Find FODMAP Specialists near you

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FAQs:

What Does FODMAP Stand For?

FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols, which are short-chain carbohydrates (sugars) that the small intestine absorbs poorly.

What are FODMAPs?

FODMAPs are:

Fermentable. These are all foods that your gut bacteria feed on, converting them to gasses in a chemical process called fermentation.

Oligosaccharides. These are soluble plant fibers known as prebiotics, which feed the beneficial bacteria in your gut. Oligosaccharides include onions, garlic, beans/lentils and many wheat products. Sensitivity to oligosaccharides may help explain some cases of non-celiac gluten sensitivity. Since gluten-free grains are lower in fermentable sugars than grains that have gluten, some people who think they are sensitive to gluten may actually be sensitive to the oligosaccharides residing in wheat products.

Disaccharides. Lactose is the fermentable sugar in this group, the sugar in dairy and human milk. Lactose intolerance is one of the most common food intolerances worldwide.

Monosaccharides. Fructose, the sugar in fruit, is the fermentable sugar in this group. But only in certain quantities and proportions, so not all fruits are affected.

Polyols. These are sugar alcohols, commonly used as artificial sweeteners. They are also found naturally in some fruits.

What is a Low-FODMAP Diet?

FODMAP is an acronym for a certain class of carbohydrates, called fermentable short-chain carbohydrates, which are more difficult for people to digest. (The full acronym stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols.) The low-FODMAP diet temporarily restricts these carbohydrates in order to relieve uncomfortable symptoms and give your digestive system a rest. Removing irritants gives your gut lining a chance to repair itself and can help restore a healthy balance of gut flora. If your symptoms improve, you can use the low-FODMAP diet to figure out which foods to limit in the future.

How Does the Low FODMAP Diet Work? 

The low FODMAP diet limits the intake of fermentable carbohydrates in your diet. Fermentable carbohydrates are sugars that bacteria in the digestive system can eat. These bacteria then produce gas as they break down these foods, which can cause discomfort to people with irritable bowel syndrome (IBS) and other digestive disorders.

The low FODMAP diet involves removing or reducing all foods that contain high amounts of these fermentable carbohydrates.

However, it is recommended that you slowly reintroduce them after a few weeks to determine which food symptoms are causing problems for you. It is important to work with a dietitian as the low FODMAP diet is a complex way of eating, and you want to ensure you’re still getting enough nutrients.

Why are FODMAPs Difficult to Digest?

FODMAPs are fermentable short-chain carbohydrates. Translated, that means two things: They are sugar molecules that are linked together in chains, and they are fermentable by the bacteria in your gut. Molecules in chains need to be broken down into single molecules to be absorbed through your small intestine. But FODMAPs can’t be broken down, so they can’t be absorbed there. Your small intestine draws in extra water to help move the FODMAPs through to your large intestine. There, the bacteria living in your colon have a field day fermenting them (eating them). This produces gasses and fatty acids as byproducts inside your gut.

Are FODMAPs Bad for Everyone?

Not at all. In fact, our digestive systems are designed to process some foods that we can’t fully digest ourselves — for example, dietary fiber, which has an important place in digestive health. And feeding the bacteria in our gut is part of our symbiotic arrangement with those bacteria. But some people with sensitive guts experience a level of indigestion from these foods that significantly impacts their quality of life. For these people, the byproducts of fermentation cause chronic symptoms of gas, bloating, abdominal pain and distension. The extra water drawn by the small intestine may cause diarrhea in excess, or constipation if there isn’t enough.

How Quickly Does FODMAP Work?

Results vary from person to person, but it really depends on the severity of your conditions and the underlying issues causing them. The good news is that most people start to feel better within two weeks of starting the elimination phase of their diet. However, it can take up to six weeks for the full effect to be felt due to the distinct phases of the diet. Research has shown that the low FODMAP diet reduces symptoms in up to 86% of people.

How Do FODMAPs Make You Feel?

