Prescribed the Low FODMAP Diet? Now What?
You were diagnosed with irritable bowel syndrome (IBS) or Fructose Malabsorption and your doctor recommended that you go on the low FODMAP diet. Maybe you received from your doctor the one page handout from Stanford University Medical Center, or maybe you were lucky and they gave you various materials, plus the name of a really good dietician who specializes in the low FODMAP diet. Either way, you are probably feeling partly relieved because there is a name and diagnosis to what you have been feeling, but also concerned and confused asking yourself, “What am I going to eat?” and “How this is all going to work?”. At least, this is how I felt when I was first diagnosed with Fructose Malabsorption and it has been a long and windy road ever since. But, it is also a road that has led me to feeling better. Through these years, I have learned that although there is a need for more research to better understand digestive disorders and the low FODMAP diet, there has also been progress and help is available and accessible. Below I gathered some information and resources to help as you embark on or continue to manage the low FODMAP diet.
First, what are FODMAPs?
FODMAP stands for Fermentable Oligosaccharides, Disaccharides, and Monosaccharides and Polyols and are found in various foods that are high in fructose, lactose, fructans (polymers of fructose), galacto-oligosaccharides, and polyols (sugar alcohols). A few examples of each category are below. For a more comprehensive list, Kate Scarlata, registered dietician, low FODMAP diet expert, and author created a handy low and high FODMAP food list.
Examples of foods with high levels
|Honey and apples|
Onions, garlic, and wheat
Sorbitol and stone fruit
FODMAPs are not digested by the small intestine and they move along to the large intestine where they are fermented by bacteria resulting in the production of gas. In addition, FODMAPs are osmotic, so they recruit water into the large intestine, which can change bowel movements. In General symptoms experienced by people who do not absorb FODMAPs well are abdominal pain, bloating, diarrhea, constipation, and nausea. Additional symptoms may include joint pain, headaches, brain fog, and fatigue. Research has shown that the low FODMAP diet can reduce or eliminate symptoms for Fructose Malabsorption and IBS.
Second, how do I navigate the low FODMAP diet?
The best way to start is to find and work with a good dietician who understands the low FOMDAP diet and then be patient. At first, you will need to refrain from eating high FODMAP foods for two to six weeks. Then, with the help of your dietician and based on your symptoms or lack thereof, step-by-step and food-by-food, you will try out different foods to test your tolerance. Over time, you will expand your diet and learn what foods you can eat and what foods you should stay away from. This was a hard step for me and it took me a while to begin trying new foods. Once I started feeling better, I was worried about becoming sick again. However, although this can be a nerve-racking process, it is important to incorporate some FODMAPs back into your diet. Some FODMAPs are prebiotics, which aids in creating a healthy and happy gut, and many foods that are high in FODMAPs are nutritious and important for a healthy well-balanced diet (for example, many fruits and vegetables). The goal is to learn what and how much of these we can tolerate.
As I mentioned, one does need to be patient. This can be a slow process and even when you figure out what you can eat, you will still have bad days or weeks. When that happens, you have some options including returning to a more restrictive diet for a couple of days, eating and drinking foods that sooth and cleanse your digestion, and/or making an appointment with your dietician. Over time you will become better at knowing what you can eat and knowing that when you make a bad food choice on purpose or by accident that your symptoms will not last forever. Additionally, you may find that if you generally eat well, your digestive system can handle a taboo food every once in a while.
Third, what and where should I eat?
This question might be the one you spend the most time on. Trying to find a recipe without onions and garlic is a tough one and finding foods you can eat when you go out is even harder. Luckily, there are some wonderful sites filled with recipes and tips to help you out, which I list below.
Fourth, how can I learn more?
Knowledge is power and being an advocate for your health is not only important, but necessary in today’s world. Knowing where to go to learn more about IBS, Fructose Malabsorption, or the low FODMAP diet can help you when you have questions and also give you support so you are not alone. There are helpful apps and online coaches who can guide you through this process. I have listed several below.
Tips & Tools:
- Recommended nutritionists in the United States & Canada by Kate Scarlata
- Cooking without onions by Contented Belly
- A breakdown of FODMAP friendly spices and herbs by FODMAP Life
- The Monash University low FODMAP diet app (For the iPhone and Android)
- FODMAP Friendly app
- FOODMaestro app (For the iPhone and Android)
- Gut Feeling FODMAP swAPP
- A Little Bit Yummy – recipes and information
- Calm Belly Kitchen – recipes, information, and online coaching
- FODMAP Friendly Program – Information
- FODMAP Journey – recipes and information
- FODMAP Life – recipes, information, and online coaching
- FODMAP Travels – Information and London based dietetic service
- Fructopia – recipes
- The Fructose Friendly Chef – recipes
- Gut Feelings – Online program
- Kate Scarlata – Registered Dietician, low FODMAP diet expert, and author
- FODMAPs King’s College London – Information
- Lisa Rothstein – IBS and low FODMAP recipe developer
- Low FODMAP Diet – recipes and information
- Monash University or what I call the mother ship of all things FODMAP
- Nicer Foods – Low FODMAP foods and information
- Patsy Catsos – Medical Nutritionist, low FODMAP expert, and author
- Strands of My Life – recipes, information, and online coaching
The low FODMAP diet has made a huge difference in my life. After being sick for years before being diagnosed, it is amazing to feel better and have a sense of control over my health. I still have my bad days but I now have the information and tools for how to take care of myself.
Do you have any tips, resources, and advice that have helped you on the low FODMAP diet?
Photo by Adrianna Calvo on Unsplash