Have you ever experienced severe bloating or abdominal pain after eating? Do you notice certain foods give you stomach aches? With one in four Americans suffering regularly from uncomfortable digestive issues, irritable bowel syndrome (IBS) in particular affecting up to 45 million Americans, the impact of our diet and lifestyle has on our gut health and microbiome (that’s all the good and bad bacteria in your intestines) is getting more attention than ever.
Because many sensitive gut issues can be hard to diagnose, doctors now recommend a dietary meal plan known as the Low-FODMAP diet. One of the few medically-endorsed, scientifically-studied approaches, it’s anything but a fad diet. The idea is simple: By identifying dietary triggers, those that contain high FODMAPS, you can eliminate discomfort and other unpleasant symptoms, while restoring your gut to a healthier, more optimum state.
So, what exactly are FODMAPs and what foods are they hiding in? “The term FODMAPs is an acronym for Fermentable, Oligo-, Di-, and Mono-saccharides and Polyols,” explains Kristen Houts, RD, a Chicago-based dietitian and nutritionist. “As a group, FODMAPs are a collection of short-chain carbohydrates that may be poorly absorbed in the small intestine and are present in many commonly eaten foods like milk, honey, apples, mango, wheat, onions, garlic and beans, to name a few.” Many people cannot fully digest FODMAPs, causing bloating, gas, and for some people, diarrhea and constipation, she explains.
It’s important to note that generally FODMAPs, which are found naturally or as additives, cause no harm for most people. In fact, many of them function like prebiotics, promoting the growth of healthy bacteria in your gut. But, if you’re suffering from gut-related symptoms or sensitives to food, they have been shown to exacerbate issues. With the diet gaining popularity in recent years, research shows that 70 to 75 percent of those with IBS do find reducing the amount of FODMAPs in their diet helps provide relief for many of their symptoms.
The Low-FODMAP diet uses a three-phase approach to identify an individual’s trigger foods. “In the first phase, often referred to as the elimination phase, all high-FODMAP foods are removed from the diet in an attempt to ‘reset’ the digestive tract,” says Houts. “Next, FODMAP-containing foods are systematically reintroduced to identify which specific foods lead to digestive distress. Finally, the integration phase allows for personalized development of a well-balanced diet incorporating all foods an individual can tolerate and avoiding those that cause uncomfortable symptoms.”
However, this is not a magic bullet, nor is it one-size-fits-all. It’s about following guidance from an expert, yes, but also listening to what your body is telling you. And, while there are some general known trigger foods, it’s important to be mindful that everyone’s body reacts differently. Alongside working with a dietitian to make sure you are getting enough dietary nutrients, which Houts can’t emphasize enough, careful planning, preparation, and research is a good idea before starting. The Monash University is the leading source for FODMAPs research, providing fascinating information and case studies. Plus, they have a handy app, too.
And while there’s plenty of guidance out there about FODMAPs, here’s a quick overview of some of the foods that are high in FODMAPS and what you should try swapping them out with.
High-FODMAPs: Generally stone fruits are high in FODMAPs, along with watermelon, apples, apricots, cherries, figs, mangoes, nectarines, peaches, pears, plums, and watermelon. Sadly, avocado falls into the high category, too, but with reduced portion size, it can be re-introduced gradually. Low-FODMAPs: Bananas, blueberries, kiwi, limes, mandarins, oranges, papaya, pineapple, rhubarb, and strawberries.
High-FODMAPs: Asparagus, brussels sprouts, cauliflower, chicory leaves, globe and Jerusalem artichokes, leeks (though the green part is lower in FODMAPs), mushrooms, and snow peas. Low-FODMAPs: Bean sprouts, capsicum, carrot, choy sum, eggplant, kale, tomato, spinach, and zucchini.
Flavor and spices
High-FODMAPS: Onion and garlic are two very concentrated sources of FODMAPs. They can be tricky to avoid as they’re so widely used in flavoring and sauces, particularly in prepared or restaurant foods. Low-FODMAPS: Alternative flavorings are ginger, lemongrass, chives or turmeric, while the green part of spring onions is low in FODMAPs too.
High-FODMAPS: Pulses and legumes, such as lentils, chickpeas, beans and split peas, are all high FODMAPs and notorious for causing gas and bloating. A good trick if you really want to keep lentils or beans in your diet after the elimination phase is to try canned options, as some of the FODMAPs drain off into the water over time.
High-FODMAPS: Gluten gets a bad rap because wheat is the biggest contributors of FODMAPs in our Western diet. Low-FODMAPS: Good swaps to make here include brown rice, buckwheat, oats, polenta, quinoa, and maize.
High-FODMAP: When it comes to dairy, lactose is the main culprit. Start by eliminating cottage cheese, cream cheese, milk, quark, ricotta, and yogurt. Low-FODMAP: Cheddar cheese, cream, feta cheese, lactose-free milk, and parmesan cheese.
While this list may seem exhausting, Houts assures us that when done correctly, the Low-FODMAP diet is not limiting and provides all the components of a nutritious, well-balanced diet. “The ‘elimination phase,’ which can appear restrictive, is only intended to last two to six weeks and exists to create the right environment to identify personal food triggers,” she says. “After that period, most people can add some FODMAP-containing foods back into their diet, and the goal is always to eat as varied a diet as possible.”
Are there other solutions before trying a Low-FODMAPs diet? Yes, of course. “Before diving into FODMAPs with my clients, I always start by talking about creating habits to support healthy digestion and regularity, including consumption of high-fiber foods, drinking adequate amounts of water during the day, and engaging in light exercise, which is a great way to keep things moving,” Houts says. While it’s not suitable for everyone, the Low-FODMAP diet could be a positive move if you’re suffering from gut-related issues.