A hot dog with sauerkraut, a smoothie with kefir pouring into the glass, a wine glass full of kombucha, and a glass cup of lactose-free yogurt are all together on a pink background.

Fermented Foods on the Low FODMAP Diet 

For many, following the low FODMAP diet for IBS is one way to see symptom improvement. During the elimination phase especially, it can be difficult to include probiotic-rich foods. Many of our favorite fermented foods with active bacterial cultures are also high FODMAP – so disappointing!

However, there are still options that can help us to include fermented foods and introduce good bacteria for gut health, even on the low FODMAP diet. Let’s review!

Probiotics vs. fermented foods

To start, I want to quickly review the comparison between probiotics and fermented foods. Both play a role in healthy digestion, but they aren’t quite the same thing. Let’s start with probiotics.

Probiotics

There’s no doubt that the term ‘probiotics’ has become a trendy topic in the health world. Probiotics are defined as the “good” bacteria in our gastrointestinal tract. More specifically, in order to be called a probiotic, a food or supplement has to yield a health benefit to the person consuming it.

We each have a unique variety of bacteria in our gut that works for us individually – no two people have the exact same microbiome! However, scientists have discovered that certain strains help to improve specific symptoms in a variety of functional gut disorders. More on this in my article titled The Low-Down on Probiotics in IBS. To put it simply, we aim to match the right person, with the right strain and dose, for the right reason. The most controlled way to do this is to use a probiotic supplement that is evidence-based and regulated. That way, we can ensure each person gets the appropriate dose each and every day.

Fermented foods

Fermented foods on the other hand, are not always regulated. They may contain active bacterial cultures, but don’t have to meet a standard of how much or which strains of bacteria are present. For this reason, we simply cannot call fermented foods “probiotics” – unless they have been scientifically tested and proven to fit the definition! Additionally, there can be a variance between different brands and varieties of the same food – just think of how many different types of yogurt are at your supermarket!

But don’t fret, fermented foods are still important for the gut. Many times, we don’t know the amounts or types of bacteria in fermented foods – so they shouldn’t be used in the same way probiotics are – to manage a specific condition or symptom. That being said, I still like to encourage my IBS and gut health patients to eat something living every day by choosing different fermented foods. There is a small body of evidence that fermented milk products help to reduce IBS and digestive symptoms, and introducing new bacteria to the gut can help to support healthy gut microbiota.

Low FODMAP fermented foods

As mentioned earlier, some of our go-to fermented foods contain FODMAPs, short chains of carbohydrates that commonly worsen IBS symptoms. In order to eat something living every day, choose fermented foods that are low in FODMAPs. This is especially important during the initial elimination phase of the low FODMAP diet!

Some of my favorite low FODMAP fermented foods include:

  • 1 tablespoon of fermented sauerkraut – add on top of a salad or use a condiment for meats
  • ½ cup (125 ml) of kombucha – sip from a wine glass to feel fancy!
  • 1 tablespoon of kefir – try mixing into a smoothie or adding to your morning oatmeal
  • Lactose-free yogurt – Although there is no lactose remaining in these products, they still contain live microorganisms! The recommended serving is ¾ cup, according to Monash University.

Keep in mind, servings larger than the ones outlined above may become high FODMAP. However, the low FODMAP diet for IBS is designed in such a way that we can likely consume these foods a few times each day if we choose. If this is the case, try to space out these fermented foods, allowing 3-4 hours between. For example, if you have kefir at breakfast, wait until lunch or dinner to have some fermented sauerkraut.

Bottom line

Including fermented foods is not the same as taking a probiotic. We are still learning how fermented foods improve our health – but at this time have fun with it by introducing small amounts of low FODMAP fermented foods to your diet!

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