Happy new year everyone! I feel like this is a timely topic to write about, as many people might have either jumped completely off the low FODMAP bandwagon during the holiday season or have been putting off beginning the diet until now, so as not to overwhelm themselves over Christmas. No judgement here, I was also tempted over the last few weeks.
So, for those who are new to this medically prescribed diet, and the not-so-new who might need a refresher course in what it’s all about and a list of resources that are just a click away, read on. The purpose of this resource package is not to tell you everything about the diet – as I have other links that do that, as do the bloggers and professionals that I list below, it is to provide all the resources that a beginner or ex-FODMAPer might need to get a handle of the diet again, by assisting you to understand the science and get inspired to create delicious low FODMAP meals.
To everyone else, I’ll be back to recipes in February – feel free to subscribe to receive emails about new posts in the top of the right hand side-bar.
What IS the low FODMAP Diet?
A much more in-depth description about FODMAPs and how they cause symptoms of irritable bowel syndrome (IBS) can be found here – please read it for full information – but the abridged version is this:
FODMAPs are a group of carbohydrates that are especially fermentable by the flora (bacteria) that live in your colon – this fermentation leads to gassy by-products and an osmotic effect that cause symptoms of abdominal pain, bloating, flatulence and altered bowel movements, to name a few. The low FODMAP diet is a medically prescribed diet that should be undertaken with the supervision of a trained dietitian, if at all possible. It aims to allow you to pin point your specific triggers by eliminating the foods with high levels of FODMAPs for a period of anywhere from 4-12 weeks (depending on who advises you and the severity of your situation) to allow your gut to settle, followed by a structured reintroduction period in which you individually test a variety of foods that are high in the different FODMAPs to learn your particular intolerances.
After completing the elimination and food trial phases, there is no need to remain completely low FODMAP, unless every food you test has caused you to react. See the “should I see a dietitian” section for more information.
The low FODMAP diet is also no longer purely for IBS sufferers. It has been found to help alleviate symptoms in those with carbohydrate malabsorption disorders (like fructose malabsorption), as well as Inflammatory Bowel Diseases, such as Crohn’s Disease and Colitis.
It is important to note that, while gluten is a gut irritant for those with Coeliac disease, non-coeliac gluten sensitivity (NCGS) or certain autoimmune disorders, gluten it is not a FODMAP. Gluten is a plant-based protein that occurs in all varieties of wheat, barley and rye, whereas FODMAPs, as mentioned earlier, are carbohydrates. A low FODMAP diet is not a gluten free diet; however, they can be used in conjunction to achieve full control of IBS (and other) symptoms.
Hopefully you were diagnosed by your dietitian, GP or gastroenterologist after having a set of tests run to rule out anything more serious that can disguise itself as IBS, such as coeliac disease or colon cancer. For obvious reasons, it is important to rule out autoimmune diseases and cancer early on, to limit damage done and improve prognosis – read more here. In addition to the more sinister causes of digestive distress, there are many disorders, diseases and food intolerances that can cause similar symptoms and muddy the diagnostic waters, so to speak.
These differential diagnoses include, but are certainly not limited to, the following conditions:
- Coeliac (celiac) disease.
- Colon cancer.
- Endometrosis (women) – can occur in addition to, or in isolation from another cause of digestive distress. Women might find that, regardless of their adherence to the low FODMAP diet (or other), they experience symptoms of IBS around ovulation and menstruation, which can be caused by endometriosis.
- Fructose malabsorption.
- Food allergies.
- Food chemical intolerance – these include naturally occurring chemicals, and those that are added from either natural or synthetic sources.
- Amines – including histamine
- Food colourings
- Hereditary fructose intolerance (HFI) – very different to fructose malabsorption, usually diagnosed at a young age and potentially life threatening.
- Inflammatory bowel disease (IBD) – such as Crohn’s and Colitis.
- Lactose intolerance/malabsorption.
- Ovarian cancer (women).
- Polyol malabsorption – including maltitol, mannitol, sorbitol etc.
- Small Intestine Bacterial Overgrowth (SIBO) – now thought to be an autoimmune response to an initial bacterial infection and potentially behind many cases of IBS with unknown causes.
Testing should be carried out for as many conditions as is deemed relevant for your individual case, until an answer is reached. The gold standard testing method for FODMAP specific malabsorptions (fructose, lactose, sorbitol) is a hydrogen/methane breath test. If your small intestine malabsorbs the carbohydrate, the concentrated solution you drink will, to varying extents, pass through into the colon, where the resident bacteria feed on it, leading to either (or both) hydrogen or methane gas production, which is measured by breathing into a bag or a meter.
Testing for coeliac disease includes an antibody blood test, as well as endoscopic procedures to check for visible signs of damage. Inflammatory bowel disease testing can include stool tests, blood tests, endoscopic procedures and imaging.
Unfortunately, not everyone will receive a standard diagnosis, and after this point “IBS” is typically diagnosed, if the case matches the Rome Criteria for IBS diagnosis.
Should I see a dietitian?
The short answer is yes, if you can. In addition to assisting with diagnosis of FODMAP specific issues, they can help with weeding out any other potential causes of your IBS. For some, FODMAPs aren’t the complete picture, or even part of their answer. For the 25% of people out there whose IBS is not related to FODMAP consumption, a dietitian will be able to help guide you to different possibilities, such as food chemical intolerances or perhaps allergies.
The low FODMAP diet is not meant to be followed forever. Many healthy foods, that are full of fibre and nutrients, are restricted during the full low FODMAP elimination phase, so it is best to get these back into your diet, if you can. Obviously, some people are unable to reintroduce some or any higher FODMAP foods; these people especially would benefit from a dietitian’s supervision, as the dietitian will be able to help them tailor an eating plan that is both low FODMAP and nutritionally balanced. The more foods you can reintroduce successfully, the more balanced your diet can be with less effort.
