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Low FODMAP Diet
Carbohydrates are a necessary part of our diet as much as proteins and fats. However, some carbohydrates can be problematic for many people. Too many carbohydrates, especially the older we get, can contribute to weight gain. Some carbohydrates can be a problem for individuals not able to digest them. Any time someone tells me that they have gone gluten free but continue to have gas and/or bloating I recommend the FODMAP diet plan.
Short chain carbohydrates and poorly absorbed sugars are commonly associated with symptoms linked to functional gut disorders, including bloating, abdominal discomfort, pain and altered bowel function. The primary cause for this is low digestibility in the small intestine, which then causes fermentation as the undigested carbohydrates and/or sugars become food for resident bacteria in the large intestine.
Decreasing consumption of these carbohydrates and sugars has been shown to provide symptom relief when a low FODMAP diet is followed for a minimum of 1 week. Longer adherence may be necessary to determine dietary efficacy.
Many people suffer from intestinal irregularities and have symptoms including bloating, excess gas, constipation, diarrhea and abdominal distention. If these symptoms occur, make sure your doctor rules out Irritable Bowel Disease (IBD). IBD conditions include Crohn's Disease and Ulcerative Colitis and might also include symptoms of rectal bleeding or weight loss. These conditions are often associated with increased inflammatory markers and can lead to very serious complications.
Irritable Bowel Syndrome (IBS) should be considered once IBD is ruled out. IBS can worsen with stressful situations, so it is crucial that this be addressed with a holistic approach. Many people who suffer from IBS report improvement with a gluten free diet. However, some continue to show problems
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When gluten free or grain free diets fail to solve the issue, sensitivity to certain foods occurs. These foods include Fermentable foods; fructo-Oligosaccharides (FOS) found in wheat, rye, onions, and garlic; Disaccharides including lactose found in milk and milk products including soft cheeses and yogurts; Monosaccharides including fructose containing foods such as in honey, high fructose corn syrup, and many fruits (apples); and Polyols such as sorbitol, and mannitol found in some fruits and vegetables and also used as artificial sweeteners. This approach is known as the FODMAP approach.
FODMAP Categories
- Fermentable: The process by which intestinal bacteria breaks down undigested carbohydrates to produce gas and leading to bloating
- Oligosaccharides: Fructo-Oligosaccharides (FOS) found in wheat, rye, onions, and garlic AND Galacto-Oligosaccharides (GOS) found in beans/legumes
- Disaccharides: lactose found in milk and milk products including soft cheeses and yogurts
- Monosaccharides: fructose found in honey, high fructose corn syrup, and many fruits (apples) AND
- Polyols: Sorbitol and Mannitol found in some fruits and vegetables and used as artificial sweeteners
List of foods that are safe and those to avoid
Fruits
- Safe
- Bananas, kiwi, lemons, lime, grapes, strawberries, blueberries, cantaloupe, cranberries, tomatoes, grapefruit, raspberries, clementine, mandarin and navel oranges, durian, honeydew melon, pineapple, star fruit, papaya, tangerines, passion fruit, taro
- Avoid
- Watermelon, peaches, pears, plums, prunes, mangos, apples, figs, cherries, lychee, persimmons, boysenberries, apricots, nectarines, avocado, blackberry, currants, dried cranberries, canned and dried fruits
Vegetables
- Safe
- Common cabbage, Brussels sprouts, green beans, celery, eggplant, mustard greens, Swiss chard, spinach, bokchoy, nappa cabbage, Choy sum, broccoli, bell peppers, carrot, celery root (celeriac), zucchini, squash (except butternut), fennel, kale, lettuce, radicchio, arugula, okra, cucumber, green onion (green part only), turnip, seaweed, radish, potatoes, parsnip, rutabaga, pumpkin, yams, olives, Asparagus, garlic, onion, shallot, leeks, globe artichoke, Jerusalem artichoke, sugar snap peas, snow peas, beets, Savoy cabbage, corn, cauliflower, mushrooms, orange sweet potato, prepared pasta sauces
- Avoid
- Asparagus, garlic, onion, shallot, leeks, globe artichoke, Jerusalem artichoke, sugar snap peas, snow peas, beets, Savoy cabbage, corn, cauliflower, mushrooms, orange sweet potato, prepared pasta sauces
Protein, Nuts and Seeds
- Safe
- Fresh meat and seafood, eggs, all other nuts, butters, and seeds (e.g. peanut, macadamia, almond, pumpkin, sunflower, walnuts, flax, sesame, pine, chia), tempeh, tofu (plain)
- Avoid
- Breaded meat or fish, beans (e.g. kidney, baked, black, adzuki, northern pinto, cannellini, lentils, chickpea, lima) edamame, hummus, pistachios, cashews
Breads and Cereals
- Safe
- Wheat free/gluten free grains, flours, breads, cereals and pastas (amaranth, millet, quinoa, teff, sorghum, rice, buckwheat, corn), corn tortilla, grits, polenta, popcorn, plain rice cakes, gluten free oatmeal, oat or rice bran, tapioca
- Avoid
- Wheat products (spelt, kamut, durum, bulgur, semolina, couscous), barley, rye, sweetened or fiber added commercial cereals, muesli
Dairy and Dairy Alternatives
- Safe
- Hard and ripened cheeses: cheddar, brie, Colby, cottage, feta, Havarti, mozzarella, gouda, parmesan and Swiss, butter, calcium fortified lactose free milk and kefir, dairy free milk and yogurt (almond, coconut, hemp, rice, oat)
- Avoid
- Cow's milk, buttermilk, regular yogurt, ice cream, sour cream, evaporated milk, condensed milk, custard
Sweeteners and Sugars
- Safe
- Natural: maple syrup, brown rice syrup, brown sugar, molasses, maple syrup, raw sugar, cocoa
- Refined: sucrose (cane or table), dextrose (glucose), stevia
- Avoid
- Natural: honey, cane syrup, pureed fruit or juice concentrates; Refined: karo syrup, agave nectar, high fructose corn syrup, corn syrup solids
- Artificial: sugar alcohols (e.g. mannitol, sorbitol, xylitol, isomalt) sucralose (Splenda), sorbitol, toothpaste, gum, candies, cough medicines made with above ingredients
Beverages
- Safe
- Tap water, mineral water, sparkling water, tea, coffee, fruit juice (safe fruit only, max ½ cup serving), sweetened drinks (safe sweeteners only), unsweetened cranberry juice
- Avoid
- Soft soft drinks and fruit juices, beer, powdered mixes and coffee made from chicory
Condiments and Spices
- Safe
- Onion/garlic free mustard, BBQ sauce, fish sauce, oyster sauce, soy sauce, tamari, vinegar, full fat mayonnaise, Worcestershire sauce, marmalade and jam (safe fruit and sweeteners only), all fresh and dried herbs other than garlic and onion, asafetida powder, garlic infused oil
- Avoid
- Pickles, chutneys, tzatziki, onion or garlic containing gravies, stock, dressings, sauces, salts or powders
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