The Low-FODMAP Diet

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

1. Irritable Bowel Syndrome (IBS)
2. Inflammatory Bowel Disease (IBD)
3. Small Intestinal Bacterial Overgrowth (SIBO)
4. Non-Celiac Gluten Sensitivity
5. Celiac Disease
6. Exercise-Induced Gastrointestinal Symptoms
7. Fecal Incontinence
8. Infantile Colic
9. Celiac Disease

how do FODMAPS cause symptoms?

1. They may be poorly absorbed in the small intestine (leading to bloating, gas, diarrhea).
2. 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.
3. 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.
4. They may increase intestinal inflammation and gut permeability.

The Three Phases: elimination, reintroduction, and 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 (2/4-6 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/Re-challenge (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

tips to add flavors to foods without using high-FODMAP ingredients

• Add mustard to marinades or salad dressings instad od garlic
• Cook with low-FODMAP herbs and spices
• Replace onions with small amounts of the green pats of the scallions and leeks
• Try using nutritional yeast instead of cheese
• Use garlic infused oil to add flavor instead of fresh garlic

Low-FODMAP fruits

Note: Use the Monash app for the most up to date data.

• Dragon fruit
• Durian
• Grapes (red, green. or black)
• Guava
• Lemons
• Limes
• Mandarin oranges
• Olives (black or green)
• Oranges
• Papaya (yellow)
• Plantain
• Prickly pear
• Pineapple
• Rhubarb
• Star fruit
• Strawberries

Low-FODMAP Veggies

Note: Use the Monash app for the most up to date data.

• Alfalfa sprouts
• Arugula
• Baby corn (canned)
• Bamboo shoots
• Bean sprouts
• Bell peppers (red only)
• Carrots
• Choy sum
• Collard greens
• Cornichon pickles
• Cucumber
• Endive
• Eggplant
• Hearts of palm (canned)
• Jalapeno (pickled)
• Kale
• Kohlrabi
• Lettuce (butter, iceberg, red, romaine)
• Oyster mushrooms (no other types)
• Parsnip
• Potatoes
• Radish
• Rutabaga
• Swiss chard
• Spaghetti squash
• Spinach
• Scallions (green part only)
• Tomatillos
• Tomatoes (3/4 canned or 1 small raw)
• Water chestnuts
• Watercress
• Yardlong beans

Low-FODMAP Grains & Starches

Note: Use the Monash app for the most up to date data.

• Agar Agar
• Arrowroot
• Buckwheat flour
• Chickpea pasta
• Corn flour, meal, or starch (not corn kernels)
• Corn tortillas (no added gums or fiber)
• Gluten-free pasta
• Green banana flour
• Kelp noodles
• Millet
• Millet flour
• Oats
• Oat bran
• Oat groats
• Oatmeal
• Polenta
• Potato starch
• Quinoa
• Quinoa flour
• Quinoa pasta
• Rice (brown, white)
• Rice bran
• Rice flour
• Rice noodles
• Sorghum flour
• Tapioca starch
• Teff flour

Low-FODMAP Nuts & Seeds

Note: Use the Monash app for the most up to date data.

• All except cashews, hazelnuts, and pistachios

Low-FODMAP Dairy & Dairy alternatives

Note: Use the Monash app for the most up to date data.

• Almond milk
• Cashew milk
• Coconut yogurt
• Hard & ripened cheeses (gruyere, manchego, pecorino, cheddar, monterey jack, colby, swiss, etc)
• Hemp milk
• Lactose-free cream cheese
• Lactose-free milk
• Lactose-free yogurt
• Macadamia milk
• Oat milk
• Quinoa milk
• Rice milk
• Soy milk (if made from soybean extract, not whole soybeans)

Low-FODMAP Meat & Vegetarian protein Sources

Note: Use the Monash app for the most up to date data.

• Bacon
• Beef
• Chicken
• Eggs
• Fish
• Kangaroo
• Lamb
• Pork
• Prawns
• Spirulina
• Tempeh
• Tofu

Low-FODMAP fats & Oils

Note: Use the Monash app for the most up to date data.

• Animal fats
• Avocado oil
• Butter & ghee
• Canola oil
• Olive oil (plain or garlic infused)
• Peanut oil
• Mayonnaise
• Rice bran oil
• Sesame oil
• Sunflower oil
• Vegetable oil
• Walnut oil

Low-FODMAP Seasonings

Note: Use the Monash app for the most up to date data.

• Any fresh herbs
• Any dried herbs or spices (except for onion and garlic)
• Allspice
• ACV
• Basil
• Black pepper
• Capers (salted or in vinegar)
• Cardamom
• Chili powder
• Chives
• Cilantro
• Cinnamon
• Cloves
• Cocoa or cacao powder
• Coriander
• Cumin
• Curry leaves
• Curry powder
• Dill
• Fennel seeds
• Fenugreek (seeds or dried leaves)
• Five spice
• Ginger
• Mint
• Nutmeg
• Saffron
• Turmeric
• & more

Low-FODMAP Sweeteners

Note: Use the Monash app for the most up to date data.