In which foods do FODMAPs occur?
For complete and up-to-date lists of the foods to avoid while in the elimination phase (with serving size recommendations), please check out one of the phone applications I have listed below (Monash University, FODMAP Friendly, or Baliza), as they regularly conduct research to test new foods and products for FODMAP content.
- The Monash University low FODMAP app for Android or iPhone. This also comes in book form which, obviously, can’t be updated as new foods are tested.
- FODMAP Friendly app for Android or iPhone.
- Baliza Food Intolerance app for Android or iPhone.
Low FODMAP Professionals Online
- The Well Balanced FODMAPer – Kate Scarlata, RD | Delicious recipes, fantastic up-to-date low FODMAP resources and an easy-to-understand food list.
- IBS: Free at Last! – Patsy Catsos, RD | Easy to make recipes, reliable low FODMAP resources for both dietitians and FODMAPers, as well as free downloads to help beginners.
- Shepherd Works and FODMAP Friendly – Sue Shepherd, RD PhD | Dr. Sue Shepherd, one of the low FODMAP diet pioneers, runs both a clinic in Melbourne, Australia and a company that has a low FODMAP app and low FODMAP food products.
- A Less Irritable Life – Glenda Bishop, PhD | Glenda is a registered nutritionist, wellness coach, neuroscientist and educator. She uses her insider experience of irritable bowel syndrome and food intolerances, alongside her expertise in nutrition, health and medical science, to develop easy to use strategies that help fellow suffers rediscover the joys of delicious food.
- R & M Dietetics – Lee Martin, RD and Mel Rendall, RD | Two dietitians who follow the low FODMAP diet, create delicious recipes, provide information about eating out and communicate important research to IBS sufferers.
- FODMAP Life – Colleen Franciolo, certified nutritionist consultant | balanced, nutritious recipes for FODMAPers and those suffering from other health conditions, such as Hashimoto’s and IBD.
- Lauren Renlund – Lauren Renlund, RD is a registered dietitian and nutrition coach from Canada | Lauren has firsthand experience following the low FODMAP diet and sees clients in person and over the phone/Skype.
Reliable Low FODMAP Websites
- The Friendly Gourmand – Nataliya Friend, B.Physio | Low FODMAP and gluten free recipes from scratch for all tastes, science-based resources and guides to travelling with food intolerances.
- Calm Belly Kitchen – Julie O’Hara | A recipe developer who works for a magazine and, in her spare time, has created a digestive wellness resource for women with IBS, offering low-FODMAP recipes and meal planning tips.
- The FODMAP Friendly Vegan – Sharon Rosenrauch, BPsyc MNut Candt. | A solid option for those eating a plant-based diet, Sharon provides healthy whole food meals that are delicious and FODMAP friendly.
- Friendly Little Kitchen – Stephanie Papillo | Delicious, inspired low FODMAP and gluten free meals from an obviously talented cook.
- Fructopia – Deniz Ficicioglu | Fructose friendly, processed sugar free and wheat free recipes that are delicious and healthy. Bonus – gorgeous food photography.
- The Fructose Friendly Chef – Melissa | A qualified chef who creates delicious fructose friendly meals, and takes gorgeous photographs to go with them. Say no more.
- Life and Thymez – Zlata Thoughtz | Quick, delicious and nourishing low FODMAP and gluten free meals – great for the new mums and busy parents out there!
- A Little Bit Yummy – Alana Scott | Low FODMAP and gluten free recipes, with additional dairy and nut free options and reliable low FODMAP diet information posts.
- My Gut Feeling – Joana | Healthy low FODMAP and gluten free recipes from a passionate (and well-travelled) foodie.
- Strands of My Life – Suzanne Perazzini | Beautiful FODMAP friendly recipes, reliable resources and a low FODMAP coaching programme for those struggling to understand the diet.
Books for those following a low FODMAP diet
- The Complete Low FODMAP Diet, by Sue Shepherd, PhD and Peter Gibson, MD.
- The Everything Guide to the Low FODMAP Diet, by Barbara Bolen, PhD and Kathleen Bradley, CPC.
- Flavor Without FODMAPs Cookbook, by Patsy Catsos, RD.
- The FODMAP Friendly Vegan – ebook, by Sharon Rosenrauch, BPsyc MNut Candt.
- Fructopia, by Deniz Ficicioglu (German).
- IBS 365, by Barbara Bolen, PhD.
- IBS: Free at Last (2nd edition), by Patsy Catsos, RD.
- Low FODMAP 28 Day Plan, by Kate Scarlata, RD.
- Low FODMAP Menus, by Suzanne Perazzini.
- Low FODMAP Snacks, by Suzanne Perazzini.
- The IBS Daily Journal, by Suzanne Perazzini.
- Re-challenging and Reintroducing FODMAPs: A self-help guide to the entire reintroduction phase of the low FODMAP diet, by Lee Martin, RD.
Low FODMAP coaching courses for IBS sufferers
- IBS Recipe for Success – Suzanne Perazzini.
Facebook Support Groups
- Australian Low FODMAP Recipes and Support.
- FORK MY BELLY - a support group for the Low FODMAP, Gluten Free and SIBO low fermentation diet.
- Fructose Malabsorption Victoria – everyone welcome, not just Aussies.
- Low FODMAP for Foodies.
- Low FODMAP Recipes and Support.
- Low FODMAP USA.
- Low FODMAP for Vegans.
- Low FODMAP | Life and Thymez.
I hope you have found this resource page useful! If there is anything you feel should be added, please leave a comment below, or email me at firstname.lastname@example.org.