The low FODMAP diet is a diet designed specifically with people with IBS (irritable bowel syndrome) in mind. Those following the diet will go through three phases: Elimination, Reintroduction, and Integration, in which they will hopefully discover which foods may be triggering their IBS symptoms and which ones they can safely continue to eat.
The low-FODMAP diet eliminates or significantly reduces your intake of certain sugars, which tend to sit in our digestive systems and ferment as we struggle to digest them. As our gut microbiota breaks them down, they produce gas, which can cause painful bloating and other uncomfortable symptoms.
IBS affects 7-15% of the general population, with many people experiencing bloating, gas, and stomach pain, as well as constipation, diarrhea, or a combination of the two. These symptoms can range from mildly uncomfortable to debilitating, with one person with IBS experiencing the condition differently than the next.
Here, we’ll explain what FODMAPs are, what you can eat on a low-FODMAP diet, and how you can manage your IBS long-term. Plus, learn more about gut health Y how to improve your digestion here on LiveScience.
What are FODMAPS?
FODMAP stands for ‘Fermentable Oligo-, Di-, Mono-saccharides, and Polyols’, which are short-chain sugars that can trigger symptoms in people with IBS when eaten.
“FODMAPs are short-chain sugars found in a variety of grains, fruits, and vegetables, as well as added to some processed foods,” explains Dr. Bridgette Wilson, a Doctify (opens in a new tab)-reviewed gut specialist and clinical and research dietitian. “Sugars are bound together in such a way that humans cannot digest them. These FODMAP sugars can be digested by gut microbes in a process called fermentation, which produces gas as a byproduct.”
FODMAPs exist in a wide range of foods, according to a study in the nutrients (opens in a new tab)daily, and people may have difficulty adequately avoiding them or sufficiently meeting their nutritional requirements while following a low-FODMAP diet, so the support of a dietician is vital for success.
What can you eat on a low FODMAP diet?
Dr. Wilson encourages those following a low-FODMAP diet to seek expert help, particularly in the restriction phase. “You can eat foods from all the food groups on a low-FODMAP diet, it is important to get specialist advice to help you follow the diet accurately and maintain a good balance of nutrients while following the restricted phase of the diet,” He says.
Some foods you can still enjoy on the low-FODMAP diet include:
- Vegetables: Carrots, spring onions, cucumbers, eggplants, bamboo shoots, spinach, spring onions, ginger, lettuce, parsnips, potatoes and turnips.
- Fruits: Lemons, limes, oranges, grapefruit, bananas, strawberries, blueberries, melons, and kiwi. It’s important to note that some of these foods become high-FODMAP when they’re overripe or overripe, so check which stages are okay to eat.
- Meat and fish: Most raw meat is fine, but watch out for processed meats like salami, which sometimes contain garlic.
- Dairy and dairy alternatives: lactose free milk, almond milk, oat milkrice milk, coconut milklactose-free yogurt and hard cheeses.
- Grain: oatmeal, rice, without gluten pasta, quinoa and corn flour. Check the label of anything that says “gluten-free” to make sure it doesn’t contain other trigger ingredients. Note: It’s not the gluten you’re avoiding on the low-FODMAP diet, but the sugars in the wheat. However, since gluten-free products also contain no wheat, you can generally eat them.
Dr. Tariq Mahmood, Physician and Medical Director of Diagnostic Concept (opens in a new tab), notes that although the low-FODMAP diet may seem restrictive at first glance, it is possible to stay healthy and satisfied while consuming a low-FODMAP diet. “There are a lot of foods that are totally fine to eat. For example, eggs, fish and meat,” she says. “There are also lots of fruits, grains, and vegetables: grapes, oranges, strawberries, cucumbers, potatoes, tomatoes, oatmeal, quinoa, and rice, to name just a few.
“Common beverages like tea and coffee can also be taken on a low-FODMAP diet, though no more than three cups a day.”
How to follow a low FODMAP diet
Dr. Mahmood lists some foods to avoid on a low-FODMAP diet: “Excessive foods to avoid on a low-FODMAP diet include fruits such as apples and watermelon, dairy products such as fresh and soft cheese, ice cream, and milk, vegetables like broccoli, mushrooms, and onions, as well as wheat products like crackers, bread, and pasta,” he says. “Then, once you’ve eliminated all of the high-FODMAP foods, you can try slowly reintroducing them one by one to see which ones do or don’t cause digestive symptoms.
“Another thing to consider is that as your diet changes, it can be difficult to make sure your body is getting all the nutrients it needs. As such, multivitamins and supplements are your friends. Omega-3, vitamin D, vitamin B6, and calcium are just a few of the most important vitamins and minerals you’ll need to keep up.”
A study in Journal of Gastroenterology and Hepatology (opens in a new tab)encourages people who want to try the low-FODMAP diet to do so under the supervision of a dietitian. She also recommends that the initial elimination stage last no longer than 4-6 weeks, as following the diet long-term can have negative effects on the gut microbiome.
Stages of the low FODMAP diet
“The low-FODMAP diet is a short-term elimination process of foods high in fermentable sugars (FODMAPs) followed by a precise reintroduction process to identify the specific group of foods that may trigger symptoms,” explains Dr. Wilson. “The final stage of this process is personalization, where the diet is expanded to include all non-trigger FODMAP foods,”
Elimination
In this phase, all high-FODMAP foods are eliminated over a period of 4 to 6 weeks. The removal guide produced by monash university (opens in a new tab) (where the low-FODMAP diet was developed) reminds us that the low-FODMAP diet is not an elimination diet, but rather a replacement diet. While it may seem difficult to swap foods with very different flavors like onions and garlic, a dietitian can point you to low-FODMAP alternatives, like chives or garlic-infused oil, that can make this phase easier.
reintroduction
Reintroduction involves strategically testing each FODMAP subgroup (fructose, lactose, sorbitol, mannitol, fructans, and galactans) to see if you can digest them without experiencing symptoms. You’ll keep the low-FODMAP diet in the background and try each subgroup individually and in increasing amounts for a few days, with a break of a couple of days before trying a new reintroduction. You may find that you can tolerate some foods in small amounts, while others can be fully integrated into your diet without restriction. It is important to have the support of a dietitian for this stage, as they will be able to advise you on which foods are best to test your tolerance for each subgroup.
Integration/customization
In the integration phase, you work with your dietitian to take the results of the reintroduction phase and apply them to your diet. If some FODMAPs still trigger you after removal, they will be avoided in the future, but you can test your tolerance every few months, as our response to FODMAPs tends to change over time.
These 5 ways to improve gut health might offer some tips to help with your gut health after the integration phase.
Benefits of a low FODMAP diet
According to Dr. Mahmood, “Digestive problems are also linked to anxiety, depression, and stress, so a low-FODMAP diet is worthwhile if you’re struggling with IBS.”
He also says that avoiding all FODMAPs is a serious challenge that borders on the impossible, as some of the most common FODMAPs include fructose (found in most fruits and vegetables), fructans (found in grains), and lactose (found in dairy products). However, research has shown that bloating, pain, and gas were also reduced in IBS patients following a low-FODMAP diet.
A study in nutrients (opens in a new tab) journal also found that the low-FODMAP diet significantly reduced swelling and pain in subjects. As these are two of the main IBS symptoms, cutting out the foods that are responsible for these symptoms could help alleviate some of the IBS burden.
“The low-FODMAP diet is clinically proven to provide a significant decrease in IBS symptoms,” adds Dr. Wilson. “It is a process of identifying specific food triggers of IBS symptoms. By knowing exactly which foods are triggers, people with IBS can regain confidence with food, freeing them from food and social anxiety..”
