Low FODMAP: Diet Commences on Doctor’s Orders

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Welcome back!

In my last blog post I talked about having to eat lots of gluten-filled foods for two months before being tested for Coeliac Disease. It wasn’t particularly pleasant but thankfully it turned out I didn’t have Coeliac Disease. Woohoo!

Upon this lack of diagnosis, I was advised to follow the Low FODMAP diet. FODMAP is an acronym standing for Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols. These are the fermentable carbohydrates that must be removed or reduced in the diet when following the low FODMAP plan. Essentially, low FODMAP is a type of elimination diet. It is only temporary and is designed to allow one to pinpoint the trigger foods for their digestive discomfort. The low FODMAP diet is not meant to be followed long term without reintroducing foods.

The Low FODMAP diet was developed by researchers at Monash University Australia. It has been used to treat IBS with a success rate of about  70%, when followed correctly under the direction of a trained dietician. A quick google search and I was able to book in with a local dietician who was fully FODMAP trained by Kings College London. Great!

I must confess I had heard of FODMAPs long before commencing the diet myself, and I always thought the idea of following such a strict elimination diet seemed pretty bleak. I knew of a few people using the probiotic Symprove alongside their low FODMAP diet and I really felt for them and thanked my lucky stars that I didn’t have to follow such a strict diet! The irony! At that time, the main thing I knew about the low FODMAP diet was that it was very complicated and garlic and onion were on the restricted list! (Even now I think those are the two most difficult things to cut out, simply because they are in everything, especially when eating out! But I found a way around it…)

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No peas and no onion on the low FODMAP diet!

Low FODMAP: What’s Out?

Let me explain a little more about what foods are restricted. Please do not take this to be an exhaustive list at all. As I said, the diet is very complicated and there are numerous foods that have to either be cut out completely or restricted to a specific small portion.

  1. Fructans: These are poorly absorbed in all people, but may only cause symptoms in some. They include the likes of wheat and rye.
  2. Galacto-oligosaccharides: Also poorly absorbed in all people. They include pulses and legumes.
  3. Polyols: Poorly absorbed in many people. These are sugar alcohols and can be found in sweet potato and avocado.
  4. Fructose: Malabsorbed only in some people. Glucose helps the absorption of fructose so it is mainly foods with fructose levels in excess of glucose that are restricted. However, overall fructose intake has to be limited regardless as glucose only helps absorption of fructose to a point. Foods that have to be avoided include honey, agave, mango and some other fruits.
  5. Lactose: Again this may only be malabsorbed in some people. Includes yogurt and milk, though lactose free versions are allowed. Mature cheddar and other low lactose dairy is FODMAP safe also.
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No more fruit overload! Fructose in excess of glucose is out.

Many of the foods that are restricted in the low FODMAP diet have been shown to contribute to symptoms of IBS in susceptible individuals. These symptoms include bloating, cramping, gas, constipation and diarrhoea. Whilst both the doctor and dietician agreed that I don’t have IBS (thankfully!) I have suffered with bloating and because I completely got rid of this issue before when I followed my original elimination diet and took Symprove, I figured that there might also be some trigger foods that I haven’t realised aren’t suiting me.

When I started to become bloated again I realised I had been eating a lot of sourdough bread – this connection to symptoms and bread was one of the reasons I was sent for Coeliac testing. In fact, it is not recommended by medical professionals that one commence a low FODMAP diet until Coeliac Disease has been completely ruled out.

It turns out that whilst gluten is not a FODMAP (it is a protein not a carbohydrate) wheat, barley and rye are high in FODMAPs. Therefore, it makes sense to me to try low FODMAP and see if I can work out exactly what my triggers are. Perhaps unbeknownst to me I had eliminated or reduced my intake of some high FODMAP trigger foods when I was symptom free? No doubt taking Symprove helped me immensely and I have to say I’ve never been as bad as I was before I found it – except perhaps when I did the pre-endoscopy gluten challenge and ate copious amounts of wheat/rye/barley and other high FODMAP foods daily for two months straight!

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Avocado brunch would be off the menu for me for a few weeks!

I hope I have given you a bit of an insight into the low FODMAP diet. If you have been advised by your doctor to trial this diet is important to follow the most up to date guidelines. Go straight to the  source of the research. To help me out with the elimination phase I downloaded both the Monash Low FODMAP diet app and the Kings College London FODMAP app onto my phone. I found them absolutely fantastic. I also had the help and guidance of a fantastic dietician. I wouldn’t advise anyone to begin the low FODMAP diet without being under the care of a registered dietician. It is important to note that this diet eliminates many healthy foods and thus it should only be undertaken in the short term until FODMAP challenges can begin and trigger foods can be identified.

In my next post I will take you through the six weeks I spent strictly following the low FODMAP diet and let you know how I got on. See you then!

The Clean Coconut x

P.S. Have you done the low FODMAP diet before? I’d love to hear about your experience and whether or not you found it helpful! Connect with me via Facebook, Twitter, Instagram or Snapchat! Let’s share the journey.

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