A nutritious diet is typically associated with improvements in physical health, vitality and energy. And when we decide to be more conscious about what we eat, we assume this will also help our digestive health. However, some of us can actually experience increased gas, bloating or digestive discomfort. This is where considering a low FODMAPs diet may become a helpful aspect to meal planning.
FODMAPs is an acronym for:
- Oligosaccharides (fructans and galacto-oligosaccharides or “GOS” – certain chains of carbohydrates/sugars)
- Disaccharides (lactose – the carbohydrate/sugar found in milk)
- Monosaccharides (fructose – excess fructose*)
- Polyols (sugar alcohols)
You can see why we just abbreviate it to FODMAPs! These are certain chains of sugars and sugar alcohols (the ‘polyols’), which are present in a variety of foods. In some people, the body does not process some or all types of FODMAPs very well, leading to digestive distress.
Don’t let the word “sugar” mislead you in to thinking high-FODMAP food must all be sweets or junk food. Chemically, all carbohydrates are types of “sugar”; chemically we call them ‘saccharides’. Most of the foods we eat contain carbohydrates, from broccoli and lentils, to the things we most typically think of when we think of carbs, like pasta and bread. High-FODMAP foods cover the whole dietary spectrum. For example, high-FODMAP foods include apples and chickpeas.
FODMAPs can cause our bodies difficulty during the digestion process. They travel to the bowel where they are fermented and processed by our gastrointestinal bacteria. In certain individuals, this interaction releases gas and creates increased bowel sounds, abdominal distension, pain, and/or altered bowel movements (diarrhoea and/or constipation). FODMAPs can also have an osmotic effect and draw excess water into the bowel, leading to diarrhoea. All up, very unpleasant side effects to eating a mixed bean salad for lunch!
The degree to which someone may react to high-FODMAP food varies based on individual tolerance to (a) the amount of the food consumed and (b) the specific type of FODMAP present (the acronym covers a variety of carbohydrate chains and sugar alcohols present in different foods). Eating FODMAPs-friendly is individualised and not necessarily about total food exclusion. It’s a sliding scale, rather than a definitive “in” or “out” approach to food choice.
Understanding FODMAPs may be helpful to you if you’ve introduced some healthy habits and are feeling nowhere near as good as you thought you’d be. Perhaps you’ve taken up the “an apple a day” guideline, only to end up with a swollen tummy and cramps. Or you’ve introduced more legumes in to your diet with similar results. It’s awesome of you to prioritise your health and eat well, but it’s not going to be sustainable or very enjoyable if you’re not feeling better for it.
Below is a non-exhaustive list of food swaps that may assist you in planning nutritious meals that your body agrees with:
- Fruits: apples, pears, cherries and mango (excess fructose*), plums, nectarine and peaches (fructans/GOS) (Also, dried fruit will be higher-FODMAP than whole fresh counterparts)
- Veggies: asparagus, snow peas and artichoke (excess fructose*), onions and leeks (fructans/GOS)
- Legumes i.e. chickpeas, lentils, butter beans, etc. (fructans/GOS)
- Grains: wheat (i.e. basis of most traditional breads, pasta, couscous), barley, rye (fructans/GOS)
- Sweeteners: the sugar alcohols sorbitol (420), mannitol (421), xylitol (967), maltitol (965), isomalt (953) (polyols), and agave (excess fructose*)
- Fruits: bananas, citrus fruits, berries, kiwi fruit, papaya, pineapple
- Veggies: eggplant/aubergine, carrots, cucumber, potato, sweet potato, parsnip, pumpkin, radishes, cabbage, zucchini/courgette, capsicum, kale, lettuce, chard, bok choy, spinach, rocket, fresh or dried herbs e.g. basil, parsley, mint
- Grains / grain substitutes: rice, quinoa, amaranth, millet, buckwheat, coconut flour (Try quinoa, millet, buckwheat and amaranth for plant-based protein that can be substituted where you might typically use legumes)
- Sweeteners: rice malt syrup, maple syrup, stevia (Honey is a relatively high-FODMAP food because of the fructose content, but a small amount may be tolerated well)
It is important to emphasise eating FODMAPs-friendly should be approached from the “sliding scale” perspective, and not as a reason or justification for excluding foods entirely on a long term basis. A typical low FODMAP diet plan would involve a period of elimination (perhaps one month), followed by a rotating re-introduction of higher FODMAP foods to determine what is causing discomfort. Once this is complete, a sensible long-term approach can be developed which is likely to involve a very broad range of foods with relatively little limitation, including some or many moderate to high FODMAP foods (though it may be that it’s recommended they’re eaten in smaller quantities and/or spread out over the course of the day rather than all in one meal).
If you are experiencing a great deal of digestive discomfort and suspect FODMAP sensitivity may be a significant issue for you, I’d suggest going to see a suitable practitioner to help you work through a low FODMAP diet period and ensure you’re eating well throughout the process.
A low-FODMAP approach can overlap with lifestyle approaches like paleo, veganism or vegetarianism. Being aware of high-FODMAP foods can be beneficial for anyone experiencing digestive distress, irrespective of other dietary choices. If you’re trying to eat well and your gut does not seem to agree with you, a few simple food swaps may make a big difference. And a final tip; if the bloat and cramps hit, try a simple peppermint tea. This is a great carminative herb that soothes digestion and may help relax a cramping, aching digestive tract…and it’s delicious too.
Here are some handy links for more general resources on FODMAPS:
- Low FODMAP resources (including link to a phone app) by Monash University
- And the Monash University low FODMAP blog (which includes recipes and interesting articles)
- Link to a page where you can buy low FODMAP guides and books produced by Dr Sue Shepherd (a well known advisor in the FODMAPs space)
- Basic FODMAPs overview sheet prepared by the Gastroenterological Society of Australia (GESA)
Here are a couple of blogs with a low FODMAPs focus that I like:
- Kate Scarlata Registered Dietician – a very comprehensive site with lots of information resources on FODMAPS
- She Can’t Eat What?! – A blog focusing on low-FODMAP, intolerance-friendly recipes
- The FODMAP free life – Another great source of low-FODMAP healthy food inspiration
*A little more information on when fructose becomes a FODMAP issue, in particular with regard to fruit. Fructose is one of the two types of sugar found in fruit; the other is glucose. Fructose is tolerated better digestively when it is consumed with glucose, so fruits that have a ratio where fructose:glucose content is 1 or less (i.e. there’s equal or more glucose) are not considered to have a high FODMAP rating. (Of course, there’s a sliding scale here; each fruit has a different ratio so some are low, some are moderate, etc). The same analogy applies to other foods, not just fruit. Very generally speaking, consider the reference to fructose above as “excess fructose”, as I have indicated throughout the article.