The FODMAP Diet
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The FODMAP Diet

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  • IBS, or Irritable Bowel Syndrome, is a functional disorder of the large intestines, or colon. It is very common in American adults—about 20% are affected. While there is no visible damage to the intestines, the symptoms are very real. People with IBS experience cramping, bloating, flatulence (gas), constipation, diarrhea, and overall abdominal pain. Unfortunately, there is no “cure” for IBS because the pathology is not well understood. Patients must learn to manage the disease by making adjustments to their lifestyle, but most importantly, to their diet.
  • The small intestine is unable to absorbs certain foods. Therefore, they pass into the large intestine, where they are fermented by bacteria. This is the primary cause of gas and bloating. Diarrhea is caused by the osmotic effect of FODMAPs, which pulls water into the digestive tract and can cause irregular bowel movements.
  • FODMAPSs are a collection of sugars that are regularly consumed in the diet by a majority of people. Though poorly digested and absorbed by everyone, people with IBS are more sensitive to their affects, which results in the uncomfortable symptoms noted previously. The FODMAP diet was developed by researchers at Monash University to guide IBS sufferers in managing and reducing their symptoms.
  • FODMAPs stands for Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. Fermentation is the process in which a substance is chemically broken down by bacteria—in this case, bacteria in the gut. Oligo-, di-, and monosaccharides, as well as polyols, are short-chain carbohydrates (less than 10 carbon atoms) that are not absorbed in the small intestine.
  • Oligosaccharides include fructans and galactans. Neither can be absorbed by anyone. Fructans are found in a variety of vegetables and herbs, including asparagus, onion, and garlic. They are also found in wheat and rye, so most breads, cereals, crackers, etc. are high in fructans. People following a low FODMAP diet should also be on the lookout for inulin, a fructans that is sometimes disguised as chicory root extract. Galactans refer to beans, lentils, legumes and soy. During my research, I came across some conflicting opinions regarding soy. Most claim that soy is high in FODMAPs, but several also allow the consumption of tofu, which is made of fermented soybeans. Furthermore, every source I came across discouraged the consumption of legumes, but claimed that eating peanut butter fine.
  • Disaccharides are found in all dairy products that contain lactose. People with lactose intolerance often experience discomfort when they consume dairy because they lack lactase, the enzyme responsible for breaking down lactose. Therefore, the sugar is only partly absorbed by the GI tract. Commonly eaten foods that can be placed in this FODMAP category include milk, ice cream, and unripened/soft cheeses, such as cottage cheese and ricotta. Because they have been aged, hard cheeses (i.e. cheddar, Swiss) contain much less lactose and can be eaten safely.
  • Monosaccharides are present in foods with excess fructose, including many fruits and natural sweeteners. Apples, stone fruits, mango, and watermelon are a few of the fruits that should be avoided. Honey and agave nectar, a staple of many health-conscious people, are also very high in fructose. Any product containing high fructose corn syrup (HFCS) is likely to cause digestive distress as well.
  • Polyols, or sugar alcohols, are added to many low-sugar and sugar-free products, such as gum, mints, and candies. Those most commonly used are sorbitol, mannitol, isomalt, and xylitol. Because the body cannot be absorb them the same way as regular sugar (sucrose), polyols are one of the primary causes of diarrhea. However, they are also found naturally in foods such as apples, stone fruits, and avocado.
  • Although there are slight disparities between sources, most recommend avoiding and/or limiting the same high FODMAP foods. Several that are inconsistent include corn, green beans, cashews, and tofu. When in doubt, it is best to remove foods you are unsure of. They can always be added back to the diet later.  
  • The list of foods one can eat on a low FODMAP diet is actually quite large. Most fruits and vegetables can still be eaten and many popular products are made wheat and dairy-free. It is important to remember that this eating pattern is temporary, so as not to get discouraged. The range of choices is wide, however, and there is no real need to feel deprived while following this diet.
  • The FODMAP diet is not forever. It is simply an tool (an intervention, if you will) manage IBS and other digestive problems. You don’t necessarily have to cut out every high FODMAPs. There is a threshold that is different for everyone. Most dieticians recommend cutting out all FODMAPS for about six weeks and then slowly adding them back in, one at a time, in order to determine what can and cannot be tolerated. Seeking professional guidance is highly recommended. Many people with digestive distress immediately think they have a gluten or lactose intolerance and eliminate all wheat and dairy products, which is more or less what I did. Once I did some in-depth research, I learned that many of the foods in my seemingly healthy diet were the cause of my discomfort. The term “healthy” is relative. Different things work for different people and by following the FODMAP diet, one can learn how to eat correctly for their individual needs.

