A low-FODMAP diet is commonly recommended for patients with irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), Crohn's Disease, and other digestive issues. Following this diet correctly may help to reduce common Irritable Bowel Syndrome (IBS) and/or SIBO symptoms like constipation, diarrhea, gas, and painful abdominal cramping.
How does the diet work? The primary focus is on eliminating potential problem or “trigger” foods and slowly adding them back in to see how they affect your body. It’s a type of elimination diet, and it can bring quick relief within 2 weeks for up to 80% of those who are suffering from gastrointestinal issues. The overall goal is managing IBS symptoms so you can live a normal life without uncomfortable bowel symptoms, and nagging stomach pains.
Irritable Bowel Syndrome (IBS)
IBS is a chronic disorder that affects the large intestine (colon). It often presents with cramping, abdominal pain and bouts of diarrhea or constipation.. IBS is related to problems with the way your brain and gut work together. Even though food is not the cause of the condition, IBS symptoms can be worse when you eat foods high in FODMAPs. That makes a low FODMAP diet the best way for most people to combat IBS.
Small Intestine Bacteria Overgrowth (SIBO)
While it is normal to have large numbers of bacteria in the large intestine, the small intestine should have far fewer. SIBO is a condition where there are too many bacteria in your small intestine. Many people who have been diagnosed with IBS have SIBO.
Low-FODMAP Diet: What to Eat and What to Avoid
Learning how to follow low-FODMAP diets can be challenging at first. It would be great to have a list of foods you can and can’t eat on the diet. But it’s a little more complicated than that. Many foods can be high, medium or low in FODMAPs depending on the serving size. There are only a few foods that should be eliminated completely during the low-FODMAP phase of the protocol. The best way to learn the details of what to eat and what to avoid is to consult the Monash University Low FODMAP app.
Foods to Avoid on the Low-FODMAP Diet
- Pistachios
- Cashews
- Garlic
- Onions
- Cow’s milk (unless lactose-free)
- Cottage Cheese (unless lactose-free)
- Yogurt (unless lactose-free)
- Rye
- Cauliflower
- Apples
- Pears
Foods Containing Significant Amounts of FODMAPs
These foods and ingredients have small low-FODMAP servings that can still be enjoyed on the diet. They will keep your diet interesting and nutritious. Consult the Monash app for details.
- Honey
- Wheat
- Beans (legumes)
- Lentils
- Nuts, all other kinds of seeds Sunflower seeds & Pepitas
- Pepitas
- Pasta made with wheat
- Bread made with wheat or rye
- Barley
- Mushrooms
- Dried Fruit
- Avocados
- Mangos
- Strawberries
- Grapes
Foods Containing Smaller Amounts of FODMAPs:
These are examples of popular foods that can be consumed in somewhat larger, though not unlimited, portions on a low-FODMAP diet. Consult the Monash app for details.
- Quinoa
- Rice
- Cornmeal/polenta
- Oats
- Sourdough bread
- Popcorn
- Bean sprouts
- Broccoli crowns
- Lettuce
- Carrots
- Cucumbers
- Eggplant
- Green beans
- Bell peppers
- Bok choy
- Plum tomatoes
- Potatoes
- Tomatoes
- Blueberries
- Kiwi
- Oranges
- Bananas
- Pineapple
- Almond milk
- Rice Milk
- Cheeses
- Firm tofu
- Olives
- Dark chocolate
Foods that Don’t Contain FODMAPs
These are examples of foods that don’t contain FODMAPs. They don’t have to be portion controlled for FODMAP reasons, so enjoy them in amounts that are appropriate for your nutrition needs. FODMAPs can be added in processing; to make sure your foods are low FODMAP stick to simple, unprocessed items or carefully read the list of ingredients.
- Eggs
- Meat, fresh, all kinds
- Fish, fresh, all kinds
- Seafood, all kinds
- Poultry, all kinds
- Game, all kinds
- Cheeses, aged or hard
- Cow’s milk products treated with lactase enzyme
- Oils, all kinds
- Mayonnaise
- Mustard
- Herbs, fresh and dried (most)
- Vinegar(most)
What does FODMAP mean?
