

Although very worth it, as many people see drastic, life-changing improvements in symptoms after implementing the low FODMAP diet – it is a complex process.

Monash University, who are among the leading researchers and experts on the low FODMAP diet, recommend that you seek guidance from a registered dietitian with experience in this area ⁽⁵⁾.

A dietitian will provide the necessary guidance to ensure that your diet remains nutritionally adequate while implementing the low FODMAP diet in your life.

It is also a misconception that the low FODMAP diet is a life-long way of eating. The restrictive, elimination phase of the low FODMAP diet is generally recommended to be 2-6 weeks (it can be longer in some cases, but the average is 2-6 weeks).

How the low FODMAP Diet is implemented

Using the low FODMAP diet to figure out what your personal intolerances are can help heal your gut, improve and manage your symptoms, keep variety in your diet, and improve healthy gut bacteria.

Below are the general steps to implementing a low FODMAP diet:

1) Seek the guidance of a registered dietitian who can ensure that your diet is well balanced and contains adequate nutrients during this phase
2) Cut out all foods that are high in FODMAPs
3) Consume only low FODMAP foods for 2-6 weeks, until symptoms improve
4) Once symptoms have had enough improvement that you can correctly identify a trigger, and your progress can be reviewed by your dietitian, challenge and re-introduce FODMAP foods by one FODMAP category or subcategory at a time
– Foods should be introduced in a structured way, again with the support of your dietitian.

The low FODMAP diet is meant to be a short-term solution, and is too restrictive to stay on long-term.

There are many nutritious foods that are high in FODMAPs. As each and every person is unique in their body and their experience, those with IBS are of course no different. Some may be sensitive to one type of FODMAPs but can consume another group with no harm. This is why it is important to remove one FODMAP category or sub-category at a time. Plus, who wants to exclude foods that are nutritious, or that they enjoy if they don’t have to? For examples of what types of foods are in each category, visit here: http://www.med.monash.edu/cecs/gastro/fodmap/description.html

Resources

Make sure to use credible sources when learning about health and nutrition advice, as there is much misinformation out there.

Check out Monash University’s website for trustworthy information on the Low FODMAP diet (http://www.med.monash.edu/cecs/gastro/fodmap/). They even have an extremely helpful app (‘Monash University Low FODMAP Diet’, which provides information about IBS and the low FODMAP diet, recipes, low FODMAP certified foods, and more.

Also, click here to check out a low FODMAP grocery list!

If you have any further questions about IBS, the low FODMAP diet, or nutrition, don’t hesitate to reach out to me.

References:

1) Hungin APS, Whorwell PJ, Tack J, Mearin F. The prevalence, patterns and impact of irritable bowel syndrome: an international survey of 40 000 subjects. Aliment Pharmacol Ther 2003; 17: 643–50. Available from: http://onlinelibrary.wiley.com.ezproxy.msvu.ca/doi/10.1046/j.1365-2036.2003.01456.x/full

2) Shepherd S, Parker F, Muir J, Gibson P. Dietary triggers of abdominal symptoms in patients with irritable bowel syndrome: randomized placebo-controlled evidence. Clin Gastroenterol Hepatol. 2008; 6: 765–71. Available from: https://www-ncbi-nlm-nih-gov.ezproxy.msvu.ca/pubmed/18456565

3) Barrett JS, Gearry RB, Muir JG et al. Dietary poorly absorbed, short-chain carbohydrates increase delivery of water and fermentable substrates to the proximal colon. Aliment Pharmacol Ther 2010; 31: 874–82. Available from: https://www-ncbi-nlm-nih-gov.ezproxy.msvu.ca/pubmed/20102355

4) de Roest, R. H., Dobbs, B. R., Chapman, B. A., Batman, B., O’Brien, L. A., Leeper, J. A., Hebblethwaite, C. R. and Gearry, R. B. (2013), The low FODMAP diet improves gastrointestinal symptoms in patients with irritable bowel syndrome: a prospective study. Int J Clin Pract, 67: 895–903. Available from: http://onlinelibrary.wiley.com.ezproxy.msvu.ca/doi/10.1111/ijcp.12128/full

5) The Monash University Low FODMAP diet. Available from: http://www.med.monash.edu/cecs/gastro/fodmap/description.html