FODMAPs are also rapidly fermented by colonic microflora producing gas. The increase in fluid and gas distends the bowel. This can cause the sensation of bloating and abdominal pain or discomfort and affects how the muscles in the wall of the bowel contract. It may cause increased forward movement (peristalsis) leading to diarrhea, but in some people, it can cause constipation.

Who Should Try the Low FODMAP Diet?

The Low FODMAP Diet can effectively reduce symptoms of Irritable Bowel Syndrome (IBS) and Small Intestinal Bacterial Overgrowth (SIBO). However, it is essential to note that the diet can be challenging for patients to follow during the elimination phase, as it is the most restrictive. It is also worthwhile to understand that the Low FODMAP Diet is not a weight-loss diet, and losing more weight can be dangerous for people that are underweight.

Who Should Avoid FODMAP?

Many foods considered high in FODMAPs are healthy foods otherwise, but they can cause symptoms in some people with a sensitive gut; particularly people with IBS or other bowel diseases and disorders like SIBO.

How Do I Know if FODMAP is Working?

Once you have been on the diet for at least 2 weeks (and been monitoring intake and/or symptoms) compare them to your  baseline to get a feel how much you have improved, and where you have improved and what issues remain. When your symptoms have reduced to manageable levels, where your symptoms are not enough to get in the way of ordinary living, then you can claim that the diet is working for you.

Symptoms and Signs that You May be Eating High FODMAP Foods

FODMAPs are not absorbed well in the small intestine. They increase the amount of fluid in the large intestine (bowel) and they produce more gas.

Symptoms and signs that suggest you may be eating products high in these short-chain carbohydrates are:

- Gas

- Pain

- Bloating

- Abdominal distention

- Abdominal pain

- Diarrhea (similar to IBS symptoms)

- A feeling of fullness after eating or drinking only a small amount of food or liquid

A diet low in FODMAPs may help relieve these problems, particularly in people with IBS.

Conditions that Low FODMAP Diet Help With

Low FODMAP diets are most often used as a tool for managing symptoms related to IBS. But some evidence suggests that they could make a difference for people with other types health issues that lead to chronic GI symptoms. Some experts believe they may even pose the potential to improve GI symptoms related to other types of inflammatory conditions.

Irritable Bowel Syndrome

As noted, many people with IBS are more sensitive to high FODMAP foods. While cutting out certain triggers won’t cure a person’s IBS, it can make the condition more manageable by significantly reducing symptoms. In fact, up to 86% of patients with IBS who adhered to a low FODMAP diet experienced an improvement in their overall GI comfort and individual symptoms including abdominal pain, bloating, constipation, diarrhea, gas, and abdominal distention, according to a review published in Clinical and Experimental Gastroenterology. Studies show that it’s tied to an improved quality of life, too.

Celiac Disease

Many patients with celiac disease are able to manage their symptoms with a gluten-free diet. But in cases where going gluten-free isn’t enough, a low FODMAP diet has been shown to improve symptoms as well as improve patients’ quality of life, according to research in Digestive Diseases.

Fibromyalgia

Fibromyalgia patients who implemented a low FODMAP diet experienced a reduction in GI symptoms as well as fibromyalgia-related pain, according to a study published in the Scandinavian Journal of Pain. While more research is still needed, the benefit is thought to come from the low FODMAP diet’s ability to reduce intestinal inflammation, which may in turn help those with certain autoimmune disorders achieve lower levels of inflammation throughout the body.

Mental Health

In patients with both IBS, low FODMAP diets are tied to less fatigue, anxiety, and depression and increased happiness and vitality. In some ways, it’s common sense: When you feel better physically, your mental state can improve as well.

Symptomatic Sclerosis

Patients with the autoimmune disorder experienced an improvement in GI symptoms on a low FODMAP diet paired with probiotic therapy, found a study in Seminars in Arthritis and Rheumatism.

Rheumatoid Arthritis

Currently, no high-quality evidence exists showing that a low FODMAP diet can improve rheumatoid arthritis symptoms. However, some experts theorize that the diet could help reduce inflammation, which may in turn contribute to a reduction of RA symptoms.

