FODMAP: What Does This Map Really Show?

A low FODMAP diet has been shown to reduce the symptoms of gut problems in many patients with IBS symptoms (Irritable Bowel Syndrome). So, what is a low-FODMAP diet, and which foods are considered to be high FODMAPs? We’ll discuss all this and more, as we discuss this Elimination Diet.

What is FODMAP?

Well to start off, FODMAP is not really a map. Real shocker eh?

FODMAP stands for —

• Fermentable,
• Oligosaccharides,
• Disaccharides,Monosaccharides,
• And Polyols

Oligo, di, and monosaccharides are all dietary sugars (carbohydrates). Many humans don’t have the digestive enzymes necessary to break down these carbs. So, they get fermented by intestinal bacteria.

Polyols are small-chain carbohydrates that contain multiple hydroxyl groups (oxygen and hydrogen-based compounds).

Why Can Some High-FODMAP Foods Cause GI Problems?

Many high-FODMAP foods are not unhealthy. However, some people don’t have the gut bacteria necessary to break down these foods efficiently.

Instead, they ferment in the large intestine. Intestinal bacteria eat these carbs as prebiotics. In turn, the bacteria release gases, including hydrogen. The metabolites and processes of these bacteria might cause GI discomfort.

Those with FODMAP sensitivity may experience IBS symptoms, such as:

• Abdominal Pain
• Diarrhea
• Bloating
• Irregular or Frequent Bowel Movements
• Constipation
• Gas
• Abdominal Pain
• Motility Issues

Anatomically, the cause of many functional gut symptoms is known to be abdominal distension (the accumulation of gas/liquid in the abdomen leading to bloating). Luminal (inner open space or cavity of an intestine) distension induces symptoms of pain, discomfort, the sensation of bloating and can lead to motility disorders (refers to disorders in intestinal contractions which aids in the process of digestion and excretion).

Why A Low FODMAP Diet?

A FODMAP Diet is a dietary therapy that has gained increased popularity to treat functional gastrointestinal disorders (FGID), which refers to the disorders of the functioning of the gut. It has, over the years, become more reliable for dietitians with its well-defined mechanism of action and established effectiveness to prescribe for patients suffering from FGID.

Intestinal distension is an effect of the solids, liquids, and gases present in the regions of the intestine and their interaction with the gut environment. The concept of FODMAP relies on the theory that by regulating the consumption of dietary elements which can cause intestinal distension, we can improve the condition and treat the symptoms of functional gut disorders.

Well, seems just about right, doesn’t it? Now that you are introduced to the basic concept of FODMAP, let us briefly dwell into the world of FODMAP and learn more about it.

What Are FODMAPs?

FODMAP is an acronym used to describe previously unrelated groups of short-chain carbohydrates and sugar alcohols (polyols).

The short-chain carbohydrates include:

• Lactose
• Fructose, Fructo- and galactooligosaccharides (Fructans, and Galactans)
• Polyols (Sorbitol, Mannitol, Xylitol, and Maltitol)

All the above mentioned dietary components fall under the three following functional properties:

• Poor absorption by the small intestine: Poor absorption as a result of slow, less efficient transport mechanisms across the intestinal membrane, reduced activity of essential enzymes, lack of enzymes, or molecules that are too large for simple diffusion.
• Small and therefore easy to absorb molecules: Dietary components which produce a laxative effect when consumed in sufficient dose by increasing the liquidity of intestinal contents and thus affecting gut motility.
• Rapidly fermented by gut bacteria: The effectiveness of fermentation by gut bacteria mainly depends on the chain length of the carbohydrate; oligosaccharides and sugars are more rapidly fermented compared to polysaccharides such as soluble dietary fiber.

So, FODMAPs basically allow us to manage our health utilizing the knowledge of the effects that different components of the food we consume have on our gut health.

What is the Role of FODMAP in Managing Gut Health?

A low-FODMAP diet has been used to manage the symptoms of many functional gut disorders such as Irritable Bowel Syndrome (IBS) and has shown significant success in improving the quality of life of those patients.

