The Low-FODMAP Diet: A Guide For Beginners

What are FODMAPS?

FODMAPs are short chain carbohydrates and sugar alcohols that are poorly digested by the body. They ferment in the large intestine during digestion drawing in water and producing carbon dioxide, hydrogen, and methane gasthat causes the intestine to expand. This causes GI symptoms such as bloating and pain that are common in disorders like IBS.

The word FODMAP stands for certain scientific terms that used to classify groups of carbs that are notorious for triggering digestive symptoms like bloating, gas and stomach pain. The letters in the word stand for the following:

• F - fermentables

• O - oligosaccharides

• D - disaccharides

• M & A - monosaccharides

• P - polyols

Additionally, each classified FODMAP group contains a specific dietary source. The following are the types of foods found within each lettered FODMAP group:

• Oligosaccharides - Wheat, rye, legumes and various fruits and vegetables, such as garlic and onions.

• Disaccharides - Milk, yogurt and soft cheese. Lactose is the main carb.

• Monosaccharides - Various fruit including figs and mangoes, and sweeteners such as honey and agave nectar. Fructose is the main carb.

• Polyols - Certain fruits and vegetables including blackberries and lychee, as well as some low-calorie sweeteners like those in sugar-free gum.

FODMAPs are found in a wide range of foods in varying amounts. Some foods contain just one type, while others contain several. FODMAPs are either naturally within foods or added in as additives. They include fructose (in fruits and vegetables), fructans (like fructose, found in some vegetables and grains), lactose (dairy), galactans (legumes), and polyols (artificial sweeteners).

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What is the Low-FODMAP diet?

A Low-FODMAP diet cuts out many common products that contain certain foods. The principle behind the diet is to give your gut a chance to heal, especially if you have GI problems, like irritable bowel syndrome. People with GI disorders often use this diet as part of their treatment.

Symptoms of a High-FODMAP diet

FODMAPs are not absorbed well in the small intestine. They increase the amount of fluid in the large intestine and they are known to produce more gas. The following are symptoms and signs that suggest you may be eating products that are high in these short chain carbohydrates:

• Gas

• Pain

• Bloating

• Abdominal distention

• Abdominal pain

• Diarrhea

• A feeling of fullness after eating or drinking only a small amount of food or liquid

However a Low-FODMAP diet is used to help alleviate these symptoms. This is done through certain foods that can naturally be digested in the small intestine.

Benefits of a Low-FODMAP diet

The Low-FODMAP diet has mostly been studied in patients with irritable bowel syndrome, which is a common digestive disorder that includes symptoms like gas, bloating, stomach cramps, diarrhea and constipation. About 14% of people in the US have IBS, and most of these people might go undiagnosed for the majority of their life.

IBS has no well-defined cause, but it is well known that diet can have a significant effect. This is where the Low-FODMAP diet comes into play. In many cases, those with IBS who try a Low-FODMAP diet experience major reductions in symptoms and impressive improvements in their quality of life.

List of Low-FODMAP foods

There are many different food categories that can provide a wide range of food options for someone looking to follow a Low-FODMAP diet. However it’s important to note that in some cases, portion sizes make a difference as to whether a product has enough high FODMAPs to cause symptoms. So pay attention to moderation. The following are lists of food groups with Low-FODMAP examples:

Vegetables

• Alfalfa sprouts, bean sprouts, bell peppers, carrots, green beans, book choy, cucumbers

• Lettuce, tomatoes, zucchini, bamboo shoots, eggplant, ginger, chives

• Olives, parsnips, potatoes, turnips

Fruits

• Oranges, grapes, honeydew melon, cantaloupe, bananas, blueberries, grapefruit

• Kiwi, lemons, limes, oranges, strawberries

Dairy

Dairy that is lactose-free, and hard cheeses, or ripened/matured cheeses including (If you are not lactose intolerant, you may not need to avoid dairy with lactose.)

• Brie

• Camembert

• Feta cheese

Meats & Protein

• Beef, pork, chicken,

• Fish, eggs

Grains

• Rice, rice bran, oats, oat bran

• Quinoa, corn flour, sourdough spelt bread

• Gluten-free breads and pastas

While gluten itself is not a FODMAP, many gluten-free products tend to be low in FODMAPs.

