Have you ever come across an acronym that you just couldn’t figure out? A colleague at work shared with me that he had just learned what LMAO stood for. How about diets? Sure there’s the DASH diet (dietary approach to stopping hypertension), the GAPS diet or gut and psychology diet, but what about the FODMAP diet? Ever heard of that one? Well on the heels of episode 97, all about candida, fungus and yeast, I thought an episode about FODMAPS could be really helpful as I had so many emails, texts and messages on social media and there are a lot of frustrated people out there dealing with issues. Clearly the more information you have to help identify health issues, the more empowered people feel. The FODMAP diet is one for gut issues like IBS, SIBO, bloating, gas, and pain without bowel habit issues – see how I threw in a couple more acronyms there – in case you don’t know, IBS is irritable bowel syndrome and SIBO is small intestinal bacterial overgrowth. And as you know that I’m rather a gut health geek and it has been quite the focus of my practice for over 20 years, this diet is one that could help you to ease your issues. Although it’s called it a diet, it’s not long term. Not one you go on and it becomes your lifestyle like Keto, for instance. But if eliminating certain foods that come under the FODMAP diet, help you to know what foods trigger your gut issues, it’s worth the experiment. Not something to be undertaken without help from a nutritionist like me, but that there is a way, a structured way of working through an elimination and reintroduction to find out if in fact that broccoli, cabbage or cauliflower sets off a gas storm in your belly.
So today on EAT THIS with Lianne, the FODMAP diet. What do all those letters stand for, what is it, is it right for you?
IBS, SIBO, bloating, flatulence, gas, pain and discomfort can really take up a lot of your day’s focus. This past week I had a really odd heavy feeling in my abdomen and it was all I could think about as I worked. Not only is the issue tiring, but mentally it’s draining too. Then there’s the stress that your body goes through when you’re in pain, as well as the stress of not having predictable bowel habit, and of course the embarrassment of gassiness that depending on the type of person you are, can actually be embarrassing or some feel quite proud of stinking up a room and making everyone run for cover. But what’s underlying is that your gut isn’t healthy. Possibly from what I mentioned in the candida episode – an overgrowth and imbalance of the microbiome in your gut – that’s the ratio of good to bad bacteria, and if it’s not around 80% good guys, and 20% bad guys, then there are issues. Can your issues come from a parasite like in the case of what I call a never-well-since situation when you had terrible food poisoning around home or while travelling and the issue has persisted off and on since.
Generally speaking gas comes from fermented foods in your gut and that’s either from the foods themselves, or from the existing gut bacteria balance being off. Today we are going to look at the foods that can create gassiness, pain, IBS and more, and those can fall under the FODMAP foods. I know you’re dying to know what on earth this is stands for so lets start there:
F stands for fermentable or foods that make gas when they are digested
O, D, M and P stand for different shapes of sugar called saccharides;
Oligosaccharides (oligo –“few,” saccharide – “sugar”) like beans, peas and lentils. Then there’s alliums from onions, garlic and cruciferous veggies, wheat barley and rye. Different from going gluten free because of the protein gliadin, this is about the carb portion.
Disaccharides (“two sugars”) Monosaccharides (“one sugar”) – dairy or lactose, and fructose or fruit sugar. HFCS too.
Polyols (these are sugar alcohols) – stone fruits and avocado. Artificial sweeteners and what’s added to gum.
FODMAPs are a type of carbohydrate, or “sugar,” found in certain foods. Carbohydrates give us energy, along with fat and protein. People with IBS, a slow moving gut, or other bowel disorder may not tolerate foods with FODMAPS; they are not easily absorbed by the bowel. Side note: as well as gas, poorly absorbed fodmaps can pull extra water into the intestines and cause diarrhea.
So this is all about carbohydrates, not about fats or protein. So all meat, poultry, fish, eggs, butter, oils, and hard cheeses don’t come into this at all.
Let’s talk about some of these sugars and the foods that they come from.
Fructose is a naturally occurring sugar found in fruit, vegetables, and honey. Fruits and fruit juices with higher levels of fructose may cause gas, bloating, abdominal cramping, and diarrhea. For some people, even a small amount of fruit juice may worsen symptoms. Glucose is also a naturally occurring sugar. Fruits and juices with more glucose (and less fructose) may be more “intestine friendly.” The tables in the following section list which fruits, juices, and other foods may be better choices if you have FODMAP intolerance.
Keep in mind the amount of fructose found in 2 apples (or 2 oz of honey) is the same as the amount of fructose in 1 can of soda, but apples have other nutritional benefits. Follow guidelines below to choose fruits, vegetables, and other foods that are friendlier to your intestines!
LOW FODMAP FRUIT: Bananas Blueberries Cantaloupe Grapefruit Grapes Honeydew Kiwi Lemons Limes Oranges Papaya Passion fruit Pineapple Raspberries Rhubarb Strawberries Tangelos Note: Avoid eating large amounts of any fruit.
HIGH FODMAP FRUITS: Apples Applesauce Avocados Blackberries Dried fruits (e.g., raisins, dates) Fruit juice Lychees Pears Persimmons Watermelons Stone fruits: Apricots Cherries Mangos Nectarines Peaches Plums Prunes
½ cup of cut fruit or a medium (baseball size) whole fruit. Limit to 1 to 2 servings per day. Fresh or fresh frozen fruit may be better tolerated than canned fruit. Tolerance may depend on the amount you eat at one time. Limit concentrated sources of fruit, such as dried fruit and fruit juices.
