Food is a common trigger of digestive symptoms. Interestingly, restricting certain foods can dramatically improve these symptoms in sensitive people.
In particular, a diet low in fermentable carbs known as FODMAPS is clinically recommended for the management of irritable bowel syndrome (IBS).
This article explains what a low-FODMAP diet is, how it works and who should try it.
What Are FODMAP's ?
FODMAP stands for :
Fermentable: Carbohydrates that are fermented in the gut by bacteria.
Oligosaccharides: Wheat, rye, legumes and various fruits and vegetables, such as garlic and onions.
Disaccharides: Milk, yogurt and soft cheese. Lactose is the main carb.
Monosaccharides: Various fruit including figs and mangoes, and sweeteners such as honey and agave nectar. Fructose is the main carb.
Polyols: Certain fruits and vegetables including blackberries and lychee, as well as some low-calorie sweeteners like those in sugar-free gum.
These are the scientific terms used to classify groups of carbs that are notorious for triggering digestive symptoms like bloating, gas and stomach pain.
FODMAPs are found in a wide range of foods in varying amounts. Some foods contain just one type, while others contain several. These are short-chain carbs that are resistant to digestion. Instead of being absorbed into your bloodstream, they reach the far end of your intestine where most of your gut bacteria reside.
Your gut bacteria then use these carbs for fuel, producing hydrogen gas and causing digestive symptoms in sensitive individuals.
FODMAPs also draw liquid into your intestine, which may cause diarrhea.
Although not everyone is sensitive to FODMAPs, this is very common among people with irritable bowel syndrome (IBS) (2Trusted Source).
Common FODMAPs include:
Fructose: A simple sugar found in many fruits and vegetables that also makes up the structure of table sugar and most added sugars.
Lactose: A carbohydrate found in dairy products like milk.
Fructans: Found in many foods, including grains like wheat, spelt, rye and barley.
Galactans: Found in large amounts in legumes.
Polyols: Sugar alcohols like xylitol, sorbitol, maltitol and mannitol. They are found in some fruits and vegetables and often used as sweeteners.
SUMMARY
FODMAP stands for "fermentable oligo-, di-, mono-saccharides and polyols." These are small carbs that many people cannot digest — particularly those with irritable bowel syndrome (IBS).
What Happens When You Eat Them?
The majority of FODMAPs pass through most of your intestine unchanged. They’re completely resistant to digestion and are categorized as a dietary fibre.
But some carbs function like FODMAPs only in some individuals. These include lactose and fructose.
General sensitivity to these carbs also differs between people. In fact, scientists believe that they contribute to digestive problems like IBS.
When FODMAPs reach your colon, they get fermented and used as fuel by gut bacteria.
The same happens when dietary fibres feed your friendly gut bacteria, which leads to various health benefits.
However, the friendly bacteria tend to produce methane, whereas the bacteria that feed on FODMAPs produce hydrogen, another type of gas, which may lead to gas, bloating, stomach cramps, pain and constipation. (3Trusted Source).
Many of these symptoms are caused by distention of the gut, which can also make your stomach look bigger (4Trusted Source).
FODMAPs are also osmotically active, which means that they can draw water into your intestine and contribute to diarrhea.
SUMMARY
In some individuals, FODMAPs are poorly digested, so they end up reaching the colon. They draw water into the intestine and get fermented by hydrogen-producing gut bacteria.
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Benefits of a Low-FODMAP Diet
The low-FODMAP diet has mostly been studied in patients with irritable bowel syndrome (IBS).
This is a common digestive disorder that includes symptoms like gas, bloating, stomach cramps, diarrhea and constipation.
About 14% of people in the US have IBS — most of them undiagnosed (5Trusted Source).
IBS has no well-defined cause, but it is well known that diet can have a significant effect. Stress can also be a major contributor (6Trusted Source, 7, 8).
According to some research, about 75% of people with IBS can benefit from a low-FODMAP diet (9Trusted Source, 10Trusted Source).
In many cases, they experience major reductions in symptoms and impressive improvements in quality of life (11Trusted Source).
A low-FODMAP diet may also be beneficial for other functional gastrointestinal disorders (FGID) — a term that encompasses various digestive problems (1).
In addition, some evidence suggests that it can be useful for people with inflammatory bowel diseases (IBD) like Crohn's disease and ulcerative colitis (12Trusted Source).
If you are intolerant, then the benefits of a low-FODMAP diet may include (9Trusted Source, 10Trusted Source):
Less gas
Less bloating
Less diarrhea
Less constipation
Less stomach pain
It may also cause positive psychological benefits, as these digestive disturbances are known to cause stress and are strongly linked to mental disorders like anxiety and depression (13Trusted Source).
