The FODMAP diet, which restricts foods like honey, apples, pears, and asparagus, is said to relieve IBS symptoms, which up to 20 percent of the U.S. population suffers from. (Photo composite: Thinkstock / Yahoo Food).
While FODMAP may look like an abbreviation for a government agency or subway system, this clunky acronym is the name of a relatively unknown diet which has actually helped smooth the tummy troubles of millions around the world.
FODMAP stands for (get ready for this) Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. Aside from being tricky to pronounce, all of these food building blocks share small chain sugars and fibers that the body may have trouble digesting. For those with sensitive guts, that could mean excess gas, stomachaches, painful bloating, and ongoing bouts of constipation or diarrhea.
Australian dietitian and nutritionist Sue Shepherd, PhD, who created the diet, estimates that around 20 percent of the population (or 64 million people in the United States) suffers from chronic digestive illnesses like irritable bowel syndrome (IBS) and non-celiac gluten sensitivity, and could potentially benefit from the approach.
While gluten-free and dairy-free diets also claim to help alleviate IBS symptoms, Boston-based dietitian Kate Scarlata, RDN, said FODMAP has extensive research showing it’s actually certain carbohydrates that truly trigger unsettling gas and bloating.
“FODMAPs are abundant in the American diet and include wheat, onion, garlic, apples, pears, mushrooms, asparagus, honey, and more,” said Scarlata, who specializes in the diet. Other top offenders include milk, ice cream, agave syrup, watermelon, peaches and apricots. For the one in five people who suffer from symptoms of IBS, eating foods low in FODMAPs can improve and even alleviate symptoms.
The FODMAP diet, which restricts foods like mushrooms, garlic, red onions, and wheat, is said to relieve IBS symptoms, which up to 20 percent of the U.S. population suffers from. (Photo composite: Thinkstock / Yahoo Food).
Created by Shepherd (a diagnosed celiac) in the late 1990s, the experimental diet was hatched after the dietitian hit a frustrating wall with patients whose gastric symptoms persisted even after adopting traditional restrictions like gluten-free eating. In search of the missing link, Shepherd hypothesized a connection between stomach issues and the simple carbohydrate sugar known as fructan that exists in wheat, as well as in many other foods.
“Exciting research shows that it may have been the fructans all along that were triggers for symptoms in non-celiac gluten-sensitive patients,” Shepherd told Yahoo Food. “The scenario is possible when you think about it. People felt some improvement eating gluten-free foods, so assumed it was gluten that was the problem – but by restricting gluten, a person has actually simultaneously restricted some of their fructan intake when avoiding wheat, rye and barley,” the Melbourne-based expert explained.
Further research by Shepherd turned up more possible triggers that can irritate the gut, like the double sugar molecules in the lactose of milk and simple sugars known as galacto-oligosaccharides in baked beans. Soon, the complete FODMAP guidelines took form.
After the plan successfully relieved symptoms in hundreds of Shepherd’s patients over a number of years, she undertook a PhD in researching the FODMAP diet for patients with IBS symptoms and celiac disease. Her findings in 2008, along with more recent clinical trials in European universities, have found that the FODMAP diet offers irritable bowel symptom relief in around 75 percent of adults who try it.
Education is key to getting and maintaining relief, since there are major misconceptions about the diet. Shepherd said the biggest one is that people think it’s permanent one-step elimination. “Each individual has a different tolerance for the amount of FODMAPs they can ingest before getting symptoms, and sensitivity triggers also differ for each person,” she said. So while some foods on the list may bother your stomach, others may not.
The two-part process starts by completely cutting the FODMAP list of foods out of your diet for two months. “This first strict phase isn’t encouraged for the long-term – it’s only meant to be an eight-week restriction,” Shepherd said. Then, FODMAP-containing foods are introduced back into the diet to see what can be tolerated without symptoms arising again.
“It’s important that people liberalize the diet to achieve the greatest amount of variety – and anyone following the process should consult with a nutritionist to ensure they’re properly guided through the second phase,” adds Shepherd, who stressed that it’s a low FODMAP diet, not a no FODMAP diet. “The underlying philosophy isn’t looking for foods that are entirely free from FODMAPs, but that rather contain a small amount of them,” she clarified.
Recent studies have suggested that the diet can change the amounts of bacteria strains in the large bowel, especially the “good” type known as bifidobacteria that helps the body absorb nutrients and keeps illness-causing “bad” bacteria in check. In addition to removing the troublesome food triggers, this change in gut bacteria may also contribute towards the relief in symptoms that patients experience afterwards.
If you’re wondering why you’ve heard little to nothing about the FODMAP diet, that’s largely because health professionals wanted to see a significant amount of science basing its use before adopting it into practice, Shepherd said. “There is now a large body evidence supporting the efficacy of the diet, so you’re, in turn, going to see a surge in uptake and awareness now,” she said.
Clever apps and resources are increasingly popping up to help make the journey more enjoyable. Scarlata offers free food checklists and helpful hints on her Well Balanced blog. Shepherd sells The Complete Low-FODMAP Diet guide that comprehensively explains and instructs the approach, along with several cookbooks on her website. And The Monash University Low FODMAP Diet app ($7.99) keeps up-to-date and accurate information at your fingertips.
At the end of the day, it’s all about focusing on the possibilities, said Scarlata. “The low FODMAP is often touted as a restrictive eating plan, but the diet allows all sorts of meat, fish, poultry, many cheeses, fresh fruit and vegetables, rice, quinoa, polenta, and potatoes,” she said. “The options are tasty and numerous.”