Do you often experience digestive stress after eating certain foods?

Can the discomfort be so severe that it affects your day-to-day activities?

The link between foods and digestive disorders is well recognised, and there is a good chance that FODMAPs – small carbohydrates in certain foods – may be the culprit.

As a food intolerance dietitian, I’ve seen how remarkable a low-FODMAP diet can be for people with chronic gastrointestinal symptoms… 

Things like recurrent bloating, gas, cramps, diarrhea or constipation. 

There's also many new case studies suggesting it can help manage symptoms of other health issues too.

If you’re keen to learn more, and maybe even try a low FODMAP diet for yourself, this 2,000 word beginner’s guide is a great place to start.

A low FODMAP diet is also known as a FODMAP elimination diet.

This is a temporary eating pattern that has a very low amount of food compounds called FODMAPs.

The acronym stands for:

● Fermentable - meaning they are broken down (fermented) by bacteria in the large bowel

● Oligosaccharides - “oligo” means “few” and “saccharide” means sugar. These molecules are made up of individual sugars joined together in a chain

● Disaccharides – “di” means two. This is a double sugar molecule

● Monosaccharides – “mono” means single. This is a single sugar molecule

● And Polyols – these are sugar alcohols (however, they don’t lead to intoxication!)

As you can see, there are four main saccharide groups that make up FODMAPs – oligosaccharides, disaccharides, monosaccharides and polyols.

These FODMAP groups have specific names and may also have more than one group within them, known as a FODMAP subgroup:

● Oligosaccharides have two subgroups, known as fructans and galactans (or galacto-oligosaccharides or GOS for short)

● Disaccharides are known as lactose and only contain one group

● Monosaccharides are known as fructose (or excess fructose) and also only contain one group

● Polyols have two subgroups, known as sorbitol and mannitol

Let’s stick with the term FODMAPs shall we?

Those saccharides and polyols are short-chain carbohydrates that, if poorly digested, ferment in the lower part of your large intestine (bowel).

This fermentation process draws in water and produces carbon dioxide, hydrogen, and/or methane gas that causes the intestine to stretch and expand.

The result is strong pain, bloating, visible abdominal distension and other related symptoms (1).

1. Food is eaten that contains FODMAPs.

2. Some FODMAPs may pull water into the small intestine, causing diarrhea

3. In those with IBS, FODMAPs can travel to the large intestine (gut) largely undigested.

4. When “unhealthy” bacteria interact with FODMAPs in the gut, it causes a range of symptoms such as bloating, gas and pain.

5. Different people are sensitive to different FODMAPs, so it’s important to identify which ones are the culprit.

This is a wonderful short video by Australian researchers that illustrates what FODMAPs are and how they impact our digestion:

Also note that like with anything food related, portion size is fundamental. A serving of 10 almonds are considered low FODMAP, but if you eat 20 almonds then you will end up eating a high amount of FODMAPs.

As with anything we eat, the dose makes the poison.

Common FODMAPs in your food include:

● Fructose: A sugar found in most fruits and vegetables.

● Lactose: A sugar found in dairy foods like milk.

● Fructans: A chain of sugars found in many vegetables and grains.

● Galactans: Found primarily in legumes.

● Polyols: Sugar alcohols like sorbitol and mannitol. You find them mainly in artificial sweeteners and chewing gum but they are also naturally occurring in various fruits and vegetables.

The Monash University low FODMAP diet phone app is a great place to start when reading food labels.

You can check the app for foods that have been tested as high FODMAP.

It’s also useful to know other common high FODMAP ingredients such as inulin (chicory root), natural flavors, high fructose corn syrup, agave, honey, etc so you can avoid them also.

Before we go any further, it’s important to clarify that following a low FODMAP diet is very restrictive and cuts out numerous common foods and food groups.

That means you need to reintroduce foods at some stage, so it cannot be a permanent solution.

The idea is that restricting all FODMAPs at once should have a far greater and more consistent effect than simply restricting one FODMAP in isolation. By reducing all high FODMAP foods, your intake of FODMAPs will reduce to a level where you no longer get symptoms.

How it works:
There are three phases of the low FODMAP diet.

● Phase 1 – Elimination/Strict low FODMAP Diet: For 3-8 weeks (depends on how you respond) you strictly exclude all high FODMAP foods from your diet.

● Phase 2 – Reintroduction/Rechallenge: You will reintroduce each FODMAP group one at a time to see what triggers symptoms. For example, you may first reintroduce fructose for three days. If you have no symptoms, you may then reintroduce lactose too, and so on.

● Phase 3 – Modified/Adapted FODMAP Diet: Once the trigger FODMAPs have been identified, you will know what you can and cannot eat. You can then use this information to formulate your own personalised diet that keeps your symptoms to a minimum.

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