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If you came across this page, chances are you actually were specifically looking for information on the FODMAP diet. In the last years, this elimination diet has gained a lot of attention in the IBS (Irritable Bowel Syndrome) community. This is because it can help 60-70% of people with IBS relieve their symptoms. Those are amazing numbers! Finally, a diet which can offer relief, when none of the others could!
There is tons of information to be found on the FODMAP diet. Unfortunately, it’s not always clear how reliable this information is, and who has written it. This is where I can help!
In my daily practice as a FODMAP (and gut health) specialized dietitian, I help a lot of people to find the cause of their gut symptoms, and often this involves the FODMAP diet. Now I’d like to share some of my knowledge with you and please don’t hesitate to contact me if you need help with your FODMAP diet.
What Are FODMAP’s?
Let’s start with the name of the diet. FODMAP is an abbreviation of the names of certain carbohydrates that are hard to digest. These carbohydrates go through your digestive system, without being digested. Once they reach the colon, the bacteria in your colon will start to digest them as their food. And this is where the trouble starts. Your bacteria will produce gas and acids as a result of digestion. These gasses can make you feel bloated or cause flatulence. The acid can attract liquids to your bowel to cause diarrhea, or they can numb the muscles in the wall of your colon so that they will not squeeze and push your ‘poop’ anymore. This will get stuck and can cause constipation.
Basically, all the symptoms that are experienced are typical IBS symptoms (click this link for my article on IBS). Since the intolerance to FODMAP’s is mostly experienced by people who have IBS. No one is able to digest FODMAPs, but people with IBS have more sensitive bowels, which will lead to the experience of symptoms.
Common symptoms are:
– Stomach aches/cramps
– Bloating (can start as soon as within 5 minutes after a meal)
– Constipation (Often not mentioned as a symptom, but definitely possible)
These symptoms can start straight after a meal up until 4 days after you’ve eaten FODMAPs (if your main symptom is constipation). Which makes it very difficult to pinpoint your trigger! (Well, it wouldn’t be fun anymore if it was easy for once right?!…..)
So, it’s clear the FODMAP’s can be a real pain in the ass (no pun intended).
What’s With The Name?
Now, I’ve already mentioned that FODMAP is an abbreviation. It’s time to fill you in on the full names:
|Fermentable||This means the gut bacteria digest them|
|Oligosaccharides||This is a group of long-chain carbohydrates|
|Disaccharides||This is a group of carbohydrates made out of 2 molecules|
|Monosaccharides||This is the single-molecule carbohydrates|
|Polyols||These are sweeteners and natural occurring sweeteners in fruit|
It is not really necessary to remember the full name, it does not tell you anything about actual products you can or can’t eat. But what is it then that you can’t eat?
The FODMAP Diet
To find your way around the FODMAP diet, it is best to seek help from a FODMAP-specialized dietitian. A dietitian can help you create a meal plan with proper nutritional value but without FODMAP’s. She can answer all your personal questions and helps to make the diet practical for you. Click here to schedule a free symptom assessment with the Positive Gut dietitian.
Getting enough fiber is the main difficulty with the FODMAP diet. Not getting enough fiber could worsen your symptoms, since fiber is the main source of nutrition to your friends, the gut bacteria (for my article on gut bacteria and weight gain, click here). Later in this article, we’ll talk about the dangers of following the FODMAP diet in the long term.
The 3 phases of the diet:
– The Elimination Diet. Which has a duration of about 2-6 weeks, in which you eliminate all the high FODMAP foods from your meals. After 2-6 weeks the evaluation takes place of your symptoms, has it gotten better? If not, the diet is not the solution for you. If it does get better, then you continue on to:
– The Introduction Phase. This phase lasts 8-10 weeks. Here you add certain products from all the FODMAP groups back into your diet very carefully and structured. You keep track of any symptoms you’re experiencing. In the end, this will give you a list of products you can and cannot eat. Once you’ve established that, you’re in the:
– The FODMAP Way Of Life. This is the last phase of the diet. You know the products you are sensitive to and are avoiding those. All other FODMAP’s are included in your diet. This last part is very important! Since it’s a bad thing to actually be on an elimination diet for an extended period of time (read on the find out more about that). Elimination diets are usually very restrictive, and it’s hard to meet your nutrient and fiber needs. Having a nutrient or fiber deficiency is not good for your health. So please don’t stay in the elimination phase!
