FODMAPs are a group of sugars that are resistant to digestion in the body. They show difficulty in either complete digestion or absorption in the body and when they reach the small intestine, they move slowly and because of the osmotic effect, attract a lot of water in the lumen of the intestine. Also, when they pass into the large intestine, they are fermented by gut bacteria, resulting in gas formation.
FODMAPs stands for:
| FERMENTABLE | The process through which gut bacteria ferment carbohydrates to produce gasses |
|---|---|
| OLIGOSACCHARIDES | Fructans - found in foods like wheat, rye, garlic, legumes |
| DISACCHARIDES | __– found in dairy products |
| MONOSACCHARIDES | Fructose – found in honey, apples, syrups |
| AND | |
| POLYOLS | Sorbitol and Mannitol – found in fruits and vegetables and used as an artificial sweetener |
In the general population, FODMAPs doesn’t trigger any signs or symptoms but in certain digestive conditions like IBS (irritable bowel syndrome), foods high in FODMAPs when reached large intestine, produce hydrogen gas when fermented by gut bacteria and that leads to gas, bloating, stomach cramps, pain, constipation or diarrhea.
Low-FODMAP diet
The effects of a low FODMAPs diet have been extensively studied in people with IBS. The benefits may include fewer GI symptoms like relief in bloating, diarrhea, constipation, and stomach pain. It may also have psychological benefits as digestive disturbances may cause stress and mental agony that disturbs the routine life.
But it is not advisable to continue the diet for a longer period (more than 4 to 6 weeks) as it may have deleterious effects on healthy microflora of the gut and can also cause deficiency of vitamins, minerals, and fiber intake. Re-introduction of a small quantity of FODMAPs food may assist in the gradual restoration of intestinal microflora by providing essential prebiotics to one’s diet. Prebiotics refers to non-absorbable compounds beneficial for native microflora of the host and assists to improve the response to FODMAPs food.
Reintroduction of FODMAPs food also helps to assess:
- Type of foods which trigger the symptoms as some foods can be well digested compared to others, so eliminate only those which are the causative agents
- Amount of food that triggers the symptoms, known as “threshold level”
Also, rather than self-assessing the symptoms and starting with a low FODMAP diet, it is always advisable to start it once __ has been diagnosed medically. If a physician has not diagnosed any GI symptoms, it is not advisable to start with a low FODMAP diet.
High FODMAPs food and Alternatives
FODMAPs are found in a wide range of fruits, vegetables, bread, cereals, legumes, and nuts. Instead of blindly following a low FODMAP diet, one should also focus on adding the alternative of food items in the diet to prevent any nutritional deficiencies.
| Category | High FODMAP Food | Low FODMAP Alternative |
|---|---|---|
| Vegetables | Cauliflower, garlic, mushrooms, onion, green peas | Eggplant, green beans, bell pepper, cucumber, carrot, potato, tomato |
| Fruits | Apple, cherries, mango, plum, pears, watermelon, pears | Grapes, kiwi, orange, pineapple, strawberries |
| Dairy | Cow’s milk, ice cream, soy milk (made from whole soybeans), yogurt, paneer | Almond Milk, feta cheese, lactose-free milk, soy milk (made from soy protein) |
| Protein Sources | Legumes/Pulses, marinated meats/seafood, processed meats | Eggs, tofu, tempeh, plain cooked meat/poultry/seafood |
| Bread and Cereals | Wheat/rye/barley bread, biscuits, breakfast cereals | Cornflakes, oats, quinoa flakes, rice cakes, wheat/rye/barley free bread |
| Sugar/Sweeteners | High fructose corn syrup, honey | Dark chocolate, maple syrup, table sugar |
| Nuts and Seeds | Cashews, pistachios | Macadamias, peanuts, walnuts, pumpkin seeds |
Following a low FODMAP diet may or may not improve the symptoms in all the patients with IBS. In those cases, other diet therapies may be recommended by the physicians along with medications. Also, low FODMAP diets need to be done under the supervision of an expert to prevent any nutritional deficiencies.
Reference list
- Healthline. (2022). What Is the Low FODMAP Diet? Food List, Steps, and Benefits.
- Monash University (2019). About FODMAPs and IBS | Monash FODMAP - Monash Fodmap.
- Syed, K. and Iswara, K. (2021). Low-FODMAP Diet.