SUMMARY
The low-FODMAP diet can improve symptoms and quality of life in many people with irritable bowel syndrome (IBS). It also reduces symptoms of various other digestive disorders.
Foods High in FODMAP's
Here is a list of some common foods and ingredients that are high in FODMAPs (1, 14Trusted Source):
Fruits: Apples, applesauce, apricots, blackberries, boysenberries, cherries, canned fruit, dates, figs, pears, peaches, watermelon
Sweeteners: Fructose, honey, high fructose corn syrup, xylitol, mannitol, maltitol, sorbitol
Dairy products: Milk (from cows, goats and sheep), ice cream, most yogurts, sour cream, soft and fresh cheeses (cottage, ricotta, etc) and whey protein supplements
Vegetables: Artichokes, asparagus, broccoli, beetroot, Brussels sprouts, cabbage, cauliflower, garlic, fennel, leeks, mushrooms, okra, onions, peas, shallots
Legumes: Beans, chickpeas, lentils, red kidney beans, baked beans, soybeans
Wheat: Bread, pasta, most breakfast cereals, tortillas, waffles, pancakes, crackers, biscuits
Other grains: Barley and rye
Beverages: Beer, fortified wines, soft drinks with high-fructose corn syrup, milk, soy milk, fruit juices.
Foods You Can Eat on a Low-FODMAP Diet
Keep in mind that the purpose of such a diet is not to completely eliminate FODMAPs — which is extremely difficult.
Simply minimizing these types of carbs is considered sufficient to reduce digestive symptoms.
There is a wide variety of healthy and nutritious foods that you can eat on a low-FODMAP diet, including (1, 14Trusted Source):
Meats, fish and eggs: These are well tolerated unless they have added high-FODMAP ingredients like wheat or high-fructose corn syrup
All fats and oils
Most herbs and spices
Nuts and seeds: Almonds, cashews, peanuts, macadamia nuts, pine nuts, sesame seeds (but not pistachios, which are high in FODMAPs)
Fruits: Bananas, blueberries, cantaloupe, grapefruit, grapes, kiwi, lemons, lime, mandarins, melons (except watermelon), oranges, passionfruit, raspberries, strawberries
Sweeteners: Maple syrup, molasses, stevia and most sugar alcohols
Dairy products: Lactose-free dairy products, hard cheeses and aged softer varieties like brie and camembert
Vegetables: Alfalfa, bell peppers, bok choy, carrots, celery, cucumbers, eggplant, ginger, green beans, kale, lettuce, chives, olives, parsnips, potatoes, radishes, spinach, spring onion (only green), squash, sweet potatoes, tomatoes, turnips, yams, water chestnuts, zucchini
Grains: Corn, oats, rice, quinoa, sorghum, tapioca
Beverages: Water, coffee, tea, kefir water, kombucha etc.
However, keep in mind that these lists are neither definitive nor exhaustive. Naturally, there are foods not listed here that are either high or low in FODMAPs.
In addition, everyone is different. You may tolerate some foods on the list of foods to avoid — while noticing digestive symptoms from foods low in FODMAPs for other reasons.
How to Do a Low-FODMAP Diet
Many commonly consumed foods are high in FODMAPs.
It’s generally recommended to completely eliminate all high-FODMAP foods for a few weeks.
This diet is unlikely to work if you only eliminate some high-FODMAP foods but not others.
If FODMAPs are the cause of your problems, then you may experience relief in as little as a few days.
After a few weeks, you can reintroduce some of these foods — one at a time. This allows you to determine which food causes your symptoms.
If you find that a certain type of food strongly upsets your digestion, you may want to permanently avoid it.
It can be difficult to get started and follow a low-FODMAP diet on your own. Therefore, it’s recommended to seek the advice of a doctor or dietitian who is trained in this area.
This may also help prevent unnecessary dietary restrictions, as certain tests can help determine whether you need to avoid the FODMAPs fructose and/or lactose.
SUMMARY
It’s recommended to eliminate all high-FODMAP foods for a few weeks, then reintroduce some of them one at a time. It’s best to do this with the help of a qualified health professional.
The Bottom Line
FODMAPs are short-chain carbs that move through your intestines undigested.
Many foods that contain FODMAPs are considered very healthy, and some FODMAPs function like healthy prebiotic fibers, supporting your friendly gut bacteria.
Therefore, people who can tolerate these types of carbs should not avoid them.
However, for people with a FODMAP intolerance, foods high in these carbs may cause unpleasant digestive issues and should be eliminated or restricted.
If you frequently experience digestive upset that lowers your quality of life, FODMAPs should be on your list of top suspects.
Though a low-FODMAP diet may not eliminate all digestive problems, chances are high that it may lead to significant improvements.
Reference: Healthline (healthline.com)
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