During the FODMAP way of life, it is important to try and challenge yourself to your food sensitivities every 6 months. Your intestinal lining renews itself every 3 days, and your gut microbes and gut health change constantly. It could be, that the food sensitivity you have now, will not be present in 3 months. It would be a shame if you never re-tested again, and never found out you could eat the foods again!
So always stay alert and critical of your diet!
What is the Best Way to Follow the FODMAP Diet?
Multiple studies have been done, trying to identify the best way to follow the low FODMAP diet. These studies show the best results on the FODMAP diet when it’s guided by a FODMAP specialized dietitian.
It is important that the dietitian explains the FODMAP diet in-depth, provides the resources, and the information you can work with, and can answer any additional questions. Especially with the FODMAP diet, it is important to have it tailored to your needs. Because of the restrictive nature of the diet, it is very easy to eat too little fiber, Iron, B-vitamins, and Calcium. Vitamin and nutrient shortages are important to prevent for your health.
If you can, always follow the low FODMAP diet under the guidance of a specialized dietitian online (this could be me! Click here to set up a free symptom assessment) or find a dietitian near you.
What if I Can’t Afford a Dietitian?
I do realize that not everyone can afford to pay for a dietitian to help them. If money is tight, you might want to do the diet yourself with the information you can find on the internet. That is where a meal plan can come in handy!
If you live in the Netherlands, it might be good to know that the dietitian is covered by basic insurance. This means that a part of the dietetic treatment will be covered. Contact your insurance if you want more information about this.
If you’re following the low FODMAP diet. Make sure to gather your information from reliable sources. This blog (Positive Gut), The Monash University website, and app are very good resources of information, and blogs written by other dietitians are also a great source of information.
But if you have read everything you possibly can, how are you going to implement it? That’s where a meal plan can come in handy!
A meal plan can contain any number of example day menus for the FODMAP diet. It can contain recipes and have low FODMAP grocery lists. Everything to make following the FODMAP diet a little easier. This might be enough for you to get yourself started.
You can often buy FODMAP meal plans online for a few euros. Pay attention to the creator though. A dietitians meal plan is expected to be different than a foodie’s (although they can sometimes be very good!).
Of course, this meal plan won’t be tailored to your specific needs, and generally, you won’t have the opportunity to ask questions. But it will provide a good example of a healthy low FODMAP day.
Low- and High-FODMAP Foods
On the internet, there are plenty of lists of high and low FODMAP foods you can download. These lists are great for giving an overview of the products that you can and cannot eat. However, personally, I’m not a big fan of them, and with good reason.
- It’s not always clear who made the list, is it a reliable source?
- Usually, the lists are quite old, when was it updated last? Information on FODMAP content can change when a product is retested, and new products are tested frequently.
- Information on the specific type of FODMAP is often not provided in the list. It just mentiones that it contains FODMAPs. This increases the change of FODMAP stacking.
- It is not easy to actually find a specific product in a list written/printed on paper
Still, the lists are better than nothing. If you specifically want to use a list, I recommend using the website of Kate Scarlata, she is a dietitian from the Monash University. Kate blogs about the FODMAP diet and has information on her website that you can download for free.
The Best List Of FODMAP Products
My recommendation is to use the Monash Uni Low FODMAP Diet app which is available on Android and Apple. You have to pay a one-time fee to use the app forever. This app gets updated whenever the university has tested a new product, gives you information on portion control, and will show you which FODMAP is present in which products. This way you always have a reliable information source on FODMAP in your pocket. I am not a partner or affiliate of this app. I just really like it, and want to help you follow the FODMAP diet the best you can.
Portion Sizes and the FODMAP Diet
For proper implementation of the low FODMAP diet, it is important to pay close attention to portion sizes. You can eat some products if you use 65 grams, and not if you take more. For the diversity in your FODMAP diet, this is very important information that you can do a lot with.
Many downloadable FODMAP lists and the FODMAP app use a ‘traffic light’ system. Products are given a ‘green’, ‘orange’ or ‘red’ label.
If you look at the screenshot of the Monash University app, you can see the traffic light in action.
In the case of aubergine, a portion size of 75 grams is green for every FODMAP.
A portion of 182 grams is orange for sorbitol.
And a portion of 260 grams is red for Sorbitol.
One thing that stands out in the FODMAP app in this case of aubergine, is the big gap between the ‘green’, ‘orange’, and ‘red’ portions.
What’s the deal if you were to eat 100 grams? Where would that leave you in the FODMAPs?
To be honest, that part is not very clearly explained.
