A Beginner's Guide to the Low-FODMAP Diet

Written By Renata Zambo

One dietary approach that has been shown to be effective in managing symptoms of IBS is the low-FODMAP diet [1]. In this beginner's guide, I'll explain what the low-FODMAP diet is, how it works, and provide tips for getting started.

What are FODMAPs?

FODMAPs are a group of carbohydrates that are poorly absorbed in the small intestine and fermented by gut bacteria in the large intestine. This can lead to symptoms such as gas, bloating, and abdominal pain in individuals with IBS [2]. FODMAPs include:

  • Fermentable oligosaccharides (fructans and galacto-oligosaccharides)

  • Disaccharides (lactose)

  • Monosaccharides (fructose)

  • Polyols (sorbitol, mannitol, xylitol, and maltitol)

How does the low-FODMAP diet work?

The low-FODMAP diet involves a two-phased approach. In the first phase, high-FODMAP foods are eliminated from the diet for 2-6 weeks [3]. This can provide relief from symptoms and allow the gut to heal. In the second phase, FODMAPs are gradually reintroduced to identify which ones are causing symptoms. This helps individuals to create a personalized, sustainable diet that includes as many foods as possible while minimizing symptoms [4]. In my clinical practice, some patients will eliminate the food longer than 2-6 weeks because they 1) symptomatically feel better, and 2) it helps to reduce the damaging burden of these foods. Since I follow their care, I am able make specific recommendations for them, so if you’ve been recommended the low FODMAP diet by your healthcare provider, please check in with them for their suggested duration for you.

What foods are high and low in FODMAPs?

High-FODMAP foods include:

  • Wheat, rye, and barley

  • Onions and garlic

  • Legumes (e.g. beans, lentils, chickpeas)

  • Dairy products that contain lactose

  • Apples, pears, mangoes, watermelons, and stone fruits (e.g. peaches, plums)

  • Honey, agave nectar, and high fructose corn syrup

  • Artificial sweeteners that contain polyols (e.g. sorbitol, mannitol, xylitol, and maltitol)

Low-FODMAP foods include:

  • Gluten-free grains (e.g. rice, quinoa, oats)

  • Vegetables (e.g. carrots, cucumber, lettuce, spinach, tomatoes)

  • Fruits (e.g. bananas, blueberries, grapes, kiwi, oranges)

  • Lactose-free dairy products (e.g. hard cheese, lactose-free milk, butter)

  • Meat, poultry, fish, eggs, and tofu

  • Nuts and seeds (e.g. almonds, walnuts, chia seeds)

  • Sweeteners such as maple syrup and stevia

Very important: the low-FODMAP diet is not a long-term solution, since it can lead to nutritional inadequacies if followed for extended periods of time [5]. It's also important to work with a healthcare professional to determine if the low-FODMAP diet is right for you, and to ensure that it is being implemented correctly.

While the low-FODMAP diet may seem daunting at first, there are many resources available to make it easier to follow. For example, there are many low-FODMAP recipes available online, and some grocery stores even have low-FODMAP sections to make shopping easier. My patients receive a low fodmap guide and low fodmap recipes as a starter pack to ease into things.

Overall, the low-FODMAP diet is a useful tool in managing digestive issues such as IBS [1]. By eliminating high-FODMAP foods and gradually reintroducing them, individuals can identify which ones are causing symptoms and work towards a more varied and nutrient-dense diet. If you're considering the low-FODMAP diet or aren’t sure if it would be a good idea for you, let’s do a discovery call and figure out what your next steps should be!

In health,

Dr. Renata, ND

References:

1. Halmos, E. P., Power, V. A., Shepherd, S. J., Gibson, P. R., & Muir, J. G. (2014). A diet low in FODMAPs reduces symptoms in patients with irritable bowel syndrome and a probiotic restores bifidobacterium species: a randomized controlled trial. Gastroenterology, 146(1), 67-75. doi: 10.1053/j.gastro.2013.09.046

2. Staudacher, H. M., Lomer, M. C., Anderson, J. L., Barrett, J. S., Muir, J. G., Irving, P. M., & Whelan, K. (2012). Fermentable carbohydrate restriction reduces luminal bifidobacteria and gastrointestinal symptoms in patients with irritable bowel syndrome. Journal of Nutrition, 142(8), 1510-1518. doi: 10.3945/jn.112.159285

3. Shepherd, S. J., & Gibson, P. R. (2013). Fructose malabsorption and symptoms of irritable bowel syndrome: guidelines for effective dietary management. Journal of the American Dietetic Association, 113(3), 383-388. doi: 10.1016/j.jada.2012.11.002

4. Staudacher, H. M., Whelan, K., & Irving, P. M. (2011). Lactose intolerance and the low-lactose diet. European Journal of Clinical Nutrition, 65(4), 501-507. doi: 10.1038/ejcn.2010.282

5. Gearry, R. B., Irving, P. M., Barrett, J. S., Nathan, D. M., & Shepherd, S. J. (2009). Reduction of dietary poorly absorbed short-chain carbohydrates (FODMAPs) improves abdominal symptoms in patients with inflammatory bowel disease-a pilot study. Journal of Crohn's and Colitis, 3(1), 8-14. doi: 10.1016/j.crohns.2008.09.011

6. Biesiekierski, J. R., Peters, S. L., Newnham, E. D., Rosella, O., Muir, J. G., & Gibson, P. R. (2013). No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates. Gastroenterology, 145(2), 320-328. doi: 10.1053/j.gastro.2013.04.051

Renata Zambo
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