Low-FODMAP - madewithbarakah.com

Low-FODMAP

The Low-FODMAP diet restricts foods that contain Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols. These short chain carbohydrates and polyols are poorly absorbed in the digestive tract and reach the colon where they are rapidly fermented by gut bacteria which may result in GI symptoms. It is a short term elimination diet where high-FODMAP foods are removed temporarily and then slowly reintroduced, one at a time, to determine which types of FODMAPs trigger GI symptoms. It has three phases: elimination/restriction (2-6 weeks), reintroduction/re-challenge (6-10 weeks), and personalization (long-term) and can take from 8-16 weeks to complete. Limiting dietary intake of FODMAPs may lower intestinal water content as well as reduce fermentation and gas production in the colon. While FODMAPs are always poorly digested, healthy individuals may not experience any adverse GI symptoms.

Oligosaccharides (FOS/Fructans, GOS/Galactans): these are highly fermentable foods. They produce gas, bloating, and abdominal pain. These include: artichokes, allium vegetables (garlic, onions), certain fruits (ripe bananas, dates, dried apricots), legumes (beans, lentils), nuts, grains (rye, wheat).

Disaccharides (Lactose): unabsorbed components are fermented in the large intestine and may result in gas and bloating. These include: dairy (butter, cheese, cream, milk).

Monosaccharides (Fructose): these foods draw water into bowel contents which can lead to pain, bloating, distention of the small intestine and may also cause diarrhea. These include: certain fruits (apples, cherries, figs, mangos, pears, watermelon), certain vegetables (beets, sugar snap peas), high-fructose corn syrup, honey.

Polyols (Mannitol, Sorbitol): these foods are likely to draw water into the bowel and may lead to pain, bloating, distention on the small intestine and can also result in diarrhea. These include: also known as sugar alcohols because of their chemical structure resembles both sugar and alcohol. certain fruits (apples, pears, stone fruit), certain vegetables (cauliflower, mushrooms, snow peas), artificial sweeteners (chewing gum, mints), erythritol, isomalt, lactitol, maltitol, mannitol, sorbitol, and xylitol.

Who might benefit from a Low-FODMAP Diet

Irritable Bowel Syndrome (IBS)
Inflammatory Bowel Disease (IBD)
Small Intestinal Bacterial Overgrowth (SIBO)
Non-Celiac Gluten Sensitivity
Celiac Disease
Exercise-Induced Gastrointestinal Symptoms
Fecal Incontinence
Infantile Colic
Celiac Disease

How do FODMAPs cause symptoms?

They may be poorly absorbed in the small intestine (leading to bloating, gas, diarrhea).
If not fully absorbed, they can draw water into the intestines. FODMAPs that aren’t properly absorbed continue to move through the GI tract where their presence draws water into the intestines through a process called osmosis.
They are rapidly fermented by gut bacteria. When unabsorbed FODMAPs enter the colon, gut bacteria can ferment them.This can lead to the productions if large amounts of gas (hydrogen, carbon dioxide, and methane) which causes bloating and abdominal pain.
They may increase intestinal inflammation and gut permeability.

The Three Phases: Elimination, Reintroduction, & Personalization

It has three phases: elimination (2-6 weeks), reintroduction (6-10 weeks), and personalization (long-term) and can take from 8-16 weeks to complete.

Phase 1: Elimination/Restriction (4-6 weeks)

During this phase, only low-FODMAP foods are consumed. The main goal is to eliminate symptoms. You may use the Monash app to determine which foods/portion sizes are considered “low-FODMAP” then plan your diet.

Phase 2: Reintroduction/Rechallenge (6-10 weeks)

Next, high-FODMAP foods are slowly reintroduced, one type at a time, to see which types of FODMAPs are triggering symptoms. A food journal or a food symptoms journal is used to track what foods and portion sizes are consumed when and when any symptoms occurred.

Phase 3: Personalization (long-term)

After finishing the reintroduction phase, clients who have determined which FODMAPs are tolerated can add those foods back into their diet. Foods containing FODMAPs that weren’t tolerated should continue to be restricted, but re-challenging foods from time to time is recommended since tolerance can change as a result of improved gut microbiome diversity. Individuals follow an individualized long-term low-FODMAP diet based on their personal tolerance.

Hidden sources of FODMAPs

The following foods can be sources of FODMAPs:

Baked goods (wheat, high-fructose corn syrup)
Gluten-free flour blends (some include bean flours)
Granola bars (agave, honey, chicory root)
Marinara (onion, garlic)
Salad dressings (onion, garlic)
Stock or broth (onion, garlic)
Supplements