The FODMAP diet is not another fad diet, it is, however, a diet that has given many people who suffer from debilitating digestive conditions enormous relief. FODMAP’s are a collection of short-chain carbohydrates (sugars) that aren’t properly absorbed by some people. It’s kind of like being lactose intolerant, but instead, you have an intolerance to FODMAP molecules.
Not many of us are comfortable talking about our gut issues (because gut issues are mostly related to bowel movements). So, HELLO TMI. Gut issues are on the rise, so if talking about your gut and bowel issues stresses you out, avoidance might not be an option. According to one source, half of our population suffers from some sort of digestive problem (1). The gut’s job sends signs and symptoms when things go south. Are you paying attention?
What Is Irritable Bowel Syndrome?
Irritable bowel syndrome (IBS) is the umbrella name given to a host of digestive symptoms. Irritable bowel syndrome may be caused by emotional stress, change in routine, poor diet, food intolerances, medications, gut infection, genetics and environmental factors. A study carried out in 2014 found irritable bowel syndrome affects nearly 11% of our global population (2). Symptoms of irritable bowel syndrome include: lower abdominal pain, cramping, change in frequency of bowel movement, diarrhea, constipation, gas, bloating, food intolerances, fatigue, insomnia, anxiety, and depression.
Symptoms of IBS
Many symptoms relate to other health conditions, so misdiagnoses are common. If you suffer from any of these symptoms, it doesn’t necessarily mean you have IBS. However, it does mean that your digestive system requires some attention. Many symptoms may be manageable, but good digestive health holds the key to vitality and optimal health. Experts suggest an array of dietary and lifestyle tips for healthy digestion. If nothing works for you, FODMAP’s could be to blame. Healthcare professionals run tests to discover if the FODMAP’s diet could help your digestive health (3).
What Does FODMAP Stand For?
FODMAP stands for ‘Fermentable, Oligo, Di, Mono-saccharides And Polyols.’ It is the acronym given to a collection of molecules (small chain carbohydrates) found in many foods we eat.
F – Fermentable – gut bacteria ferments undigested carbohydrate and produces gas
O – Oligosaccharides – Fructans and Galacto-oligosaccharides (GOS)
D – Disaccharides – Lactose
M – Monosaccharides – Fructose
A – And
P – Polyols – Sorbitol, Mannitol, Maltitol, Xylitol and Isomalt
These FODMAP’s are found in foods such as:
Fructose: Natural sugar found in many fruits, vegetables, and sugars
Lactose: Carbohydrate in dairy products
Fructans: Gluten grains like wheat, spelt, rye and barley
Galactans: Legumes
Polyols: Sugar alcohols like xylitol, sorbitol, maltitol, mannitol and some fruits and vegetables.
These small chain carbohydrates (FODMAP’s) often pass through the digestive tract of many people without any symptoms. They are not bad molecules. But, some people poorly absorb these FODMAP molecules. When this happens, the FODMAP’s feed the bacteria of the gut, and when bacteria digest them, the FODMAP molecules cause gas, diarrhea, constipation, abdominal bloating, flatulence, nausea, abdominal pain, or a combination, along with other gastrointestinal symptoms. Which, on paper, all scream IBS symptoms too (4).
Low FODMAP Diet
Dr. Sue Shepherd developed the low FODMAP Diet after she created a successful fructose malabsorption diet in 1999. The low FODMAP diet (LFD) temporarily restricts fermentable carbohydrates. The diet provides you with an approach to manage your gut symptoms, including IBS, inflammatory bowel disease, small intestinal bacterial overgrowth (SIBO) and other functional gastrointestinal disorders.
If you suffer from other health conditions or an autoimmune disease such as fibromyalgia, rheumatoid arthritis, eczema and migraines, you might find the Low FODMAP’s Diet helps ease or completely removes your digestive symptoms, and maybe even your associated health conditions. Many experts suggest that the underlying cause of many health conditions lies within the gut.
Many tests determine the degree of dietary restriction required for specific situations, including the breath hydrogen test for fructose and lactose intolerance. More importantly, you need to identify which foods trigger your symptoms, and that’s what the Low FODMAP’s Diet does.