The term FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. FODMAPS are certain carbohydrates can be difficult for the gut to digest and absorb, which is why they trigger IBS symptoms in some people.
- Oligosaccharides: Found in onions, garlic, legumes, wheat, rye, and certain fruits and vegetables
- Disaccharides: Found in dairy products that contain lactose, such as cow’s milk, yogurt, and soft cheeses
- Monosaccharides: Found in fruits that contain fructose, such as mangoes and apples, as well as sweeteners like honey and high fructose corn syrup
- Polyols: Found in some fruits and vegetables and certain low-calorie or sugar-free foods.
When people with IBS eat large amounts of FODMAPs, they can feed the gut microbes in the colon and pull water into the lower intestine, leading to painful gas and contributing to other uncomfortable gastrointestinal symptoms.
A trial low-FODMAP diet, step one of a FODMAP Elimination Diet protocol, is a great way to pinpoint, which FODMAPS disagree with you, and which ones are well tolerated.
Does the low-FODMAP diet work?
Studies show that following thelow-FODMAP diet can decrease the gastrointestinal symptoms related to IBS in up to 80% of people and improve the quality of life for the patient.
What are the benefits of a low-FODMAP diet?
People who remove high-FODMAP foods from their diet and replace them with Low FODMAP foods often notice an immediate improvement in their symptoms. Most people begin to feel better after just a few days, with significant changes occurring within two to six weeks.
Reduced Digestive Symptoms
The hallmarks of IBS include stomach pain, flatulence, reflux, bloating, diarrhea and constipation. These symptoms can affect quality of life, and sometimes even be debilitating. Studies show that this diet can reduce symptoms by up to 81%.
Improved Quality of Life
Not only does a low-FODMAP diet improve quality of life by managing digestive symptoms, it can also increase energy levels in people who suffer from IBS.
A Low-FODMAP Diet Isn’t for Everyone
Although the low-FODMAP diet is backed by science, it’s not necessary for every patient with IBS. You shouldn’t limit your diet unless there is a good reason to do so, so be sure to consult with your doctor, dietitian, or nutritionist before making any major changes.
If you have a history of an eating disorder, then this diet may be too restrictive for you. People with IBS who are pregnant or have other dietary restrictions may do best on a modified or FODMAP-gentle diet, which involves eliminating only the very highest FODMAP foods, such as onions, garlic, apples, regular milk, and large portions of wheat and legumes.
Your Low-FODMAP Diet Plan: How to Get Started
Before you try the diet, work with your doctor to confirm that you actually have IBS and that the Low-FODMAP Diet Plan is right for you. Serious conditions like Crohn’s disease, ulcerative colitis, colon cancer, and celiac disease can mimic IBS symptoms, so proper diagnosis is essential.
There are three stages to the diet. It’s best to work with a registered dietitian or nutritionist when you’re first starting out because FODMAPs can be hard to identify. Nutrient deficiencies could also become an issue without professional guidance.
Phase 1: Elimination
Phase 1, is known as the Elimination Phase, or Low-FODMAP Phase. It begins with greatly reducing your intake of FODMAPs. A dietitian can help you choose appropriate substitutes for your favorite foods. One of the greatest challenges will be staying on track when you’re away from home, such as when you’re eating out, at work, or traveling.
Planning ahead for various scenarios will be extremely beneficial. Make a list of what to buy and stock your kitchen with low-FODMAP foods in advance. Don’t forget to plan ahead for those times when you’ll be away from your own kitchen.
This phase lasts for two to four weeks.
Meal delivery services like ModifyHealth are ideal for the Elimination phase. ModifyHealth’s Monash University LowFODMAP-certified meals help make the transition to this diet easier. The meals are heat-and-eat(no preparation) and you can have confidence that the meals you are eating are certified to be low in FODMAPs. Go learn more at www.modifyhealth.com
Phase 2: Reintroduction
Phase 2 is the Reintroduction Phase. The primary goal here is to identify the foods that trigger your symptoms. The best way to approach this phase is to start with a list foods thatcontain significant amounts of each FODMAP.
Work your way down the list by reintroducing each type of FODMAP one at a time. For example, one week you might reintroduce lactose by drinking cow’s milk. Another week, you might reintroduce fructose by eating honey.
