Bloating, abdominal cramps, gas, constipation, diarrhea, sudden bowel movements: Irritable Bowel Syndrome (IBS) is found in up to 30% of the population. FODMAP, a new approach that has recently been gaining in popularity, was developed by researchers at Monash University in Australia to reduce symptoms related to IBS. Over 75% of the people who adopt its principles experience positive results relating to their gut health.
The acronym FODMAP comes from Fermentable Oligosaccharides Disaccharides Monosaccharides And Polyols. All of these are different types of sugars that can cause or aggravate the unpleasant symptoms of IBS. They are poorly digested in the intestinal tracks, where rapid fermentation by colon bacteria produces gas that can be quite painful. These small molecules also tend to trigger too much water in the intestines, which then results in diarrhea.
Where are they found?
OLIGOSACCHARIDES
They are found in some fruits and vegetables (including onion and garlic), pistachios, cashews, several legumes (beans, lentils, peas and soybeans), chicory, inulin, as well as products made from wheat, kamut, barley and rye (flour, pasta, couscous, crackers, cookies, bread, etc.).
DISACCHARIDES
The most problematic disaccharide is lactose. Cow, sheep or goat’s milk, ice cream, yogurt and cheese contain the most lactose. Butter, lactose-free products and some aged cheeses (e.g. parmesan) contain very little.
MONOSACCHARIDES
Fructose, which we consume a lot more of when compared to glucose, is the real culprit here. It is abundant in several fruits (but not all!), some vegetables and sweeteners (molasses, honey, fructose, corn syrup and agave syrup).
POLYOLS
Also called sugar alcohols, polyols are found in sugary foods such as sweeteners ending in ol (sorbitol, maltitol, mannitol, xylitol), isomalt and polydextrose. Some fruits and vegetables also naturally contain polyols.
Many FODMAP food lists can be found online. The Monash University Low FODMAP Diet mobile app is also an excellent reference tool. Note that the seasonality, variety, and maturity of fruits and vegetables can modify their FODMAP content.
Following the approach
The first step is to eliminate all high FODMAP foods for a few weeks. If symptoms improve, it may possibly be related to FODMAP foods. Once stability and comfort are achieved, the next step is to gradually reintroduce FODMAP foods. This will make it possible to identify which foods are the culprits, to evaluate how much of each one can tolerated and, above all, to resume a varied diet.
This approach is very restrictive at first. To make things easier, it is best to prepare simple meals with few ingredients and to avoid restaurants and processed foods. However, it is not mandatory to avoid products that may contain small traces of FODMAPs. Indeed, in the case of IBS, it’s all about the QUANTITY of FOPMAPs ingested. For example, a food that has a high FODMAP content, but that is very far down the ingredients lists may not cause problem. Who knows, maybe one day "low in FODMAP" labels will become the norm in grocery stores!
Putting the odds in your favour
Adopting this diet involves major changes in eating habits and presents risks of nutrient deficiency, especially in the case of allergies, vegetarianism or veganism. Being supervised by a nutritionist/dietician will help you to adapt this method according to your needs, your risk level and your motivation level. The closer a diet is monitored, the faster you get results!
Before starting this diet, it is also recommended to rule out any possibility of being celiac or gluten intolerant, because once you stop eating wheat (therefore gluten protein), celiac disease could go unnoticed.
Finally, although choosing the right food plays an important role in reducing symptoms, having a healthy overall lifestyle is paramount. Good habits to adopt include: practicing regular physical activity, trying out relaxation techniques, sleeping and resting sufficiently, avoiding behaviours that induce air swallowing (chewing gum, eating fast and speaking while eating), eating at regular hours, avoiding overeating, avoiding heavy or fatty meals, decreasing alcohol, coffee and soft drinks consumption, etc.
References
Cuneo, C. et al. (2016). La solution FODMAP : pour en finir avec les maux de ventre. Montréal, QC. Les Éditions du journal.
L’approche FODMAP pour les symptômes gastro-intestinaux. (2014, November 4). Retrieved August, 2017, from http://www.extenso.org/article/l-approche-fodmap-pour-les-symptomes-gastro-intestinaux/
Desjardins, M. (2017, August 14). L’approche FODMAP ou comment atténuer les effets du syndrome du côlon irritable! Retrieved August, 2017, from http://blondstory.com/nutrition-lapproche-fodmap-ou-comment-gerer-le-syndrome-du-colon-irritable/