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Educational Tip

Low FODMAP Diet

By Gali Health in partnership with @plentyandwellwithnat, medically reviewed by Kate Schlag, RD

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A diet that includes most meats, fruits, vegetables, and grains, and is focused on eliminating fermentable carbohydrates and foods high in FODMAPs to help digestion.

TABLE OF CONTENTS

  1. How It Came to Be
  2. Let’s Eat
  3. Foods to Steer Clear Of
  4. Low FODMAP Fried Rice
  5. Flare Friendly Foods
  6. Common Swaps
  7. Weekly Tip
  8. Research

HOW IT CAME TO BE

 

FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols…quite
a mouthful! These are short-chain carbohydrates and sugar alcohols that are poorly absorbed by the gut, which
can lead to abdominal pain and bloating.

The Low FODMAP diet is not intended to be used long-term or forever. Rather, it’s meant to be used as a short-term elimination diet to help you pinpoint which foods are causing digestive distress or exacerbating symptoms.

Once those foods are identified, foods that do not cause symptoms or inflammation – even if they contain FODMAPs – can be re-introduced.

LET’S EAT!

With all dietary restrictions, it’s important to focus on what you CAN eat, not just on what you can’t eat. With that being said, it’s definitely an easier process with stricter dietary changes like low FODMAP to look at the elimination foods and know that all other foods ARE allowed.

Low FODMAP is meant to be used as a short-term elimination diet to find your trigger foods! It is highly recommended to work with an RD or nutritionist while doing this diet because it can get tricky with measurements of certain foods that are allowed (and extra support is amazing!) Generally speaking, on the low FODMAP diet, you are able to eat a diverse range of produce, meats, legumes, and healthy fats.

STEER CLEAR OF

  • Garlic, onion, and leek
  • Veggies such as artichoke, asparagus, beetroot, cauliflower, celery, mushrooms, and sugar snap peas
  • Many fruits, such as ripe bananas, cherries, avocado, pears, peaches, and watermelon
  • Most dried fruit
  • All legumes other than chickpeas, lentils, and peanuts
  • Cashews and pistachios
  • Some grains, such as barley, rye, wheat, amaranth, and couscous
  • Any beverages made from cow’s milk
  • Other beverages such as soy milk, pear juice, apple juice, and kombucha
  • Most dairy products
  • Sweeteners such as honey, agave, and high fructose corn syrup

For a full list of “no” foods, click here.

LOW FODMAP FRIED RICE

INGREDIENTS

(** makes 4 servings)

  • 1 Tbsp oil of choice (for pan)
  • 3 eggs
  • 1/4 cup chopped snap peas
  • 1/4 cup chopped carrots
  • 1/4 cup chopped zucchini
  • 1 1/2 cup white rice (cooked)
  • 1 Tbsp sesame oil
  • 1 Tbsp soy sauce
  • 1 tsp salt

DIRECTIONS

  1. To cook your white rice, place 2 cups of water in a pot and turn on high heat. Once boiling, pour in uncooked rice and turn to medium heat. Continually stir until the rice has absorbed all of the water.
  2. While your rice is cooking, chop your snap peas, carrots, and zucchini.
  3. In a pan add the Tbsp of cooking oil and add in your vegetables and the teaspoon of salt.
  4. Once your rice is done, add it into the pan, along with the soy sauce and sesame oil.
  5. Crack your eggs in the pan with the veggie and rice mixture and continue stirring until the egg is fully cooked in.
  6. Enjoy!

FLARE FRIENDLY FOODS

Oatmeal

Rice

Bone broth soups

Small amount of pureed sweet potato

Steamed and pureed carrots

Boiled chicken or white fish

Rice cake with 1 Tbsp smooth almond butter

Scrambled eggs

*We suggest downloading the “Low FODMAP Diet A to Z” app to easily check which foods are low FODMAP and which ones are not.

COMMON SWAPS

Kombucha: sparkling water

Avocado: other sources of healthy fats like coconut, almonds, pecans, and walnuts

Cow’s milk: almond milk, coconut milk, oat milk, hemp milk (as long as they don’t include FODMAP ingredients)

Honey / Agave: maple syrup

For things like ketchup with HFCS or jam with HFCS: search for ketchup and jams without HFCS. Many stores carry these products.

Yogurt: coconut yogurt, almond yogurt (check for FODMAP ingredients that “aren’t allowed”)

WEEKLY TIP

Concerned about traveling while eating a new diet? We’ve got you!

  • Pack food for the trip! Things like snacks and other shelf-stable foods.
  • On that note – pack food for the airport. Most airports allow Tupperware meals through TSA as long as they aren’t liquid.
  • Communicate with the people you’re going to be traveling with before you leave. This helps you feel empowered to make decisions you need to make for your health while traveling.
  • Research the area before you go to find a grocery store you can stop at and restaurants you can find options at.

RESEARCH

Several studies have shown that the low FODMAP diet may reduce IBD symptoms. According to researchers, the malabsorption of rapidly fermented carbohydrates can lead to increased gas production, causing symptoms common in IBS patients like gas, bloating, and pain.

Upon removing FODMAPs from IBS patients’ diets, many reported a reduction in symptoms. These results have led researchers to investigate whether a low FODMAP diet may also reduce symptoms in IBD patients.

A 2009 retrospective study of 72 patients with IBD found that 56% of patients who received one-on-one dietary advice from a dietitian reported improved overall symptoms after receiving such advice, which included recommendations on removing fructose, fructans, lactose, sorbitol, and raffinose.

A 2016 study supported these results: 88 patients with IBD were referred to a specialty gastroenterology dietitian and instructed to follow a low FODMAP diet for a minimum of 6 weeks; patients also were offered a 30-minute follow-up appointment to review their symptoms and to receive reintroduction dietary education.

At follow-up, there was a significant reduction in the number of patients who experienced moderate to severe symptoms. While a mechanistic cause was not explored in this study, researchers identified several potential factors, including malabsorption, the osmotic activity of FODMAPs, and increased gas production caused by the fermentation of FODMAPs.

Despite the improvements in symptoms that IBD patients may experience after following a low FODMAP diet, research has not shown a significant effect on decreasing inflammation. A 2019 study analyzed symptom severity, markers of inflammation via fecal calprotectin, and microbiome composition in 43 patients who were either assigned to the low FODMAP diet (n=21) or sham diet (n=22).

While participants who followed the low FODMAP diet did experience a greater reduction in symptoms than those who followed the sham diet, this effect was not statistically significant.

It’s important to consider the risk of the low FODMAP diet in managing symptoms in IBD patients. Because the low FODMAP diet is so restrictive, it has the potential to lead to nutritional deficiencies in patients who already are at an increased risk for undernutrition or malnutrition.

IBD patients who wish to try the low FODMAP diet should do so under the supervision of a trained dietitian who can monitor the patient. Foods that are deemed to not cause symptoms should be reintroduced, and “non-responders” -patients who do not see improvements in symptoms after following the diet – should also consider stopping the diet.

For more information and tips on living with inflammatory bowel disease from the medical and patient communities, download the Gali friend for IBD mobile app and she will create a personalized feed of articles just for you!

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