The FODMAP diet is used to help alleviate symptoms of irritable bowel syndrome (IBS). It can also help with symptoms of Crohn’s disease, ulcerative colitis, and celiac disease. It is not a cure for these diseases, but it may help to prevent bloating, cramping, diarrhea, flatulence, and other symptoms that are common for people who suffer from these conditions.
FODMAP is an abbreviation for the poorly absorbed short-chain carbohydrates that feed on naturally-occurring bacteria found primarily in the large bowel: Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols. For IBS suffers, consumption of these sugars and sugar alcohols can cause digestive discomfort. The intestinal bacteria found in the large bowel feed on these indigestible sugars, leading to negative gastrointestinal symptoms. The premise of this diet is that through avoidance of FODMAPs, symptoms of digestive discomfort may be eliminated.
Many carbohydrates in food are poorly digested and not absorbed by the small bowel. One example of this is dietary fiber. Some oligosaccharides and simple sugars cannot be absorbed but can be broken down by intestinal bacteria, producing gas. To reduce the amount of gas produced, a person following a FODMAP diet should eat a limited amount of carbohydrates, except those that are readily digested (such as sucrose and glucose).
The approach to this diet is to eliminate all foods containing FODMAPs for eight weeks. After eight weeks, you slowly reintroduce FODMAPs one at a time. Using this technique, you may be able to find out which of the FODMAPs are contributing to increased gas production in the bowel. For many people, simple avoidance of one or two of these carbohydrates that are causing most of the gas production causes a dramatic decrease in their IBS symptoms.
What are the foods to be avoided on a low FODMAP diet?
The list of foods to be avoided is extensive, and includes (but is not limited to) the following:
- Oligosaccharides (fructans and galacto-oligosaccharides): wheat, garlic, onion, beans, and lentils
- Disaccharides (lactose): all milk-containing products, including cow’s milk, yogurt, and cheese
- Monosaccharides (fructose): many fruits, honey, and high-fructose corn syrup
- Polyols (sugar alcohols): sorbitol, mannitol, mannitol, xylitol, polydextrose, and isomalt
A more detailed list of foods to avoid, including recipes consisting of only low FODMAP foods can be found at www.thelowfodmapdiet.com.
What is OK to Eat?
There are many fruits and vegetables that are not on this list that are fine to eat during the elimination period. These include grapes, oranges, strawberries, carrots, kale, lettuce, and squash, to name a few. To ensure you are getting adequate calcium, consider adding milk-substitutes such as almond and soy milk to your diet.
How successful is the FODMAP diet?**
Research with this diet has shown that for 25 percent of people who have attempted to follow this elimination diet, there was no change in their symptoms. But for the remaining 75 percent, IBS sufferers reported at least some improvement in their symptoms. Read more information about FODMAP research.
Is the FODMAP diet for me?
If you suffer from any of the digestive orders listed above, there is no harm in attempting to follow the low FODMAP diet under medical supervision to see if it alleviates your chronic symptoms. A registered dietitian and/or a gastroenterologist skilled in the execution of the low FODMAP diet can assist you in implementing the diet while ensuring that your diet remains nutritionally balanced during the elimination period.
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Carmen Roberts, M.S., R.D., L.D.N., is a registered dietitian, receiving her undergraduate degree in dietetics from James Madison University and her master’s degree in health education and administration from Towson University. She is a certified specialist in adult weight management and teaches cooking classes. Carmen enjoys educating her clients about how nutrition affects the body and its role in overall health and wellness. She also loves volunteering, including as a Girl Scout troop leader.