For some time now, we’ve known that certain foods can trigger particular gastrointestinal symptoms, but thanks to advancements in science and technology it’s now easier to pinpoint which types of ingredients and in what quantities cause such discomfort. FODMAPs can be particularly troublesome for those with hyperactive gut sensitivities. To find out exactly what is involved, here’s a beginner’s guide to understanding more about the Low FODMAP Diet.

What are FODMAPs?

In short, they are a group of poorly absorbed fermentable short chained carbohydrates that can lead to excessive fluid and gas production causing gastrointestinal discomfort (e.g. bloating, abdominal pain and distension in some people

FODMAP definition (what the fancy acronym stands for):

• Fermentable – carbohydrates that are broken down by microorganisms (bacteria) in the gut to produce an alcohol or organic acids
• Oligosaccharides – ‘oligo’ means a few individual sugars that are joined together
• Disaccharides – two sugar molecules
• Monosaccharides – one sugar molecule
• Polyols – sugar alcohols

Due to their smaller molecular size, FODMAPs draws in water causing an osmotic effect in the large intestine (think diarrhoea!). Of the carbohydrates that are poorly absorbed they undergo fermentation in the large bowel producing hydrogen and methane gas (think bloating, excessive flatulence, abdominal pain and distension!)

How does the diet work?

Dietary restriction of FODMAPs or what is known as the low FODMAP diet has been shown to be an effective treatment for reducing IBS symptoms in 50-76% patients by reducing the fermentable load on the colon, thereby reducing gas production and the internal expansion/pressure of the lumen increasing abdominal size. To take the science out of it – less FODMAPs = less stress on the colon, less gas, pressure & discomfort^1-6.

The diet follows a three-phase approach and is a temporary means for pinpointing which ingredients trigger symptoms in an individual. (Take note peeps, it is a very restrictive diet and can be a complex intervention).

It’s always recommended that you get guided assistance from an Accredited Practicing Dietitian (APD) who specialises in low FODMAP diets so they can tailor modifications for you without compromising on the nutritional adequacy of your diet. It is important to remember that everyone differs in their tolerance thresholds and that not everyone will experience symptoms with every type of FODMAP. Some you’ll be fine with, others might be an absolute no-go for you.

Common FODMAPS

FODMAPs are found in a variety of foods⁸ with the main ones being:

• Dairy products like milk & soft cheeses
• Honey, apples, mango, high fructose corn syrup
• Onion, leek, garlic, wheat
• Legume beans, chickpeas, lentils
• Sorbitol, mannitol, xylitol 

Great Low FODMAP Resources

To easily identify where these occur the Low FODMAP Monash App uses a traffic light system to categorize foods into what can be eaten freely and which should be limited. ‘Red foods are those high in FODMAPS and should be avoided, orange foods are moderate in FODMAPs and may be tolerated by some and green foods are low in FODMAPs and safe for consumption’. Think of it as the master of all FODMAP databases… particularly because Monash basically invented the diet. If you'd prefer a hard copy, the Monash University Low FODMAP Diet Guide is a great read and hs a shopping list, general advice and some delicious Low FODMAP recipes.

Alternatively, resources such as the Low FODMAP Diet Food Shopping Guide by Sue Shepherd or the FODMAP Friendly App are also useful.

Tips for following a Low FODMAP diet

• High FODMAP ingredients within a meal may not necessarily make the entire food high FODMAP as well, onion or garlic in small amounts that make up less than 5% of the total product may still be tolerable
• Look for lactose-free dairy products but be wary of sweeteners such as honey, maple syrup or fruit flavours that are high in FODMAPs (E.g. mango, blackberries)
• Look for sourdough bread made from spelt flour or bread varieties that undergo the sourdough proving process. These breads contain lower amounts of fructan and gluten⁹ as the longer proving time allows the yeast and bacteria to feed on the FODMAPs.
• If following a vegetarian low FODMAP diet, legumes and beans, a source of plant protein can be replaced with tofu, eggs, nuts and seeds in small quantities (excluding pistachios and cashews), tempeh, whole grains (such as quinoa, buckwheat) this will also ensure that you’re getting the iron and zinc your body needs.
• Beware of hidden FODMAPs such as onions, garlic, shallots which can be found in sauces, marinades & gravies. Keep in mind ‘common names’ that might be missed in the ingredients list (e.g. vegetable powder or dehydrated vegetables).