Benefits of the Low FODMAP Diet

Although the Low FODMAP Diet may be challenging for your patients to follow, many benefits make it worthwhile for patients with life-affecting health conditions. Here are some of them:

1. Highly researched

Hundreds of research studies have been conducted on the Low FODMAP diet to further examine the relationship between nutrition and digestive health. The Low FODMAP Diet has a strong scientific foundation and proves effective at managing digestive disorders symptoms.

2. Highlight dietary triggers

The gradual reintroduction of high-FODMAP foods in the second reintroduction phase of the diet helps patients identify which foods are more likely to cause IBS symptoms, making it a diagnostic treatment.

3. Reduces bloating

Bloating is an uncomfortable condition that affects patients physical and mental well-being. It can be caused by various factors, such as overeating, consuming gas-producing foods, or drinking carbonated beverages. Bloating can be a side effect of Irritable Bowel Syndrome due to the fermentation of FODMAP’s in the gut. Therefore, following a Low FODMAP Diet can improve this.

4. Reduces diarrhoea

Diarrhoea can be a significant source of discomfort for those with IBS-D (diarrhoea-predominant IBS) or IBS-M (mixed IBS). The Low FODMAP Diet is a first-line treatment recommended for individuals with IBS-D or IBS-M. By eliminating high-FODMAP foods, the diet regulates digestion and absorption, reducing the frequency and intensity of diarrhoea. Additionally, the diet helps identify trigger foods that can be eliminated to prevent future instances of diarrhoea. Note that using the low FODMAP diet is not a long-term solution for diarrhoea, so it is essential to follow the diet under the guidance of a doctor or a FODMAP-trained dietitian.

5. Improve the quality of life

People with IBS often have significant digestive problems that negatively impact their daily lives. The Low FODMAP Diet may positively affect other aspects of well-being, such as reducing fatigue, depression, and stress, while increasing happiness and vitality. In other words, reducing symptoms of IBS can improve mental health.

6. Plenty of resources are available

You can access plenty of resources to learn more about the low FODMAP diet, including articles, books, apps, and websites. You can also find practical advice on low-FODMAP foods and meals in recipe books and meal plans.

FODMAP Foods

If you are following a low FODMAP diet, it’s important to know which foods are safe to eat and which ones to avoid. Low FODMAP foods are those that contain minimal amounts of fermentable carbohydrates that can trigger digestive symptoms in people with irritable bowel syndrome (IBS) and other digestive disorders. By including a variety of low FODMAP foods in your diet, you can ensure that you are getting the nutrients you need while also managing your symptoms. In this section, we will explore some of the best low FODMAP foods to include in your diet and the high FODMAP foods you should avoid.

High FODMAP foods that you should avoid include:

1. Fructose: Fruits (including apples, mangos, pears, watermelon), honey, high-fructose corn syrup, agave

2. Lactose: Dairy (milk from cows, goats, or sheep), custard, yogurt, ice cream

3. Fructans: Rye and Wheat, asparagus, broccoli, cabbage, onions, garlic

4. Galactans: Legumes, such as beans (including baked beans), lentils, chickpeas, and soybeans

5. Polyols: Sugar alcohols and fruits that have pits or seeds, such as apples, apricots, avocados, cherries, figs, peaches, pears, or plums

Low FODMAP foods to enjoy instead include:

1. Dairy: Almond milk, lactose-free milk, rice milk, coconut milk, lactose-free yogurt, and hard cheeses.

2. Fruit: Bananas, blueberries, cantaloupe, grapefruit, honeydew, kiwi, lemon, lime, oranges, and strawberries.

3. Vegetables: Bamboo shoots, bean sprouts, bok choy, carrots, chives, cucumbers, eggplant, ginger, lettuce, olives, parsnips, potatoes, spring onions, and turnips.

