By: Annabelle Shaffer, Dietetics senior at University of Illinois Urbana-Champaign
What is it?
To begin, FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are types of carbohydrates that can be found in common food items, such as honey, dairy, onion, and garlic1. Once in the gut, these carbohydrates may be improperly absorbed leading to fermentation by the bacteria, or microbiota, naturally found in your gut1. Individuals who suffer from Irritable Bowel Syndrome (IBS) experience gas, bloating, cramping, and changes in stool frequency or form after eating a large amount of foods containing FODMAPs1. IBS is diagnosed by a physician specializing in gastroenterology.
A FODMAP diet is a diet low in fructose, fructans, galactans, lactose, and polyols2. Fructose can be found in apples, honey, sugar snap peas, watermelon, and mango. Fructans and galactans can be found in wheat products, legumes, and cashews. Lactose is found in varying amounts in all dairy products. Polyols are in apricots, mushrooms, as well as sugar alternatives such as xylitol and sorbitol.
FODMAP diets are not intended to be lifelong. Instead, with advisement from a healthcare professional, you would eliminate all high FODMAP containing foods and eat low FODMAP alternatives for 6-8 weeks2. After the elimination period, the patient begins the challenge phase2. In this phase, the patient adds FODMAP foods back into their diet one at a time and identifies any foods that precipitate symptoms2.
Who can benefit?
The FODMAP diet was developed by researchers at Monash University in Australia to ease the symptoms of IBS. Since the diet’s creation, studies have been done on the efficacy of a low FODMAP diet in IBS symptom reduction. Thus far, the research is promising:
- A controlled cross-over study found that low FODMAP diets reduced IBS symptoms in comparison to the study population’s typical diet: “The results of this study provide high-quality evidence that the low FODMAP diet is efficacious for treatment of functional gastrointestinal symptoms in unselected IBS with symptoms being halved compared with a typical Australian diet.”3
- A randomized control study also concluded a low FODMAP diet was successful in IBS symptom reduction: “A low-FODMAP diet reduced IBS-like symptoms and increased quality of life in patients with IBD in remission.”4
- A review analyzing clinical and observational research studies supports the use of low FODMAP diets in IBS treatment: “There is now high-quality evidence supporting the low FODMAP diet as a first-line therapy in IBS, demonstrating significant improvement in symptoms in 70% of all subtypes of IBS patients.”5
In conclusion, low FODMAP diets show promise in diminishing IBS symptoms. Patients should be assisted by a nutrition professional during the elimination and challenge phases of the FODMAP diet. Different foods will precipitate symptoms in IBS patients and therefore, the diet must be individualized.
1. Low FODMAP Diet. Stanfordhealthcare.org. https://stanfordhealthcare.org/medical-treatments/l/low-fodmap-diet.html. Published 2018. Accessed December 1, 2018.
2. Mahan L, Raymond J. Krause’s Food & The Nutrition Care Process. 14th ed. [Philadelphia, Pa.]: Saunders; 2017:546-548.
3. Halmos E, Power V, Shepherd S, Gibson P, Muir J. A Diet Low in FODMAPs Reduces Symptoms of Irritable Bowel Syndrome. Gastroenterology. 2014;146(1):67-75.e5. doi:10.1053/j.gastro.2013.09.046
4. Pedersen N, Felding M, Ankersen D, Vegh Z, Burisch J, Munkholm P. Low FODMAP diet reduces irritable bowel symptoms and improves quality of life in patients with inflammatory bowel disease in a randomized controlled trial. Journal of Crohn’s and Colitis. 2014;8:S47. doi:10.1016/s1873-9946(14)60092-1
5. Manning L, Biesiekierski J. Use of dietary interventions for functional gastrointestinal disorders. Curr Opin Pharmacol. 2018;43:132-138. doi:10.1016/j.coph.2018.09.003