What is a Low FODMAP diet?
A diet low in FODMAPs is an effective treatment for gut symptoms such as bloating, wind, abdominal pain and an altered bowel habit, usually associated with IBS.
FODMAP stands for
'fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. The
low FODMAP diet does not take on the question of what causes
IBS, rather it looks at the role that certain foods play in
triggering digestive symptoms.
The main dietary sources of
the four groups of FODMAPs include:
- Oligosaccharides: Wheat, rye, legumes and
various fruits and vegetables, such as garlic and onions.
- Disaccharides: Milk, yogurt and soft cheese.
Lactose is the main carb.
- Monosaccharides: Various fruit including figs
and mangoes, and sweeteners such as honey and agave nectar. Fructose is the main carb.
- Polyols: Certain fruits and vegetables
including blackberries and lychee, as well as some low-calorie sweeteners like
those in sugar-free gum.
The low FODMAP diet was developed by a team at Monash University in Melbourne, Australia. It has been successfully adapted to the UK by researchers at King’s College London and implemented at Guy’s and St Thomas’ NHS Trust in London FODMAP foods are foods that contain certain types of carbohydrates.
Why might FODMAPs affect my gut symptoms?:
Once ingested, some FODMAPs do not get absorbed in the small intestine. They increase the amount of water in the small intestine which may contribute to loose stools.
They also pass along the gut to the large intestine
where there are billions of bacteria which ferment them. This fermentation may
result in gas production and symptoms such as wind and bloating. Reducing the
intake of FODMAPs has been shown to improve gut symptoms in most people with
functional bowel disorders like irritable bowel syndrome (IBS).
Benefits of a Low-FODMAP Diet:
IBS digestive symptoms can
vary widely, including stomach pain, bloating, reflux, flatulence and bowel
urgency. Stomach pain is a hallmark of the condition, and bloating has been
found to affect more than 80% of people with IBS.
Needless to say, these symptoms
can be debilitating. Fortunately, both stomach pain and bloating have been
shown to significantly decrease with a low-FODMAP diet.
Evidence from four
high-quality studies concluded that if you follow a low-FODMAP diet, your odds
of improving stomach pain and bloating are 81% and 75% greater, respectively.
Who Should Follow a Low-FODMAP Diet?:
A low-FODMAP diet is not for everyone. Unless you have been diagnosed with IBS, research suggests the diet could do more harm than good. This is because most FODMAPs are prebiotics, meaning they support the growth of good gut bacteria. Also, most of the research has been in adults. Therefore, there is limited support for the diet in children with IBS.
If you have IBS, consider this
diet if you:
- Have ongoing gut symptoms.
- Haven't responded to stress management
- Haven't responded to first-line dietary advice,
including restricting alcohol, caffeine, spicy food and other common trigger
It is important to be aware that the diet is an involved process. For this reason, it's recommended that you work with a trained dietitian who can guide you through the appropriate foods.
How do I follow the low FODMAP diet?
There are 3 stages to the low FODMAP diet:
Stage 1 Restriction: In this stage, you reduce
your FODMAP intake by avoiding foods that are high in FODMAPs for 4 to 8 weeks
as this period is considered long enough to identify if symptoms will respond
to a low FODMAP diet.
Stage 2 Reintroduction: If your symptoms have
improved following FODMAP restriction, it is important to reintroduce some high
FODMAP foods. This will enable you to identify which FODMAPs you are most
sensitive to, as well as how much of a high FODMAP food triggers your symptoms.
Stage 3 Personalisation : The long term aim of a low FODMAP diet is to personalise your diet so you only avoid foods that trigger your symptoms and you return to as normal a diet as possible.
I want to try the low FODMAP diet. What should I do?