FODMAP diet: what it is and how it helps against SIBO, irritable bowel syndrome or celiac disease (with menus and advice for day-to-day)

The number of people with Gastrointestinal disorders does not stop growing all over the world and its treatment represents a challenge for health professionals, because they have symptoms that significantly affect quality of life. In fact, they are one of the main causes of absence from work and school.

These alterations require comprehensive treatment beyond mere medication. In this sense, the diet known as FODMAP (acronym of Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols) has become a key strategy.

FODMAP diet: what is it

FODMAP is a diet low in fermentable short-chain carbohydrates (HCCC), created more than ten years ago in Australia. The acronym responds in English to each of these carbohydrates: oligosaccharides, disaccharides, monosaccharides and fermentable polyols.

These types of carbohydrates are found in lesser or greater amounts in dairy products (lactose is one of them) and in plant foods as common as wheat and other cereals, legumes and some vegetables and fruits.

The low FODMAP diet has proven to be effective and has been internationally accepted as a dietary strategy for adults with irritable bowel syndrome.

The acronym stands for Low Carb Diet FODMAPs are an acronym for foods that are reduced in the diet:

F for FERMENTABLE. Carbohydrates rapidly fermented by intestinal bacteria. They produce short-chain fatty acids.or of orLIGOSACCHARIDES. Molecules composed of various sugars, such as those found in wheat, rye, legumes, garlic…D of DISACHARIDES. Group of carbohydrates to which lactose belongs, the milk sugar, poorly ingested by some people.M of MONOSACCHARISES. Carbohydrates with a single sugar molecule (glucose, fructose, galactose,…)A of AND…P for POIL OILS. Alcohols that are slowly absorbed. They are used as sweeteners and are found in fruits, mushrooms, etc.

Low FODMAP diet: who is it for?

The FODMAP diet is recommended to people with irritable bowel syndrome (IBS) or with non-celiac gluten sensitivity. And it can also help inflammatory bowel diseases (ulcerative colitis and Crohn’s disease) and others with similar gastrointestinal symptoms.

The basic problem of all these alterations is usually a nutrient malabsorption which can generate:

Vitamin deficiencies.Conditions like intestinal hypersensitivity due to increased gas production.bacterial overgrowth in the small intestine (SIBO).increased gas production in the large intestine.

For all these reasons, foods that make a large contribution of FODMAP are harmful in these cases.

A special case is the Celiac Diseasea multisystem autoimmune disorder of genetic origin, triggered by the ingestion of gluten.

It has gastrointestinal manifestations similar to IBS and the usual treatment is a gluten-free diet, a protein present in some cereals such as wheat, rye, barley. Gluten produces small intestinal inflammations and its exclusion improves the symptoms and the clinic.

However, there are people who, even on a gluten-free diet, still have gastrointestinal symptoms. In these cases, it has been proven that the recurring symptoms are due to the presence of other sources of FODMAPs, such as some fruits and vegetables, so a no FODMAP diet may help.

Why does the low fodmap diet help?

To understand why the low FODMPA diet helps in certain cases, we must first understand why Short Chain Carbohydrates (HCCC) can aggravate gastrointestinal discomfort. And it happens because they present 3 functional properties that, although they are beneficial for most people, can aggravate gastrointestinal discomfort: These 3 properties usually beneficial are:

They absorb liquid. They increase intestinal motility. rapidly fermented by digestive bacteria with the consequent production of short chain fatty acids (SCFA) and gases such as carbon dioxide, methane and hydrogen.

The HCCC are beneficial to most people because they modulate the immune system, reduce cholesterol and triglyceride levels, facilitate the absorption of calcium and stimulate the growth of beneficial digestive bacteria.

However, when the response to HCCCs is exaggerated, as is the case with people with certain diseases and sensitivities, complaints such as bloating, gaspain, nausea, constipation or diarrheaetc.

For this reason, in these people a low FODMAP diet, which must be performed for a limited time. To do it well and ensure that no nutrients are lost, the advice of a nutrition professional can be very useful.

low FODMAP diet: how to do it

As we have seen, a low FODMAP diet can help improve the intestinal symptoms of IBS and other diseases. But it is not, in any case, a diet to follow a lifetime. The nutritionist or medical specialist is the one who should assess their need.

