Coeliac disease and digestive issues run in my family and throughout my whole adult life I have suffered varying degrees of digestive dysfunction. My discomfort seems to flare up in times of high stress, both physical and emotional, when I am exhausted or when I have let my diet sprawl just a bit too far into the processed, sugar/carb loaded realm. This article is based on my research findings, my personal experience and my experimentation with a low FODMAP diet in conjunction with a qualified naturopath.
Disclaimer: I want to preface this post by stating that I am not a dietitian nor a naturopath. Topics explored on this blog share my own personal beliefs, opinions and experiences and I do not speak on behalf of any other individual or organization.
Now, lets get into it.
What is the point of a low FODMAP diet?
It has been shown that individuals with functional digestive issues such as irritable bowel syndrome (IBS), crohns, and ulcerative colitis, can benefit from utilizing a low FODMAP diet. I have also recently learnt that FODMAP’s may also benefit individuals with gynaecological conditions such as Polycystic Ovary Syndrome (PCOS) and Endometriosis (See more info here). This diet is utilized to enable an individual to gain greater control over digestive symptoms and, with the assistance and guidance of a dietitian/naturopath, establish which foods are triggers for digestive flare ups causing increased inflammation/discomfort, and which are better tolerated and can be reintroduced after an initial elimination phase. For evidence based research findings on the topic see http://shepherdworks.com.au/disease-information/research-studies/.
What does FODMAP mean?
FODMAP is an abbreviation for a group of short chain carbohydrates that are highly fermentable and poorly digested, which for some people, leads to digestive discomfort including bloating, gas, abdominal pain, visceral organ pain, constipation and/or diahorrea. FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols. Listed below are some examples, but not an exhaustive list, of items from each group.
Fermentable Oligosaccharides - Artichokes, Garlic (in large amounts), Leek, Onion (brown, white, Spanish, onion powder), Spring Onion (white part), Shallots, Wheat (in large amounts), Rye (in large amounts), Barley (in large amounts).
Disaccharides – Milk, icecream, custard, dairy desserts, condensed and evaporated milk, milk powder, yoghurt, soft unripened cheeses (eg. ricotta, cottage, cream, marscarpone).
Monosaccharides Honey, Apples, Mango, Pear, Watermelon, High Fructose Corn Syrup.
And Polyols – Apples, Apricots, Nectarines, Pears, Plums, Prunes, Mushrooms, sorbitol (420), mannitol (421), xylitol (967), maltitol (965) and isomalt (953).
How does a low FODMAP diet work?
As you can see from the list above the diet is quite restrictive and it would be very challenging to commit to this way of eating long term. BUT never fear, the low FODMAP diet is designed to be a temporary method to identify foods that individuals are sensitive to and discover the amount of each group tolerable to the individual. In some cases a variety of foods may need to be eliminated to improve gut health and comfort. However, for others it will be about managing portion sizes, avoiding eating too many high FODMAP foods in one meal/day or all together avoiding certain items that are identified as being poorly tolerated.
There are two phases for a low FODMAP diet:
Phase 1 – Elimination phase: You must stick to a strict low FODMAP diet for 6-8weeks, cutting out all foods high in FODMAP’s to give your body time to recoup, reduce inflammation of the digestive tract and allow your symptoms to subside. The length of phase 1 will varying from one person to another depending on the severity of your symptoms and the underlying pathophysiology of them, therefore it is extremely beneficial to seek the guidance of a qualified naturopath, nutritionist or dietician.
Phase 2 – Reintroductory phase: This phase includes reincorporating foods at differing volumes over a number of weeks to determine which foods are tolerable for you and which foods are not. Its important that this phase is completed properly to ensure that all your hard work during the initial phase is not undone by too hastily jumping back into a normal diet.
Chocolate Hazelnut Bliss Balls
Salted Caramel Popcorn Slice
Almond and pumpkin seed quinoa breakfast brittle
“Monash University Low FODMAP Diet” app - The team at the Department of Gastroenterology at Monash University have developed a smartphone application which provides accurate information about foods that trigger IBS reactions in order to help sufferers manage their symptoms. This app enables you to search for food items and determine their FODMAP status. It is very helpful as a quick resource when dining out, at the supermarket and incorporating FODMAP containing food back into your diet in moderated doses once out of the elimination phase.
Sue Shepard - Dr Sue Shepherd is an Advanced Accredited Practising Dietitian and Accredited Nutritionist. She has authored comprehensive evidence based guide and cookbooks on the low FODMAP diet and has a low FODMAP-dedicated food brand, titled “Sue Shepherd” which offers a range of products. These products are all FODMAP Friendly (low FODMAP) and gluten free. They are made in Australia and have no artificial colours, flavours or preservatives. http://shepherdworks.com.au/
FODMAPPER - Fodmapper are also a brand specializing in low FODMAP products including stocks, pasta sauces, soups and simmer sauces, they are available at Coles and also independent health food stores – http://www.fodmapped.com/
TIPS FOR NEW FODMAPPERS:
- If you’re going to dine out with friends, choose to go for breakfast or brunch. Lots of places offer “make your own” style breakfasts with extras that can be added to a basic base of gluten free toast or poached eggs on gluten free toast. Friendly Little Kitchen has a great list of cafes/restaurants in Melbourne who have been happy to accommodate her dietary requirements, so there is hope and no harm is asking.
- Print a copy of the list and stick it to the fridge, stock up big on the things you can have so you don’t feel deprived.
- If you’re going out for dinner, call the restaurant prior to see if they will cater for your dietary requirements, in this day and age you are not the first, and you certainly wont be the last person to ask for a FODMAP friendly meal. If they get annoyed or confused by the large list of things you cannot have, make it simple and just tell them the things you can eat. Eg. Salmon with steamed vegetables or vegetables cooked in olive oil with herbs.
- Use onion and garlic infused oils, they will add the flavour to your dishes minus the discomfort. You are also able to have the green section of leeks, spring onions or chives to add extra flavour to dishes.
- Experiment with things you don’t normally use in the kitchen. Now is a great time to embrace the ingredients on the “can have” list that you have yet to unlocked the full potential of. Take this opportunity to master chef it up.
- STICK TO THE RULES as strictly as possible, this is what will underpin your success. Yes its hard, yes its limiting, but trust me it gets easier and its not forever.
- Seek the help and guidance of a professional; I know its expensive and you’re probably thinking “hey I could just do this myself” however, if you’ve been suffering symptoms for quite some time and you are finally considering doing this very restricting diet, do it properly! You want to reap the benefits of your hard work, so give yourself the best chance of achieving that. Also, by seeking assistance from a professional you will also benefit from hearing their tips and tricks and receiving additional supplements and tonics that will aid you along the way.
Best of luck!