Studies suggest that you don’t need to stay on the Low FODMAPs Diet forever. With the help of a registered FODMAP’s dietitian and a detailed food diary, people discover exactly what they tolerate well (and not so well).
FODMAP Food List
Let’s take a look at all the foods low and high in FODMAP’s.
Foods High In FODMAP – Avoid/Reduce
Vegetables and Legumes
- Garlic – avoid entirely if possible
- Onions – avoid entirely if possible
- Artichoke
- Asparagus
- Baked beans
- Bananas, ripe
- Beetroot, fresh
- Black beans
- Black-eyed peas
- Broad beans
- Butter beans
- Cassava
- Cauliflower
- Celery – greater than 5 cm of stalk
- Choko
- Falafel
- Fermented cabbage, e.g., sauerkraut
- Haricot beans
- Kidney beans
- Lima beans
- Leek bulb
- Mange Tout
- Mixed vegetables
- Mung beans
- Mushrooms
- Peas, sugar snap
- Pickled vegetables
- Red kidney beans
- Savoy Cabbage
- Soybeans/soya beans
- Split peas
- Scallions / spring onions (bulb / white part)
- Shallots
- Taro
Fruit – fruits can contain high fructose
- Apples
- Apricots
- Avocado
- Blackberries
- Blackcurrants
- Boysenberry
- Cherries
- Currants
- Custard apple
- Dates
- Feijoa
- Figs
- Goji berries
- Grapefruit
- Guava, unripe
- Lychee
- Mango
- Nectarines
- Pawpaw, dried
- Peaches
- Pears
- Persimmon
- Pineapple, dried
- Plums
- Pomegranate
- Prunes
- Raisins
- Sea buckthorns
- Sultanas
- Tamarillo
- Tinned fruit in apple/pear juice
- Watermelon
Meats, Poultry, and Meat Substitutes
- Chorizo
- Sausages
Cereals, Grains, Breads, Biscuits, Pasta, Nuts and Cakes
- Wheat containing products such as (be sure to check labels):
- Biscuits including chocolate chip biscuits
- Bread, wheat – over one slice
- Breadcrumbs
- Cakes
- Cereal bar, wheat-based
- Croissants
- Crumpets
- Egg noodles
- Muffins
- Pastries
- Pasta, wheat over 1/2 cup cooked
- Udon noodles
- Wheat Bran, cereals, flour, germ, noodles, rolls
- Almond meal
- Amaranth flour
- Barley including flour
- Bran cereal
- Granary bread
- Multigrain bread
- Naan
- Oatmeal bread
- Pumpernickel bread
- Roti
- Sourdough with Kamut
- Cashews
- Couscous
- Einkorn flour
- Freekeh
- Gnocchi
- Granola bar
- Muesli cereal
- Muesli bar
- Pistachios
- Rye
- Rye crispbread
- Semolina
- Spelt flour
Condiments, Dips, Sweets, Sweeteners, and Spreads
- Agave
- Caviar Dip
- Fructose
- Fruit bar
- Gravy, if it contains onion
- High fructose corn syrup (HFCS)
- Houmous
- Honey
- Jam, mixed berries
- Jam, strawberry, if it contains HFCS
- Molasses
- Pesto sauce
- Quince Paste
- Relish/vegetable pickle
- Stock cubes
- Sugar-free sweets containing polyols – usually ending in – ol or isomalt
Sweeteners and corresponding E number:
- Inulin
- Isomalt (E953 / 953)
- Lactitol (E966 / 966)
- Maltitol (E965 / 965)
- Mannitol (E241 / 421)
- Sorbitol (E420 / 420)
- Xylitol (E967 / 967)
- Tahini paste
- Tzatziki dip
- For a tasty low FODMAP seasoning try Paleo Powder FODMAP
- Prebiotic Foods
The following items may be hiding in yogurts, snack bars, etc.:
- FOS – fructooligosaccharides
- Inulin
- Oligofructose
Drinks and Protein Powders
- Beer –(more than one bottle)
- Coconut water
- Cordial, apple and raspberry with 50-100% real juice
- Cordial, orange with 25-50% real juice
- Fruit and herbal teas with apple added, in large quantities or made of apple, pear, mango
- Kombucha
- Malted chocolate flavored drink
- Orange juice in quantities over 100ml
- Quinoa milk
- Rum
- Sodas containing High Fructose Corn Syrup (HFCS)
- Soy milk made with soybeans – commonly found in the USA
- Sports drinks
- Whey protein, concentrate unless lactose-free
- Whey protein, hydrolyzed unless lactose-free
- Wine (more than one glass)
Tea:
- Black tea with added soy milk
- Chai tea, strong
- Dandelion tea, strong
- Fennel tea
- Chamomile tea
- Herbal tea, strong
- Oolong tea
Dairy Foods
- Buttermilk
- Cheese – cream, Halloumi, ricotta
- Cream
- Custard
- Gelato
- Ice cream
- Kefir
- Milk:
- Cow milk
- Goat milk
- Evaporated milk
- Sheep’s milk
- Sour cream
- Yogurt
Cooking Ingredients
Carob powder
Foods Low In FODMAP – Enjoy
This is your low FODMAP grocery list.
