What are FODMAPs?

• FODMAPs are poorly absorbed, rapidly fermentable sugars and fibers that don’t completely digest in the small intestine, leading to abdominal pain, bloating, excess gas, and constipation or diarrhea. These symptoms are typically referred to as irritable bowel syndrome (IBS).
• A low FODMAP diet greatly reduces or eliminates symptoms associated with IBS.
• When you follow a low FODMAP elimination and reintroduction protocol, you’ll be able to zero in on which FODMAPs trigger IBS symptoms.

Read this guide to learn more about FODMAPs. It will help you decide if a low FODMAP diet is right for you.

We all know that certain foods can wreak havoc on the gut, but you might be surprised to learn that some seemingly harmless, yet troublesome dietary staples are lurking in your meals. Garlic, apples, and brussels sprouts are examples of foods that seem like they should be good for you, but are actually common IBS triggers because they are high in FODMAPs. Not everyone has the same FODMAP symptom triggers. A low FODMAP diet followed by a structured reintroduction process is the best way to find out which FODMAPs may be bothering you. 

The low FODMAP diet was originally based on Monash University’s research. Their work has been replicated by other research programs over the past 20 years. It is now well known that low FODMAP diet helps about 75% of patients with all different kinds of IBS, and it is widely considered a first line treatment for IBS. 

 

 

What does FODMAP stand for? 

FODMAP stands for Fermentable, Oligosaccharides, Disaccharides, Monosaccharides And Polyols. These are certain sugars and certain fibers that are widely distributed in food. Sugars and fibers are carbohydrates. All FODMAPs are carbohydrates, but not all carbohydrates are FODMAPs!

Why are FODMAPs problematic?

FODMAPs have some things in common with each other. FODMAPs are all capable of pulling some extra water into the gut in a process called osmosis. This results in diarrhea for some IBS patients. FODMAPs are also rapidly fermentable by the gut bacteria, which is a gas-producing process. The latest research suggests that FODMAPs might also promote inflammation in IBS patients. 

However, FODMAPs are neither good nor bad. It’s a mistake to think of foods that are rich in FODMAPs as bad foods, or foods that are low in FODMAPs as good foods. It's interesting to note that FODMAPs are not a problem for many people. People with chronic digestive health conditions have difficulties with gut-brain interaction which make them more sensitive to the effects of FODMAPs. This is called visceral hypersensitivity. 

F is for Fermentable

The F in FODMAP stands for fermentable. Unlike the rest of the acronym, the F does not represent a type of sugar or fiber. Instead, it serves as a descriptor of the letters that follow—O,D,M and P. It reminds us that rapid fermentability is part of the definition of FODMAPs. Fermentation in the gut is not all bad! Fermentation and gas formation are normal parts of how the human body works, when the fibers we eat are consumed by the microbes present in a healthy large intestine. Our gut microbes do some good work for us through fermentation. They produce healing substances like short chain fatty acids, and help us get some extra nutrients from our food. But when fermentation happens too rapidly it can cause bloating, abdominal pain and even constipation.

The F in FODMAP has nothing to do with fermented foods.

O is for OLIGOSACCHARIDES (Fructans and GOS)

Now for the first carb in the lineup: Oligosaccharides. Oligosaccharides are carbohydrate molecules containing 2-10 units of sugar, linked together like a chain. Oligosaccharides can be broken down into two categories: fructans and galactans.

• Fructans—Fructans are short chains of the sugar, fructose. They are found in foods such as alliums (garlic and onions) and some other vegetables, wheat products like bread, and dried fruits. A low FODMAP diet is not gluten-free, but it does require eating much smaller servings of regular breads and pastas. Several studies have now shown that fructans are the most common FODMAP trigger for IBS.
• Galactans—Galactans are short chains of the sugars galactose and glucose. They are found in legumes, nuts, and seeds 

D is for DISACCHARIDES (Lactose)

A disaccharide consists of just two sugar molecules linked together. While there are many other disaccharides in food, lactose is the disaccharide that falls under the FODMAP umbrella. Lactose intolerance is a very common problem for adults. Many of us do not produce as much of the enzyme, lactase, in our intestines after childhood, so we have more trouble digesting and absorbing lactose. For some, this can lead to symptoms of intolerance and IBS. 

