Health & Fit: Everything You Need to Know About a Low-FODMAP Diet

If you’ve ever suffered from gastrointestinal (GI) distress, you’ve likely heard the term ‘FODMAP’ and maybe even wondered, “What the hell does that mean?” It sounds complicated (and it kinda is), but reducing or eliminating FODMAPs from your diet may help ease your digestive woes. FODMAPs refer to a certain group of small carbohydrates—fibers and sugars—that are commonly malabsorbed and have been shown to trigger symptoms of irritable bowel syndrome (IBS), primarily abdominal pain and bloating. A few of the main food offenders in FODMAP land are dairy products, wheat, and beans.

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A low-FODMAP diet has been shown to improve digestive symptoms of IBS for up to 86%¹ (but typically closer to 70%²) of those living with this condition, Kate Scarlata, M.P.H., R.D.N., digestive health and FODMAP diet expert and author of The Low-FODMAP Diet Step by Step, tells SELF. (IBS is a condition in which people experience abdominal pain and changes in bowel movements, including diarrhea and constipation.)

The connection between eating fewer FODMAPs and improved GI symptoms is not well understood. “But we know consuming FODMAPs stretches the intestine, which can trigger pain and the sensation of bloating in sensitive people,” Scarlata explains. In theory, reducing this stretching should relieve uncomfortable IBS symptoms.

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There is some evidence to back this theory up. A 2019 study² published in Nutrients examined the quality of life in those who have IBS, and concluded that following a low-FODMAP diet for four weeks reduced symptom severity, including bloating and abdominal pain. There is some animal research³ to suggest that a high-FODMAP diet may cause an imbalance in the bacteria in your gut, as well as inflammation and a loosening of the intestinal wall, which allows toxins and bacteria to flow from the gut to the bloodstream. But “diet research in IBS is a relatively new science, so we still have a lot to learn,” adds Scarlata.

With that, let’s jump into what foods are considered low-FODMAP and high-FODMAP, how the diet works overall, and some meal planning and prepping ideas to get you started.

What does FODMAP mean? | How to get started | How it works | Low-FODMAP foods | High-FODMAP foods | Shopping list and recipes

So, what does FODMAP actually mean?

The term ‘FODMAP’ is just a fancy acronym for these simple and complex sugars: fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. (Try saying that five times fast!)

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While those sound more like foods from outer space, they are commonly found in everyday eats, including:

• Fructo-oligosaccharides: You can find these in wheat, onions, and legumes.
• Lactose: This is the type of sugar found in milk and dairy products.
• Fructose: If you’ve ever eaten fruits, vegetables, or honey, you’ve had fructose.
• Galactans: These are sugars found in legumes.
• Sorbitol: You consume this in stone fruits and artificial sweeteners.³

What to know before you start a low-FODMAP diet

Before you jump in, it’s important to note that a low-FODMAP diet can be very restrictive, meaning it can also be challenging to follow. In addition, it’s really important to speak with a professional, such as a registered dietitian who is familiar with digestive disorders, before you start this eating plan—or any diet intended to relieve GI symptoms—because you could develop side effects like unintended weight loss or nutritional deficiencies if it’s not done correctly.

“Working with a registered dietitian who is trained in the low-FODMAP diet can help to ensure that you are an appropriate candidate for the diet, following the protocol correctly, meeting your nutrient needs and, hopefully, minimizing stress and maximizing enjoyment while following the protocol,” digestive health expert Alyssa Lavy, M.S., R.D., C.D.N., tells SELF.

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This may sound far-fetched, but science suggests otherwise.If you're unfamiliar (lucky, lucky you!), IBS is a chronic disorder affecting the large intestine. Typical symptoms include cramping, bloating, gas, and abdominal pain. Some people with IBS experience constipation, while others experience diarrhea, and others experience a vacillation between both. While it affects a significant portion of the population, there is a spectrum of severity when it comes to IBS; some people experience mild, occasional symptoms, and others deal with more severe cases.

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Unsurprisingly, it’s a bit complicated (there are three stages involved). The purpose is to figure out which foods are troublesome for you and in what amounts, so you can safely and comfortably create an eating plan tailored to your personalized needs. Here is what you can expect from each stage:

1. Restricting high-FODMAP foods: During this stage, you strictly avoid all high-FODMAP foods (see more on what those are below). You typically only do this for two to six weeks, according to Johns Hopkins Medicine, but how long it takes to feel relief from your GI symptoms depends on your personal health. But once you feel better, you can move on to stage two.
2. Reintroducing high-FODMAP foods: At this point, you can start adding back a high-FODMAP food every three days. This is where working with a registered dietitian comes in handy, as they can help you through this process.
3. Finding what works for you: Once you know how your body reacts to different high-FODMAP foods, and the amounts you can tolerate, you can create a modified low-FODMAP diet to follow long-term. In this stage, you can freely eat the foods that don’t give you GI distress, and limit or avoid those that do. Getting here is an accomplishment and important not only for your IBS symptoms, but also for your overall gut health.⁴

Probably the most complicated part of the low-FODMAP diet (besides pronouncing all the names) is distinguishing which foods are safe to eat. Low-FODMAP foods are very low in the problematic sugars. So, what can you actually put on your plate?

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The answer really depends on your GI symptoms.“What works for one person with IBS might not work for someone else,” Christine Henigan M.S., R.D., L.D.N., a clinical dietitian at Jefferson Lansdale Hospital in Philadelphia, tells SELF.