This doesn’t mean that FODMAP vigilance is restricted to people suffering from functional gut disorders. If you want to understand how FODMAPs affect your individual health and make conscious diet decisions using this understanding, you too can make use of FODMAPs. If everybody around you isn’t talking about it already, they soon will be.

But, before we jump into this seemingly complicated world of FODMAPs let us understand the two main underlying principles of it.

• FODMAPs are not the cause of functional gut disorders: FODMAP is a concept which looks at gut disorders where there is malabsorption of certain dietary components (FODMAPs) due to hypersensitivity( lactose and fructose intolerance), excessive gas production by the gut microbes leading to the symptoms presented by the disorders. This essentially provides an opportunity to manage symptoms and improve the quality of life.
• FODMAP as a dietary therapy works on the concept of global restriction of FODMAPs and not individually: Whereas many dietary therapies involve restricting specific FODMAPs, the dietary therapy of FODMAP involves the reduction of the consumption of all poorly absorbed short-chain carbohydrates for better management of gut disorders and proper functioning of the gut.

Diets differing in their FODMAP content have been shown to alter the diversity of the gut microbes. Low FODMAP diet has been associated with a greater diversity of gut microbes than seen in patients with functional gut disorders. Especially, in IBS patients where the diversity of the gut is inversely related to the degree of intestinal inflammation.

Now that you are formally introduced to FODMAP, let us briefly address certain key points.

What Are High FODMAP Foods?

Cutting out FODMAPs is going to cover a lot of food groups. These omissions will also include foods that you believe are healthy…and are!

A low-FODMAP diet is only meant to be a temporary lifestyle. You should omit the potentially problematic foods for a short period and then slowly reintroduce them into your diet. Observe how your body feels. This intuitive exercise can help you determine which high FODMAPs are troublesome for your body.

Any dietary changes you make should be done with the consultation of your physician. They should monitor your process and help make recommendations.

Some high-FODMAP foods include:

Fruits – High in Sorbitol and/or Fructose

Fruits have natural sugars that tempt us to eat them. These candies from nature have great fiber and can improve our energy. However, they can also feed opportunistic bacteria.

• Apricots
• Apples
• Blackberries
• Canned Fruit (Contains A Lot of High-Fructose Corn Syrup)
• Cherries
• Fermented Fruits
• Mangos
• Nectarines
• Pears
• Plums
• Ripe Bananas
• Watermelon

Vegetables – High in Fructans and Mannitol

Many vegetables contain carbohydrates that can help bacteria grow. When you are experiencing stomach issues, your healthy diet might be just as healthy to the bad bacteria. So, you must make some changes to your plant-based diet to eat fewer FODMAPs.

• Artichokes
• Asparagus
• Beetroot
• Broccoli
• Brussels Sprouts
• Cauliflower
• Celery
• Garlic
• Leeks
• Mushrooms
• Okra
• Onion
• Scallions
• Snow Peas

Dairy & Dairy Substitutes – High in Lactose

Approximately 65% of people lose the ability to break down lactose as they enter adulthood. When we transition to solid foods, we no longer need to produce the enzyme lactase that breaks lactose down. Therefore, many people’s digestive systems have issues with eliminating dairy.

• Almond Milk
• Buttermilk
• Cream
• Half & Half
• Ice Cream
• Oat Milk (More than 1/8 A Serving)
• Soft Cheese
• Soy Milk
• Yogurt
• Snow Peas

Whole Grains– High in Fructans and GOS

Many whole grains contain gluten, which triggers zonulin production. Zonulin is a protein that stimulates tight junctions around the gut lining to open. Gluten can cause toxic materials from the intestines to enter the bloodstream. This action is responsible for many cases of Irritable Bowel Syndrome (IBS) and Small Intestinal Bacterial Overgrowth (SIBO).

• Barley
• Cereal
• Couscous
• Farro
• Muesli
• Rye Bread
• Semolina
• Whole What Pasta

Legumes – High in GOS

Legumes can also be high in lectins. Lectins are known as anti-nutrients because they attach to vitamins and minerals in our diets. Try soaking any legumes in water prior to cooking to limit lectin content.

