Who is affected by irritable bowel syndrome, often suffers after each meal of digestive discomfort. The so-called low-FODMAP diet is supposed to be able to provide relief. What is this diet all about? What should sufferers pay attention to? And does the diet really help? In the following, we explain what FODMAP is and how it can help with irritable bowel syndrome.
What does FODMAP mean?
FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and (in English and) Polyols. These substances are short-chain sugars as well as sugar alcohols, such as lactose and fructose. They are a component of many different foods: from baked goods and dairy products to fruits and vegetables. Fermentable means that these substances trigger fermentation processes during digestion. For healthy people, this is not a problem. Irritable bowel patients, on the other hand, have a very sensitive digestive tract. In them, these fermentation processes can trigger complaints such as flatulence, diarrhea and cramps.
What is the low-FODMAP diet?
Foods that contain FODMAPs are not inherently unhealthy. On the contrary, the carbohydrates and sugar alcohols in question are also found in many healthy foods. The fact that they nevertheless trigger digestive complaints in irritable bowel syndrome sufferers can be explained by the sensitivity of the intestine. Healthy people therefore do not usually need to pay attention to the FODMAP value of foods – for people with chronic digestive problems, however, it can be important. The low FODMAP diet (or simply FODMAP diet) is therefore not a method for losing weight, but a special diet for irritable bowel syndrome sufferers. In this diet, foods are classified according to their FODMAP value and those with a high value are avoided as far as possible.
Why FODMAPs cause intestinal symptoms.
During the normal digestive process, ingested food is broken down into its components in the stomach and intestines. When the contained FODMAPs enter the large intestine, they initiate fermentation processes there. This produces gases that can irritate a sensitive intestine. In addition, the FODMAPs attract water in the intestine. This can lead to diarrhea. The increased gas and water content inflates the intestine and also stretches the intestinal wall. This makes them more permeable. Irritable bowel syndrome can thus lead to leaky gut syndrome. In this case, substances enter the body through the intestinal wall that actually have no business being there. This is accompanied by inflammatory reactions, among other things.
Where are FODMAPs found?
FODMAPs are found in a wide variety of foods, such as:
- Certain types of fruit (for example, apples, mangoes, peaches, watermelons).
- Certain vegetables (for example, artichokes, asparagus and onions).
- Certain cereals (including wheat and rye).
- Lactose-containing dairy products
- Honey
- Sugar substitutes such as xylitol, sorbitol and maltitol
- Glucose–fructose syrup and other additives in processed foods.
In the FODMAP diet, therefore, the intake of the above foods is first paused and then gradually resumed in small doses. Coffee is low FODMAP in itself – so you do not necessarily have to give up coffee at breakfast. However, it is best to drink it black, since milk and coffee cream as well as many sweeteners contain FODMAPs – conventional sugar is often tolerated in small amounts. It should be remembered, however, that coffee irritates the digestive tract even without FODMAPs at all.
How does the FODMAP diet work?
This irritable bowel diet is divided into three phases:
- For four to six weeks, all FODMAPs are rigorously eliminated from the diet during the restriction phase.
- In the re-exposure phase, a FODMAP-containing food is tested every one to two weeks. If one tolerates it, it can be integrated back into the menu. If the symptoms worsen, it is still possible to test the food again at a later time.
- Once all foods have been tested and the tolerable among them have been reintegrated into the diet plan, the maintenance phase follows.
From this point, affected people know which foods are suitable for them and which are not and can be guided by this list when composing their meals.However, tolerance (tolerance) to individual FODMAPs changes over time, so it may be necessary to adjust the diet every now and then.
FODMAP: What to eat.
The fact is that completely eliminating FODMAPs severely restricts the diet. Especially in the first few weeks, when only foods from the low-FODMAP list may be consumed, this dietary approach can be challenging. A FODMAP table can help in putting together the diet plan. Care should be taken to consume as many different “allowed” foods as possible to bring as much variety as possible into the diet to ensure the intake of the necessary nutrients. For example, the list of low-FODMAP foods includes:
- Lean meat and fish
- Eggs
- Eggplant, tomato, fennel, zucchini and cucumber
- Leaf lettuce and arugula
- Grapes, kiwi, pineapple and honeydew melon
- Rice, potatoes, quinoa and polenta
- Soy milk
- Green tea and mint tea
Challenges of the low-FODMAP diet
Processed foods and convenience foods almost always contain FODMAPs. So it is necessary to prepare a large part of the meals yourself. The low-FODMAP diet is also often accompanied by additional costs. Restaurant visits or dinner invitations with family and friends become more difficult. Who makes its own experiences with the FODMAP Diät however and a use for itself can determine, learns soon to deal with such difficulties. A FODMAP app can also help with this.
Where can I find low FODMAP recipes?
Numerous free low FODMAP recipes can be found on the Internet. In addition, corresponding cookbooks are available. To modify conventional recipes according to the Low FODMAP rules is often difficult. But there are instructions on how to prepare well-known dishes low or free of FODMAP, for example vegetable dishes such as ratatouille and even fruit cakes. Bread can also be eaten as long as it is a low-FODMAP recipe.
How quickly does FODMAP work?
Like any dietary change, the FODMAP diet does not take effect immediately or after a few days. Therefore, the first phase lasts four to six weeks to give the body time to adjust to the changes. Within this time the complaints should improve. If this is not the case, it is not worth continuing the diet.
Differences in effect: when does FODMAP work?
Scientific studies provide evidence that this form of diet can relieve the symptoms of IBS. However, the effect of the diet depends on the type of patient. Affected individuals are divided into three groups, according to the Institute of Microecology:
- FODMAP type 1 tolerates FODMAPs well and therefore usually cannot benefit from the dietary change.
- FODMAP type 2 tolerates only certain FODMAP-containing foods or small amounts of them. So here it is worth trying the diet.
- FODMAP type 3 has only a very low FODMAP tolerance and should therefore largely avoid appropriate foods.
FODMAP: When to expect long-term improvement.
Not all irritable bowel patients who benefit from the FODMAP diet, the symptoms disappear completely. Possibly “only” an improvement of the symptoms is achieved. In order for this positive effect to last, those affected must also be prepared in the long term to eat according to the low FODMAP diet and to regularly check the tolerance of individual foods. However, the restriction is not always as severe as in the first phase, since later the FODMAP-rich foods that did not cause a flare-up of symptoms during the second phase may also be consumed.
How does the FODMAP diet work?
Exactly how the low-FODMAP diet works has not yet been researched. It is suspected that it has tremendous effects on the gut microbiome. The gut microbiome, also known as the gut flora, refers to bacteria that populate the gut of every human being. These can be beneficial bacteria as well as harmful ones. The composition of the intestinal flora depends on numerous different factors. Individual nutrition has a particularly strong influence. Any diseases such as irritable bowel syndrome are also related to the intestinal flora.
Side effects: For whom is the FODMAP diet suitable?
The long-term effects of the low-FODMAP diet are not yet foreseeable, as there are no scientific studies to date on the lasting effects of this comparatively new form of nutrition. In addition, there is a risk of a one-sided diet if patients eat only low-FODMAP foods for a long time. This in turn can lead to an undersupply of important nutrients. For these reasons, the diet is really only suitable for people suffering from IBS. For other people, it offers no health benefits. The results of various scientific studies indicate that at least some IBS sufferers could benefit from it. It could also alleviate accompanying symptoms such as fatigue and depression. Because it involves a major dietary change with potentially severe effects on the body, the FODMAP diet should only be followed under the supervision of a physician or qualified nutritionist.