The green servings have a note below them that multiple green foods can be combined in 1 meal. But in this case, it’s important to keep in mind, that multiple ‘green’ foods with sorbitol all combined, can become an ‘orange’ or ‘red’ food because of FODMAP stacking
What I generally tell my clients, is to stick to the ‘green’ portion sizes, and to use a maximum of 2 ‘green’ portions of the same FODMAP group to avoid FODMAP stacking. That way you will always be sure you’re eating FODMAP safe portion sizes.
In this case, I will add a note, if you’re not using any other sorbitol-containing foods in the meal you’re making with aubergine, a portion of 90 grams instead of the ‘green’ 75 grams will be unlikely to cause any symptoms for you. But this has to be evaluated for each meal!
If you just want to be safe, stick to the ‘green’ portion sizes. If you’re unsure about the FODMAP diet and what to eat, find help from a specialized dietitian! Having the diet tailored to your needs and being able to ask all your questions to a reliable source will make it so much easier to do it right! Click here to schedule a free symptom assessment with the FODMAP dietitian.
Reading Labels and Picking Brands
Alright, now you have a proper list of foods you can and cannot eat. You go to the grocery store and see all sorts of products that consist of multiple ingredients. Not all ingredients are always clear to be high or low FODMAP.
To make this a little easier, here is a list of HIGH and LOW ingredients.
Of course, the list is never complete, but I hope it will help you figure out whether you can eat a product or not.
|High FODMAP||Low FODMAP|
High fructose corn syrup (HFCS)
Dried fruit (most varieties)
Whey protein isolate
Apart from figuring it all out yourself, there are some proper low-FODMAP brands that are available. One example is Fody Food. They have a whole range of products like salsa, spice mixes, and energy bars. So if you don’t want to have to dive into the ingredients list with a magnifying glass, try using a low FODMAP brand!
The FODMAP Diet in the long term
When the diet is followed correctly and with the guidance of a specialized dietitian, the FODMAP diet won’t pose a threat to your health. It certainly is a good diet to identify your food intolerances and help reduce IBS symptoms.
But many of the clients that come to me, have not been guided through the diet correctly or have been following the diet on their own (and did not manage to do it right after all). This has led them to stay in the low FODMAP phase for way longer than the intended 2-6 weeks and this can result in damage to the intestinal microbiome.
The Dangers of the FODMAP Diet
When done correctly, the FODMAP diet poses no danger to (gut) health. But a prolonged low FODMAP diet has shown to reduce bacterial diversity in the intestines.
Bacterial diversity is a marker for a healthy gut and the healthy bacteria in your gut also play a vital role in keeping you healthy. For example, with the production of Butyrate (click for my article about it).
The reason the FODMAP diet affects bacterial diversity is a lack of fiber (and a variety of fiber) in the diet. Fiber is the main source of energy for our healthy gut bacteria and fiber makes sure your healthy gut bacteria stay strong and thrive in your gut.
FODMAPs are carbohydrates that are hard to digest. In some cases, the FODMAP itself is a fiber. In other cases, the foods that contain FODMAPs also contain a lot of fiber. Studies on the FODMAP diet have shown that for this reason, the FODMAP diet can easily be lacking in dietary fiber.
When our gut bacteria aren’t getting fed (fiber), they will starve and diminish. Leaving us with a less healthy and less diverse gut.
In the case of FODMAP digesting bacteria, this can be even more worrisome. When the bacteria that digest FODMAPs are getting fed very little for a long time on the low FODMAP diet, they will also reduce. But with FODMAP digesting bacteria gone, it will be harder to get FODMAPs back into your diet during the introduction phase.
You might recognize it. Doing your FODMAP reintroductions and feeling like you react to everything? It’s probably worth it to try and strengthen your gut microbiome first and then continue on!
What to Do When I’ve Been Following Low FODMAP for Months??
You’ve been following the FODMAP diet for a long period and didn’t have success reintroducing FODMAP groups? Strengthen your microbiome first, then continue on with the reintroduction.
It has no use to try and reintroduce FODMAPs to a weakened gut. You will get symptoms.
Make sure to work in enough fiber in your diet and low amounts of FODMAP-containing foods. This way you’ll feed your healthy gut microbiome and are strengthening the FODMAP digesting bacteria.
After about 1-2 months of strengthening the gut, you can try and start reintroduction again. Building a healthy microbiome takes time! So don’t try to rush this.
This is the basic outline of the FODMAP diet, and what to take into account if you’re following the diet, planning on following the diet, or have been on the diet for a while. If you want to continue reading, click here to find all my FODMAP-related articles!
Have you done the FODMAP diet? Or are you doing it now? What are your best tips? Please let me know in a comment below!