What is the Low FODMAP diet?
The Low FODMAP diet is often one of the first recommendations for many people with IBS or gut whoas. It is a short term diet plan that can help you to identify foods that might be contributing to your IBS or SIBO flare ups. For many, this diet can feel super overwhelming and confusing. Here is a quick look at the diet from a dietitian’s perspective.
My Story
To be honest, when I saw the low FODMAP diet for the first time in practice, I thought it sounded ridiculous. (And I’m a dietitian!)
Why would you eliminate onion, garlic, and apples? And why could you only have a small portion of a banana unless it was a green banana?! I remember specifically thinking, “I hope I never have to do this diet.”
Years later, I was having recurrent and chronic nausea. For the life of me I could not figure out why. I tried cutting out gluten and then dairy. I tried so many things.
When I went to the gastroenterologist she suggested the low FODMAP diet as a trial. I dismissed it because I didn’t want to take out so many foods that I loved for no reason.
Then after about a year of seeing many providers and trying many other interventions without relief I finally wound up seeing a functional medicine doctor.
I thought that at least a functional medicine doctor would take time to hear me out to figure out what in the world happened to me. There I was diagnosed with SIBO and dysbiosis.
Guess what was suggested to help alleviate symptoms? The low FODMAP diet! And guess what? It actually helped relieve my nausea and digestive distress until I could fully eradicate the SIBO.
This was life changing for me since I was dealing with chronic cyclical nausea for almost two years.
It helped me start feeling like a normal person again. It gave me physical relief and more mental capacity to keep fighting for my health.
Before I felt like I was barely treading water. So, I know this diet sounds weird and confusing, but it might be worth a try if you are stuck and feeling miserable too.
Ok… now what is the low FODMAP diet?
What does FODMAP stand for?
First off… FODMAP is an acronym. It stands for:
Fermentable
Oligosaccharides
Disaccharides
Monosaccharides
And
Polyols
What are FODMAPs?
FODMAPs are carbohydrates that can either pull water into your gut, or ferment and produce gas. When your intestines are stretched it can lead to pain, bloating, gas, and changes in bowel movements. By limiting these carbohydrates, it is possible that you can have significant improvement in your IBS or SIBO symptoms.
FODMAPs foods contain at least one of the following:
Oligosaccharides include: fructans and galacto-oligosaccharides (GOS)
Disaccharides: lactose
Monosaccharides: fructose
Polyols include: sorbitol and mannitol
The low FODMAP diet was developed when researchers recognized that some carbohydrates are poorly absorbed in your intestines.
This malabsorption can play a role in digestive symptoms. Researchers hypothesized that by developing and implementing a diet that restricts these poorly absorbed carbohydrates, it could provide more symptom relief than people just trying various restrictions on their own. This began the research on the now “low FODMAP diet.”
The good new is that FODMAPs don’t actually harm your gut when you do eat them. In fact, many foods that contain FODMAPs are nutritious.
To be clear, the low FODMAP diet doesn’t cure your SIBO or IBS; however, it can provide relief while you address the root cause(s) of your gut struggles.
A food sensitivity is often a sign that something is off in your gut health. As your gut heals, you will likely be able to tolerate more and more FODMAPs regularly. Let that motivate you to find your root cause!
The low FODMAP diet is a short term eating plan. It is a tool to provide relief while you work to heal your gut. Once you are able to, it is good to add FODMAP containing foods back into your regular eating pattern.
How the low FODMAP diet works…
The low FODMAP diet has 3 phases.
Phase 1: temporarily reduces the poorly absorbed carbohydrates to see how much they influence your individual symptoms. This phase can last anywhere from 2-6 weeks.
It is not recommended to go past 8 weeks, as this has shown to effect gut microbiota. (You want your good bacteria to stay around to help you!)
Phase 2: strategically reintroduces FODMAPs to see which ones you tolerate, and at what portions you can handle them. The low FODMAP diet is not a ‘no-FODMAP’ diet or a forever diet.
Thankfully, most of the time you will be able to tolerate certain categories and portions of FODMAP containing foods even when you are addressing the root causes of your symptoms.
Phase 3: focuses on how to include the foods you tolerate long term. Our ultimate goal is to have the most liberalized diet as possible for you, while balancing symptom management, so you can feel less stressed about food and your gut.
After this phase you should feel confident about what you can eat to have continued symptom management. There is power in knowledge!
Moving forward as you heal your gut you can rechallenge food groups that caused symptoms in the past. And the great news is you don’t to redo Phase 1 to get there!
We do a simplified version of phase 2. This usually happens a few months after you’ve passed phase 3. We can cross that bridge when we get there.
The Low FODMAP diet for IBS
Over and over again, studies have shown that a low FODMAP diet improves IBS symptoms. One study found that 86% of IBS patients following the low FODMAP diet reported improvement with their IBS symptoms (source).