LOW veggies – Bamboo shoots Bok choy Carrots Celery Chives Cucumber Eggplant Green beans Kale Lettuce Parsnips Pumpkin Radish Red bell pepper Spinach Squash Sweet potato Turnip White potato Zucchini
High veggies – Artichokes Asparagus Beets Broccoli Brussels sprouts Cabbage Cauliflower Fennel, Garlic Green bell peppers Leeks Mushrooms Okra Onions Shallots Sweet corn Tomato paste.
High Fructose Corn Syrup (HFCS) HFCS is an ingredient in many processed foods. HFCS is made up of almost half glucose and half fructose, similar to regular table sugar (i.e., “sucrose”). HFCS may not be a problem for people with FODMAP intolerance. So, foods and drinks with HFCS, such as soft drinks, may be ok to include in your diet as long as they are limited to 12 oz per day and are taken with a meal. But for some people, even a small amount of processed fruit juice or HFCS may cause intestinal discomfort and/or malabsorption.
Sorbitol Sorbitol (or sorbose) is a sugar alcohol that is found naturally in fruits and fruit juices. It is used as an artificial sweetener. It can also be found in many “diet foods” or “diabetic” foods like diet soft drinks, sugarless gum, sugar free jelly/jam, and other sugar-free foods. It may also be found in liquid medications. Sorbitol often creates similar symptoms as fructose – especially when fructose and sorbitol are taken together. Medications Many liquid medications and some personal care items may contain sugar alcohols (sorbitol, mannitol, xylitol, maltitol, isomalt). Examples include: liquid pain relievers (including liquid gel caps), cough medicines, and cough drops. If possible, choose a tablet or caplet form instead of liquid medication.
If you have eliminated FODMAPs from your diet and are still having symptoms, talk to your pharmacist to see if any of your medications contain lactose or sugar alcohols.
Three Steps to a Low FODMAP Diet
Remember I said that this is NOT a long term diet, it’s meant as a big fat test and so getting help with it is your best case scenario. I have worked with clients for years, taking foods out of their diet and putting them back in to see, and let me tell you, discerning symptoms and how things unfold in either the elimination stage or the reintroduction stage, can be so confusing, so someone helping is essential.
Remember that it’s short term, and while we all hate change, taking foods out of your diet and that feeling of deprivation can be high, keep your eye on the prize of feeling better, and knowing that you’re really following this to get relief from all that’s going ono. Further to that, with testing like my energetic testing method, or Coach Jay’s EAV or Dr Brockenshire’s muscle testing, you can find out what’s underneath this in terms of bacteria, parasites and follow up with gut healing as this diet is to give you relief and figure out what triggers your symptoms. It’s multi-layered, and not just one thing.
Ok back to it. The low FODMAP diet is not a traditional diet like ones you may have heard of or tried. Instead, it’s a learning process that will help you find out which foods make your symptoms worse, without taking away any that don’t.
Step 1: First, look over the list of high FODMAP foods. If you eat too much of any of them, try cutting them out first.
Step 2: If you feel a lot better, that may be all you need to do. If not, try to cut out all high FODMAP foods as much as you can for 6-8 weeks.
Step 3: After 6-8 weeks of cutting out all high FODMAP foods, bring foods back in one at a time. That way, if your symptoms get worse, you will know which food caused it.
The reintroduction of these foods is where it starts to get interesting and where help continues to be essential. There has not been enough research on the low FODMAP diet to know for sure what the best way is to bring foods back. Here are three ways:
Option 1: Bring back lower FODMAP foods first, slowly working up to the highest FODMAP sources.
Option 2: Bring back high FODMAP foods first.
Option 3: Bring back your favourite FODMAP foods first.
Ok to recap: FODMAPS are foods that can cause discomfort, bloating, gassiness, IBS; constipation and diarrhea, even nausea. You’re going to cut out the high fod map foods for between two and 8 weeks, but then add them back one by one to see if they cause issues. All stages being followed by a healthcare provider like myself, a registered nutritionist, is key for this. You don’t want to end up deficient, triggering any food restrictive behaviours, and you must re-introduce them. This is not a long term restriction, but just long enough to give your gut a rest and then try again. The healing portion that’s not really a part of this diet is crucial too. That’s another reason to work with a nutritionist who specializes in gut health. Sure these foods may not be genetically right for you, there’s that, but you must rule out any other issues like candida, parasites, or other microbiome imbalance.
Eliminate products with ingredients that list fructose, crystalline fructose (not HFCS), honey, and sorbitol on the label. Avoid sugar alcohols. These include sorbitol, isomalt, lactitol, maltitol, mannitol, xylitol, erythritol, and lactitol. These are often found in “diet” or “diabetic foods” such as diet drinks, ice cream, candy, processed goods, etc.
Limit drinks with HFCS. If you drink them, drink less than the recommended serving size – less than 12 oz of soda. It may help to drink with a meal.
Check your medications for fructose and sorbitol. They are not always listed on the label, so check with your pharmacist or the manufacturer.