Have you been diagnosed with irritable bowel syndrome? Not sure what to eat? In the past, your doctor might have automatically recommended a high fiber diet. A high fiber diet is certainly worth a try considering fiber’s many well-known health benefits; increasing fiber intake with high fiber foods and fiber supplements can resolve some cases of IBS. However, if a high fiber diet made your symptoms worse, instead of better, it’s time to learn about FODMAPs, a promising new nutrition approach for IBS.
If you’ve never heard the term FODMAP before you are not alone! The term FODMAPs was coined by Australian researchers Susan J. Shepherd and Peter R. Gibson; they found that a low FODMAP diet helped up to 75% of their IBS patients. A low FODMAP diet avoids foods containing certain sugars and fibers capable of causing diarrhea, constipation, gas, bloating and abdominal pain in people with IBS. Examples of FODMAPs include:
- Lactose (also known as milk sugar, found in milk, yogurt and ice cream)
- Fructose (also known as fruit sugar, found in fruit, high-fructose corn syrup, honey and agave syrup)
- Sorbitol, mannitol, and other “-ol” sweeteners (found in certain fruits and vegetables as well as some types of sugar-free gums and candies)
- Fructans (a type of fiber found in wheat, onions, garlic and chicory root)
- GOS (a type of fiber found in beans, hummus and soy milk)
These five types of FODMAPs have several things in common: They can be poorly absorbed during the digestive process. They are rapidly fermented by the bacteria that live in your gut. They can alter the fluid balance in your gut. Together, these effects can lead to bouts of IBS symptoms within hours of eating a high FODMAP meal or snack. By reducing the overall dietary load of these carbohydrates, you can often reduce your troublesome GI symptoms.
Ironically, many high-FODMAP foods are otherwise healthy choices, and are often recommended by health care providers. For those who can tolerate them, high FODMAP fruits, vegetables, milk products, legumes and whole grains may be wonderful foods! But people with IBS often have to limit their portions of these foods or suffer the consequences.
Click here for a downloadable PDF of this chart. This is not an complete list of high or low FODMAP foods, but hits many of the highlights in the diets of people with IBS.
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Common high FODMAP foods or ingredients
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Low FODMAP alternatives
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Soy milk; cow’s or goat’s milk, yogurt, ice cream
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Lactose-free cow’s milk, yogurt, ice cream; rice, coconut or almond milk
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Beverages, syrups or condiments sweetened with high-fructose corn syrup, honey, agave
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Beverages, syrups or condiments sweetened with granulated sugar, evaporated cane juice, brown sugar, 100% pure maple syrup
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Dried fruit, fruit juice, trail mix, fruit bars
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Fresh or frozen fruit
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Apples, pears, stone fruits (cherries, peaches, plums/prunes, apricots, avocados, mango), watermelon, blackberries
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Small portions (1/2 cup) of strawberries, blueberries, cranberries, grapes, pineapple, cantaloupe, honeydew melon, kiwi, ripe bananas, oranges, lemons, limes, grapefruit
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Garlic, onions, broccoli, cauliflower, cabbage, mushrooms, sweet corn
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Garlic-infused oil, chives, spinach, lettuce, fresh tomatoes, cucumber, carrots, zucchini, bell peppers, white potatoes, small portions (1/2 cup) of green beans, peas, sweet potato
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Wheat, barley or rye; breads, cereals, pastas or baked goods made of wheat, barley or rye; high-fiber bars or cereals
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Oats, rice, cornmeal or quinoa; breads, cereals, pastas or baked goods made of oats, rice, cornmeal or quinoa
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Sugar-free candy sweetened with sorbitol, mannitol, maltitol
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Small portions (1-2 ounces) of sugar-sweetened candy
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Beans, baked or refried beans, hummus
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Firm tofu
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Pistachios, cashews
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Small portions (1 handful) of other nuts, nut butters or seeds
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© 2012 Patsy Catsos, www.ibsfree.net
A FODMAP elimination diet may be recommended by your doctor or dietitian. An elimination diet is a “learning diet” with a strategy and a plan; close monitoring of your symptoms will help you learn how the food you eat affects you. At the beginning, you may limit all of the FODMAPs in your diet. Soon, it will be time to reintroduce FODMAPs one type at a time. You may find that only one or two FODMAPs are responsible for most of your symptoms. In the end, most people find they can still have their favorite high-FODMAP foods in moderation. For example, if you discover high-FODMAP grains are a problem area but pizza is your favorite food, your new knowledge can help you to decide how to handle it: choose pizza with a thinner crust; have fewer pieces; use a wheat-free crust; eat less other FODMAPs at that meal, eat it less often, or go for the gusto and endure the resulting belly-ache. The ultimate goal is for each person to eat the most varied diet that he or she can tolerate, not to restrict the diet with a one-size-fits-all rules.
There are a few things you can do to get your low-FODMAP diet off to a good start:
- Consult your doctor to rule out other causes of your symptoms; celiac disease in particular should be ruled out before trying this wheat-free diet, since going wheat-free will interfere with the accuracy of future celiac testing.
- Choose a trial period when you have a little extra time for label reading and home food preparation.
- Eat mostly whole foods, simply prepared, during the low-FODMAP trial. No labels, no label reading—easy!
- If eating out, choose simply prepared foods with easily recognizable ingredients, such as grilled steak or fish, a baked potato and a green salad (hold the onions) with olive oil and balsamic vinegar.
- Get some guidance from a registered dietitian, especially if you have other health conditions that affect your diet. Word is now getting out in the health care community about FODMAPs, but some doctors and dietitians may not yet be “in the know”. Mention your interest in FODMAPs as you schedule your appointment, so that your dietitian can be well-prepared for your visit.
Don’t just learn to live with your IBS symptoms. Instead, learn about FODMAPs! Try an elimination diet, and find out if a low FODMAP diet is right for you!