• Baked Bans
• Butter Beans
• Black-Eyed Peas
• Kidney Beans
• Lentils
• Chickpeas/Garbanzo Beans
• Falafel (Especially Prepared In Hydrogenated Oils)
• Soybeans

Sweeteners – High in Fructose and/or Polyols

• Agave
• Cane Sugar
• Confectionary Sugar
• High Fructose Corn Syrup
• Honey
• Maple Syrup

Nuts and Seeds – High in GOS and Fructans

Nuts and seeds are an excellent source of healthy fats and protein. Most are low-FODMAP but some might cause some GI issues. These problems are especially true with seeds. They are difficult for our bodies to digest. Be sure to chew seeds thoroughly.

• Cashews
• Pistachios

Processed Foods

Processed foods are made with fillers, artificial ingredients, and preservatives. These can cause inflammation that promotes obesity, mental health issues, and more. Limit your processed food intake as much as possible.

• Baked Goods
• Condiments
• Deli Meats (Turkey, Ham, Bologna)
• Packaged Cereals
• Soda

What Are Low-FODMAP Foods?

Removing high-FODMAPs might seem restrictive. However, there are plenty of nutritious and delicious low-FODMAP foods.

Fruits

It seems almost improbable, but you can eat fruit when watching your FODMAPs. You just need to know what to choose!

• Blueberries
• Grapes
• Cantaloupes
• Grapefruits
• Honeydew Melons
• Kiwis
• Lemons
• Limes
• Oranges
• Pineapples
• Strawberries

Vegetables

There are plenty of veggies you can add to your meals that are FODMAP-friendly. Opt for foods with higher water concentrations. Water will naturally lower sugar content.

• Alfalfa Sprouts
• Bamboo Shoots
• Bean Sprouts
• Bell Peppers
• Bok Choy
• Carrots
• Chives
• Eggplants
• Green Beans
• Ginger
• Cucumbers
• Lettuce
• Olives
• Parsnips
• Potatoes
• Spinach
• Tomatoes
• Turnips
• Zucchini

Dairy & Dairy Substitutes

There are some dairy items that are okay when you’re keeping your carbs low.

• Lactose-Free Cheese
• Aged Cheese
• Hard Cheeses
• Brie
• Camembert
• Feta Cheese
• Butter
• Lactose-Free Milk (Almond Milk, Rice Milk, Hemp Milk)

Whole Grains

Grains are a great source of fiber that will act as prebiotics for probiotic bacteria. You should opt for grains that are naturally gluten-free. Try to get grains that have the least processing to ensure the best health benefits.

• Amaranth
• Burghul
• Buckwheat
• Millet
• Quinoa
• Wild Rice
• Spelt

Legumes

Get plant-based protein without triggering an immune response. Get canned legumes to ease digestion. Don’t eat more than 1/2 cup at a time.

Sweeteners

• Artificial Sweeteners Not Ending in -ol
• Maple Syrup
• Sucrose

• Almonds (Up to 10)
• Brazil Nuts
• Chia Seeds
• Hazelnuts (Up to 10)
• Macadamia
• Pine Nuts
• Pumpkin Seeds
• Sesame Seeds
• Sunflower Seeds
• Walnuts

Protein

Many people eat TV dinners and drive-thru specials as their meals. These processed foods are a bad source of nutrition. Eat healthier by choosing whole foods and organic protein sources.

• Free-Range Poultry (Chicken, Turkey)
• Eggs
• Fish
• Grass-fed Beef
• Pork
• Tofu/Tempeh
• Walnuts

What Are The Considerations?

There must be caution exercised when suggesting a low-FODMAP diet for a long term. FODMAP can be used as a way to manage symptoms of any functional gut disorders and should be looked at as an individual concept where we can access its potential health benefits.

So, if you want to better understand the effect of what you eat and keep that gut happy, the best way to start is by observing how different foods affect your digestion. So, say hello to FODMAP, and do not forget to carry this ‘map’ along in your mind when you venture out on your upcoming food journeys.