The Low-FODMAP Diet: Who and What Does It Help?
The low FODMAP diet (LFD) is an elimination diet that supports intestine function and digestion in people with IBS and other gastrointestinal problems.
It starts with eliminating foods that are high in certain types of carbohydrates:
F – Fermentable
O – Oligosaccharides
D – Disaccharides
M – Monosaccharides
P – Polyols
These carbs are bonded sugar molecules. Since your small intestine can only break down single molecules, it moves these carbs to your large intestine by taking in extra water. The bacteria present in your colon then ferment them, which results in gasses and fatty acids in your gut¹.
This process does not cause problems for everyone, but it can lead to discomfort and pain for those with sensitive guts. It can be particularly helpful for those with certain conditions that affect the intestines and colon.
The foods that bother you might differ from those that bother someone else, so it’s important to talk to your doctor before trying the low-FODMAP diet. A functional medicine practitioner can help you navigate every phase of this diet and find what works for you.
Can the Low FODMAP Diet Benefit You?
A low FODMAP diet plan might help you if you’re experiencing chronic gut issues. Some common symptoms that signal the need for a dietary change include:
Gas
Bloating
Abdominal pain
Diarrhea or constipation
Abnormal swelling in the abdomen (distention)
These symptoms can result from different gastrointestinal issues and diseases such as:
Celiac disease
Irritable Bowel Syndrome (IBS)
Small intestinal bacterial overgrowth (SIBO)
Inflammatory bowel disease (IBD): Crohn’s disease (CD) and ulcerative colitis (UC)
The low FODMAP diet is often recommended for individuals with these conditions because FODMAPs affect the intestines, leading to issues with digestion.
Digestion either slows or speeds up. This can cause uncomfortable symptoms like constipation (slow digestion) or diarrhea (sped-up digestion)². SIBO and IBS in particular slow down digestion, which supports fermentation and creates an optimal environment for bacteria to feed and thrive on high FODMAP foods³.
The Low FODMAP Diet for IBD and IBS
Many people diagnosed with IBS have had success in reducing their symptoms with the LFD⁴. The LFD has proven to be effective for alleviating certain IBS symptoms such as bloating and abdominal pain⁵.
The success of this diet for IBS has led to experimentation with the low FODMAP diet for IBD.
The ingestion of FODMAPs aids in the delivery of fermentable substrate and water to the small intestine and colon, which triggers functional gut symptoms⁶. Removing these foods from your diet often addresses the root problem and reduces IBS symptoms.
While the use of this diet for IBD is still being tested, studies have shown promising results.
An analysis of nine different studies was done on patients with IBD who tried the LFD⁷. The diet appeared to only improve certain IBD symptoms including bloating, gas, abdominal pain, and fatigue. The LFD, in these studies, did not lead to a change in other symptoms like nausea and vomiting.
Another small, recent study observed the effects of the LFD on children with IBD. Seven of the nine children saw a reduction in their GI symptoms, while the other two saw no change⁸.
Due to the limitations of these studies and because studies on the LFD for IBD are relatively new, it’s important to consult a healthcare provider before trying this diet for your symptoms.
The Low FODMAP Diet and Celiac Disease
Individuals with Celiac disease have to remove gluten from their diet, but what about FODMAPs?
A review of several studies on the low FODMAP diet for Celiac disease showed a decrease in persistent IBS-like symptoms⁹. There was also a significant improvement in quality of life and well-being.
It’s important to note that there are limitations and potential biases in these studies, but they show an overall positive outcome for LFD interventions in Celiac patients.
The Low FODMAP Diet Plan
It might surprise you that a lot of healthy, natural foods are high in FODMAPs. Some categories of foods that have a high level of FODMAPs are:
Fruit
Dairy
Cereals
Legumes
But not every type of food in these categories contains high levels of these carbs. Here are some high-FODMAP foods followed by low FODMAP diet snacks to have instead.
Drinks high in caffeine and alcohol
Certain nuts like cashews and pistachios
Watermelon, apricots, cherries, and other stone fruit
Some artificial sweeteners like high fructose corn syrup
Artichokes, onions, beets, and certain cruciferous vegetables
Dairy products including regular cow milk, yogurt, ice cream, and certain cheeses
Wheat and rye products (you have to avoid these if you’re diagnosed with Celiac disease)
If your functional medicine doctor recommends avoiding these foods, it can be overwhelming to think of alternative low FODMAP diet meals. Foods you can have on this diet include:
Pineapples, kiwis, and oranges
Natural sweeteners like maple syrup and dark chocolate
Eggplants, carrots, potatoes, and some other vegetables
Lactose-free milk, almond milk, brie, and most hard cheeses
Oats, quinoa, rice, gluten-free bread, and other products with corn as a base instead of wheat flour
Eggs, Tofu, and certain meats and seafood (usually those that aren’t marinated, heavily processed, or fried with wheat flour)
It might sound daunting to avoid some of your favorite foods to feel better. However, not all high FODMAP foods will bother you.
The low FODMAP diet also isn’t a long-term diet. Removing all these foods from your diet can lead to mineral and vitamin deficiencies¹⁰. How long you follow the diet will depend on your symptoms and what your healthcare provider recommends.
Many studies have demonstrated the importance of a dietician-led diet plan, showing that those who don’t consult their doctor have a more difficult time following the diet and getting results¹¹.
There are three different phases to help you implement a long-term diet that works for you.
The Phases of the Low FODMAP Diet
The three phases are:
Elimination
Reintroduction
Maintenance
The Elimination phase typically lasts two to six weeks and consists of removing all foods high in FODMAPs from your diet. This is essentially a detoxification phase that allows your body to get rid of these carbs. You might feel better a few days into the LFD, or it might take a few weeks.
The Reintroduction phase involves adding these foods back into your diet one at a time so you can determine which ones your body tolerates well. This usually takes six to eight weeks.
As with the other phases, the low FODMAP diet reintroduction is most effective under the supervision of a healthcare professional. It helps to wait until after you’ve recovered from a reaction to reintroduce another food so you can be accurate when tracing which foods cause your symptoms¹².
Finally, the Maintenance phase is your long-term, sustainable diet plan based on your experiences with the low-FODMAP diet. You can eat foods that don’t trigger your symptoms and avoid those that do.
Is the Low FODMAP Diet for You?
It’s important to consult your doctor before trying this diet because the high-FODMAP foods you can tolerate are unique to you and your body. The low-FODMAP diet helps a lot of people with gastrointestinal issues and conditions, but it might not be the answer for you.
Request a free consultation with me, Dr. Martina Sturm, to take the first step toward identifying the root cause of your symptoms so you can reduce your digestive pain and discomfort.
https://www.sciencedirect.com/science/article/pii/S0924224419309252
What-are-fodmaps-Rupa Health
https://www.lidsen.com/journals/rpn/rpn-03-02-009/rpn.2302009.pdf
Low fod-map diet- Dr. Rusco