Have you ever felt like the quote “when the student is ready the teacher will appear”? Lately this sums up how I feel. After years of ignoring the FODMAP diet, 10 years to be exact, I decided that I needed to determine if my remaining digestive distress could be relieved once and for all. The catalyst was our 2 week Italian trip in September. Due to abdominal pain, bloating and irregular bowel movements I was sidelined from visiting my uncle’s truffle farm and taking long walks with my family. On our return I started the FODMAP diet and my experience has been a revelation.
In 1999 I began eating gluten free which improved my IBS symptoms but unfortunately I continued to experience life limiting digestive discomfort. Gluten containing grains are high in FODMAP which is likely why I found some relief. Through the next 17 years my quest for a calm belly lead me to dabble in high dose probiotics, elimination diets, the paleo diet, AIP, digestive enzymes and veganism…nothing helped. Actually vegetarian/vegan diets made my symptoms worse which is no surprise once you realize beans, a main staple on a vegan diet, are high in FODMAP’s.
FODMAP stands for Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols. What? I know!
FODMAP’s are short chain carbohydrates or sugars that are not fully digested in the small bowel. The undigested carbohydrates move into the large intestine where they pull in water and ferment. This causes typical IBS symptoms, such as abdominal pain, gas, bloating, diarrhea, constipation and fatigue. Research on FODMAP’s and IBS came out of Monash University in Australia in the late 90′s. Led by Sue Shepard, PhD and Peter Gibson, MD they determined that when FODMAP’s were removed symptoms improved by up to 75%. Most people can slowly and methodically add FODMAP’s back into their diet to determine which foods need to be avoided or limited. A methodical reintroduction also provides information on how much of a particular FODMAP is tolerated before symptoms occur. A low FODMAP diet may also help if you have Colitis, Crohn’s, gluten intolerance and Celiac disease with remaining gut discomfort, especially if you are in remission or strictly following a gluten free diet without success.
Here is a short list of the FODMAP foods that I have eliminated for a short period of time, 2-4 weeks.
Oligosaccharides; nectarines, watermelon, peaches, artichokes, onions, garlic scallions, shallots, asparagus, beets, Brussel sprouts, green peas, butternut squash, all wheat products and flours, barley, rye, legumes (lentils, beans, soybeans), pistachio, cashews, chicory and probiotic supplements with FOS or inulin.
Disaccharides ; dairy such as milk, cottage cheese, ice cream, yogurt and soft cheeses.
Monosaccharides; honey, mango, apples, pears, figs, cherries, black berries, agave nectar, fruit juice concentrate and high-fructose syrup
Polyols such as fruits already mentioned, prunes, plums, cauliflower, mushrooms, snow peas, avocado, “sugar free” foods, candy or gum with sorbitol, mannitol, xylitol, erythritol, polydextrose and isomalt.
Here is a list of what to eat instead.
Starchy vegetables and gluten free grains such as quinoa, buckwheat, corn, oats, rice, tapioca, arrowroot and millet, carrots, parsnips, pumpkin, sweet potatoes, turnips, taro, yams white potatoes and all summer and winter squash.
Fruits such as bananas, blueberries, citrus (oranges, tangerines, lemon, limes) cranberries, grapes, grapefruit, kiwi, melon, pineapple, raspberries, strawberries and tomato.
Vegetables such as alfalfa sprouts, bean shoots, bell peppers, bok chop, carrots, Chinese cabbage, chives, cucumber, eggplant, endive, ginger, green leafy vegetables (spinach, kale, Swiss chard, lettuce, bok choy, watercress), green beans, olives, green tops of scallions and leeks (not the white onion part) and up to 1/4 cup of broccoli or 4 Brussel sprouts.
Dairy and dairy alternatives such as hard cheese and lactose dairy (my favorite brand is organic Green Valley brand), almond milk, rice milk, hemp milk, oat milk (look for brands without carrageenan and sugar). There are healthy concerns in consuming dairy and my stance is to consume in small amounts such as a sprinkle of parmesan or a splash of kefir.
Nuts and seeds such as 10 almonds, macadamia nuts, pecans, walnuts, psyllium, flax seeds, chia seeds and most other seeds.
Animal protein foods and fats don’t contain FODMAP’s. The best animal protein choices are fresh meats, fish and eggs without additives, opt for organic and grass fed if available and in budget. If you are vegetarian legumes are out but organic tempeh and tofu are low in FODMAP’s.
Healthy fats are coconut oil, olive oil, avocado oil and ghee.
Within 36 hours of starting a low FODMAP trial my 20+ years of abdominal pain, gas, bloating and diarrhea disappeared! Obviously not everyone will respond as quickly, if you suffer from consipation it can take longer but within a few weeks you should know if the FODMAP diet is going to work for you. As a dietitian I fundamentally believe that the food we eat impacts our health but I could never pinpoint exactly which foods were causing me digestive problems. Now with the low FODMAP diet in hand I am reinvigorated to share this approach with everyone who will listen. My new advanced focus is digestive wellness, IBS and the low FODMAP diet. I hope you will check back and engage with me as together we dive deep into healing our guts.