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The Low FODMAP Diet - What you need to know

What are FODMAPS? - The Simple Explanation


The letters in FODMAP stand for food types that the average person probably hasn't heard of. These FODMAP groups however include more familiar food sub-groups that include Fructose and Lactose.


FODMAPS are carbohydrate groups that some individuals have problems digesting at high levels or sometimes at all. These indigestible Carbohydrates often ferment in the intestines which causes gas, pain and bloating.


Who usually participates in a Low FODMAP Diet?


According to current research, people with a Irritable Bowel Syndrome diagnosis can benefit the most from this diet. In the US, 77% of gastroenterologists recommend this diet for IBS patients. For a complicated condition like IBS where an exact cause has not been identified, the best course of action is to do what is necessary to control symptoms due to their disruptive nature. Since there are most likely many different causes, the solution needs to be multi-faceted. A low FODMAP diet is one approach that can be used to manage the condition successfully.


The Process


There are 3 main steps to applying this eating plan.

1. Remove / Reduce / Replace.

2. Reintroduce

3. Rejig.

Step one

Foods in these groups are removed or reduced to tolerable levels for 4 – 6 weeks. This has been reported to equate to the removal of approximately 10% of foods from a person’s original diet. But this can obviously depend on your current eating habits.


Step Two

The troublesome foods are gradually reintroduced one group at a time.

Symptoms are tracked to see which groups are the most problematic and how much can be tolerated.


Step Three

A modified diet can be applied long term based on the findings in step two.

It is recommended that all steps are completed with the guidance of a health professional. The best results and more successful adherence can be achieved this way. However, don’t let the need to for expert guidance stop you if this diet has been recommend. Get on top of it ASAP.


What the diet is and isn't:

  • FODMAP Diets are not for the general population.

  • The diet is for testing irritant foods short term and IBS symptom management longer term.

  • Although it is restrictive, It’s not for weight loss or a diet to embark on to improve general intestinal health. It is a way to control serious symptoms for some people who need options.

Pros

  • It’s one of the most effective treatments for IBS symptoms. IBS sufferers are hypersensitive to changes in the intestinal tract so even the smallest changes make a huge difference.

  • Better quality of life is reported, symptoms get relieved and some find it easy to follow.

  • FODMAPing highlights the importance of variety in the diet and opening up to new food options which is essential for microbiome health. The gut doesn’t like you eating the same things over and over.

Cons

  • Some find the changes difficult because it is so different to their usual diet.

  • The diet is even harder to apply to children due to the fact they commonly have food aversions, then there are subsequent concerns over nutrient deficiencies.

  • In adults, there are reports of dietary deficiencies such as fibre and a lack of prebiotic fibre. This is despite the food options being quite diverse and capable of fulfilling one's nutritional needs. Professional help during the process should prevent this.

The long term effects of low FODMAP diets is unknown. It is considered sustainable enough for people to follow long term – meaning that people can adapt to it easily enough. The physical ramifications from a longitudinal stand point have not been investigated.


If you are considering if the diet is for you:

  • If you are already on a restricted or elimination diet, it's not for you right now.

  • If you have IBS, speak to your doctor or a health professional about the diet.

  • If you have signs of IBS, get this investigated by a doctor as other conditions share similar symptoms. A diagnosis is important prior to embarking on the diet.

  • Studies have shown that dietary changes other than Low FODMAP eating can reduce IBS or IBS like symptoms so are worth considering. This can be some general dietary modifications that can be implemented by a Nutritionist.

If you’re about to do the Diet:

  • Get help from a health professional. Where the diet's efficacy has been demonstrated in clinical trials, the participants were always managed by a Dietician.

  • If it has been recommended to you, don’t delay in starting.

  • Download the Monash University App and explore the contents - this is essential. It makes the process much easier and is the best and most up to date source of information.

  • Do the removal phase when there’s less going on in your social life and you’re not eating out very much. Evidence supports the use of probiotics using this phase as well to support microbiome health, reduce oxidative stress and inflammation.

  • Eating low FODMAP is NOT an invitation to avoid fresh produce. Just change the types of fruits and vegetables you are eating or reduce your current ones accordingly.

  • Care needs to be taken with processed foods such as gluten free products which may contain more FODMAP foods than expected.

  • This is an opportunity to remove processed foods and improve the variety of the foods you eat.

Remember to ask your health provider any questions you have but it is always worthwhile doing your own research if you feel the need. Always use reputable research sources from Australia as FODMAP contents in foods may differ from country to country. As I mentioned, Monash University is the best Australian source of information: https://www.monashfodmap.com/


Evidence Used:


Barrett, J. S. (2016). How to institute the low-FODMAP diet. Journal of Gastroenterology and Hepatology, 32 (Suppl. 1), 8-10. doi:10.1111/jgh.13686


Gibson, P. R. (2016). The evidence base for efficacy of the low FODMAP diet in irritable bowel syndrome: is it ready for prime time as a first-line therapy? Journal of Gastroenterology and Hepatology, 32 (Suppl. 1), 32–35. doi:10.1111/jgh.13693


Pensabene, L. et al. (2019). Low FODMAPs diet for functional abdominal pain

disorders in children: critical review of current knowledge. Pediatr (Rio J), 95(6), 642-656. doi: https://doi.org/10.1016/j.jped.2019.03.004


Slomski, A. (2020). The Low-FODMAP Diet Helps IBS Symptoms, but Questions Remain. JAMA, 323(11), 1029-1031


Varney, J. et al. (2017). FODMAPs: food composition, defining cutoff values and

international application. Journal of Gastroenterology and Hepatology, 32 (Suppl. 1), 53-61. doi:10.1111/jgh.13698

 

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