If you have IBS, and have been told that following a low FODMAP diet can potentially help manage your symptoms, you may have taken one look at it and immediately felt defeated.
If you’re starting out with the low FODMAP diet, knowing which foods are allowed and which ones aren’t can be extremely daunting. Never fear – a little knowledge can go a long way, especially when utilizing Metro’s My Health, My Choices program.
FODMAPs are types of carbohydrates (sugars) found in everyday foods. Carbohydrates are made up of carbon, hydrogen, and oxygen and provide an important source of energy for the body. FODMAPs are carbohydrates that may be poorly absorbed in the small intestine of some people. They move through the digestive tract to the large intestine, where they can draw water into the colon and are rapidly fermented by naturally occurring gut bacteria. The fermentation of FODMAPs produces gas and other byproducts (Magge, 2020).
FODMAP is an acronym for fermentable-oligosaccharides-disaccharides-monosaccharides-and-polyols.
Fermentable: Fermentable carbohydrates are sugars that are broken down and digested by bacteria in our intestines, producing gas and other byproducts.
Oligosaccharides: Oligosaccharides are short chains of carbohydrate molecules linked together. Fructans (a chain of fructose molecules) and galacto-oligosaccharides (a chain of galactose molecules) are oligosaccharides that humans cannot break down and properly absorb in the small intestine.
Disaccharides: Disaccharides are two carbohydrate molecules linked together. Lactose, the sugar found in milk and dairy products, is a disaccharide composed of glucose and galactose. Lactose must be broken down by the digestive enzyme lactase before it can be absorbed in the small intestine. In people with lactose intolerance, the level of lactose enzyme is insufficient to properly digest lactose, and so lactose travels to the colon where fermentation occurs.
Monosaccharides: Monosaccharides are single carbohydrate molecules. Fructose, the sugar found in many fruits and some vegetables, is a monosaccharide and does not require digestion before it is absorbed. When foods containing equal amounts of fructose and glucose are eaten, glucose helps fructose to be completely absorbed. However, when fructose is present in greater quantities than glucose, fructose absorption depends upon the activity of sugar transporters located in the intestinal wall. The ability to absorb excess fructose varies from person to person. In people with fructose malabsorption, the capacity of sugar transporters is limited and excess fructose travels to the colon where fermentation occurs.
Polyols: Polyols, or sugar alcohols, are a type of carbohydrate that humans can only partially digest and absorb in the small intestine. Polyols, such as sorbitol, mannitol, xylitol, maltitol, and isomalt, mimic the sweetness of sucrose. However, because their absorption is much slower, only a small amount of what is eaten is actually absorbed. Polyols are often used as low-calorie sweeteners in sugar-free and diet products.
Most importantly, it is important to remember that a low FODMAP diet isn’t a lifetime diet. Once you understand your IBS trigger foods and food intolerances, you can adapt your diet to ensure you are living comfortably!
In order to get there, a little bit of work on your end is required! Although the low FODMAP diet can seem hard, it can truly can be life-changing for you, helping you to better understand what works on a personal level and what doesn’t. With a little education and commitment, you can be on your way to living a healthier and happier life, unencumbered by unnecessary gut triggers (Hill, 2017).
The three phases of the low FODMAP diet are elimination, reintroduction, and integration. It is important to note that the diet is best implemented under the supervision of a qualified health professional, such as a registered dietitian.
The objective here is to identify the high FODMAP foods from your current diet that are aggravating symptoms of IBS and the like by getting rid of them all.
Low FODMAP alternatives can help many people feel better as early as two days into the elimination phase, but for some people it can take weeks. Don’t be discouraged! It is also important to note that cheat days are certainly not recommended on this diet. The better you stick to it, the more effective and accurate the results. Your time spent in this phase should be determined in consultation with your healthcare professional, but it typically lasts from 2-6 weeks.
The objective during this phase is to determine which foods and FODMAPs specifically trigger symptoms and which do not.
The reintroduction phase is where you gradually reintroduce individual high FODMAP foods back into your diet. If a certain food causes no symptoms, then you’ll be able to include that food in your permanent diet going forward. If it causes symptoms, you’ll want to cut it out for good!
You’ll be going down the list of foods in each of the FODMAP subcategories. Each subgroup will be reintroduced separately while your base diet remains low in FODMAPs. This approach allows you to see which FODMAP groups you may have food intolerances to. Consulting with a dietitian during this step is beneficial, as this part of the process can be the trickiest for people. You should take a break of a few days between the reintroduction of foods to avoid any crossover effects (Bellini, 2020).
This is where you can establish your long-term, personalized FODMAP diet. Once you and your dietitian interpret your food triggers and tolerances, you can begin reintroducing foods and FODMAPs that were tolerated well and avoiding only those that trigger your symptoms.
Remember everyone’s food intolerances are different! Once your plan is in motion, this is the start of a stress-free life. Embrace your new lifestyle and live your life – your way!
Naturally, this FODMAP experience can be daunting for most people. How will I know what to eat? What is left for me to eat? Which brand of foods are low FODMAP? As mentioned earlier, this process is best undertaken with the close supervision of a registered dietitian, but even then, it may be difficult to know what to eat on a daily basis for each meal. Here are a few tips and guidelines on what you can eat, based on the Monash University FODMAP Diet app, which is constantly being updated by the university (Monash, 2021).
Fruit: Stick to things like strawberries, oranges, grapes, lemons, limes, bananas, pineapple, and lychee. Avoid high fructose fruits like apples, cherries, plums, pears, and watermelon.
Vegetables: Leafy greens, red bell peppers, spaghetti squash, parsnip, radish, eggplant, bok choy, cucumbers, tomatoes, and oyster mushrooms are all examples of low FODMAP vegetables. Avoid vegetables like artichokes, asparagus, cauliflower, onions, and garlic.
Milk: Plant-based milks and lactose-free dairy are all viable options while avoiding the lactose in regular milk, yogurt, and the like.
Meat: Meat, chicken, fish, and eggs are all low FODMAP, whereas soy, beans, tofu, and cashews should be avoided.
Grains: Gluten-free bread, traditional sourdough, and quinoa are excellent examples of low FODMAP grains. Rye, wheat, and barley are high in FODMAPs and should be avoided.
Beverages: The low FODMAP diet eliminates many of the sweet beverages readily in your grocery stores, cafeterias, and vending machines. Rest assured, with the low FODMAP diet we’re aiming for progress, not perfection!
Ok, that’s great. But how do I know which brands are specifically low FODMAP?
One way to help with choosing specific brands you can be confident are low FODMAP is by using Metro’s My Health, My Choices program. Their online grocery shopping platform categorizes thousands of products based on a list of nearly 50 attributes. Those attributes include categories such as gluten-free, lactose-free, plant-based, keto, vegan, whole grain, high source of fibre, and the topic of discussion today – low FODMAP products.
If you click on the low FODMAP category on Metro’s online grocery website here, you will see a wide range of low FODMAP products (some of which you probably didn’t know were low FODMAP when consuming the recommended portion size), for example:
If you are interested in learning more about the low FODMAP diet and numerous other gut health trends, CDHF is presenting a virtual event starting November 3rd involving a variety of health care professionals. Click here to register now and ensure you don’t miss out!
Bellini, M. 2020. Low FODMAP Diet: Evidence, Doubts, and Hopes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019579/
Hill, P. 2017. Controversies and Recent Developments of the Low-FODMAP Diet. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5390324/
Magge, S. 2012. Low-FODMAP Diet for Treatment of Irritable Bowel Syndrome. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966170/
Monash University, 2021. https://www.monashfodmap.com/ibs-central/i-have-ibs/get-the-app/