It seems to be increasingly difficult for the average person to enjoy a meal these days without experiencing digestive repercussions. Whether it’s gluten or lactose or some other sensitivity, it’s driving many to eliminate beloved foods from their diets in the name of gastrointestinal health.
But now doctors and scientists are zeroing in on a new subset of culprits and eliminating them isn’t as easy as it may sound. They’re FODMAPs, an acronym for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. They’re found in a lot of foods and are especially nefarious to people who suffer from GI issues like excessive gas and bloating, irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD).
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FODMAPs include the lactose in dairy products, the fructose in some fruits and vegetables, the galactans in legumes, the fructans in wheat and rye, and the sugar alcohols (like maltitol and sorbitol) found in gum and candies.
“Simply put, a FODMAP is a really small molecule of sugar that exists in common foods and that’s poorly digested by some people,” says Stephanie Clairmont, digestive dietitian and founder of StephanieClairmont.com. “When it’s not broken down and digested, it stays in the gut and ferments. Some foods, like pulses, have a lot of FODMAPs, which is why you can feel bloated and gassy after eating a lot of chili.”
FODMAPs don’t cause everyone distress, and in fact, are really important to the digestive process — even to those who are sensitive to them.
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“The thing is, they’re really good for gut health. They’re prebiotic fibres that help probiotics, the healthy bacteria in your gut, to thrive.”
Who should follow a low-FODMAP diet?
Clairmont calls this a “scientifically based diet” that’s especially beneficial to people who suffer from IBS, IBD, and severe and recurrent GI issues like gas, bloating, abdominal distention, diarrhea and constipation.
There have been a number of small studies conducted that point to the benefits of a low-FODMAP diet in patients with IBS. One study published in the journal Gastroenterolgy found “reduced functional gastrointestinal symptoms” in IBS patients who followed a low-FODMAP diet for 21 days, while control subjects remained unchanged. In a more recent study published in the same journal, researchers found that participants who identify as gluten sensitive were, in fact, sensitive to the fructan in cereal bars and not gluten.
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Because FODMAPs are ultimately necessary, however, it’s not a question of cutting them out altogether, but rather of eliminating them for a period of two to six weeks and then reintroducing them slowly to see which ones are most distressing.
“Research shows that if you cut them out forever, it affects all the bacteria in your gut, including the good kind, and we know we need that for digestion,” she says.
More importantly, Clairmont stresses that this should not be treated as a weight-loss program. In December 2016, Blake Lively posted to social media that she was using gluten-free, low-FODMAP meal delivery service Epicured to help her “fit into my jeans again.” But more than one dietitian pointed out that unless she has a sensitivity to FODMAPs or gluten specifically, she’s not only potentially depriving herself of valuable nutrients, but she also could be wasting her time.
Registered dietitian and author of The Small Change Diet, Keri Gans, noted to Women’s Health that while cutting out vegetables like chickpeas, sugar snap peas, beets, celery, brussels sprouts and others, as well as dairy and bread, she would de-bloat, but she wouldn’t necessarily lose weight.
“It’s like so many other diets. When you start to bring attention to what you’re eating, you eat better and you’re probably cooking more at home,” Clairmont says. “But following a low-FODMAP diet when you don’t need to is a bit dangerous because it’s very restrictive and you could end up eating very little.”
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Adding another layer of complication to the low-FODMAP diet is the fact that sometimes it can merely come down to quantities. For example, a person who’s sensitive to fructan may be able to tolerate a slice of bread once a day or once a week, but not multiple times in a day. And the quantities may not even be specific to the person consuming them.
“There are some foods that have maximum amounts. For example, a quarter-cup of chickpeas or a half-cup of lentils are low in FODMAPs, but once you double those quantities respectively, there are too many FODMAPs in them.”
Which explains why one bowl of chili may not cause you any distress but three bowls could have you avoiding mixed company for a few hours.
Does it work for people who suffer from serious digestive issues?
From the limited amount of studies conducted and the success they’ve shown, all signs point to a low-FODMAP diet as providing immense relief to people who suffer from serious gastrointestinal issues, which is news that surely comes as a relief to the five million Canadians who suffer from IBS.
Clairmont stresses that any GI concerns should be addressed first with your doctor and then with a registered dietitian to find the best course of action for you. But she says she has seen positive anecdotal results with this diet.
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“It’s life-changing for people with frequent symptoms that really affect their lives. I’ve had some patients tell me they couldn’t go to the park with their kids because they had frequent diarrhea and needed to be close to a bathroom,” she says.
“This diet is geared for people with serious digestive issues and they’ll really benefit from it. But the rest don’t need it. Just learn about digestive health and things that are generally bad for your digestion. You can use other strategies that aren’t nearly as restrictive.”
For a list of high- and low-FODMAP foods, click here.
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