What is a LOW FODMAP Diet?

What is the Low FODMAP diet? Do I need to be on it if I don’t feel sick? What is the Low FODMAP diet for? If you’re wondering any of this – which I was, just a few months ago – this is the blog post for you.

I can’t thank Delicious Living enough for spreading the word about the Low-FODMAP diet. Why? Because I had to actually start the Low-FODMAP diet a few months ago. Why? Because during the Portland GFBloggerRetreat I got sick. And I didn’t seem to get better. I had every stool and blood test around. I had yet another colonoscopy. I even had the genetic test for IBD looking for signs of Crohn’s disease or colitis. Thankfully, there was no sign of anything serious, but why was I so sick? They just told me over and over again that the only answer was IBS.

IBS – the seemingly catch-all diagnosis. I was diagnosed with it once before I was diagnosed with celiac disease. Was it the right explanation then? Is it the right explanation now? I’m not sure we’ll ever know. However, one thing that doctors do recommend for IBS, besides limiting stress (yeah right), is to start a Low FODMAP diet, to find out if you have a sensitivity to any FODMAP that might be giving you an irritable bowel. Little did I know, this diet was a hell of a lot more complicated than the gluten-free medically-necessary diet I have to have for celiac disease.

This list by Stanford Health Care, provides an overview of which foods are high in FODMAPS (and should therefore be avoided), and which are low.

FODMAPs (fermentable oligo-, di-, mono-saccharides and polyols) are carbohydrates (sugars) found in foods. FODMAPs pull water into the intestinal tract, they may not be digested or absorbed well by the body—and, in in excess, could be fermented upon by bacteria in the intestinal tract. For many people, this can lead to symptoms of diarrhea, constipation, gas, bloating and/or cramping – all signs and symptoms that are correlated with IBS.

High-FODMAP foods (the foods you don’t want) include:

• Fructose: some fruits (including apples, dates, pears), honey, high-fructose corn syrup
• Lactose: dairy (milk, chocolate, ice cream, sour cream)
• Fructans: chains of fructose in wheat, rye, garlic, onion
• Galactans: legumes such as beans, lentils, soybeans
• Polyols: sweeteners that end with “ol” (mannitol, sorbitol, xylitol) and some stone fruits (such as peaches, cherries, plums)

But I never learned what carbohydrates are in each food and I bet you didn’t either, so I had to dig through what this meant for each food group. Here’s the list from Delicious Living. I’ve added my own commentary on each section.

Eggs, Meats, Poultry & Fish

This was pretty easy for me. Although some crappy deli meat has HFCS.

• Low FODMAPs (eat): Beef, chicken, deli slices, eggs, fish, lamb, pork, shellfish, turkey
• High FODMAPs (avoid): Any meats made with high fructose corn syrup

 

Dairy

Again, easy for me, I already took dairy out of my diet. 

• Low FODMAPs (eat): Lactose free dairy (any), low lactose dairy: cream cheese, half and half, hard cheeses (cheddar, colby, parmesan, swiss, etc.), soft cheeses (brie, feta, mozzarella, etc.), sherbet, yogurt (greek), whipped cream
• High FODMAPs (avoid): High lactose dairy: buttermilk, chocolate, creamy/cheesy sauces, custard, ice cream, milk (cow’s, goat’s, sheep’s, condensed, evaporated), soft cheeses (cottage, ricotta, etc.), sour cream

 

Meat & Non-Dairy Alternatives

This one is pretty difficult because I LOVE lentils and cashews, especially for my dairy-free cheese.

• Low FODMAPs (eat): Almond, coconut, rice, soy (made from soy protein), nuts (walnut, macadamia, peanut, pecan, pine), nut butters, tempeh, tofu
• High FODMAPs (avoid): Cashews, beans, black eyed peas, bulgur, lentils, miso, pistachios, soybeans, soy milk (made from soybeans)

 

Grains

If you’re already gluten-free like I am, you just need to worry about chicory root and inulin.

• Low FODMAPs (eat): Made with gluten free/spelt grains (corn, oats, potato, quinoa, rice, tapioca, etc.): bagels, biscuits, breads, cereals, chips, crackers, noodles, pancakes, pastas, pretzels, tortillas, waffles, oatmeal, oat bran, popcorn, quinoa, rice, rice bran
• High FODMAPs (avoid): Made with wheat/barley/rye when it’s the major ingredient, gluten free/spelt grains made with foods to limit, chicory root, inulin

 

Fruits

This was the most difficult one for me. I LOVE apples and ate at least one a day for years. I also love blackberries, dried fruits, peaches, and pears. And Watermelon??? How DARE they take away my watermelon. I haven’t attempted to add these items back in, but they are first on my list.

