What Is FODMAP?

I don’t know why people squirm as soon as there is mention of bowel habits. Maybe it’s one of those taboo topics carried over from generation to generation, just a subject we’re taught not to discuss. Despite this, it’s usually one of the most important questions we ask a client. Of course, we put a subtle spin on the matter, not wanting to cause embarrassment or awkwardness; “So can you tell me about your bowel habits” or “How frequently do your bowels open” or “what is the shape or texture like?” Occasionally there will be a disconcerting look of “did you really just ask such a personal question”, but usually, people will go with the flow, or so to speak.

More and more people are complaining of bloating, gas, lethargy, pain, and runny poos. Over the past ten to twenty years, there appears to have been a sudden rise in the number of people suffering from Irritable bowel syndrome (IBS) symptoms. This is why it’s excellent we can now provide those suffering from gas, bloating or diarrhoea with more information on the low FODMAP diet. 

What Does FODMAP stand for?

 

FODMAPs is an acronym for Fermentable Oligosaccharides, Disaccharides, Monosaccharide’s, and Polyols (What a mouthful, you can see why they went for the acronym). If you’re looking at your screen with a scrunched-up look of confusion, don’t fret. Put simply, FODMAPs refers to poorly absorbed sugars or carbohydrates that cause fermentation in our gut.

Let us use Monosaccharide & Disaccharide as examples to explain FODMAPs further.

Mono = One Saccharide = Sugar

Monosaccahride = One Sugar Molecule (e.g. Fructose)

Di = Two Saccharide = Sugar

Disaccharide = Two sugar molecules (e.g. Lactose (galactose + glucose))

Don’t get too caught up with the long unusual words. Essentially each word refers to a different sugar molecule of a different length. Each of the sugars can be poorly absorbed in our gut which causes fermentation leading to gas, bloating and other uncomfortable symptoms.

 

How do FODMAP Affect Our Body?

 

If you were under the impression that we have two intestines, you would be correct; we have a small intestine and a large intestine. 

Fun Fact: Your small intestine is almost the length of a double-decker bus when fully stretched out. 

If you’re wondering why all of this mention of intestines? Well, they are an integral part of our FODMAPs story.

When we eat, food travels from our mouth down our oesophagus to our stomach. From here, the partially digested food moves to our small intestine. In the small intestine, most of the nutrients and water from our food is absorbed before it finally travels to our large intestine, where more water is removed before whatever solid matter left over leaves our body as poo.

IBS symptoms can be caused by high FODMAP foods being poorly absorbed in the small intestine. This poorly absorbed food moves from the small intestine to the large to further break down the food. In this stage, excessive bacteria can form that produces gases, known as the fermentation process. The picture below should help to explain this fermentation process.

Photo Source: Monash University, Faculty Medicine, Nursing and Health Sciences

How Can a Low FODMAP Diet Help You?

Irritable bowel syndrome (IBS) is more common than you may think, affecting one in seven Australian adults. The condition is characterised by chronic and relapsing symptoms of lower abdominal pain and discomfort, bloating, wind and altered bowel habits.

Monash University is at the forefront of the Low FODMAP diet. Their research found that the temporary removal of foods high in FODMAPs reduced IBS symptoms. Eating less of these poorly absorbed foods results in fermentation within the large intestine, subsequently producing less gas and bloating. Happy days!

 

What Is a Low FODMAP Diet?

Just as it sounds, a low FODMAP diet is eating foods that are low in FODMAPs and temporarily removing all foods that are high in FODMAPs. A low FODMAP diet is usually only recommended as a trial for 6-8 weeks to initially help reduce symptoms. After this trial period, once the symptoms are controlled, as most people can tolerate certain FODMAPs, certain foods can be reintroduced into the diet to increase nutritional variety. Each FODMAP must be systematically challenged one at a time; an experienced Dietitian can help you complete these challenges correctly. The process is very individual, Sally for example may find she can tolerate small amounts of lactose, fructose and Polyols. In contrast, John may discover he can only consume foods that contain fructans and Polyols.

 

What are FODMAP foods? 

 

MONOSACCHARIDES (High Fructose)

  • Vegetables: asparagus, artichokes, sugar snap peas
  • Fruit: apples, cherries, figs, dried fruit, fruit bars, mango, nashi, pears, tinned fruit in natural fruit juice, watermelon
  • Drinks & Sugars: Apple juice, fruit blends, high fructose corn syrup, honey, tropical juices

DISACCHRIDES (High Lactose)

  • Milk
  • Condensed milk
  • Yoghurt
  • Soft cheese
  • Custard
  • Evaporated milk
  • Ice cream

OLIGOSACCHARIDES (Fructans or Galactans (GOS))

  • Vegetables: artichokes, garlic, legumes, onion
  • Fruit: Custard apples, nectarines, white peaches, persimmon, tamarillo, watermelon
  • Bread/cereals/snacks: Barley, rye, wheat (pasta, couscous, wheat bran, bread), muesli based fruit bars
  • Nuts, seeds: Cashews, pistachios

POLYOLS

Sorbitol

  • Fruit: apples, apricots, blackberries, nashi pears, nectarines, peaches, pears, plums
  • Artificial sweeteners: Sorbitol, mannitol, xylitol

Mannitol

  • Vegetables: cauliflower, mushrooms, snow peas
  • Fruit: peach, watermelon

ALCOHOL (Side note)

  • Alcohol is irritant to the gut
  • FODMAPs are present in some wines and ciders
  • Limit intake of sticky wine, sparkling wine and rum if you have fructose malabsorption

What are low FODMAP foods? 

 I know it can look overwhelming to see so many of your favourite foods on the high FODMAP list but remember, you may not have to avoid these foods forever. In the meantime, there are plenty of foods that are low in FODMAPs, including gluten-free bread, pasta and cereals, a number of fruits and vegetables and lactose-free dairy products. A full list of low FODMAP foods can be found on the Monash University website, along with many more resources, including a sample Low FODMAP diet.

NOW WHAT …

If you’re suffering from persistent IBS symptoms and think a low FODMAP diet could help you, find your nearest Accredited Practicing Dietitian to help, you get things started properly. And remember it’s essential to seek professional advice before cutting any food groups out of your diet; a Dietitian can help ensure your diet remains balanced and nutritionally adequate.

There are also great low FODMAP products and even a low FODMAP grocery store.