The Low FODMAP Diet
Researchers at Monash University in Australia developed the low FODMAP Diet, which aims to reduce or eliminate foods that have certain carbohydrates. These are characterized as Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols (FODMAP). These short-chain carbohydrates (sugars) have been shown to induce the IBS symptoms of diarrhea, bloating, abdominal pain, and gas due to their poor absorption, their ability to hold water in the intestinal tract, and rapid fermentation.1,2
Professor Peter Gibson, Director of Gastroenterology at The Alfred Hospital and Monash University and Dr. Jane Muir, Head of Translational Nutrition Science at Monash University led the first group in the world to measure the majority of FODMAPs in food. The team now has a comprehensive database of FODMAP content in food that has been generated out of their laboratory at Monash University.
Low FODMAP diet and IBS
Research suggests that symptoms from irritable bowel syndrome (IBS) in one-quarter of patients may be exacerbated by one or more dietary components, and dietary components may play a role in the causation of IBS in some patients.3 Several studies show a benefit in diets that eliminate or reduce certain foods that tend to exacerbate IBS symptoms, and most patients with IBS believe that diet plays a significant role in their symptoms.3,4
What are FODMAPs?
When foods that are high in FODMAPs are eaten, they are not easily disgested by the body. These foods cause more water to be pulled into the intestines. In addition, because they aren’t absorbed in the small intestines, they act as fuel for the bacteria in the large intestines. The bacteria ferment these FODMAPs and produce gas. The excess water and gas cause the intestines to expand and cause abdominal pain.1
Foods that are high FODMAPs that are to be reduced or eliminated in the diet include:
The following is not a complete list but gives an idea of what foods are low in FODMAPs and those that are high in FODMAPs. Foods high in FODMAPs are to be avoided.5 Patients should consult with a dietitian or their health care provider for more information on the diet. It should be noted that there is no one diet that fits all IBS patients.
Low vs. High FODMAP Foods
|Food Groups||Low FODMAPs (Good)||High FODMAPs (Limit or Avoid)|
|Eggs, Meats, Poultry, Fish||Beef, chicken, eggs, fish, lamb, pork, turkey||Limit any made with high fructose corn syrup|
|Dairy||Any lactose-free/low lactose dairy: cream cheese, half & half, hard cheeses (cheddar, Parmesan, Swiss), soft cheeses (brie, feta, mozzarella), sherbet, Greek yogurt, whipped cream||High lactose dairy: milk (cow’s, goat’s, sheep’s, condensed, evaporated), buttermilk, chocolate, creamy or cheesy sauces, custard, ice cream, sour cream, soft cheeses (cottage cheese, ricotta)|
|Meat, Non-Dairy Alternatives||Milk alternatives (almond, coconut, rice, soy made from soy protein), nuts (walnut, macadamia, peanut, pecan, pine), nut butters, tempeh, tofu||Nuts (cashews, pistachios), beans, black eyed peas, bulgur, lentils, miso, soybeans, soy milk made from soybeans|
|Grains||Made with gluten free/spelt grains (corn, oats, potato, quinoa, rice, tapioca, etc)||Made with wheat/barley/rye when it’s the major ingredient, wheat flours (terms for wheat flour: bromated, durum, enriched, farina, graham, semolina, white flours), flour tortillas, chicory root|
|Fruits||Bananas, blueberries, cantaloupe, cranberries, grapes, honeydew, kiwi, lemon, lime, mandarin, orange, pineapple, raspberries, strawberries, tangerine||Apples, applesauce, apricots, blackberries, canned fruit, dates, dried fruits, figs, guava, mango, nectarines, papaya, peaches, pears, plums, prunes, watermelon|
|Vegetables||Bean sprouts, bamboo shoots, bell peppers, bok choy, carrots, cabbage, cucumbers, eggplant, green beans, kale, lettuce, pumpkin, potatoes, radishes, seaweed, spinach, squash, tomatoes, zucchini||Artichokes, broccoli, cauliflower, mushrooms, sugar snap peas|
Source: Stanford University Medical Center, Digestive Health Center, Nutrition Services. The Low FODMAP Diet
Resources for people with IBS
Monash University has developed a smartphone application (app) to help people with IBS follow the Low FODMAP diet. The app is available for a small fee for the iPhone, the iPad and for Android phones. The app includes information about FODMAPs, a food guide that details the FODMAP content for hundreds of foods, a recipe book, a shopping list for organizing low FODMAP foods, and a one-week challenge to trial and monitor a strict FODMAP diet.1