Vegetables and Legumes
- Alfalfa
- Bamboo shoots
- Bean sprouts
- Beetroot, canned and pickled
- Bok choy / pak choi
- Broccoli, whole – 1 cup, heads – 1 cup, stalks – 1/2 cup
- Brussels sprouts – 1 serving of 2 sprouts
- Butternut squash – 1/4 cup
- Cabbage, common and red up to 1 cup
- Callaloo
- Carrots
- Celeriac
- Celery – less than 5 cm of the stalk
- Chicory leaves
- Chickpeas – 1/4 cup
- Chilli – if tolerable
- Chives
- Cho Cho – 1/2 cup diced
- Choy sum
- Collard greens
- Corn / sweet corn – if tolerable and only in small amounts – 1/2 cob
- Courgette
- Cucumber
- Eggplant/aubergine
- Fennel
- Green beans
- Green pepper / green bell pepper / green capsicum
- Ginger
- Kale
- Karela
- Leek leaves
- Lentils – in small amounts
- Lettuce:
- Butter lettuce
- Iceberg lettuce
- Radicchio lettuce
- Red coral lettuce
- Rocket lettuce
- Romaine/Cos lettuce
- Marrow
- Okra
- Olives
- Parsnip
- Peas, snow – 5 pods
- Pickled gherkins
- Pickled onions, large
- Potato
- Pumpkin
- Pumpkin, canned – 1/4 cup, 2.2 oz
- Radish
- Red peppers / red bell pepper / red capsicum
- Scallions / spring onions (green part)
- Seaweed/Nori
- Silverbeet/chard
- Spaghetti squash
- Spinach, baby
- Squash
- Sun-dried tomatoes – 4 pieces
- Swede
- Swiss chard
- Sweet potato – 1/2 cup
- Tomato – canned, cherry, common, Roma
- Turnip
- Water chestnuts
- Yam
- Zucchini
Fruit
- Ackee
- Bananas, unripe
- Bilberries
- Blueberries
- Breadfruit
- Carambola
- Cantaloupe
- Cranberry – 1 tbsp
- Clementine
- Dragon fruit
- Lingonberries
- Grapes
- Guava, ripe
- Honeydew and Galia melons
- Kiwifruit
- Lemon including lemon juice
- Lime including lime juice
- Mandarin
- Orange
- Passionfruit
- Pawpaw
- Papaya
- Pineapple
- Plantain, peeled
- Raspberry
- Rhubarb
- Strawberry
- Tamarind
- Tangelo
Meats, Poultry, and Meat Substitutes
- Beef
- Chicken
- Kangaroo
- Lamb
- Pork
- Prosciutto
- Quorn, mince
- Turkey
- Cold cuts/deli meat / cold meats such as ham and turkey breast
- Processed meat – check ingredients
Fish and Seafood
- Canned tuna
- Cod
- Haddock
- Plaice
- Salmon
- Trout
- Tuna
- Seafood (ensure nothing else is added) e.g.
