The low FODMAP diet was developed by Dr. Sue Shepherd and Dr. Peter Gibson in 1999 to manage symptoms of IBS. FODMAPs, which stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols, are short-chain carbohydrates that some people cannot properly absorb in the small intestine. They then travel to the large intestine where they:
- are fermented by gut bacteria, and
- have an osmotic effect (draw water from the intestinal vessels into the digestive tract).
The combination of fermentation and osmosis can cause gas, bloating, pain, and diarrhea – symptoms of IBS.
FODMAP intolerance is not the cause of IBS; rather, people with IBS tend to be intolerant of FODMAPs. Keep in mind that foods high in FODMAPs are by no means inherently unhealthy (in fact, many are extremely nutrient-dense!); they just happen to trigger digestive distress in certain people with compromised digestive health.
what exactly does the low FODMAP diet consist of?
There are two phases to the low FODMAP diet. In the first phase, you eliminate all high FODMAP foods for a period of 6 - 8 weeks. Examples of high FODMAP foods are:
· Fructose – apples, cherries, mangos, pears, persimmon, honey, HFCS, etc.
· Lactose – dairy
· Fructans – wheat, garlic, onion, inulin, etc.
· Galactans – legumes, pulses
· Polyols – sweeteners containing isomalt, mannitol, sorbitol, and xylitol; stone fruits such as avocado, apricots, cherries, nectarines, peaches, plums, etc.
For a comprehensive list of foods to avoid and foods that are safe, visit http://www.ibsdiets.org/fodmap-diet/fodmap-food-list/
After symptoms subside in phase one, you're ready to move on to the second phase. Here, you gradually re-introduce foods with higher FODMAP contents to see which foods (and in what amounts) you can tolerate. The results of that testing determine the personalized, long-term diet that should keep your symptoms at bay.
SHORTCOMINGS OF THE FODMAP DIET
Phase two of the low FODMAP diet is designed to be followed until the foods are no longer a problem, which may very well be forever if there is no protocol in place to treat the underlying cause of the FODMAP intolerance. And therein lies the biggest shortcoming of this diet: there is no healing protocol in place. The FODMAP diet aims only to relieve symptoms, not to heal the underlying problem(s) that is causing the digestive distress in the first place. The long-term solution is not simply to avoid the problematic foods forever; rather, the solution is to remove these from the diet while starting a gut-healing protocol that corrects the underlying problem that is causing the intolerance. Once the underlying GI issue has been resolved and the gut is healthier, you can re-test problematic foods as they may well be tolerated.
Another issue is that many people who go on this diet end up with nutritional insufficiencies or deficiencies because so many nutrient-dense foods (e.g. fruits and vegetables) are off limits. To combat this, it's important to do the diet under the supervision of a trained nutrition professional who can provide you with the supplements you need to make sure your nutritional bases are covered. A therapeutic supplement regimen that addresses nutrient needs and fosters gut healing is a critical adjunct to this diet.
MY TAKE ON THE FODMAP DIET?
It can be a good starting point for treating IBS, but definitely isn't the most comprehensive or advanced protocol. In my practice, I use my own, more refined variation of the FODMAP diet with clients, but quite rarely - only in very particular situations that warrant such a high level of restriction. I rely much more on creating less restrictive, personalized protocols that address the specific symptoms that each client is facing. And I always include a personalized therapeutic regimen aimed at healing the gut, re-balancing the body, and correcting the underlying problems. After all, IBS presents in many different ways so there really isn't a one-size-fits-all approach.
If you or anyone you know is suffering from digestive issues (IBS or otherwise), get in touch! I specialize in helping people heal from digestive problems and have had amazing success with my clients.