Following a low FODMAP diet can be challenging as most foods do not list their high FODMAP ingredients on labels explicitly. Although not all food and food ingredients have a clearly defined safe quantity level, research into the area is rapid and constantly evolving. Check out this blog to find out more about how research is conducted.

Importance of Serving Size

So you’ve gone through the battle of the elimination phase, but still haven’t seen any improvements? If your gut is particularly sensitive, eating a combination of low FODMAP ingredients throughout the day may still be triggering symptoms, something that is referred to as ‘stacking’.  

Stacking occurs when you eat multiple quantities of one or more low FODMAP foods that come from the same FODMAP group whether in a single meal or close together. These FODMAPs can then accumulate and trigger symptoms. This goes without saying that this diet is largely dose-dependent meaning serving size is particularly crucial. This is why regular assessment to understand your threshold is a must!

Gluten Free vs Low FODMAP

Gluten is a protein found in wheat, rye, barley and oats whereas FODMAPs are carbohydrates. Although the low FODMAP diet counters for a lot of carbohydrate sources that contain gluten, gluten free products are not necessarily also low FODMAP and vice versa. For example, chickpea flour, inulin (a common starchy carbohydrate found in chicory root) and honey may be commonly found in gluten free items but are considered high FODMAP ingredients. Wheat containing fructans may not always necessarily be avoided as well. As labelling laws require wheat to be declared as an allergen some including wheat starch, wheat maltodextrin, wheat glucose, and caramel colouring as a derivative of glucose syrup are usually acceptable. Soy sauce containing wheat are also low FODMAP at 2 tablespoons per serve, which is more than enough for seasoning.

Dineamic Low FODMAP Meals

If you are struggling to understand the cause of your symptoms, it’s best to see your medical practitioner and get checked out. If you have been advised to follow a low FODMAP diet Dineamic can help. Dineamic provides a range of Low FODMAP meals created according to the Monash guidelines without the use of garlic or onion in any of the meals. All products are also Gluten-Free and the majority are Dairy-Free with a focus on mains so that you have the flexibility of adding in your own sides (whichever works best for you).  To find out the exact quantities within each meal check out the nutritional info for each product on our website or get in touch with the Dineamic Team.

References

1. Bohn L, Storsrud S, Liljebo T, et al. Diet low in FODMAPs reduces symptoms of irritable bowel syndrome as well as traditional dietary advice: a randomized controlled trial. Gastroenterology. 2015;149:1399‐1407.
2. Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology. 2014;146(67–75):e65.
3. Ong DK, Mitchell SB, Barrett JS, et al. Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome. J Gastroenterol Hepatol. 2010;25:1366‐1373.
4. Shepherd SJ, Gibson PR. Fructose malabsorption and symptoms of irritable bowel syndrome: guidelines for effective dietary management. J Am Diet Assoc. 2006;106:1631‐1639.
5. Staudacher HM, Lomer MC, Anderson JL, et al. Fermentable carbohydrate restriction reduces luminal bifidobacteria and gastrointestinal symptoms in patients with irritable bowel syndrome. J Nutr. 2012;142:1510‐1518.
6. Halmos EP, Christophersen CT, Bird AR, Shepherd SJ, Gibson PR, Muir JG. Diets that differ in their FODMAP content alter the colonic luminal microenvironment. Gut. 2015;64:93‐100.
7. Monash University. Monash FODMAP. https://www.monashfodmap.com/blog/3-phases-low-fodmap-diet/
8. Magge, S & Lembo A. Low FODMAP Diet for Treatment of Irritable Bowel Syndrome. Gastroenterol Hepatol (N Y) 2012 8(11): 739-745
9. Monash University. Monash FODMAP. https://www.monashfodmap.com/blog/sourdough-processing-fodmaps/