4. Protein: Beef, pork, chicken, fish, eggs, and tofu.

5. Nuts/seeds:  (limit to 10-15 each) Almonds, macadamia nuts, peanuts, pine nuts, and walnuts.

6. Grain: Oats, oat bran, rice bran, gluten-free pasta, quinoa, white rice, and corn flour.

How to Find FODMAP Food Triggers

Sometimes, diets that restrict the foods you eat can seem rigid or controlling. A low FODMAP diet is more about finding your food triggers than limiting you. You may only be sensitive to a few FODMAP carbs and, once you identify them, may continue to enjoy others without symptoms. Even after identifying your trigger foods, there are still many delicious and nutritious low FODMAP vegetables, fruits, proteins, nuts, grains, and even dairy foods.

Finding the foods that trigger your symptoms typically follows a three-step process. The first step involves eliminating all high FODMAP foods for several weeks. It’s essential to work with a nutritionist, as it can be challenging to eliminate all high FODMAP carbs and identify triggers while still meeting your nutritional needs.

The three steps are:

1. Elimination – In the elimination phase of the FODMAP diet, you eliminate all FODMAP carbs for several weeks. Your symptoms may improve immediately or over several weeks.

2. Reintroduction – In the reintroduction phase of the FODMAP diet, you’ll introduce FODMAPs one at a time to identify which foods you can tolerate and in what amount.

3. Personalization – Finally, you’ll modify your diet to increase variety while adjusting the type and amount of FODMAP carbs you eat, based on what you learned in step 2.

Your nutritionist can help you move forward with your gut-friendly diet, answering questions, sharing low FODMAP recipes, and helping you plan healthy low FODMAP snacks.

Things to Know about a Low-FODMAP Diet

Here are a few things you should know about this diet.

1. It’s a Low-FODMAP Diet, Not a No-FODMAP Diet

Unlike food allergies, you do not need to completely eliminate FODMAPs from your diet. In fact, they are beneficial for gut health.Therefore, it’s recommended that you include them in your diet and up to your own personal tolerance.

2. A Low-FODMAP Diet Is Not Gluten-Free

This diet is typically lower in gluten by default. This is because wheat, which is a main source of gluten, is excluded because it’s high in fructans. However, a low-FODMAP diet is not a gluten-free diet. Foods such as sourdough spelt bread, which contains gluten, are allowed.

3. A Low-FODMAP Diet Is Not Dairy-Free

The FODMAP lactose is typically found in dairy products. Nonetheless, many dairy products contain low levels of lactose, making them low-FODMAP. Some examples of low-FODMAP dairy foods include hard and aged cheeses, crème fraîche and sour cream.

4. The Low-FODMAP Diet Is Not a Long-Term Diet

It is not desirable or recommended to follow this diet for longer than eight weeks. In fact, the low-FODMAP diet process involves three steps to reintroduce FODMAPs to your diet up to your personal tolerance.

5. Information on FODMAPs Is Not Readily Available

Unlike other nutrient data for vitamins and minerals, information on which foods contain FODMAPs is not readily available to the public. Nonetheless, there are many low-FODMAP food lists available online. Yet you should be aware that these are secondary sources of data and are incomplete.

Risks of the Low FODMAP Diet

While the low FODMAP diet may help people with digestive issues, it is important to understand any possible health risks. 

Consuming a restricted diet may increase your risk of nutritional deficiencies. This can occur if you do not eat various foods to get all the essential nutrients. This can include:

- not getting enough fiber, which can lead to conditions such as heart disease, stroke, hypertension, type 2 diabetes, and cancer

- not getting enough calories, which can lead to unintended weight loss

- not eating certain vegetables, which can lead to not getting enough natural antioxidants

You may wish to contact your doctor for advice before making changes to your diet. They may refer you to a dietician or nutritionist who can help create a plan to ensure you get all the essential nutrients.

Sources:

Hopkins Medicine

Cleveland Clinic

Gastroenterology Consultants

Healthline

Modify Health

About IBS

Medicine Net

Health Grades

GI Institute

The Food Intolerance Dietitian

Health Central

 

The content herein is provided for general informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Medical information changes constantly, and therefore the content on this website should not be assumed to be current, complete or exhaustive. Always seek the advice of your doctor before starting or changing treatment. If you think you may have a medical emergency, please call your doctor or 9-1-1 (in the United States) immediately.