Low FODMAP Diet: Help with Irritable Bowel Syndrome?

Those   affected by irritable bowel syndrome often suffer from indigestion after every meal. The so-called low-FODMAP diet is said to be able to provide relief. What is this diet all about? What should sufferers pay attention to? And does the diet actually help? Below we explain what FODMAP is and how it can help with irritable bowel syndrome.

What does FODMAP mean?

FODMAP  stands for  Fermentable O ligosaccharides,  Disaccharides ,  M onosaccharides and (in English  and )  P olyols.

These substances are short-chain sugars and sugar alcohols such as lactose and fructose. They are part of many different foods: from baked goods and dairy products to fruits and vegetables.

Fermentable means that these substances trigger fermentation processes during digestion. This is not a problem for healthy people. Irritable bowel patients, on the other hand, have a very sensitive digestive tract. These fermentation processes can cause symptoms such as flatulence ,  diarrhea  and cramps in them  .

What is the low FODMAP diet?

Foods that contain FODMAPs are not inherently unhealthy. On the contrary, the carbohydrates and sugar alcohols in question are also found in many healthy foods.

The fact that they still trigger digestive problems in people with irritable bowel syndrome can be explained by the sensitivity of the intestine. Therefore, healthy people usually do not need to pay attention to the FODMAP value of food – it can be important for people with chronic digestive problems.

The low-FODMAP diet (or simply FODMAP diet) is not a method of losing weight, but a  special form of nutrition for people with irritable bowel syndrome.  Food is classified based on its FODMAP value and those with a high value are avoided as far as possible.

Why FODMAPs Cause Gut Discomfort

During the normal digestive process, food is broken down into its components in the stomach and intestines.

When the FODMAPs they contain reach the large intestine, they start fermentation processes there. This creates gases that can irritate a sensitive intestine. In addition, the FODMAPs in the intestine attract water. This can lead to diarrhea. 

The increased gas and water content swells the intestines and also stretches the intestinal wall. That makes them more permeable. Irritable bowel syndrome can lead to  leaky gut syndrome  . Substances enter the body through the intestinal wall that actually have no place there. This is accompanied, among other things, by inflammatory reactions.

Where are FODMAPs included?

FODMAPs are found in a wide variety of foods, such as:

• Certain types of fruit (e.g. apples, mangoes, peaches, watermelons)
• Certain vegetables (e.g. artichokes, asparagus and onions)
• certain cereals (including wheat and rye)
• dairy products containing lactose
• Honig
• Sugar substitutes such as  xylitol ,  sorbitol  and maltitol
• glucose-fructose syrup and other additives in processed foods

With the FODMAP diet, the intake of the above-mentioned foods is therefore first paused and then gradually resumed in small doses.

Coffee  is low in FODMAPs, so you don’t necessarily have to do without coffee at breakfast. However, it is best drunk black, as  milk  and coffee cream and many sweeteners contain FODMAPs – conventional sugar is often tolerated in small amounts. However, one should keep in mind that coffee irritates the digestive tract even without FODMAPs.

How does the FODMAP diet work?

This irritable bowel diet is divided into three phases: 

1. During the  restriction phase  , all FODMAPs are rigorously eliminated from the diet for four to six weeks. 
2. In the  re-exposure phase  , a FODMAP-containing food is tested every one to two weeks. If you tolerate it, it can be reintegrated into the diet. If the symptoms worsen, it is still possible to test the food again at a later date. 
3. Once all foods have been tested and those that are compatible have been reintegrated into the diet plan, the  maintenance phase follows.

From this point on, those affected know which foods are suitable for them and which are not and can use this list as a guide when putting together their meals. However, tolerance to the individual FODMAPs changes over time, so it may be necessary to adjust the diet from time to time.

FODMAP: What to eat?

In fact, eliminating FODMAPs completely severely restricts your diet. Especially in the first few weeks, when only foods from the low-FODMAP list are allowed to be eaten, this form of nutrition can pose a challenge.