- Crab
- Lobster
- Mussels
- Oysters
- Prawns
- Shrimp
Cereals, Grains, Breads, Biscuits, Pasta, Nuts and Cakes
- Wheat-free breads
- Gluten-free breads
- Cornbread
- Oat bread
- Rice bread
- Spelt sourdough bread
- Potato flour bread
- Wheat free or gluten-free pasta
- Bread, wheat – 1 slice
- Almonds – max of 15
- Biscuit, savory
- Biscuit, shortbread – 1 only
- Brazil nuts
- Bulgur – 1/4 cup cooked, a 44g serving
- Buckwheat, flour, noodles
- Brown rice / whole grain rice
- Chestnuts
- Chips, plain / potato crisps, plain
- Cornflour / maize
- Crispbread
- Corn Cakes
- Cornflakes – 1/2 cup
- Cornflakes, gluten-free
- Coconut – milk, cream, flesh
- Corn, creamed and canned (up to 1/3 cup)
- Corn tortillas, three tortillas
- Crackers, plain
- Hazelnuts – max of 15
- Macadamia nuts
- Millet
- Mixed nuts
- Oatmeal, 1/2 cup
- Oats
- Oatcakes
- Peanuts
- Pecans – max of 15
- Pine nuts – max of 15
- Polenta
- Popcorn
- Porridge and oat based cereals
- Potato flour
- Pretzels
- Quinoa
- Pasta, wheat – up to 1/2 cup cooked
Rice:
- Basmati rice
- Brown rice
- Rice noodles
- White rice
- Rice bran, cakes, crackers, flakes. flour, Krispies
Seeds:
- Chia seeds
- Egusi seeds
- Poppy seeds
- Pumpkin seeds
- Sesame seeds
- Sunflower seeds
- Starch, maize, potato, and tapioca
- Sorghum
- Tortilla chips/corn chips
- Walnuts
Condiments, Dips, Sweets, Sweeteners, and Spreads
- Almond butter
- Barbecue sauce – check the label carefully
- Capers in vinegar
- Capers, salted
- Chocolate:
- Dark chocolate
- Milk chocolate – 3 squares
- White chocolate – 3 squares
- Chutney, one tablespoon
- Erythritol (E968 / 968)
- Fish sauce
- Golden syrup
- Glucose
- Glycerol (E422 / 422)
- Jam/jelly, strawberry
- Ketchup (USA) – 1 sachet
- Maple syrup
- Marmalade
- Marmite
- Mayonnaise – ensuring no garlic or onion in ingredients
- Miso paste
- Mustard
- Oyster sauce
- Pesto sauce – less than 1 tbsp
- Peanut butter
- Rice malt syrup
- Saccharine
- Shrimp paste
- Soy sauce
- Stevia
- Sweet and sour sauce
- Sucralose
- Sugar – also called sucrose
- Tamarind paste
- Tomato sauce, 13g
- Vegemite
Vinegar:
- Apple cider vinegar, 2 tbsp
- Balsamic vinegar, 2 tbsp
- Rice wine vinegar
- Wasabi
- Worcestershire sauce – has onion and garlic but very very low amount making it low FODMAP
Drinks and Protein Powders
- Alcohol – is an irritant to the gut, limited intake advised
- Beer – limited to one drink
- Clear spirits such as Vodka
- Gin
- Whiskey
- Wine – limited to one drink
Coffee:
- Espresso coffee, regular or decaffeinated, black
- Espresso coffee, regular or decaffeinated, with up to 250 ml lactose-free milk
- Instant coffee, regular or decaffeinated, black
- Instant coffee, regular or decaffeinated, with up to 250 ml lactose-free milk
- Drinking chocolate powder
- Fruit juice, 125ml, and safe fruits only
- Kvass
- Lemonade – in low quantities
- Protein powders:
- Egg protein
- Pea protein – up to 20g
- Rice protein
- Sacha Inchi protein
- Whey protein isolate
- Soya milk made with soy protein
- Sugar-free fizzy drink/soft drinks/soda – diet coke, in low quantities as aspartame and acesulfame k can be irritants
- ‘Sugar’ fizzy drinks/soft drinks/soda that does not contain HFCS such as lemonade, cola. Limit intake due to these drinks being generally unhealthy and can cause gut irritation
Tea:
- Black tea, weak
- Chai tea, weak
- Fruit and herbal tea, weak – ensure no apple added
- Green tea
- Peppermint tea
- White tea
- Water
Dairy Foods and Eggs
- Butter
Cheese:
- Brie
- Camembert
- Cheddar
- Cottage
- Feta
- Goat/chevre
- Mozzarella
- Parmesan