• Brown sugar
• Cane sugar (white sugar)
• Dark chocolate (70%+)
• Maple syrup
• Palm sugar
• Rice malt syrup
• Stevia

Low-FODMAP Beverages

Note: Use the Monash app for the most up to date data.

• Beer
• Coffee
• Gin
• Cranberry juice (unsweetened)
• Tea (black, green, or white)
• Vodka
• Whiskey
• Wine

Common High-FODMAP Foods

Note: Use the Monash app for the most up to date data.

Fruits

• High-Fructan: banana (ripe), blueberry, coconut flour, cranberries (dried), currants, dates, figs (dried), goji berries (dried), grapefruit, honeydew, melon, longan, mango (dried), nectarines, paw paw (dried), peaches (white), persimmon, pineapple (dried), plum, pomegranate, prunes, raisins, rambutan, raspberry, sultanas, watermelon.
• High-GOS: custard apple
• High-Lactose:
• High-Fructose: apple, asian pear, cherry, coconut flour, figs (fresh), guava (unripe), mango (fresh), pear, sultanas, tamarillo, watermelon
• High-Sorbitol: apple, apricot, asian pear, avocado, blackberry, cherry, coconut flour, longan, lychee, nectarines, peaches (clingstone, white, yellow), pear, plum, prunes.
• High-Mannitol: peaches (clingstone), watermelon.

Vegetables

• High-Fructan: artichoke, asparagus, beets, brussels, sprouts, cabbage, corn (canned), fennel bulb, garlic, green onion (white part), green peas (frozen), leek (white part), lotus root (dried), onion (red, white), shallots, snow peas.
• High-GOS: beets, bitter melon, butternut squash, green peas (canned, frozen), karela, snow peas, yucca.
• High-Lactose:
• High-Fructose: artichoke, asparagus, black garlic, broccoli stalks, broccolini, chipotle chile (dried), lotus root (dried), sugar snap peas.
• High-Sorbitol: corn (fresh), mushrooms (dried black chanterelle)
• High-Mannitol: cauliflower, celery, mushrooms (white, button, enoki, dried porcini, portobello, shiitake), sauerkraut, snow peas.

Grains

• High-Fructan: amaranth, barley, freekeh, rye, spelt, wheat.
• High-GOS: amaranth, barley, freekeh.
• High-Lactose:
• High-Fructose:
• High-Sorbitol:
• High-Mannitol:

Legumes

• High-Fructan: baked beans, black beans, kidney beans, lima beans, mung beans, navy beans, pinto beans, soy beans, split peas.
• High-GOS: adzuki beans, baked beans, black beans, borlotti beans, butter beans, chana del chickpeas, sprouted kidney beans, lima beans, mung beans, navy beans, pinto beans, soy beans, split peas.
• High-Lactose:
• High-Fructose: baked beans, broad beans, fava beans.
• High-Sorbitol:
• High-Mannitol:

Nuts & Seeds

• High-Fructan: cashews, pistachios.
• High-GOS: almonds, cashews, and pistachios.
• High-Lactose:
• High-Fructose:
• High-Sorbitol:
• High-Mannitol:

Dairy & Dairy Alternatives

• High-Fructan: oat milk.
• High-GOS: soy milk (from soy beans)
• High-Lactose: buttermilk, condensed milk, cow’s milk, custard, evaporated milk, goat milk, kefir, yogurt.
• High-Fructose:
• High-Sorbitol:
• High-Mannitol:

Other

• High-Fructan: agave, carob powder, chai tea, chamomile tea, coconut water, cream-based pasta sauce, dandelion tea, fennel tea, golden syrup, herbal tea, hummus, ketchup, kombucha, molasses, oolong tea, pasta sauce with garlic and onion, sorghum syrup, tzatziki.
• High-GOS: pasta sauce with garlic and onion.
• High-Lactose: cream-based pasta sauce.
• High-Fructose: agave, apple juice, honey, jam, molasses, orange juice, rum, tzatziki.
• High-Sorbitol: apple juice, coconut water.
• High-Mannitol:

Low-FODMAP protein sources for vegans

• Certain soy products (tempeh, firm tofu) – FODMAPs are water soluble so most are pressed out of the tofu.
• Milk substitutes (protein-enriched rice milk, quinoa milk, hemp milk, macadamia nut milk, almond milk, or soy milk made with soy protein.)
• Nutritional yeast
• Nuts and seeds (except pistachios and cashews)
• Seitan (vital wheat gluten)
• Spirulina
• Whole grains (buckwheat, millet,quinoa, wild rice)

Low-FODMAP protein sources for Vegetarians

Includes all of the above plus:

• Eggs
• Hard cheeses (cheddar, parmesan, swiss)
• Lactose-free milk
• Lactose yogurt

The FODMAP-gentle diet

If a strict low FODMAP diet isn’t feasible, then the FODMAP-gentle diet may be substituted. It restricts only a few of the foods highest in FODMAPs.