A Foodie Makes Friends with low FODMAPs
This post is a brief intro to the low FODMAPs diet.
But first…
I have to admit that, as a chef and person who loves food, it took me a while to come around to the wisdom of this dietary approach.
Several years ago, I was sitting in front of a GI doc who was looking at the results of my colonoscopy and blood tests, and happily declared, “Good news--everything is normal!” Of course, like everyone who deals with IBS knows, nothing felt normal, or ok, or like good news. This was a point I tried to impart—but it was futile. He just looked at me blankly, indicating he didn’t have anything else to offer.
On my way out the door, he handed me a sheet of paper and said, with no conviction and certainly no helpful pointers, “You could try this…” It was entitled (perplexingly) “Low FODMAPS Diet” and it contained a list of foods in YES and NO columns. In the NO column were many of my favorite foods, and ones I knew to be healthy, wonderful, anti-inflammatory plants: garlic, onion, apples, peaches, cauliflower, sweet potatoes. So, obviously, I threw the stupid list in the trash.
Some time later, I began to take my health more fully into my own hands. I read every study I could find on IBS. Again and again, the low FODMAPs diet came up as an effective strategy for a large proportion of people (as much as 75% of people can experience an improvement in symptoms). So, I got to know it. And I realized that while it doesn’t make intuitive sense for a foodie, it makes perfect scientific sense.
Long story short: I tried it, and it helped. Then I cajoled my partner Aaron into trying it. He lived in the jungle in Chiappas, Mexico for 6 years and picked up more parasites than he can count, with the result that he lives with Post-Infectious IBS. The diet also helped him. Once I started working with clients, if their symptoms indicated it might be right for them, I guided them as they tried it—and much more often than not, it helped them.
So…now me and low FODMAPs are friends!
Three Important Things to Know about FODMAPS
There are many great low FODMAPs resources out there, so i don’t need to repeat all the details of it here. If you want to read more about it, check out the links below. In this post, I want to highlight three things I think are important.
1. If you regularly have symptoms of IBS (i.e. bloating, cramping, painful gas, diarrhea, constipation) and they negatively impact your daily life, this diet is worth a shot.
FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols, which are carbohydrates that the small intestine absorbs poorly. The poor absorption creates fluid in the intestines. The carbohydrates that are not absorbed well then go into the large intestine, where our friendly microbiome enjoy what we did not absorb. This creates gas as a bi-product.
More fluid + more gas in our guts causes many of the symptoms we know well: bloating, gas pains, diarrhea, etc. Take the carbohydrates away and people often feel relief, and often pretty quickly.
2. Low FODMAPS can be less restrictive than many other diets—if it’s followed correctly.
This diet is largely misunderstood. Many people are not following it as it was intended, and the result is that it’s much more restrictive than it should be. This can lead to other problems. Let me clarify.
Low FODMAPS has 3 phases:
1. Elimination: This is where you take away all high FODMAP foods. If you’re like me, this includes many of the foods you like. But —this phase is not intended to last long! Only about 2-4 weeks. If you are one of those who feel better, the happiness of symptom relief can far outweigh the temporary loss of these foods.
2. The “challenge” phase where you test foods to see which ones bother you, and in what amount. This lasts about 8-10 weeks. It takes commitment. But you get to be a scientist and learn a lot about your body and your triggers.
3. Based on what works for your body, you create your own modified low FODMAP diet. For most people, this modified low FODMAPS does not have to be that restrictive. You get to bring many foods back into your diet without restriction, and you learn which you have to be more careful about.
The biggest mistake people make is to stay in the elimination phase for a long time. That’s NOT the point!
The brilliant part about this diet is that it was created to help you figure out just the specific foods you need to reduce, or eliminate—and it wants you to eat all the rest of the foods.
Eliminating lots of good, healthy foods reduces the diversity of your microbiome, which ultimately makes your body less resilient. Not to mention that staying on a very restrictive makes it very hard to relax, share meals with others, and not micro-manage the detail of every meal. Remember: stress and anxiety are also a trigger for IBS!
3. Low FODMAPS overlaps with gluten free and dairy free diets—and it may give you more flexibility.
Some people who have IBS feel better on gluten free and/or dairy free diets. If that’s you, and you’re happy with both your food choices and how you feel, that’s wonderful! It’s worth noting, however, that it’s possible that those diets are working not because of the gluten, or the dairy, but because of you’re reducing your FODMAPs.
Wheat is high in fructans (one of the fermentable carbohydrates) and some dairy is high in lactose (another fermentable). Therefore, it’s possible that if you feel better on gluten-free and dairy-free it’s not because you are sensitive to gluten or dairy, but because you are reacting to the fructans and lactose. This means that you may not need to completely eliminate all wheat and all dairy to feel better.
For example, sourdough bread is low in fructans, and many people feel fine eating it. You might even be able to smear it with butter— because it’s low in lactose.
Bottom line: if you haven’t yet tried any of these elimination diets (gluten, dairy, low FODMAPs) but are thinking about trying one, strongly consider low FODMAPs. Even though it’s more restrictive for a short time, it can be a lot less restrictive in the long run. And it helps you learn about your body and your triggers, which is key for effectively managing IBS.
If you want to talk about whether you’re a person who might benefit from Low FODMAPs, reach out for a free consult.
Good Low FODMAPS Resources
Monash University (where the Low FODMAPS diet originated)
A Little Bit of Yummy (Lots of recipes and good blog posts)
Re-challenging and Reintroducing FODMAPS (a very thorough resource for stages 2 and 3)
