The Low FODMAP Diet – How can it help?
Firstly, what is the Low FODMAP Diet? It stands for ‘Fermentable, Oligo-, Di-, Mono-saccharides and Polyols ‘ (FODMAPs) and they are short-chain carbohydrates. Usually, these carbohydrates are poorly absorbed within the small intestine and can cause discomfort.
Typical foods that they can be found in, include;
- Oligo-saccharides: e.g. fructans (found in wheat, rye and some vegetables) and galactooligosaccharides (found in pulses and legumes)
- Di-saccharides: e.g. lactose (found in mammalian milk)
- Mono-saccharides: e.g. free fructose (found in honey, some fruit and fruit juices)
- Polyols: e.g. sorbitol and mannitol (found in some fruits and vegetables).
The original low FODMAPS idea was developed by Monash University in Melbourne, Australia, and has been introduced and adapted by the KIngs College London.
How are FODMAPs affecting me?
FODMAPs do not get ingested in the small intestine like normal carbohydrates, instead, they increase the amount of water, which may lead to an increase to loose stools.
After passing through the small intestine, they arrive at the large intestine, where billions of bacteria start to ferment the FODMAPs. This fermentation may result in an increase in gas production and can contribute to wind and bloating.
By reducing the overall intake of FODMAPs have been shown to improve overall gut health and symptoms, and thus reducing the bloating and gas.
How easy is it to follow a Low FODMAP Diet?
According to the University of Monash, and Kings College London, there are 3 distinct stages to following a low FODMAP diet.
Stage 1 – Restriction
Much like the reduction technique used by many IBS sufferers, this stage works by reducing certain types of food, specifically those high in FODMAPs, usually this is done for between 4 – 8 weeks. This is considered the optimum amount of time to identify symptoms.
Stage 2 – Reintroduction
Once symptoms have been identified, and then suffering has eased or improved, it is vital that SOME high FODMAPs foods are reintroduced into your diet. Again much like the reintroduction phase found here it helps identify what foods and FODMAPs could be causing your symptoms.
Stage 3 – Personalisation
Once Stages 1 and 2 have been completed, it is good to start to personalise your diet, this can include keeping food diaries and knowing the foods that can trigger your symptoms.
How effective is a Low FODMAP Diet?
Studies have shown that the low FODMAP diet is effective for around 70% of IBS suffers (which in my opinion is pretty good!). Its prime focus is for long-term gut health and is shown to be effective for relieving gut based issues, unfortunately, it is not effective for other symptoms such as headaches.
I want to get started on a Low FODMAP Diet
Brilliant, but first, talk to a dietitian or GP. The low FODMAP diet can be quite a complex diet and has 3 distinct stages. As such it is vital that you talk to a consultant or dietitian.
A registered dietitian (one who has experience with Low FODMAP Diets would be preferable) will help you follow this diet, but at the same time keeping your food intake balanced and can offer advice on alternative foods.
You should be able to consult your GP or if you have one a gastroenterologist (gut specialist) who will be able to point you in the right direction.
It is vital that you work with your chosen dietitian to ensure that your diet and food intake are balanced, healthy and personalised to your goal.
Can’t I go it alone?
A Low FODMAP diet is quite complex and time-consuming diet. As well as finding suitable foods and foods that can be swapped out for low FODMAP options, you will need to be able to read and understand food labelling, and how to make sensible informed decisions on eating out.
Secondly, the low FODMAP diet is still in its infancy. A lot of the information out there may be out of date as new research appears or may be wrong. It may cause confusion with regards to the different types of food you can include.
You may also miss out on certain foods that are essential to good health. Without the guidance and support from a dietitian or GP you may end up eliminating whole food types or groups from your diet, and start to have adverse effects on health.
Lastly, to be effective, the low FODMAPs diet needs to be followed correctly, and for this to occur having the advice of a registered dietitian is essential.
My Dietitian hasn’t heard of the low
The low FODMAP diet is still a new concept for the UK and as such you may face some GPs or dietitians who are not up to date or knowledgeable about low FODMAP diets, if this is the case, you can point them in the direction of the NICE national guidelines or request a professional with experience with the diet.
A low FODMAP diet has been shown to be an effective way of dealing with gut issues associated with IBS such as bloating and pain and can be a great way of helping ease the suffering without the need for medication. As the low FODMAP diet becomes more recognised, the more useful it will become for IBS sufferers. It will be really useful for finding new foods that are low FODMAP as well as recognising why these foods cause the issues that we suffer!