A FODMAP chart can help you put together your meal plan. It is important to ensure that as many different “permitted” foods as possible are consumed in order to bring as much variety into the diet as possible and thus   ensure  the intake of the necessary nutrients .

For example, the  list of low-FODMAP foods  includes:

• lean meat and fish
• Owner
• Aubergine, tomato, fennel, zucchini and  cucumber
• Leaf lettuce and rocket
• Grapes , kiwi, pineapple and  honeydew melon
• Rice ,  potatoes ,  quinoa  and polenta
• soy milk
• green  tea  and mint tea

Challenges of the low FODMAP diet

Processed foods and ready meals almost always contain FODMAPs. It is therefore necessary to prepare a large part of the meals yourself. The low-FODMAP diet is often associated with additional costs. Visiting restaurants or inviting family and friends to eat is made more difficult.

However, those who make their own experiences with the FODMAP diet and see a benefit for themselves will soon learn to deal with such difficulties. A FODMAP app can also help.

Where can I find low FODMAP recipes?

There are numerous free low-FODMAP recipes available online. Corresponding cookbooks are also available.

Adapting conventional recipes to the Low FODMAP rules is often difficult. But there are instructions on how to prepare well-known dishes low or zero-FODMAP, for example vegetable dishes such as ratatouille and even fruit cake.

Bread can also be consumed as long as it is a low FODMAP recipe.

How fast does FODMAP work?

Like any change in diet, the FODMAP diet does not take effect immediately or after a few days. Therefore, the first phase lasts four to six weeks to give the body time to adapt to the changes.

The symptoms should improve within this time. If this is not the case, then it is not worth continuing the diet.

Differences in effect: When does FODMAP work?

Scientific studies provide evidence that this form of nutrition can alleviate the symptoms of irritable bowel syndrome. 

However, the effect of the diet depends on the type of patient. According to the Institute for Microecology, those affected are divided into three groups:

• FODMAP type 1  tolerates FODMAPs well and therefore usually cannot benefit from the change in diet.
• FODMAP type 2  can only tolerate certain foods containing FODMAP or small amounts of them. So here it is worth trying the diet.
• FODMAP type 3  has only a very low FODMAP tolerance and should therefore avoid appropriate foods as far as possible.

FODMAP: when to expect long-term improvement

Not all irritable bowel patients who benefit from the FODMAP diet experience complete symptom relief. Possibly “only” an improvement of the symptoms is achieved.

In order for this positive effect to last, those affected must also be willing to eat according to the low-FODMAP diet in the long term and to regularly check the tolerance of individual foods.

However, the restriction is not always as strong as in the first phase, since later the FODMAP-rich foods that did not lead to a flare-up of symptoms during the second phase can also be consumed.

How does the FODMAP diet work?

How exactly the low-FODMAP diet works has not yet been researched. It is believed to have an enormous impact on the gut microbiome.

The intestinal microbiome, also  known as the intestinal flora  , refers to bacteria that colonize the intestines of every human being. These bacteria can be either beneficial or harmful.

The composition of the intestinal flora depends on numerous different factors. Individual diet has a particularly strong influence. Possible diseases such as irritable bowel syndrome are also related to the intestinal flora.

Side effects: Who is the FODMAP diet suitable for?

The long-term consequences of the low-FODMAP diet are not yet foreseeable, as there are no scientific studies on the long-term effects of this comparatively new form of nutrition. There is also the risk of an unbalanced diet if patients eat only low-FODMAP foods over a long period of time. This in turn can lead to an undersupply of important nutrients.

For these reasons, the diet is really  only suitable for people who suffer from irritable bowel syndrome.  For other people, it offers no health benefits. The results of various scientific studies indicate that at least some people affected by irritable bowel syndrome could benefit from it. Accompanying symptoms such as fatigue and  depression  could also be alleviated.

Because this is a major dietary change with potentially serious effects on the body, the FODMAP diet should only be followed under the supervision of a doctor or qualified nutritionist.