What is a low FODMAP diet?

What is a low FODMAP diet?

A low FODMAP diet is a treatment used to manage the symptoms of IBS if initial dietary advice has been unsuccessful in improving symptoms. According to research, the low FODMAP diet has a very high success rate, with 70-75% of patients with IBS reporting an improvement in their symptoms.

A low FODMAP diet should be undertaken under the guidance of a dietitian as the diet involves restricting a range of foods from different food groups. It is important to have the help of a dietitian in order to ensure your diet remains healthy, well-balanced and varied.

There are three key phases to a low FODMAP diet.

  1. Restriction
    All FODMAPs need to be restricted in the first stage of the diet.  This stage of the low FODMAP diet would typically last for 4-8 weeks, and you should only continue if you experience improvements in your symptoms.
     
  2. Reintroduction
    If symptoms have improved on a low FODMAP diet it is important to start to reintroduce some higher FODMAP foods to increase variety and food choices in the diet.

    This helps to identify which FODMAPs trigger and worsen IBS symptoms and which FODMAPs can be tolerated. Tolerance levels will vary from person to person.

    If you experience symptoms after a food challenge, you should avoid this food completely.  It is possible to rechallenge with that food again, in a smaller amount, at a later time.

    If you do not get symptoms after a food challenge, you can assume that the FODMAP is well tolerated and include it as part of your diet once the reintroduction phase is completed.

    Sometimes including a problem food as part of a meal rather than on its own can cause less symptoms.
     

  3. Adaption
    Once you have established which FODMAPs affect your symptoms, the low FODMAP diet enables you to personalise your diet, avoiding foods that trigger your symptoms and including foods that don’t. Dietary triggers of IBS symptoms and tolerance to these triggers will vary between people.

    If your symptoms return, it could be because you have included a number of FODMAPs within one meal. It is also important to remember that sensitivity to FODMAPs may change over time and therefore it is worth trying to reintroduce any ‘failed’ FODMAPs again at a later date.

    Whilst excluding dietary triggers will help you to self-manage your symptoms it should be noted that diet is not the only cause of symptoms. Other factors include a busy lifestyle, stress and anxiety can often affect your gut which can make you more sensitive to the food you eat.

The idea of the low FODMAP diet is to ensure that whilst you identify which foods trigger your symptoms, you reintroduce those that do not, in order to ensure you have a well balanced and varied diet which includes plenty of fruit and vegetables.

Top tips for following a low FODMAP diet

Plan ahead

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Before starting on a low FODMAP diet, spend a few days or week familiarising yourself with the diet, identifying which foods to avoid and which can be included. The low FODMAP diet requires avoidance of multiple foods and ingredients, to help manage your new diet effectively try planning your meals a week in advance. Make a shopping list and ensure you have all the foods and ingredients needed to prepare each of your meals, plus suitable ready-to-eat snacks for when hunger strikes!

Keep meals balanced – main meals should include carbohydrate, protein and vegetables.

Ready meals and ready-prepared sauces often contain high FODMAP ingredients, cooking from scratch will ensure you are in control of what foods and ingredients you consume. Save time by ‘batch cooking’ your favourite meals and freezing individual/ family-sized portions for when you have less time to cook.   

Read food labels carefully

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High FODMAP sugars and sweeteners may be added to a variety of processed foods, here’s a list of high FODMAP ingredients to look out for when you’re scanning food labels:

  • Fructose
  • Fructose-glucose syrup
  • High fructose corn syrup
  • Lactose
  • Agave
  • Honey
  • Isomalt
  • Mannitol
  • Sorbitol
  • Molasses
  • Xylitol
  • Fruit juice concentrate

In addition, these ingredients represent added fructan ingredients and should also be avoided (may be present in yogurt-based products and/or certain cereals):

  • Prebiotics
  • Fructo-oligosaccharides
  • Inulin
  • Oligofructose

Eat out with confidence

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Eating out whilst following a low FODMAP diet can be a daunting prospect. Some simple steps will give you the confidence to still enjoy meals eaten away from home:

  • Call your chosen restaurant in advance – make sure they are able to cater for special dietary requirements.
  • Check out the menu online before booking – most restaurants have a website which features menus and may also highlight common allergens in various dishes.
  • The low FODMAP diet may be a difficult concept to explain to someone who hasn’t experienced it before. When discussing your requirements with waiting staff, you may find it easier to summarise your requirements as ‘wheat, dairy, garlic and onion free’, these are the high FODMAP ingredients most likely to be encountered in a main meal.
  • When dining out for the first time, you might feel more comfortable if you book during an ‘off peak’ period to ensure the waiting and kitchen staff have more time to respond to your needs.
  • Larger Italian restaurant chains are likely to produce gluten free (and therefore wheat free) pizza and pasta dishes
  • Thai, Chinese and Japanese restaurants have a greater choice of rice-based cuisine, select low FODMAP vegetables and ask for sauces to be served separately.
  • Steak houses are a good option, offering plainer meats, salads and potato-based side dishes. Ask for salad dressings to be served separately.

Enjoy your food and the restaurant experience! Eating out with friends and family should be relaxing and enjoyable. You may find it hard to avoid all sources of FODMAPs but if you do your best to minimise your intake of key FODMAP ingredients you should find that the benefits of taking part in this important social event outweigh any possible symptoms you experience.

Eat a diet rich in fibre

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When following a low FODMAP diet, many people find that their fibre intake also reduces. Fibre is essential for maintaining gut health so it’s important to include a variety of higher fibre foods within your low FODMAP diet. Products that contain 6g fibre or more per 100g are considered to be high in fibre. Some good sources of fibre include:

  • High fibre/ seeded gluten free breads
  • Porridge oats
  • High fibre gluten free cereals
  • High fibre gluten free pasta
  • Brown rice
  • Nuts and seeds
  • Low FODMAP veg
  • Low FODMAP fruits
  • Potatoes eaten with skin on
  • Linseeds (Flaxseeds)
  • Plain popcorn
  • Quinoa
  • Buckwheat

Boost your calcium intake

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If you are avoiding lactose (the sugar found in milk and a known FODMAP ingredient) then your calcium intake may be low. Calcium is essential to maintain good bone health, aim to eat 2-3 portions of calcium rich foods each day. These include:

  • 200ml Lactose free milk 200ml Calcium-enriched milk alternatives (e.g oat, rice, almond, hazelnut milk or soya milk – up to 60ml per sitting)
  • 1 pot of lactose free or soya yogurt (limit soya yogurt to 125ml/ sitting)
  • 30g/ match-box sized piece of cheddar cheese
  • 1 tbsp cottage cheese
  • ½ can of sardines/ pilchards
  • 80g of green, leafy veg e.g kale, watercress or spinach

Schär have had a range of their foods tested and certified by Monash University as suitable for those following a low FODMAP diet to help manage their IBS.  The product range includes breads, rolls, pizza bases and breadsticks which are available nationwide in many supermarkets. Read more here.