FODMAPS diet, why and how

Moving away from the theme of viruses – hooray! –  and talking to you today about the FODMAPS diet, specifically the low FODMAPS diet.
If you’re wondering what this word even means, it’s an acronym for terms describing certain carbohydrates (and their fermentable effect on digestion):  Fermentable Oligosaccharides Disaccharides Monosaccharides And Polyols.
Easy to understand why the acronym’s preferred.  Those carbs are quite a mouthful!

low FODMAPS

Fodmaps are found naturally in a wide range of foods.  They are different types of carbohydrates that are not easily absorbed in the gut, and which therefore can kick off IBS-type symptoms in some people.

Due to this diversity of potentially troublesome carbs it can be difficult to navigate the low FODMAPS diet, so here is a broad brush stroke of information to help you decide if you want to give it a go, either with a therapist, or on your own.

Let’s look a bit closer at this acronym.
Fermentables:  This is what happens when your gut bacteria ferments undigested carbohydrates.
Oligosaccharides: mainly found in wheat, rye, pulses but also garlic and onions..and more.
Disaccharides: mainly in dairy produce, including those yoghurts you might be eating daily because you believe they’re healthy (which they are for some, and perhaps for you, once you’ve been eating low FODMAP and introduced it later, in a small way; possibly only occasionally.  All very individual).
Monosaccharides:  these mainly cover fructose and include a variety of fruit plus honey – and corn syrups (do read labels when you go shopping!)
Polyols:  these are also found in different veg and fruit; also in articial sweeteners.

First thing to keep in mind when considering this diet is that you have to be dealing with IBS symptoms.  This isn’t a weight loss programme, nor is it a particularly healthy diet to keep in your life.  On the contrary.  As it excludes a lot of normally healthy prebiotic foods, this is an eating regime to do SHORT-TERM in order to reduce your IBS-ish symptoms.  Some prebiotic foods are included but not many, and you need these prebiotics for a healthy gut, for your diversely populated microbiome, hence this isn’t a diet for the long haul.

I normally suggest two to three weeks with clients, but if you’re feeling vastly better on it then an extra week or two is fine.  Monash university, which developed it in the first place years ago, and have an excellent app (more about that below), states you can follow it up to eight weeks.  Personally, I prefer clients to move back onto some of those ‘missed’ higher FODMAP foods earlier than that.

And this brings me to the next stage of the diet.  After your three or so weeks of ‘low’ eating, you then gradually introduce one higher FODMAP food, from one of the above groups, back into your menu to see how it feels, to check if you react and have symptoms.

This sort of challenge is what a lot of clients try out in order to identify ‘intolerance’ foods.  Exclude then reintroduce, one at a time, giving yourself days inbetween to allow some slower symptoms to emerge – or not.

With the FODMAPS approach – which is not about intolerance foods but about hard-to-digest carbs – once you’ve followed it for your two or three weeks, you then introduce a higher FODMAP food to your meal.  In a small way the first time, then building up slightly the following day.  On the third day you try a ‘normal’ (not huge!) amount of that food with your meal.

I recommend waiting a couple of days before you try another new higher FODMAPS food so that you’re not overloading your digestion, not challenging it too much.
Some people find their old gut symptoms return when they’re stepping up the amounts, so back off with that food, wait a couple of days and then try another higher FODMAP food.  Waiting those two days inbetween these trials gives pause for your digestion.

Always play it safe.  Stick to re-introducing one new food in one FODMAP group at a time.  Start small and gradually.
Everyone is different.  Some digestions are more sensitive or reactive than others, and this is one reason why it may help to work with a practitioner.
Another reason to work with someone:  You might be starting this diet because you feel you’ve “tried everything”.  Left out gluten then excluded that daily biscuit or sweet, reduced wine hugely, stopped the pizzas, left out some cheese.
This approach can often be too random, and if nothing else, there should be a logical and informed plan to how you go about changing your diet.  Some people may want the support of a nutritionist or naturopath with this plan.

Also important to be aware of is that a lot of gut distress can be due to overgrowths of yeasts or bacteria or parasites.  Stool tests would then be indicated, or other home test kits to rule out SIBO or gut permeability for instance.  Dietary changes alone won’t clear up an overgrowth of pathogenic gut bacteria, and eliminating sugars (& using a pessary) won’t resolve systemic candida.

Stress, too, can play a huge role.  In clinic, when talking about stress, often a client will say, ‘yes I’m stressed but isn’t everyone?’  Short-term stress, sure.  That’s part of life, and your body is wonderfully geared to coping with it.
Ongoing chronic stress, however, should never be considered the norm.  A low FODMAPS diet might relieve some gut symptoms but if underlying anxiety, stress, anger or insomnia are big in your life, the triggers to your digestive distress, then switching diets won’t be the magic bullet.  (Luckily there are lots of other magic bullets that can help you!)

All this low and high FODMAP food talk may sound like a pfaff but you can either work with a therapist or use something like the Monash University FODMAP app.  And if you don’t use apps there are some excellent online lists of food and recipes you can print off.

If working on your own, take your time to read about the FODMAP diet first.  Get your head around the aim of the diet, the foods and stages it involves so you are fully committed and have your kitchen stocked and those menu plans in place.  And don’t feel you have to eat a food just because it’s low FODMAP.  If you don’t normally want a banana, don’t eat it just because it’s ‘allowed’!

For those of you thinking life will be a vegetable misery for the weeks you’re on this diet you’ll be jumping for joy.  There are loads of fab veg which are low in FODMAPS.   Animal protein isn’t a problem, and there are good options for vegetarians like tempeh, eggs, quorn…

The above photo shows just a few vegetables I had at hand for some clients last month.  Instead of their regular follow-up, we had an extra hour of going through the foods together, then cooking a couple of dishes and eating the low FODMAP way.

Key points to remember:
First make sure this diet is right for you, that you’ve ruled out other players such as gut overgrowths, intolerance foods, stress….
Work with a therapist if you can, especially regarding the above issues you may not have considered.
If going it alone, I recommend downloading the above-mentioned Monash University app. There are other apps on the market – do take a look online – but this is the one I’m familiar with and which is specifically for tracking and working with FODMAPS and not overall diets.  Otherwise, google low FODMAPS diet and print off the food and menu lists.  Get your kitchen and your head ready for a couple of weeks of changed meals.

If you’d like any more information about the FODMAP diet I always offer 15 mins free calls.  And if you have any other worries about diet, health or well being do please contact me for a chat.

I’ve stopped 1:1 consultations during these times of social distancing, but skype, facetime and landline consultations work really well and have been part of my clinic for years.  Our voices and ears are in fine form and can side-step viruses to cross towns, counties and oceans via amazing technology.
How lucky we are for that!

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