You may be familiar with the term FODMAP or have seen it in relation to gut health and the gut microbiome on social media but what is it and how is it related to your digestive system?
In this blog, we will explain what the FODMAP diet is, what it can mean for you, and how it plays its part in digestive health to potentially alleviate symptoms such as constant bloating, a heavy stomach feeling, excess gas, constipation, and diarrhea.
What is the low FODMAP diet?
The low FODMAP diet was developed in 2004 by scientists at Monash University and works by excluding certain carbohydrates from the diet to establish whether they are causing dysbiosis in the gut microbiome, leading to painful and uncomfortable symptoms in relation to irritable bowel syndrome (IBS) or small intestinal bacteria overgrowth (SIBO).
“Recent evidence suggests that 61% of individuals experience symptom relief with the Low FODMAP diet (Martin et al., 2015).”
What does FODMAP stand for?
The acronym can be broken down into fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. The ‘F’ stands for fermentable, which refers to sugars that are readily fermented by the bacteria present in the large intestine, producing gas. For sugars to be fermented they must reach the large intestine, meaning that they are not digested or fully absorbed in the small intestine first. Oligosaccharides, disaccharides, monosaccharides, and are the ‘ODMAP’, and are all examples of short-chain carbohydrates that are absorbed poorly in the small intestine, meaning that they can be present in large quantities in the large intestine, and fermented.
Fermentation of food in the large intestine is normal, however, excessive fermentation leads to large amounts of gas and water being produced. This then stretches the walls of the intestines, leading to digestive health symptoms such as abdominal pain, bloating, diarrhea or constipation, nausea, and fatigue. Therefore, for some people reducing the number of FODMAPs they eat can reduce the amount of fermentable food in their large intestine which in turn can help to alleviate symptoms.
How does the low FODMAP diet work?
There are three phases of the diet: elimination, reintroduction, and maintenance. The first stage sees the removal of high FODMAP foods from the diet, the second oversees the slow introduction of them to the diet to see what may trigger symptoms. And finally, if you have identified foods that can cause symptoms, you are able to remove or reduce them within the diet during the final section.
The idea of the diet is that by consuming fewer FODMAPs, the gas-producing bacteria have less material to ferment, and this then leads to an easing of symptoms. Scientists are not yet sure if these bacteria die or just reduce their activity, and further studies are needed.
The NHS recommends following the diet for 4-6 weeks to see if it can help to alleviate your symptoms. After this period, you should reintroduce foods into your diet gradually and try to determine which ones are worsening your digestive health symptoms.
What foods are low FODMAP?
Apparently, “Is diet coke low FODMAP?” is a commonly asked question!
There are lots of low FODMAP diet books available and you should be able to obtain a full list of included and excluded foods from your doctor. Each list will vary but generally, lower FODMAP foods include eggs, unprocessed meats, and fish, cheese such as cheddar, feta, and brie, milk alternatives such as oat or almond, some whole grains like oats, quinoa, and rice, certain gluten-free products and some fruits and vegetables.
And yes, diet coke is classified as low FODMAP!
You can find out a whole host of low FODMAP certified recipe in our recipe book too.
Can I still get enough fiber on a low FODMAP diet?
Many high FODMAP foods such as beans and lentils or onion and garlic are also high in fiber. Cutting these foods out could lower your fiber intake, reducing key prebiotics which help feed your good bacteria. While most people only follow a FODMAP elimination diet for a short period, it is still important to maintain a balanced diet. In our blog on fiber and the low FODMAP diet, we give examples of high-fiber low FODMAP foods that can help keep your fiber intake up without causing symptoms. Since each person is unique, we recommend working with a healthcare or nutrition science professional.
Who should follow the low FODMAP diet?
FODMAP diets are usually recommended for patients who have been diagnosed with digestive health conditions such as IBS or SIBO. However, as the diet is very restrictive it is not recommended for long-term use or seen as a treatment for SIBO or IBS. There are not currently enough studies to access the longitudinal impact of the low FODMAP diet.
The FODMAP diet has been shown to be able to reduce IBS symptoms. A recent study conducted in Belgium divided a group of 459 patients into two treatment cohorts, with half being treated with a low FODMAP diet and the others prescribed medicinal treatment. The study concluded that ‘a FODMAP-lowering diet should be considered the first-line treatment for IBS in primary care,’ with 71% of the dietary treatment group seeing a reduction in symptoms, compared to 62% in the other group. Remember, you should seek advice from your GP or healthcare professional before commencing a low FODMAP diet.
IBS foods list: What can be some of the worst foods for IBS?
Refined sugar – Feeding the microbes in your gut with sugar when you have an already imbalanced microbiome could make your IBS symptoms worse.
Gluten – Some people can tolerate gluten with no issues, but some with IBS can find this creates trouble.
Dairy – Dairy contains high levels of calcium, vitamin B and protein, which are great for our overall health. However for many people milk products are hard to digest and often struggle with IBS symptoms after consuming it.
How can we help?
If you are interested in longer term monitoring of your gut health, our Breath Analyzer and paired App will allow you to track your food intake, symptoms, and the corresponding hydrogen and methane levels on your breath. This gives you the ability to monitor the effectiveness of any prescribed medicines, changes in diet, over-the-counter medications, or other lifestyle changes you may make for the improvement of your digestive health.
You could also choose to explore out Gut Reset+ Plan, a doctor-led program that helps to find and treat SIBO and IMO, common and treatable causes of uncomfortable gut symptoms. Using the OMED Health Breath Analyzer and testing substrates, you will complete at-home hydrogen methane breath tests to identify SIBO or IMO. Once your results have been reviewed by one of our in-house doctors, they will put together a antimicrobial based treatment plan personalized to you. Does this sound like it could help you? Find out more on our Gut Reset+ page.
