The low fodmap diet – solutions for IBS and food intolerance with Brisbane Nutritionists & Naturopaths
What are Fermentable, Oligo-, Di-, Mono-saccharides And Polyols (FODMAPs)?
FODMAPs are a group of sugars and carbohydrates that occur in everyday, natural whole foods that ferment in your digestive tract, often causing IBS and digestive upsets. If you don’t break down these sugars and carbohydrates properly in your digestive tract, they ferment and give off gas, which cause lots of digestive problems. Think of it like a little home brew factory in your belly, too much fermentation and there’s trouble!
- Monosaccharide (fructose)
- Disaccharide (lactose)
- Oligosaccarides (fructans & galactans, inc. fructo-oligsaccardies, inulin and raffinose)
- Polyols (sorbitol, mannitol, xylitol, maltitol & isomalt)
What happens to FODMAPs in susceptible people?
FODMAPs are osmotically active molecules, which means the malabsorbed molecules that remain in the intestine can draw water into the lumen via osmosis. This may lead to visible abdominal bloating, gastrointestinal pain and altered bowel motions (eg diarrhoea).
Short chain carbohydrates are rapidly fermented by both commensal and dysbiotic bacteria in the intestine. Excessive fermentation can lead to an increase in the production of hydrogen, carbon dioxide and methane gases, resulting in excessive wind and bloating.
(Image from: Barret & Gibson 2007, p. 53)
IMPORTANT NOTE: FODMAPs do not cause symptoms in most individuals, however, when functional gastrointestinal disorders such as IBS, already have altered intestinal bacteria and heightened activation of the enteric nervous system, a low FODMAP diet can be useful (Gibson & Shepard 2010, p. 252).
What should you do if this sounds like you?
Eliminate all high FODMAPs foods from your diet for at least two weeks and see if the symptoms remain (use a symptom and diet diary). Following elimination, a period of re-introducing different groups slowly will allow for the identification of more specific groups to avoid. Although this requires a lot of time and effort, your digestive system, thus your whole body will thank you!
Here is a list of high FODMAP foods and alternatives:
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HIGH FODMAP FOODS |
ALTERNATIVE FOODS |
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Excess fructose |
Fruits: apples, boysenberries, cherries, figs, pears, nashi, peaches, mango, watermelon, tamarillo, tinned fruit in natural juice Vegetables: asparsgus, artichokes, sugar snap peas Sweetners: Honey, fructose, high fructose corn syrup, dried fruit Large total fructose dose: concentrated fruit sources, large serves of fruit Drinks: fruit juice, soft drinks sweetened with fructose, dessert wine, sparkling wine, cider, rum |
Fruits: banana, blueberry, durian, grapefruit, grape, honeydew, kiwifruit, lemon, lime, mandarin, orange, passionfruit, paw paw, raspberry, rockmelon, strawberry, tangelo Honey substitutes: maple syrup, golden syrup Sweetners: any except polyols |
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Lactose |
Milk: cow, goat and sheep (regular and low fat), condensed milk, evaporated milk, Yoghurt : (regular and low fat) Cheese: soft and fresh (eg ricotta, cottage) Other: margarine, ice cream, custard |
Milk: lactose-free, rice milk Yoghurt: lactose-free, coconut Cheese: ‘hard’ cheeses inc. brie, camembert Icecream substitutes: gelati, sorbet |
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Fructans |
Fruits: custard apple, nectarines, white peaches, rambutan, persimmon, tamarillo, watermelon Vegetables: artichokes, asparagus (>3), beetroot (>4 slices), brussel sprouts (> ½ cup), broccoli (> ½ cup), cabbage (>1 cup), chicory root, corn (> ½ cup), fennel (> ½ cup), garlic, leeks, okra, onions, peas (> ⅓ cup), radicchio lettuce, snow peas (>10), spring onion or shallots Cereals: wheat, rye and barley products when eaten in large amounts (eg bread, pasta, couscous, crackers, biscuits) Nuts: cashews, pistachios
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Vegetables: bamboo shoots, bok choy, carrot, celery, capsicum, choy sum, eggplant, green beans, lettuce, chives, parsnip, pumpkin, silverbeet, spring onion (green only), tomato, garlic-infused oil Cereals: gluten-free and spelt bread/cereal products |
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Galactans |
Legumes: all (eg chickpeas, lentils, dried/canned beans, baked beans, red kidney beans)
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All fruit and vegetables mentioned above and below. |
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Polyols |
Fruits: apples, apricots, avocado (> ¼), blackberries, cherries (>3), longan (>10), lychee, nashi, nectarine, pears, peaches, plums, prunes, watermelon Vegetables: cauliflower, celery, (>1 stick), mushrooms, snow peas, sweet potato (> ½ cup) Sweetners: sorbitol (420), mannitol (421), xylitol (967), maltitol (965), isomalt (953) and others ending in ‘–ol’
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Fruits: banana, blueberry, carambola, durian, grapefruit, grape, honeydew, kiwifruit, lemon, lime, mandarin, orange, passionfruit, paw paw, raspberry, rockmelon Sweetners: sugar (sucrose), glucose, others not ending in ‘–ol’
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This is where an experienced FODMAP Nutritonist or Naturopath can help you, as it can be confusing to do this on your own. The team at Vibe Natural Health can help you with a healthy supervised FODMAP elimination. Avoiding all of the high FODMAP foods is not ideal long term. Combined with a gut healing program, you may only need to avoid a few of the foods listed above to achieve optimal health. For a step by step guide to re-introducing each FODMAP group, see one of our Nutritionists or Naturopaths at Vibe Natural Health in Brisbane. We understand everyone is unique and can tailor and monitor your responses to achieve the greatest outcome.
Need help knowing if you have a problem with FODMAP foods?
The Naturopaths at Vibe Natural Health offer appointments at our clinic at 210 Days Rd, Grange in Brisbane.
Visit our appointment diary on the top right of screen to book now.
If you have questions, please email us rather than commenting on the blog at info@vibenaturalhealth.com.au
Or phone us on (07) 3366 7970. We would love to help you!
Helpful links:
http://www.med.monash.edu/cecs/gastro/fodmap/
http://www.taste.com.au/recipes/collections/low+fodmap+diet+recipes
References
Barrett, JS and Gibson, PR 2007, ‘Clinical ramifications of malabsorption of fructose’, Practical Gastroenterology, vol. 53, p. 51-65.
Gibson, PR and Shepherd, SJ 2010, ‘Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach’, Journal of Gastroenterology and Hepatology, vol. 25, pp. 252-258.