“​​Some examples of foods that do not contain detectable FODMAPs include strawberries, pineapple, kale, spinach, carrots, oranges, cucumbers and parsnips, additionally, meat, poultry, fish and eggs—unless prepared with marinades, sauces, or seasonings that include high FODMAP ingredients,” says Lavy.

If that’s not enough to get you meal planning, you can find a complete list of low-FODMAP foods here. If you need a little more direction, Scarlata adds that some of her low-to-moderate FODMAP grocery store staples include:

• Oats
• Brown rice
• Quinoa
• Chia and pumpkin seeds
• Slow leavened sourdough bread
• Peanut butter
• Lactose-free plain Greek yogurt and lactose-free milk
• Firm tofu
• Pumpkin

If you’re looking for more of an on-the-go snack, there are low-FODMAP snack bars you can buy at the store or online, such as FODY foods, Go Macro, and Enjoy Life foods.

When someone with IBS eats high-FODMAP foods, they will likely experience unpleasant side effects, like stomach pain, bloating, gas, and an urgency or a change in their bowel habits, according to Monash University. While researchers are still trying to understand what exactly is happening in the body and brains of people with IBS, they do think it has something to do with how the brain perceives these symptoms, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

“Our gut bacteria ferment these carbohydrates and this can produce gas and draw water into the intestines,” says Lavy. “While this process occurs in everyone, those with IBS typically tend to have visceral hypersensitivity, meaning their brain may perceive this normal reaction as painful.”

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Some commonly consumed high-FODMAP food triggers for IBS include:

• Onion
• Garlic
• Mango
• Honey
• Foods rich in lactose, like milk and yogurt
• Stone fruits
• Cauliflower
• Broccoli
• Watermelon
• Wheat
• Rye
• Barley
• Apples and pears
• Most beans

The thought is that by avoiding these foods, you may be able to reduce or eliminate the painful GI symptoms associated with IBS.

Although you may think your options are limited on a low-FODMAP diet, there are plenty of foods to add to your grocery cart. You just may need to get a little creative when it comes to your meals. To help, Scarlata has an extensive list of low-FODMAP foods that she shares with patients, and there are a number of easy tips and recipe ideas you can follow.

One way to add flavor is with infusion, says Lavy. “Garlic-infused oil can be used in recipes to provide flavor without the FODMAPs, since FODMAPs are not fat soluble, meaning they cannot leach into fat,” says Lavy. Another tip is to swap onions for other flavor-producing vegetables. “Chives and the dark green parts of scallions and leeks are low-FODMAP, so these options can be used in place of onion,” she recommends.

And don’t forget other high-flavor add-ins like citrus and herbs. For example, lemon juice or fresh orange slices can brighten a dish, and herbs and spices, such as cinnamon, rosemary, thyme, oregano or paprika, add tons of flavor, says Lavy.

If you’re looking for a few staple low-FODMAP meals, Scarlatas has three go-to meal ideas that she recommends:

Nourish bowls

If you’re looking for comfort in a bowl, look no further than this veggie-packed dinner. Start with a layer of brown rice or quinoa, and then top with your favorite low-FODMAP veggies. A few good options include:

• Celery
• Red bell pepper
• Carrots
• Spinach

Then you add your protein, which can include things like grilled chicken, shrimp, or sauteed firm tofu. Finish with a drizzle of Fody foods Sesame Ginger Sauce (which is a certified low- FODMAP dressing), or a homemade lemon, olive oil, and Dijon mustard vinaigrette. It’ll taste just as good as your Sweetgreen salad, we promise.

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Veggie and tofu “fried rice”

If you thought Chinese food was off the table, think again. For this hearty meal, sauté your favorite low-FODMAP veggies (see above for ideas), and mung bean sprouts in sesame oil. Then add in firm tofu until it starts to brown. Next, fold in cooked brown rice (Pro tip: Buy frozen brown rice and cook in the microwave for an easy weeknight dinner). Finally, season with soy sauce and more sesame oil, to taste. And there you have it, all the flavors of takeout without the gas and bloating.

Low-FODMAP pizza

Pizza may not seem like a low-FODMAP essential, but if you use a suitable low-FODMAP crust (Scarlata likes Udi’s frozen gluten free crusts), it totally is. Just top the crust with a low-FODMAP marina, a handful of shredded mozzarella, and bake it up. Voila, the pizza of your IBS dreams.

The bottom line when it comes to the low-FODMAP diet is it can be a really useful tool in the fight against IBS symptoms. That’s not to say the journey will be easy or fun, but working with a registered dietician can help you through to the other side—a life where you know what foods to eat to feel your best.

Sources:

1. Dovepress, Efficacy of the low FODMAP diet for treating irritable bowel syndrome: the evidence to date
2. Gastroenterology and Hepatology, The evidence base for efficacy of the low FODMAP diet in irritable bowel syndrome: is it ready for prime time as a first-line therapy?
3. Nutrients, Effect of Three Diets (Low-FODMAP, Gluten-free and Balanced) on Irritable Bowel Syndrome Symptoms and Health-Related Quality of Life
4. World Journal Gastroenterology, Diet therapy for inflammatory bowel diseases: The established and the new
5. Molecular Metabolism, A healthy gastrointestinal microbiome is dependent on dietary diversity

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