Contrary to its name, a low-FODMAP diet is not a lifestyle choice. Rather, it is a process of eliminating trigger foods, especially if you are suffering from IBS (Inflammatory Bowel Syndrome) or SIBO (Small Intestinal Bacterial Overgrowth). The low-FODMAP diet is an effective method for identifying and eliminating foods that may be irritating your digestive system and causing stomach aches. If you have persistent symptoms or have food sensitivities, then you should consider an organized process of eliminating certain foods.
WHAT EXACTLY IS FODMAP?
FODMAP is an acronym for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are a certain class of carbohydrates called fermentable short-chain carbohydrates, which are more difficult for people to digest. The low-FODMAP diet temporarily restricts these substances in order to isolate those foods that may be causing gastrointestinal disturbances in people. Getting rid of anything that causes inflammation in the digestive system allows the intestinal walls to heal and helps to reinstate normal gut flora. This is the basis of a low-FODMAP diet.
Let’s understand each one of the letters in "FODMAP" in a little more detail.
Fermentable means any food product that, when broken down by bacteria, produces gases through a process called fermentation.
Oligosaccharides are soluble plant fibers that feed the "good" bacteria in your gut. Examples of foods containing oligosaccharides include onions, garlic, many wheat products, etc. Sensitivity to these oligosaccharides can sometimes be the reason for non-celiac gluten sensitivity.
Disaccharides are carbohydrates with two simple sugar molecules linked together. Lactose is the most common example. Lactose is found in milk, and lactose intolerance is among the most common food sensitivities.
Monosaccharides are carbohydrates with one simple sugar molecule. Glucose is an example. Fructose, the sugar found in fruits, is another example.
Polyols are sugar alcohols; they are used in artificial sweeteners.
Why should fodmap sensitivity be looked out for?
These FODMAPs may be difficult to digest in the small intestine in some people for a variety of medical reasons. They are then moved to the large intestine, where bacteria feast on them, producing gases and a variety of other by-products that make the person feel bloated, gassy, distended, and ill. The extra water drawn by the small intestine may cause diarrhea in excess or constipation if there isn’t enough. This is why these sensitivities must be identified and the offending foods removed from such people's diets.
What is the process involved?
According to the Cleveland Clinic, there are three phases in a low-FODMAP diet: an elimination phase, a reintroduction phase, and a maintenance phase. During the exclusion phase, you will have to abstain from all foods that are high in FODMAPs—an inventory of specific fruits, vegetables, dairy products, and grains. Initially, the removal of these items from your diet may seem to limit your food choices significantly. However, there is still a decent selection of foods in each category that you can consume. It may take some restraint to remain consistent with the diet, though you won't starve while following it. After two to four weeks, you will start the reintroduction phase, wherein you bring back certain foods one by one. The third phase is intended to keep foods that make you feel good while eliminating those that do not.
Here is a list of high-FODMAP foods and some low-FODMAP alternatives you can try instead:
Fruits:
High FODMAP: Apples, cherries, mango, pears, watermelon, and plums
Low FODMAP: grapes, cantaloupe, kiwi, orange, pineapple, strawberries
Vegetables:
High FODMAP: artichoke, asparagus, cauliflower, garlic, onion, and mushrooms
Low FODMAP: brinjal, green beans, carrots, cucumber, potato, and tomato
Dairy and milk alternatives
High FODMAP: Milk, ice cream, soy milk, yogurt
Low FODMAP: almond milk, feta, brie, lactose-free milk
Breads and cereals
High FODMAP: wheat/rye/barley-based breads, breakfast cereals, biscuits, and snacks
Low FODMAP: oats, rice cakes, sourdough bread, corn flakes
Proteins
High FODMAP – legumes, some marinated meats/poultry/seafood
Low FODMAP: eggs, firm tofu, tempeh
The FODMAP diet is best tried under the supervision of a medical doctor. The low-FODMAP diet has a high predicted success rate for people with IBS, but up to 25% may not benefit. Research on the benefits of the low-FODMAP diet on other conditions is limited as of now. FODMAP-rich foods are obviously not bad for everyone. This diet is aimed only at those who cannot fully digest these substances and may not have had a chance to evaluate exactly what the implicating substance in these cases was.