Pay attention to how your body reacts to each of the reintroduced FODMAPs. If lactose triggers your symptoms, you know that other foods that contain lactose going to be problems for you too. Use a food journal or app to keep track of your progress and symptoms.
It’s best to wait at least 24-48 before reintroducing the next FODMAP Keep servings small at first to reduce the chances of triggering severe symptoms but do increase them over the week to find out how you tolerate your normal portions. This phase generally takes 6 to 8 weeks to complete.
Services like ModifyHealth can also be helpful in this stage as their meals can be used as a baseline while you test FODMAP food categories. ModifyHealth also offers optional dietitian support to guide you through the Reintroduction phase.
Phase 3: Personalization
During this phase, you will continue to personalize your low-FODMAP diet plan by emphasizing foods that you tolerate well and limiting or eliminating foods that trigger your symptoms. This phase is all about experimenting.
Many people will find that they don’t have to avoid any single food completely. Foods that aren’t as well tolerated can often be eaten occasionally when the rest of the meal is not too high in FODMAPs, or in small servings. The goal isn’t to have a FODMAP-free diet, but simply to reduce FODMAPs enough to control your symptoms.
Commonly Asked Questions About the Low-FODMAP Diet
What is FODMAP intolerance?
The term FODMAP intolerance usually refers to symptoms like constipation, diarrhea, bloating, and gas that occur after eating large portions of FODMAP-rich foods
Does a low-FODMAP diet promote weight loss?
A low-FODMAP diet is not designed to promote weight loss. Rather, it is a type of learning diet that has been designed to reduce the gastrointestinal symptoms of IBS and to help IBS-sufferers pinpoint which FODMAPs trigger their digestive issues.
Can I eat bread on a low-FODMAP diet?
Yes, you can eat bread. Sourdough bread (2 slices) made from wheat is low-FODMAP. Many gluten-free breads are too. Regular breads and rolls made from wheat tend to be higher in FODMAPs, but very small servings of certain kinds are low-FODMAP. Consult the Monash app for details. Many people find that bread made from sourdough, corn, and millet, as well as gluten-free bread, are well tolerated, especially in small servings.
Can vegetarians follow a low-FODMAP diet?
Yes, but it will be more challenging. Since typical serving sizes of beans and legumes are high in FODMAPS, vegetarians will have to plan their diets carefully to get enough protein.
Overcoming the Obstacles of a Low-FODMAP Diet
Two potential concerns on a low-FODMAP diet are meeting nutritional needs and learning how to follow the diet itself. Though there are many good lower-FODMAP sources of nutrients, a low-FODMAP diet should be carefully planned to meet your nutritional needs. Following the diet is not easy, because many foods we normally think of as healthy are high in FODMAPs.
These issues come to a head when patients attempt to start a low-FODMAP diet low without professional guidance. Ask your doctor for a referral to a dietitian, who will help you create a plan to learn the most from your elimination diet process.For the details of what to eat, how much, on what to eat on a low-FODMAP diet, download the Monash Low FODMAP Diet app. Monash University is the creator of the low-FODMAP diet approach, and their app is the gold standard for anyone new to the low-FODMAP way of eating.
Should you try a low-FODMAP diet?
If you have IBS, it’s worth talking to your doctor to see if you should try a low-FODMAP diet. For many people, a Low FODMAP diet can drastically improve IBS-related gut symptoms and improve their quality of life.
Remember, a low-FODMAP diet isn’t for people with eating disorders, those with too many other dietary restrictions, or those who are pregnant. These people should consider alternatives like a FODMAP-gentle diet. This resource is not medical advice. We suggest meeting with your doctor or dietitian to determine if this diet is right for you.
ModifyHealth Can Help You
Interested in making the Low FODMAP diet simple and easy? Join ModifyHealth’s Low FODMAP meal plan where you can receive home-delivered, Monash University Low FODMAP certified meals and optional dietitian support to guide you through each phase of the program.
ModifyHealth is on a mission to allow people to be proactive about their health by using food as medicine. We believe that a balanced diet, exercise, and rest can help eliminate many chronic conditions that Americans suffer from today.
Click hereto learn more about our delicious Low FODMAP meal plan and optional dietary support.