Again, this diet can be confusing and pretty restrictive in the elimination phase. So it is very important to work with a dietitian. A dietitian will be able to check to see if you are following the diet correctly.
This is crucial to success, and it is so important to make sure you maintain proper nutrition. If you are underweight, then it is even more important for you to have help in order to not lose more weight on this diet.
The FODMAP diet isn’t for everyone. If there is an active or past eating disorder, this diet can be triggering. If that is the case, a dietitian may be able to help assist in using a gentle low FODMAP diet where there are less restrictions, yet there can still be symptom relief.
There are many ways to help alleviate IBS symptoms. If this diet doesn’t suit you well or work for you, there are other avenues you can follow to help alleviate your symptoms as well.
The Low FODMAP diet for SIBO
Many with Small Intestinal Bacteria Overgrowth (SIBO) also experience relief from a low FODMAP diet. The bacteria in your small intestine love to eat up FODMAPs, this can cause excess bloating, pain, and altered bowel movements.
Many practitioners will suggest some sort of low FODMAP diet to provide relief while working to eradicate SIBO.
When I found out I had SIBO, I was still nursing my son. Therefore, my doctor and I did not want to risk the herbs used to kill off the SIBO to go into my breastmilk when I nursed my son.
We decided to wait to fully treat my SIBO until I weaned him. I found an incredible amount of symptom relief from doing a gentle low FODMAP diet until I weaned him. I was thankful to not have to wean earlier than we both desired.
It is important to find the root cause to your SIBO. Eating a low FODMAP diet will not get rid of SIBO. SIBO has a root cause, and it is crucial to discover the cause in order to prevent relapse. Again, work with a skilled doctor or dietitian to help you find yours.
On the other side, it is thought that a root cause of IBS might actually be SIBO for many people. Studies have shown that some of those with diagnosed IBS have SIBO (source, source).
How long does it take for the low FODMAP diet to work?
It usually takes 2-6 weeks of true adherence for the low FODMAP diet to work. Do this with a trained dietitian so that you don’t have to wonder if you did it correctly.
Many times it doesn’t work because something was overlooked or missed. If you have done the diet correctly and you haven’t had symptom relief, you might be a non-responder to the diet.
(Remember, there are many root causes of IBS, so there is still hope to find relief for you too!)
Can you eat low FODMAP forever?
No! Remember, you don’t want to restrict FODMAPs if you don’t have to.
They can have prebiotics that feed your good bacteria too! Prolonged periods of the strict low FODMAP diet has been shown to poorly effect your gut microbiota by reducing your friendly bacteria (source).
We want you to eat as freely as possible to keep the good bacteria fed and strong. Most people are able to tolerate different types of FODMAPs after they work through Phase 2 in the FODMAP protocol.
The goal of the low FODMAP diet is to alleviate your symptoms while you work with your practitioner to find the root cause of your IBS or SIBO.
Once you have addressed the root cause, you should have more and more freedom to consume foods that previously caused GI distress.
So, the low FODMAP is good in that it give you symptom relief; however, it is not the end all be all to your IBS or SIBO. It does not heal your IBS, but it can help you live life while you get the help you need.
Sources to help:
I highly suggest to Monash University’s FODMAP Diet app. It shows what foods are high in FODMAPS and at what portions you can have them.
There is a term called “FODMAP stacking” where you can eat too much of a lower FODMAP food, and then it becomes high FODMAP. This app helps you do avoid this.
For example, 10 almonds are considered to be low FODMAP. However, 20 almonds are high in GOS which makes it high FODMAP. Save yourself a lot of headache, and buy the app!
Another source I have enjoyed lately is an app called “Spoonful.” It allows you to scan barcodes of an item at a store to see if it is considered low FODMAP or not.
This has helped me while shopping. It can take a long time to sift through labels. When condiments say “spices” that can usually mean garlic or onion was used even if it’s not listed. You’ll avoid frustration and give yourself extra time and freedom by using this app.
What can you eat on the low FODMAP diet? Here is a quick list of foods:
Do you ever wonder what fruit is low FODMAP or what vegetables are high FODMAP? Check this list for a quick list on foods to consume and what foods to avoid in the low FODMAP diet.
I actually found that in starting the low FODMAP diet, I ate a wider variety of foods because I felt more confident to try new foods instead of my few “safe foods.”
I restricted so many things in effort to feel better before I tried the low FODMAP diet. Come to find out, a lot of my “safe foods” were actually causing flares. That is why it is so important to follow a low FODMAP diet with a trained dietitian.
We tend to self diagnosis and restrict in ways that aren’t truly helpful. Maybe the low FODMAP diet can help you too!
Let’s work to get your life back!
Let us help you on your low FODMAP journey! We have so many easy and delicious recipes so that you don’t have to wonder where to start. You can also work with us personally with a nutrition consult. Please reach out to us and don’t go at the low FODMAP diet alone.
