Eating a Low-FODMAP Diet for IBS

What is the low-FODMAP diet?

The term FODMAP refers to 5 sugars found in certain foods. These are:

• Fructose

• Lactose

• Fructans

• Galactans

• Polyols (includes xylitol snd sorbitol)

For some people with IBS, the body has trouble absorbing these sugars. That may lead to belly pain and bloating (swelling), gas, nausea, diarrhea, or constipation.

A large number of foods contain these sugars. Many would ordinarily be good for you. In this diet, you work with your healthcare provider or a registered dietitian to find out which of these foods are causing your symptoms. The process has 3 phases:

• Phase 1. Giving up all high-FODMAP foods for 2 to 6 weeks.

• Phase 2. Restarting high-FODMAP foods one group at a time so you can find out which ones make your symptoms worse.

• Phase 3. Easing into long-term diet changes that help keep your symptoms at bay but also let you eat a variety of foods.

How can this diet help you?

A low-FODMAP diet may help lessen IBS symptoms. Pain and bloating seem to be reduced the most.

Does this diet have any risks?

In the first phase of a low-FODMAP diet, your choice of foods is limited. If you eat an overly restricted diet, it may lead to poor nutrition. Cutting out FODMAPs for too long might also disrupt the healthy balance of bacteria in your gut. Your provider or a dietitian who has experience with this diet can guide you on using it safely.

What foods should you eat?

Low-FODMAP foods are OK to eat at every phase of this diet. These foods include:

• Vegetables such as carrots, cucumber, green beans, lettuce, and tomatoes

• Fruits such as cantaloupe, grapes, oranges, pineapple, and strawberries

• Grain foods such as corn flakes, oats, plain rice cakes, and gluten-free breads as long as they don’t contain other high-FODMAP ingredients

• Dairy products such as lactose-free milk, brie and feta cheeses, and almond milk

• Protein foods such as poultry, fish, eggs, lean beef, firm tofu, and certain nuts (macadamias and walnuts)

Which foods should you pass up?

In the first phase of this diet, skip all foods that are high in FODMAPs. They include:

• Vegetables such as artichokes, cauliflower, garlic, onions, and mushrooms

• Fruits such as apples, cherries, peaches, pears, and watermelon

• Grain foods such as breads and cereals made with wheat, rye, or barley

• Dairy products such as milk, ice cream, yogurt, and soy milk (made from whole soybeans)

• Protein foods such as most dry beans and peas, some marinated meats, and certain nuts (cashews and pistachios)

• Sweeteners such as honey, high-fructose corn syrup, and those with names ending in “ol.” For example, maltitol, mannitol, sorbitol, and xylitol.

This is not a long-term diet. It’s simply a way of finding out if cutting out high-FODMAP foods can help you feel better.

If it does, you will gradually retry specific foods in the second phase of the diet. The goal of this phase is to narrow down your "do not eat" list. You and your provider or dietitian will work together to figure out which high-FODMAP items are major triggers for your symptoms.

In the third phase of the diet, you can choose foods more freely. But you may still need to limit certain high-FODMAP foods. Your provider or dietitian can help you create a diet plan that you can stick with long term.

Tips for following this diet

• Carry a list of high-FODMAP foods and ingredients with you when grocery shopping.

• Choose unprocessed foods such as fresh fruits and vegetables when possible. You won’t have to worry about hidden ingredients.

• With processed foods, you will need to read the ingredients list carefully to tell whether they contain FODMAPs. Don’t forget to check the ingredients in sugar-free chewing gum, too.

Suggestions for planning meals

• For breakfast, pour almond milk over corn flakes and top with sliced strawberries.

• For lunch, have a salad of lettuce, cucumber, and tomato sprinkled with feta cheese crumbles and chopped walnuts.

• For dinner, have grilled, unmarinated chicken with steamed carrots and green beans.

• In a restaurant, order grilled fish, chicken, or lean meat that can be cooked to order. Specify that you want it cooked plain with no marinades, onion, or garlic.