Drinks

• Tea and coffee (use non-dairy milk or creamers)

• Fruit juice not from concentrate

• Water

nuts and seeds

Almonds

• Macadamia, pumpkin seeds, peanuts, pine nuts

• Walnuts (fewer than 10-15/serving for nuts)

List of High-FODMAP foods

Many foods considered high in FODMAPs are actually healthy foods, but they can cause symptoms in some people with a sensitive gut; particularly people with IBS or other bowel diseases and disorders. The following are lists of food groups with High-FODMAP examples that you should try to avoid:

vegetables

• Onions, cabbage, broccoli, cauliflower, snow peas, asparagus, mushrooms

• Artichokes, leeks, beetroot, celery, sweet corn, brussels sprouts,

Fruits

• Peaches, apricots, nectarines, plums, prunes, mangoes

• Apples, pears, watermelon, cherries, blackberries

Grains

• Breads

• Cereals

• Pastas

• Crackers

• Pizza

• Rye & wheat

Dairy

Any dairy product that contains lactose should be avoided

• Milk, soft cheese, yogurt, ice cream

• Custard, pudding, cottage cheese

Additional foods to avoid

• Legumes and beans

• Nuts, like cashews and pistachios

• Artificial sweeteners, like high fructose corn syrup

• Alcohol

• Sports drinks

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How to follow a Low-FODMAP diet

A Low-FODMAP diet can be a bit complex if you have never followed it before, or even if you are familiar with it. The diet consists of three different stages to be followed in their respective order. The following are those stages:

Stage 1: Restriction

This stage involves the strict avoidance of all high-FODMAP foods, which were listed earlier. Some people who follow this diet often think they should avoid all FODMAPs long-term, but this stage should only last about 3–8 weeks. This is because it’s important to include FODMAPs in the diet for gut health, so they should not be entirely cut from your diet forever.

Some people notice an improvement in symptoms in the first week, while others take the full eight weeks. Once you have adequate relief of your digestive symptoms, you can progress to the second stage.

Stage 2: Reintroduction

This stage involves systematically reintroducing high-FODMAP foods.

The purpose of this stage is to identify which types of FODMAPs you tolerate, and to establish the amount of FODMAPs you can tolerate. This is known as your “threshold level.” In this step, you test specific foods one by one for three days each so that you are able to identify which food might be triggering you. 

It is worth noting that you need to continue a low-FODMAP diet throughout this stage. This means even if you can tolerate a certain high-FODMAP food, you must continue to restrict it until stage 3. It is also important to remember that, unlike people with most food allergies, people with IBS can tolerate small amounts of FODMAPs. Lastly, although digestive symptoms can be debilitating, they will not cause long-term damage to your body.

Stage 3: Personalization

This stage is also known as the modified low-FODMAP diet. In other words, you still restrict some FODMAPs but the amount and type are tailored to your own personal tolerance. Those that were identified in stage 2.

It is important to progress to this final stage in order to increase your diet variety and flexibility. These qualities are linked with improved long-term compliance, quality of life and even gut health.

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The low-FODMAP diet can dramatically improve digestive symptoms, including those in people with IBS. However, not everyone with IBS responds to the diet, and the three-stage process can take up to six months. Unless you need a Low-FODMAP diet, it may end up doing more harm than good, since FODMAPs are prebiotics that support the growth of beneficial bacteria in your gut. Nonetheless, this diet could be truly life-changing for those struggling with IBS.

Extra Low-FODMAP tips

• Many foods are naturally low in FODMAPs. That said, many processed foods have added FODMAPs and should be limited.

• There are also many low-FODMAP, protein-rich options for vegetarians, including tempeh, tofu, eggs, Quorn (a meat substitute) and most nuts and seeds.

• There are many low-FODMAP herbs, spices and savory flavorings that can be substituted for garlic and onions. Some examples are chives, chili, fenugreek, ginger, lemongrass, mustard seeds, pepper, saffron and turmeric.