By Dr. Colin O’Brien, ND
So, a friend has recently told you that they started to follow a “Low FODMAP” diet and it has helped with their digestive health. You start wondering:
“I get gas and bloating at times, often some cramping, and my bowel movements aren’t exactly regular … should I be doing this low FODMAP diet, too?”
The Low FODMAP Diet, an acronym for various types of sugars (“fermentable oligosaccharides, disaccharides, monosaccharides and polyols”) has gained quite a bit of popularity over the past decade with more research, media attention and doctor recommendations. And rightfully so.
Many people that suffer from Irritable Bowel Syndrome (IBS) find great relief in a wide array of their symptoms when they cut out these specific FODMAP foods.
The general idea is that high FODMAP foods, for certain individuals, become fermented by the gut bacteria and produce excessive gas which can cause great discomfort in the digestive tract. Any combination of flatulence, bloating, abdominal cramping, pain, diarrhea and/or constipation can be the result.
For any IBS-sufferer, the promise of symptom relief by simply restricting certain foods may sound like a big win with little downside.
But it’s important to know that there are “right” and “wrong” ways to try or maintain a low FODMAP diet. Here are some simple suggestions if you’re thinking about starting or if you’re already well on your way:
DO: Use the MONASH University recommendations
There are many guidelines and charts available online to outline the foods that are FODMAP friendly and those that are not.
While these may provide a general concept or overview of foods to include and exclude, the most trusted resource is the group that developed the diet and scientifically validated its use: Monash University at monashfodmap.com.
Monash University offers research articles, cookbooks and other resources to those trying to adopt a low FODMAP diet and, importantly, they are always updating their lists to ensure that new tested foods are added accordingly.
They offer a low-cost phone app that allows you to check foods while on-the-go (i.e. at a restaurant or while grocery shopping). If you’re serious about trying out the low FODMAP diet, use the Monash tools.
DON’T: Stay on the Low FODMAP Diet indefinitely
Unlike a nutrition plan such as the Mediterranean diet, the low FODMAP diet is not a long-term approach. Clinically, this happens to patients often: they try the diet, it reduces symptoms and they feel better, so they decide to stay low FODMAP indefinitely.
What’s wrong with this? The problem largely comes from the microbiome in that a less varied diet (and lower fibre) is only supporting the growth of certain bacterial species and may make the microbiome less diverse.
Studies consistently show that a more diverse range of bugs in your digestive tract is protective for disease.
The other issues may be related to eating disorders (fear of many “healthy” foods for fear of a negative reaction), nutrient depletions as a result of eating the same foods over and over again (and thereby missing out on the same vitamins and minerals over and over again) and creating a dietary path with no exit strategy.
Ideally, we don’t want the low FODMAP diet to be the only diet for the rest of your life.
In a “best-case” scenario, a low FODMAP diet relieves some stress on your gut while you are taking other steps to rebuild your digestive system.
DO: Explore other underlying causes of digestive issues
There was a time when your digestive system could tolerate high FODMAP foods without any negative effects.
The factors that led your digestive tract to a point where it could no longer tolerate FODMAP foods were likely diverse and align with the fact that there are many underlying and individual aggravating factors in IBS (ie stress, food intolerances, poor fibre intake, microbial infections and even genetics).
The point here is that we don’t want to assume that FODMAP foods are the only issue. Consider speaking with a practitioner about other dietary and lifestyle strategies, nutritional supplementation and lab tests to get a more complete picture of your digestive health and explore other underlying causes and treatments.
You may uncover that stress management techniques greatly improve your digestion. Or perhaps a peppermint tea relieves that sluggish sensation in your gut. The low FODMAP diet is one of many tools.
DON’T: Assume that all low FODMAP food is healthy
In the short-term, your digestive tract may be happy to rid itself of the pain and cramping from FODMAP foods.
But don’t throw the core nutrition tenets out the window! The goal is always to consume whole foods, unprocessed with minimal additives.
Just because your stomach doesn’t hurt when you eat plain potato chips, it doesn’t make them healthy.
In the same way that high FODMAP foods can hurt your gut, lots of low FODMAP foods can have negative health consequences in other areas of your body (ie trans fats and your cardiovascular system).
Essentially, continue to strive for the most nutrient dense and diverse diet that you can, within the parameters of your digestive tolerance and the low FODMAP diet.
In the end, IBS is complicated, just like our entire bodies. A low FODMAP diet is simply one of many tools that may work for one person and not for another.
Use it cautiously and, when in doubt, speak with a qualified healthcare practitioner about how, and when, to safely reintroduce foods back into your dietary rotation.
After all, we want to support your digestive system not only in its current state, but for many years to come.
Dr. Colin O’Brien ND is a practicing doctor at Sprout Wellness Clinic in Kitchener- Waterloo, ON. He has a strong focus on clinical nutrition and nutritional supplementation within a family medicine context. He continues to fulfill his passion for research, writing and education in his role as the Medical Director for Cyto-Matrix.
