What is a FODMAP Diet?
If you struggle with IBS (Irritable Bowel Syndrome), chances are you’ve heard of FODMAPs. A few years ago a gastroenterologist asked me if I’d heard of FODMAPs and my response was simply a furrowed brow followed by “fod-WHAT?” These days a low FODMAP diet is becoming one of the mainstays of treatment for IBS, and for good reason – many patients say they’ve been cured of their daily struggles with gas, bloating irregularity, and abdominal pain.
But like all things worth having, remission of your IBS symptoms does not come easily. It
can be a daily battle of trying to figure out your specific dietary triggers. Gluten? Dairy? Too much fiber? Too little fiber? Then just as you think you’ve figured out that gluten is the cause of all the world’s evils you eat a bagel the next day and feel fine. What gives?
If you can relate to this story, you’re probably a perfect candidate for a low FODMAP elimination diet trial. Let’s break down the acronym to attempt to understand it further:
F = Fermentable (a.k.a. gas)
O = Oligosaccharides (a type of sugar molecule)
D = Disaccharides (another type of sugar molecule)
M = Monosaccharides (a single sugar molecule)
A = and
P = Polyols (sugar alcohols – given the name because part of their structure resembles sugar and part resembles alcohol (not ethanol, the kind found in alcoholic beverages). Some polyols are found naturally in foods and some are used as a sugar substitute in dietetic products like sugar-free jelly beans)
So if you’re noticing a trend with the word “sugar” you’re correct. Sugar is a carbohydrate, therefore all FODMAPs are carbohydrates. But not all carbohydrates are FODMAPs. FODMAPs represent a group of carbohydrates that are poorly absorbed in the gut. Some are obvious (beans, Brussels sprouts) while others not so much (apples, wheat). Many individuals with irritable bowel syndrome appear to have a heightened sensitivity to the effects of FODMAPs due to colonic dysmotility (erratic contractions of the muscles in the colon) or visceral hypersensitivity (increased sensitivity of the nerves in the gut). So while your friend [without IBS] experiences some mild discomfort after eating a few too many beans, you [a person with IBS] would experience excruciating pain, followed by debilitating gas, bloating, diarrhea and/or constipation. The reason for this heightened sensitivity isn’t entirely clear. What we know for sure is that it’s miserable.
So what foods, specifically, are high in FODMAPs?
FODMAPs represent a group of carbohydrates that are poorly absorbed in the gut. These include lactose (dairy products), fructose (fruit sugar and 50% of what makes up table sugar), fructans (wheat, garlic, onions), galactans (beans and soy), and polyols (sugar alcohols).
Below is a clickable, printable chart of high- and low-FODMAP foods:
Here’s how a Registered Dietitian can help: Things can get complicated because not every individual is sensitive to every single type of FODMAP and levels of sensitivity vary from person to person. A registered dietitian trained in low FODMAP elimination diets can help individuals navigate where to begin and how to create a meal plan based around the right foods. We can also help transition individuals from the initial strict phase of the diet to more liberal phases where a greater variety of foods are allowed. While there is no cure for IBS, the ultimate goal is to empower the sufferer with information and tools to determine their personal dietary triggers, allowing them to take control of their life once again.