• Low FODMAPs (eat): Bananas, blueberries, cantaloupe, cranberries, grapes, honeydew, kiwi, lemon, lime, mandarin, orange, passion fruit, pineapple, raspberries, rhubarb, strawberries, tangerine
• High FODMAPs (avoid): Apples, applesauce, apricots, blackberries, boysenberries, canned fruit, dates, dried fruits, figs, guava, mango, nectarines, papaya, peaches, pears, plums, persimmon, prunes, watermelon

 

Vegetables

I am so bummed about all the vegetables I can’t eat. I used to eat one head of cauliflower at least every few days. And mushrooms? I love them on my pizza, in asian stir-frys – everywhere….

• Low FODMAPs (eat): Alfalfa/bean sprouts, bamboo shoots, bell peppers, bok choy, carrots, cabbage (common), cucumbers, eggplant, green beans, kale, lettuce, parsnips, pumpkin, potatoes, radishes, rutabaga, seaweed (nori), spinach, squash, tomatoes, turnips, water chestnuts, zucchini
• High FODMAPs (avoid): Artichokes, cauliflower, mushrooms, sugar snap peas

 

Beverages

It’s probably a blessing to avoid any beverage with HFCS anyways. I drink LaCroix regardless, this wasn’t an issue for me.

• Low FODMAPs (eat): Fruit and vegetable juices/smoothies made with foods allowed (limit to ½ cup at a time), coffee, tea
• High FODMAPs (avoid): Fortified wines (sherry, port); any beverages made with high-fructose corn syrup or foods to limit

 

Seasonings, Condiments

The bullet to my chest. Getting rid of garlic and onions is like saying goodbye to two of my best friends. And then you throw in honey and hummus and you’re basically just making me cry into a pillow at night. However, I purchase onion and garlic free oil, pasta sauce, and BBQ sauce at The FODY Shop. This is THE best place to find Low FODMAP foods.

• Low FODMAPs (eat): Jam, jelly, pickle, relish, salsa, sauce, salad dressing made with foods allowed, most spices and herbs, broth (homemade), butter, chives, cooking oils, garlic/onion infused oil, maple syrup without HFCS, mustard, margarine, mayonnaise, onion (spring-green part), olives, pepper, pesto, salt, seeds (chia, flax, pumpkin, sesame, sunflower), sugar, soy sauce, vinegar
• High FODMAPs (avoid): Chutney, jam, jelly, pickle, relish, salsa, sauce or salad dressing made with HFCS/ foods to limit, agave, garlic, garlic salt/powders, honey, hummus, molasses, onions (brown, leeks, shallots, spanish, white, spring-white part), onion salt/powders, tomato paste, artificial sweeteners (isomalt, mannitol, sorbitol, xylitol)

         

However, the low FODMAP diet is more complicated than this. It’s meant to be a short-term diet. A few months on a strict diet, until your symptoms settle, and then a planned reintroduction. Introduce one food, see how your gut acts, and then you’ll put it on the “forever no” or “heck yes I can eat this again” list. Currently I’ve attempted to reintroduce beans, garlic, and onions with terrible, gut-wrenching results. Sad face.

I’m not sure if I’m doing better on this diet overall honestly. I also have to factor in that during this test, I also was tested for SIBO, small intestine bacterial overgrowth. I was placed on a Xifaxan for a week to help with the overgrowth, as this medication stays in the gut and is the medication for SIBO. I was really sick while taking the medication and finally eating a week after I stopped the medication. The whole time, I was on a Low FODMAP diet to help with any bacterial overgrowth and fermentation in the gut. SIBO isn’t fully understood, and GIs really don’t know how to best deal with it, but I was sick of being sick. Whether it’s the antibiotics or the diet, I think I may be getting better. Maybe.

I guess I won’t know how good I feel now until I reintroduce a high FODMAP food that I’ve been missing – like an apple – and see what happens, and try re-introducing those garlic, onions, and bean failures – again, in a few weeks once I feel better. Like any elimination diet, it’s best to do under the guise of a dietitian or nutritionist, or a really good GI that cares. Again, the low FODMAP diet is not meant to be a permanent diet.

If you’re interested in learning more about Low FODMAP diets, check out my friend Colleen Francioli’s book The Everything Low FODMAP Diet. If you are starting a Low FODMAP diet, I highly recommend purchasing the FODMAP app from Monash University – the founders of the Low FODMAP diet. It’s definitely worth the $7.99.

Unfortunately, this blog post doesn’t end with loose ends all tied up neat and tidy. I’m still working on FODMAP reintroduction and trying to slay this IBS. While FODMAPs were never something I wanted to learn about first hand, at least there are plenty of resources online to help everyone on this crazy journey to better health.