We know that diet advice can be confusing. There are so many fad diets that it can be hard to distinguish between fact and fad. Everyone is now talking about the Low FODMAP diet so we asked one of our dietitians to give us the low down on what it all means.
Low FODMAP diet
Roslyn Seselja APD
A low FODMAP diet is often recommended for people with Irritable Bowel Syndrome (IBS). IBS is a relatively common gastro-intestinal disorder, with symptoms including abdominal bloating, pain or discomfort; excessive wind; distension; and altered bowel habits such as constipation and/or diarrhoea. As you can imagine, this can cause of a lot of distress and embarrassment!
Approximately one in seven Australians have IBS, and in people with disabilities, including mood disorders, chronic fatigue syndrome, rheumatoid arthritis, lupus and ankylosing spondilytis, the prevalence is even higher (Solmaz et al, 2015). People with IBS often notice an association between eating particular foods and their digestive symptoms, but it can be quite difficult to determine exactly what food causes the issues.
So what exactly is a FODMAP? FODMAP is an acronym for various naturally occurring sugars in some foods containing carbohydrates. In people with Irritable Bowel Syndrome (IBS) these sugars (Fermentable Oligosaccharides, Disaccharides, Monosccharides and Polyols) are not absorbed well and unpleasant digestive symptoms arise.
Fortunately, researchers at Monash University in Melbourne have found that following a low FODMAP diet can provide relief from symptoms that often affect quality of life. The goal of the low FODMAP diet is to identify exactly what foods containing FODMAPs produce symptoms (as not all of them will). This knowledge about exactly what food causes symptoms allows people with IBS to avoid problematic foods and eat freely from foods that aren’t problematic, giving back some freedom lost when symptoms were present.
The low FODMAP diet consists of three stages - Elimination, Re-challenge and Maintenance, and it is recommended that the diet only be followed with the assistance of an experienced Dietitian. The first phase involves eliminating foods containing FODMAPs for a period of about 6-8 weeks. At the end of this period, most people will notice their symptoms have disappeared and they are ready to move onto the re-challenge phase. The Re-challenge phase involves reintroducing foods containing FODMAPs back into the diet and observing if any symptoms previously experienced return- if no symptoms, the food can be eaten freely once more. Some foods that do result in a return of symptoms may not be problematic if eaten in small amounts, so during this challenge phase a Dietitian can help you determine how much of a particular food can be eaten. The final Maintenance phase involves avoiding those foods (either totally or up to a particular amount) that give symptoms and eating freely from other foods that do not.
Importantly, if you have any of the symptoms of IBS, do not commence the low FODMAP diet without seeking the advice of your doctor. Your symptoms may be the result of a number of other conditions which will need to be ruled out before your doctor will diagnose IBS and possibly recommend the low FODMAP diet.
The elimination phase of the low FODMAP diet should not be followed for any longer than eight weeks. Many of the foods that contain FODMAPs (such as onions, apples, milk, celery, legumes) have many nutritional benefits and should not be restricted for any longer than necessary- the aim of the low FODMAP diet is to get you back to eating from a wide variety of foods you can tolerate as soon as possible. If you are not getting any relief from your symptoms after eight weeks in the Elimination phase, go back to your doctor to discuss further.
If you think a low FODMAP diet may benefit you because of your medically-diagnosed IBS, talk to a dietitian today. Dietitians are the experts in prescribing the right diet for your individual needs. Our dietitians have loads of experience working with people with disabilities who need to change their diets to improve their health and relieve the stress and embarrassment of gut symptoms. We can also come to you.
Solmaz D, Avci O, Yildirim O, et al FRI0206 Prevalence of Irritable Bowel Syndrome in Patients with Ankylosing Spondylitis Annals of the Rheumatic Diseases 2015;74:499.
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