Is a Low FODMAP Diet Right for You?

You have probably seen the low FODMAP diet popping up on the cover of health magazines and in your social media feed. What exactly is a FODMAP, and should you be worried about it? Here's what you need to know before jumping on this new diet bandwagon.

A low FODMAP diet is used to treat irritable bowel syndrome, or IBS. It was created by researchers at Monash University to help control gastrointestinal symptoms associated with this condition. These researchers have discovered that the symptoms of IBS seem to be triggered by a specific group of carbohydrates, called FODMAPs.

What Are FODMAPs?

FODMAP stands for Fermentable, Oligo-Saccharides, Disaccharides, Mono-saccharides, and Polyols. These are a group of carbohydrates that are poorly absorbed in the small intestine. They end up rapidly fermenting in the gut, causing painful and sometimes embarrassing symptoms. FODMAPs are found in everyday foods like wheat, apples, onions, and sugar-free gum.

What Are the Symptoms of IBS?

• Changes in bowel habits, constipation, diarrhea
• Indigestion
• Nausea
• Excessive gas and bloating
• Abdominal pain and cramping

10-20% of the global population suffers from IBS and it is more common in women than in men. It can be highly debilitating, affecting work, sleep, and even relationships.

How Is IBS Treated?

Until recently, IBS has only been treated with medications that often do not provide adequate relief of symptoms and can cause unwanted side effects. There is currently no cure for IBS. That is what makes the low FODMAP diet an exciting possibility.

How Does a Low FODMAP Diet Work?

The low FODMAP diet consists of three phases: Elimination, Reintroduction, and Maintenance.

1. Elimination: First, you will eliminate all high FODMAP foods from your diet for 2-6 weeks. During this time, you will only eat foods from the approved low FODMAP list, including things like gluten-free grains, small servings of nuts and seeds, specific fruits and vegetables, protein, hard cheeses and lactose-free dairy products.
2. Reintroduction: With the help of a registered dietitian, you will gradually re-introduce FODMAPs in a methodical manner to assess your tolerance for each one.
3. Maintenance: As you learn more about what you can and cannot tolerate, you will be able to design your own, personalized, well-balanced diet. Many people can return to a fairly normal diet, only having to restrict a few high FODMAP foods in large amounts. A strict low FODMAP diet is not recommended to be followed long term.

Is a Low FODMAP Diet Effective in Treating IBS?

Because of the high interest in this dietary option of treating IBS, there are many ongoing clinical trials and observational studies.

In one short study, 15 healthy subjects and 15 subjects with IBS were provided a low and high FODMAP diet for two days each, with a 7-day regular diet period in between. All subjects with IBS complained of significantly worsened symptoms with the high FODMAP diet, while the healthy subjects only complained of increased gas.  

A recent clinical trial by the University of Michigan Health System showed that more than 50 percent of patients with IBS had significant relief from a low FODMAP diet over six weeks, resulting in improved quality of life, better sleep, and a reduction in canceled activities.

According to FODMAP expert and registered dietitian Kate Scarlata, up to 75% of those who suffer from IBS will benefit from a dietary restriction of FODMAPs with proper implementation.

Should I Try a Low FODMAP Diet?

Maybe! But if you are suffering from gastrointestinal symptoms it is important to see your doctor first to rule out any serious conditions such as celiac disease, colon cancer, inflammatory bowel disease, or ovarian cancer. If your doctor concludes you do have IBS and you want to try a dietary approach for treating it, ask for a referral to a registered dietitian who specializes in FODMAPs.

Resources:

1. Monash University (https://www.monash.edu/medicine/ccs/gastroenterology/fodmap)
2. Low FODMAP Diet App for iPhone and Android (https://www.monash.edu/medicine/ccs/gastroenterology/fodmap/education/iphone-app)
3. FODMAPS 101 - A free handout (http://www.katescarlata.com/fodmaps-101/)
4. Low FODMAP Shopping List (http://www.katescarlata.com/low-fodmapgrocerylist/)
5. FODMAP Dietitian Directory (http://www.katescarlata.com/fodmapdietitians/)
6. University of Michigan Clinical Study Summary (https://www.sciencedaily.com/releases/2016/05/160524121551.htm)