So you’ve been following the Low FODMAP diet, and have completed the elimination phase. But where do you go from here?
This is where I often see people get stuck! They did great with the Low FODMAP diet and got some symptom improvement, had a clear list of what they can eat and what they should avoid, but now they aren’t sure how to add FODMAPs back in and assess their tolerance.
How do you reintroduce FODMAP’s?
Reintroducing FODMAP’s is a strategic endeavour. Why? Because we want to reintroduce by FODMAP category, and choose foods only containing that 1 type of FODMAP.
As a reminder, the FODMAP categories are:
What are the steps to reintroduce FODMAP’s?
Step 1 – picking the FODMAP foods
Choose a food that only contains 1 type of FODMAP. The Monash App has a list, and so does our Reintroduce FODMAP’s step by step course! We strongly suggest you have the Monash app or an up-to-date course like ours in case these foods change with new testing. Doses or types of food may change over time as Monash expands its research.
Step 2 – Reintroducing those foods
Introduce that food over 3 days, starting with a moderate (yellow) portion, and incrementally increasing the portions to high and higher FODMAP (or a ‘normal’ portion of that food). The Monash app outlines a strategy for portions. In our course, we have a SUPER SIMPLE handout to outline dosing, as well as tips and tricks on how to get that unusual amount of food in a typical day (how should you include a clove of garlic in a sitting, anyway?)
Step 3 – Symptom Tracking
Track the results of your symptoms. If you get through the 3 day challenge without any symptoms – that is awesome! It means you tolerated that category well. If you have symptoms at any time, take a few days break, until you’re back at your ‘baseline’ or starting symptoms. At Ignite, we like to always test again to see how you do. We prefer to test at the symptomatic dose to assess – was it back to back days, or that dose all in one sitting that caused your symptoms?
Tracking your symptoms is an important part of understanding what sorts of portions of FODMAP’s you might tolerate from that category. Having a strategy to track those symptoms can make it a lot more simple. In our course, we outline a strategy to track what percent worse symptoms are, and how to apply those findings to the third phase of the Low FODMAP diet, liberalization (personalization).
At minimum you want to outline what symptoms you had, and your perception of how severe they were, so that you can make smart decisions on how to liberalize your diet in phase 3.
Step 4 – interpretation
Once you’ve introduced all categories you need to interpret the findings! We typically suggest beginning to include all the categories you ‘passed with flying colours’. If you’re nervous about doing that, we provide some other suggestions in our Reintroduce FODMAP’s course on how to do this strategically and to your ‘risk’ tolerance.
From there, you will be left with a list of foods that gave you symptoms at some doses.You will want to incorporate in small portions at the amounts you tolerated of these foods. Typically we like to suggest consuming 1 of the less tolerable FODMAP’s a day, at a portion you did OK with, and work your way up from there to 2, 3, or more! Pair back if you get symptoms.
For the foods you didn’t tolerate at even the lowest dose, you can always go back and test them in even smaller doses, or test other foods from that category to see if you tolerate those better.
In the end you should end up with a more liberal diet – including FODMAP’s you tolerated, and small amounts of ones you need to watch the portions on.
Other Pro Reintroduction Tips
- Test again every 3-6 months as FODMAP tolerance can change
- Want to ‘improve’ your tolerance to FODMAP’s? Consider other interventions that aren’t JUST food to help improve your IBS symptoms! Check out our blog post on our 4 Pillar Approach here.
- Don’t be afraid to modify the reintroduction to doses you’re comfortable with. If you are nervous, starting with a dose that builds body trust can be empowering when it goes well. If you need to do this – go for it!
- Practice self compassion! Self compassion is crucial in learning to manage IBS. We talk about this in our Reintroduce FODMAP’s step-by-step course in detail so that you can become more resilient and improve your quality of life no matter what your IBS is up to!