Getting started on the low FODMAP diet?
It can feel overwhelming. I know when I first looked at those lists over 8 years ago – I laughed and said ‘ there’s no way in hell I’m following this crazy low FODMAP diet’. (I WAS a dietitian at the time, my IBS was at it’s WORST, and it seemed almost impossible to me.)
Fast forward 8 years, and the low FODMAP diet has gained a TON of evidence to support its efficacy.
While the low FODMAP diet isn’t always my immediate go to in practice, we DO know that 50-75% of patients will feel better on the low FODMAP diet. So, if starting the low FODMAP diet is something you’re interested in trying, let’s start with the basics.
What is a FODMAP?
FODMAP is an acronym for ‘fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.’ It’s a mouthful – hence the acronym. What FODMAP’s REALLY are, are types of carbohydrates that either pull water into the gut, and/or ferment in the gut leading to symptoms of bloating, distension, pain, gas, diarrhea, constipation, or a mix of both.
Where are FODMAP’s found?
FODMAP’s are found in certain foods that contain carbohydrates. This includes
- certain fruits and vegetables like onion, garlic, apples, and watermelon
- certain grains; specifically wheat, rye and barley
- certain nuts & seeds like pistachios & cashews
- Pulses like black beans, kidney beans, and others
- Lactose-containing dairy (*only if you’re lactose intolerant!)
- Processed foods that contain high FODMAP ingredients or high FODMAP sweeteners
An extensive list can be found through your dietitian, the Monash FODMAP app, or our free course ‘Getting Started on the Low FODMAP diet‘.
Are FODMAP’s good, or bad for our guts?
Contrary to popular belief (because how could something that causes so much pain be good for our guts?) FODMAP’s are often GOOD for your guts, primarily when they come from whole foods. The reason why is – they feed good bacteria in your colon. What we want to do is find a balance where you can still fuel those good gut bacteria, and manage your symptoms.
I always like to describe FODMAP’s like a ‘bucket’. When you overfill the bucket, that’s when you get symptoms. This is why it’s often hard for people to pinpoint what foods cause symptoms, because it can vary so much! Read more about the bucket effect here.
How do I safely follow a low FODMAP diet?
The low FODMAP diet is meant to be a short term elimination style (we prefer the term ‘swap this for that’) diet of 2-6 weeks, followed by strategic reintroduction, and a long term plan to have the most liberalized diet possible.
What we actually see happen is:
- patient tries the low FODMAP diet on their own
- They feel better, and are nervous to add foods back in or aren’t sure how
- They stay on the low FODMAP diet WAY too long – increasing risk of malnutrition, potentially negatively impacting the gut microbiota, and often ending up obsessing over foods!
If this sounds like you, I HIGHLY recommend you get in touch with a trained IBS dietitian ASAP. We can help you to safely follow and reintroduce FODMAP’s, and hopefully find a good balance long term! In fact, food isn’t the ONLY way to manage IBS, which is why we’ve developed our highly successful ‘4 Pillar Plan’. Read more about our 4 Pillar Plan HERE.
Are there risks with following a low FODMAP diet?
Yes, absolutely there are risks – which is why all current practice guidelines suggest you do this with the help of a trained dietitian. Any diet where you eliminate foods, especially one as potentially restrictive as FODMAP’s puts you at risk for:
- Malnutrition – the risk of malnutrition is real! The most common nutrients I see missing in the low FODMAP diet include fibre, calcium, folate & others.
- Food anxiety – if you’re afraid to eat out, if food takes up more space in your mind than it should, if you’re constantly worried about how food is going to affect your gut – this is definitely a red flag to see a dietitian!
- Challenges with symptoms not improving due to other factors – IBS is more complex than diet – which is why we’ve amalgamated the evidence on IBS & gut health, and have created our 4 Pillar Plan – to get patients feeling better in the simplest way possible.
What if I need help?
We have a team of 3 dietitians and a psychologist, and we’ll work alongside your family doctor or gastroenterologist to get you started & be successful with the low FODMAP diet – FAST. To learn more about our ‘4 Pillar Plan’ program, click here!