- Ricotta – 2 tablespoons
- Swiss
- Dairy-free chocolate pudding
- Eggs
- Margarine
Milk:
- Almond milk
- Hemp milk
- Lactose-free milk
- Macadamia milk
- Oat milk – 30ml, enough for cereal
- Rice milk – up to 200 ml per sitting
- Sorbet
- Soy protein (avoid soya beans)
- Swiss cheese
- Tempeh
- Tofu – drained and firm varieties
- Whipped cream
Yogurt:
- Coconut yogurt
- Greek yogurt, in small amounts
- Lactose-free yogurt
- Goats yogurt
Cooking Ingredients, Herbs, and Spices
- Herbs: Basil, Bay leaves, Cilantro, Coriander, Curry leaves, Fenugreek, Gotu Kola, Lemongrass, Mint, Oregano, Pandan, Parsley, Rampa, Rosemary, Sage, Tarragon, Thyme
- Spices: Allspice, Black pepper, Cardamom, Chilli powder (check ingredients, sometimes has garlic added), Cinnamon, Cloves, Cumin, Curry powder, Fennel seeds, Five spice, Goraka, Mustard seeds, Nutmeg, Paprika, Saffron, Star anise, Turmeric
- Oils: Avocado oil, Canola oil, Coconut oil, Olive oil, Peanut oil, Rice bran oil, Sesame oil, Soybean oil, Sunflower oil, Vegetable oil
- Garlic infused oil
- Onion infused oil
- Asafoetida powder – excellent onion substitute
- Baking powder
- Baking soda
- Cacao powder
- Cocoa powder
- Cream, 1/2 cup
- Gelatine
- Ghee
- Icing sugar
- Lard
- Nutritional yeast
- Salt
- Soybean oil
Foods lists are resources from the IBS Diet website (5).
FODMAP Elimination Diet
The FODMAP Elimination diet is often a twelve-week program based on, as the name suggests, eliminating the high FODMAP foods. There are two phases to the Low FODMAP’s Diet. Once your healthcare professional has diagnosed you as having an intolerance to FODMAPs, make an appointment with a dietitian who specializes in the Low FODMAP Diet. The 131 Method has a team of Registered Dietitians who can help answer questions during an elimination diet.
The first phase involves removing all foods which high are in FODMAPs for one to four weeks. Journal all symptoms occurring during this change. Ensure you substitute the removed foods with other foods to keep your daily dietary intake nutritionally high.
The second phase involves reintroducing each food from the high FODMAP’s food list (which you removed during the first phase) one at a time to identify precisely which foods you tolerate well. From these findings, a dietary program is created.
When we suggest creating a food and symptoms diary/journal to record:
- Time of day you ate the food
- Food eaten and quantity
- Symptoms felt after eating
- Bowel movement after eating
- Any other notable changes
Record your bowel movement according to the Bristol Stool Scale
Resources and programs we like:
- The Complete Low-FODMAP Diet (6)
- The Gut Program (7)
- fit fab FODMAP (8)
- Low FODMAP Diet App (9)
- The FODMAP Challenge (10)
Stress, lack of sleep, too much caffeine, alcohol, medications and fatty foods can all contribute to gut issues. Remember that FODMAP’s are not bad, they are only harmful if you have an intolerance to them (11). We hope this article helps you on your journey to a healthier gut and happier you.
References
- www.gutfoundation.com.au/about
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921083/
- https://onlinelibrary.wiley.com/doi/full/10.1111/j.1440-1746.2009.06149.x
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966170/
- https://www.ibsdiets.org/fodmap-diet/fodmap-food-list/
- www.shepherdworks.com.au/shop/
- https://www.thegutprogram.com
- https://fitfabfodmap.com
- https://www.monashfodmap.com/i-have-ibs/get-the-app/
- https://fodmapchallenge.com
- https://www.ncbi.nlm.nih.gov/pubmed/24076059