The phases of the diet low FODMAP:

First phase. Initially, a low FODMAP diet is proposed for two to six weeks, giving the patient alternatives to low FODMAP foods.Second stage. After this time, it is recommended gradually introduce foods from a carbohydrate group (for example, fructans), one at a time and over a period of three days in a row. After three days, another food from the same group is introduced, and so on, observing tolerance and associated symptoms that the person is having.Third and last phase. The person who follows the FODMAP diet has learned in this time to know what tolerates better and worseand at the end a more open diet is established than the one at the beginning, taking into account high FODMAP foods that the person tolerates and accepts correctly.

So, it is a diet that varies based on individual tolerance of each person and at the end many verify that it is not necessary for their diet to be as strict as the one initially proposed. It is more open in terms of its variety, easier to carry and more practical to manage the symptoms associated with intestinal problems.

In the case of following a strict low FODMAP diet, should not exceed six weeks. If it stays long term, you may have a negative impact on gut microbiota and harmful consequences for health, because FODMAPs, as we said before, also play a beneficial role.

In summary, when the low FODMAP diet is necessary 3 steps must be strictly followed for it to be beneficial; First you have to eliminate the foods high in FODMAP and then reintroduce them one by one.

Phase 1: Eliminate foods high in FODMAPs

are replaced during 2-6 weeks high FODMAP foods with low FODMAP ones.

Phase 2: Reintroduce them little by little

During 8-12 weeks the eliminated foods are reintroduced:

Try only one food group and avoid the rest. From the chosen group, try one food for three days with a rest day in between and gradually increase the serving size. Write down your symptoms in a diary.

Phase 3: Personalize the diet

The tolerance It varies from one person to another, so each one has to find their balance.

Low FODMAP foods

You can include them in your diet:

FRUIT: blueberries, green banana, strawberry, kiwi, lemon, tangerine, melon, blackberry, orange, papaya, pineapple and grapefruit.VEGETABLES: celery, eggplant, broccoli, zucchini, pumpkin, parsnip, cabbage and cauliflower, spinach, green beans, lettuce, fresh corn, potato, cucumber, bell pepper, tomato and carrot.NUTS: peanut, macadamia, walnuts, brazil nuts, pecan and pine nutsGRAIN: rice, oats (up to half a cup), spelt (sourdough bread), corn, gluten-free bread, gluten-free pasta, polenta, and quinoa.OTHERS: sugar, stevia, nuts, glucose, maple syrup and agave syrup.

Foods with a high FODMAP content

You should avoid them in the first weeks and reintroduce them little by little, in the second phase:

Fructans

Vegetables: garlic, artichoke, dried onion, shallots, cabbage, asparagus, leek and beetroot.Cereals: rye, wheat pasta, bran and wheat.Fruit: custard apple, dried fruit, pomegranate and watermelon.Nuts: cashew and pistachio.

Galactans

Legumes: chickpeas, dried beans and lentilsNuts: cashew and pistachio

Fructose

Fruit: fruit in syrup, fig, mango, apple, pear, watermelon and fruit juiceSweeteners: fruit concentrate, fructose, high fructose corn syrup and honey large servings of fruit.

polyols

Vegetables: avocado, cauliflower, sweet corn and mushroomsFruit: apricot, cherry, plum (fresh and raisin), apple, peach, blackberry, nectarine, pear and watermelon.

Lactose

All the dairy products contain lactose, which should be avoided.

FODMAP diet: menu

At first, the low FODMAP diet may seem very restrictive. this menu it will help you pass the first phase where more food is temporarily withdrawn:

Breakfast

Option 1: buckwheat bread toast with vegetable pate. Rice or sesame drink.Option 2: Chia with a vegetable drink and cinnamon or a vegetable drink with hazelnuts or sesame.

Meal

Option 1: a pumpkin and cinnamon cream accompanied by a quinoa salad.Option 2: zucchini spaghetti with pesto without cheese. Buckwheat with spinach and carrot.

Dinner

Option 1: Grilled zucchini or zucchini cream with vegan butter. Tempeh with spinach.Option 2: turnip and carrot cream accompanied by oat flakes and hemp seeds.

fodmap diet: more information

Nowadays interested people have at their disposal a lots of digital resources that can help you to follow a low FODMAP diet in an easier and, above all, safer way.

One of the most recommended apps where you can find additional information about these foods, and about starting and following a low FODMAP diet, is the FODMAP APP. It is a proposal from Monash University, in Australia, which made this diet known and carried out the first investigations on its effects.