If you have recently found out you have IBS (irritable bowel syndrome), or have been struggling with this disorder for a while, you may have come across the Low FODMAP diet in online forums, healthcare websites, and other information online. But what are FODMAPs, and how does this diet work?
What are FODMAPs?
Before we delve into the Low FODMAP diet, it is first important to understand what FODMAPs are. Here is what the acronym stands for:
Fermentable
Oligosaccharides
Disaccharides
Monosaccharides
And
Polyols
This sounds complicated, so let’s break it down. Oligosaccharides, disaccharides, monosaccharides and polyols are types of short-chain carbohydrates that are not absorbed fully by the small intestine. Instead of being absorbed, they travel through the gut and reach the large intestine, where they become food for gut bacteria, who ferment them (break them down), producing gas as a byproduct.
This process can often lead to uncomfortable symptoms experienced by people with IBS, including bloating, diarrhea, constipation, and abdominal pain. A diet high in FODMAPs can aggravate IBS symptoms because in people with IBS, the gut is often hypersensitive, experiencing pain and discomfort in response to normal stimuli.
Here are some examples of foods high in FODMAPs:
- Beans and legumes
- Onion and garlic
- Dairy products containing lactose
- Certain fruits such as apples, pears, and stone fruit
- Wheat, rye, and barley
The Low FODMAP Diet
The connection between FODMAPs and IBS was initially discovered by studies led by Monash University in Australia. Researchers found that high FODMAP foods could trigger IBS symptoms, and that a diet low in FODMAPs could improve symptoms. In 2016, the low FODMAP diet was launched, with three key stages: elimination, reintroduction, and personalisation. This 3-step approach is key as it allows those with IBS to discover which high FODMAP foods trigger their symptoms.
It is important to trial the diet with the help of a FODMAP-trained dietitian. They can ensure you are following the diet correctly so that you get clear results about which foods are triggers for you. They can also help make sure your diet stays balanced, particularly if you have any dietary requirements, for example, if you are a vegetarian. Careful meal planning is crucial to ensure the process is thorough and effective.
The Elimination Phase
During step 1, the elimination phase, foods high in FODMAPs are removed from the diet over a set period (usually 2-6 weeks) and replaced with low FODMAP alternatives. This phase helps establish if you are sensitive to FODMAPs, and if so, you should see an improvement in your symptoms.
To help guide your food choices, Monash University has developed an app that allows you to see which foods are low or high in FODMAPs and in what portion sizes. This resource provides you with up-to-date information to guide your food choices.
If you are unsure which foods you need to remove from your diet during the elimination phase, specialised FODMAP meal services can be helpful. Field Doctor has developed a low FODMAP ready meal range, certified by experts at Monash University, with over 25 meal choices, making it easier for you to follow the diet. Planning all your meals for this phase can be challenging, particularly if you lead a busy life, so it is useful to work with a dietitian to ensure you are following the diet properly.
The Reintroduction Phase
If your symptoms improve in the elimination phase, you’ll move on to step 2, the reintroduction phase. This is where high FODMAP foods are gradually reintroduced into the diet one at a time. This stage is often where people need the most guidance, but it is arguably the most important part of the process. This phase allows you to discover which specific FODMAPs trigger your symptoms and in what quantities, enabling you to create a more personalised food plan.
This systematic process typically takes a few weeks and involves testing different FODMAP groups one at a time to see how your body responds. You will try a small amount of a test food, gradually increasing the portion over three days, then return to a strict low FODMAP diet for a 2 to 3-day period before testing the next food.
Tailoring Your Diet
After the reintroduction phase, you should have a better understanding of which foods do and do not trigger your IBS symptoms. You can then work with a dietitian to personalise your meal plan based on your individual triggers and tolerance levels. It may also be beneficial to retest triggers every few months to ensure your tolerances haven’t changed over time due to factors such as stress and illness.
Benefits of a Low FODMAP diet
- Improvement in IBS symptoms: Many people experience improvements in IBS symptoms, like reductions in gas and bloating and a normalisation of stools (less diarrhoea or constipation, for example)
- Identification of personal triggers: You will gain valuable knowledge about which foods affect you most, which can give you clarity
- A better understanding of your disorder: If working with a specialist dietitian, you can understand your IBS and symptoms better, and get personalised advice on balancing your diet
- Improved daily functioning: With symptoms under control, daily activities become more manageable
- Increased food confidence: Knowing which foods trigger your symptoms can help reduce anxieties about food choices
Ultimately, the low FODMAP diet represents a milestone development in IBS management. If you or someone you know is looking to follow a low FODMAP diet, it is beneficial to consult an IBS-trained dietitian to guide you through the process and ensure you understand the diet properly. Remember that everybody is different, with triggers varying significantly from person to person, so a personalised approach is essential.