Lactose is a natural sugar found in dairy milk. Some products made from milk have a lot of lactose in them (regular fluid milk, evaporated milk, regular yogurt, and ice cream), and some have very little (natural cheeses, kefir, and fluid milk and yogurt that have been treated with the lactase enzyme). A low FODMAP diet is not dairy-free, but it does require choosing low lactose milk products.

M is for MONOSACCHARIDES (Fructose)

Monosaccharides are single sugar molecules. There are many monosaccharides in food, but fructose is singled out as a FODMAP because it is only slowly absorbed by humans. Fructose is the reason that many people with IBS have digestive distress after consuming large servings of fruit or fruit juice. Favorites such as apples, pears and watermelon are rich in fructose. It is also found in certain vegetables such as tomatoes and broccoli.

Fortunately, even on a low FODMAP diet you can still have small servings of some of these foods. A low FODMAP diet does require avoiding foods and beverages sweetened with high fructose corn syrup.

A is for AND...

P is for POLYOLS (Sorbitol and Mannitol)

The final category in the FODMAP acronym is polyols, also known as sugar alcohols. Only a small fraction of the polyols we consume are absorbed. Most sorbitol and mannitol we consume stays in the intestines, where it is rapidly fermented by gut bacteria, and increases the water content of our poop.

Sorbitol and mannitol are naturally found in certain fruits and vegetables, sometimes in combination with other FODMAPs. For example, apples and pears are rich in both fructose and sorbitol. Cauliflower and mushrooms are rich in mannitol, one of the most common FODMAP food triggers.

Some polyols are added to sugar-free foods as sweeteners. If you’ve ever experienced diarrhea or excess gas after eating sugar-free candies, you may be familiar with their powerful effects!

What is a Low FODMAP diet?

Now that you understand how FODMAPs can affect your digestive health and cause IBS symptoms, you can see why you might benefit from a low FODMAP diet. Because many higher FODMAP foods are very nutritious and enjoyable to eat, a low FODMAP diet is meant to be temporary. With ModifyHealth, the low FODMAP diet takes around eight weeks and requires you to eliminate high FODMAP foods and reintroduce them in the following phases:

• Elimination phase, or low-FODMAP phase: During the elimination phase of two to three weeks, you swap higher FODMAP foods and serving sizes for lower FODMAP ones. This is extremely simple  with our low FODMAP meal plans.
• Reintroduction phase: During the next 6-8 weeks, you will systematically re-introduce higher FODMAP foods and serving sizes under the guidance of a dietitian. This is where you learn which FODMAPs are your personal symptom triggers.
• Personalization phase: During this phase, you will expand your diet and learn how to enjoy many more foods. 

Should you try a Low FODMAP diet?

Low FODMAP diets are proven to reduce excess gas, bloating, abdominal pain, diarrhea, and constipation in people with IBS, often in as little as two weeks. They can also help people with other medical conditions who have IBS-like symptoms. If you have Crohn’s or ulcerative colitis in remission, but still have symptoms, you might benefit from the diet. If you have celiac disease but still have symptoms on a gluten-free diet, you also might benefit from the diet. Some people with functional dyspepsia and gastroparesis find low FODMAP diet helpful.

However, like every treatment, low FODMAP diet is not right for everyone. If you have an eating disorder or are at risk for what we call “maladaptive eating behaviors” you should not follow an elimination diet. If you have pre-existing health conditions or believe you may have an undiagnosed condition related to your digestive health, it’s always a good idea to speak with your physician before starting any elimination diet such as the low FODMAP diet.

Try Low FODMAP Diet meal delivery...

The easiest way to try a Low FODMAP diet is to sign up for the Low FODMAP Program from ModifyHealth. Our program allows you to determine if FODMAPs are playing a role in your GI symptoms, and which ones are triggering your digestive issues. Our Low FODMAP meals are an easy way to make sure your diet is low in FODMAPs while you go through the FODMAP elimination diet process. We offer fully prepared Low FODMAP meals as well as optional Dietitian support.