The FODMAP Diet The FODMAP Diet Presentation Transcript

  • Treating IBS with the FODMAP Diet { By Emily Glynn
  • What is IBS? • Irritable Bowel Syndrome • Functional disorder of the large intestines (colon) • No visible damage to the gastrointestinal tract Symptoms include cramping, bloating, flatulence (gas), constipation, diarrhea, and general abdominal pain
  • What Causes Some of the Symptoms of IBS? Certain foods are not absorbed in the small intestine Pass into the large intestine or colon Certain foods have an osmotic effect Cause excess water to be pulled into the digestive system Fermented by bacteria Leads to irregular motility of the bowels (usually diarrhea) Leads to gas and bloating
  • What are FODMAPs?  Collection of sugars regularly consumed in the diet  Poorly digested and absorbed by everyone, but affect people with IBS more severely  The FODMAP diet was developed at Monash University in Melbourne to help IBS sufferers manage and reduce their symptoms  Focuses on limiting consumption of high FODMAP foods
  • What does FODMAP stand for?
  • Oligosaccharides  Fructans     Asparagus, onion, and garlic Wheat and rye Inulin (chicory root extract) Galactans  Beans, lentils, legumes, and soy
  • Disaccharides    Found in all dairy products that contain lactose Include milk, ice cream, and soft cheeses The more lactose, the harder the food is to digest
  • Monosaccharides     Present in foods with excess fructose Found in many fruits, including apples, stone fruits, and watermelon Natural sweeteners, such as honey and agave High fructose corn syrup
  • Polyols     Also known as sugar alcohols Most commonly used are sorbitol, mannitol, isomalt, and xylitol Found in sugar-free gums, mints, and candies Also occur naturally in apples and stone fruits (peaches, plums, avocado, etc.)
  • Foods to Avoid on the FODMAP Diet Food Group Foods to Avoid Protein Sources Meats made with high FODMAP sauces, beans, legumes, lentils, hummus, soy and coconut products Dairy Milk, ice cream, whipped cream, sour cream, yogurt, soft cheese (ricotta, cottage) Grains Wheat products, grains with HFCS or inulin/chicory root extract Fruits Avocado, apples, dried/canned fruit, mango, stone fruit, watermelon, coconut Vegetables Artichokes, asparagus, beets, onions, broccoli, brussel sprouts, cabbage, cauliflower, fennel, green beans, mushroom, snow peas, okra summer squash Seasonings & Condiments HFCS, honey, agave, jam/jelly, onions, garlic, pickles, relish, artificial sweeteners
  • Foods to Enjoy on the FODMAP Diet Food Groups Foods to Enjoy Protein Sources Red meat, poultry, fish, eggs, cold cuts Dairy Lactose-free dairy products, hard cheeses (cheddar, Swiss, mozzarella), butter Grains Wheat & gluten free grains Fruits Bananas, berries, cantaloupe, honeydew grapes, citrus, pineapple, kiwi Vegetables Bell peppers, bok choy, cucumber, carrots, celery, eggplant, lettuce, greens, potatoes, yams, zucchini, tomatoes Seasonings & Condiments Most spices and herbs, chives, flaxseed, garlic and onion powder, olives, mayonnaise, olive oil, salt, pepper, mustard, vinegar, maple syrup, sugar
  • Following the FODMAP Diet  Seek help from a nutrition professional    Everyone is has a different threshold for certain FODMAPs General recommendation is to cut out FODMAPs for six weeks, then slowly reintroduce them one at a time Remember that this diet is not forever.
  • Sources Horn, Jason. (2007, Apr. 10). Why can lactose-intolerant people eat some cheeses and not others? Retrieved from http://www.chow.com/food-news/53922/why-can-lactose-intolerant-people-eat-somecheeses-and-not-others/ Iannelli, L & Halmos, E. (2012). Information About Low FODMAP Diet to Improve Irritable Bowel Syndrome (IBS) Symptom Control. Retrieved from http://media.wix.com/ugd/83219a_0740c68fddd4f0d43e0a916792cd60c6.pdf (2011, Jun. 29). Irritable bowel syndrome. Retrieved from http://www.mayoclinic.com/health/irritable-bowel-syndrome/DS00106 Scarlata, K. (2010, Aug.). The FODMAPs Approach: Minimize Consumption of Fermentable Carbs to Manage Functional Gut Disorder Symptoms. Today’s Dietitian, 12. Retrieved from http://www.todaysdietitian.com/newarchives/072710p30.shtml Strealy, N. (2012, Jun. 19). Tip #6 avoid polyols. Retrieved from http://www.diarrheadietitian.com/?p=149 (2012, Aug.). The Low FODMAP Diet (FODMAP=fermentable oligo-di-monosaccharides and polyols. Retrieved from http://stanfordhospital.org/digestivehealth/nutrition/DH-Low-FODMAP-DietHandout.pdf