Should You Follow a Low-FODMAP Diet?

If you have irritable bowel syndrome (IBS), you’re likely way too familiar with abdominal pain, bloating, constipation and diarrhea. But you might have the power to kick some of these symptoms to the curb. It starts with finding out which foods could be making your IBS symptoms worse.

But how do you know which foods are the problem? Enter the low-FODMAP diet — the detective for your gut. Registered dietitian and researcher Gail Cresci, PhD, RD explains the low-FODMAP diet and whether you should try it.

What are FODMAPs?

FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. FODMAPs are short-chain carbohydrates that you may have trouble digesting because:

• Your intestines can’t digest and/or absorb them well.
• Natural bacteria in your gut ferment them.
• They draw extra water into your intestines.

Despite these traits, not all FODMAPs are the enemy. “Chances are, you can tolerate some — or most —FODMAP-containing foods,” says Dr. Cresci. “Plus, many healthy foods have FODMAPs in them, like dried beans/legumes, Brussels sprouts and apples. So you don’t want to cut out all high-FODMAP foods forever if they’re not bothering you. You just want to avoid or cut back on the few that don’t work for you.”

What is the low-FODMAP diet?

A team of researchers designed the low-FODMAP diet to relieve symptoms of IBS. The plan helps you determine which FODMAPs are giving you trouble and which ones are your friends. The diet follows three basic steps:

1. Restriction: Limit or eliminate all high-FODMAP foods for two to six weeks. You and your provider can determine the length of this step based on your symptoms, health history and current diet.
2. Reintroduction: Add high-FODMAP foods back into your diet, one food at a time, for three days each. Take note of your IBS symptoms as you try each new food.
3. Personalization: Create a customized diet that limits or avoids the high-FODMAP foods that aggravate your IBS symptoms. Start eating other high-FODMAP foods that didn’t bother you during step two.

“Cutting out high-FODMAP foods in the first step resets your intestines so you can start with a clean slate,” says Dr. Cresci. “Introducing only one high-FODMAP food at a time allows you to pinpoint which foods, if any, are causing IBS flares. Then, you can build a new diet that improves IBS symptoms.”

How to follow a low-FODMAP diet

The first step to starting a low-FODMAP diet is to get your healthcare provider’s approval and guidance. The restrictions in step one severely limit the foods you can eat and, over time, can lead to nutrient deficiencies. That’s why the first two steps of this plan are only meant to be temporary measures — not a long-term solution.

If you have IBS, try the low-FODMAP diet:

• Before trying IBS medications, if your provider gives you the go-ahead.
• While taking your IBS medications for extra help with symptoms.

But don’t eliminate all high-FODMAP foods for more than a few weeks. “Your gut needs some high-FODMAP foods to optimally function,” says Dr. Cresci.

Your low-FODMAP shopping list

It can be overwhelming to eliminate all high-FODMAP foods in step one. But remember that this step is short-term. And there are plenty of low-FODMAP foods you can enjoy now to get you ready for steps two and three.

When you head to the grocery store, pick up some of these low-FODMAP foods:

Low-FODMAP fruits

Some fruits contain high amounts of sorbitol and fructose, which are monosaccharides and polyols — the M and P in FODMAP. Pick up these fruits for low-FODMAP alternatives:

• Cantaloupe.
• Grapes.
• Kiwifruit (green).
• Oranges.
• Pineapple.
• Strawberries.

Low-FODMAP vegetables

Some vegetables contain oligosaccharides or polyols, which can irritate a sensitive gut. Pack your kitchen with these easier-to-digest veggies:

• Bell peppers.
• Bok choy.
• Carrots.
• Cucumbers.
• Eggplant.
• Green beans.
• Lettuce.
• Potatoes.
• Tomatoes.
• Zucchini.

Low-FODMAP dairy alternatives

Many dairy products contain lactose, which is a disaccharide. Try these options instead.

Milk alternatives:

• Almond milk.
• Lactose-free milk.
• Oat milk.
• Soy milk (made from soy protein, not whole soybeans).

Cheeses:

• Brie.
• Camembert.

Low-FODMAP protein options

Meat marinades and sauces may contain various FODMAPs. Legumes (beans and pulses) are also high in oligosaccharides. Power up with these low-FODMAP proteins instead:

• Eggs.
• Firm tofu.
• Plain, cooked meats, poultry and seafood (use herbs for flavor, but avoid garlic and onion).
• Tempeh.

Low-FODMAP bread and grains

Many common breads and grains contain oligosaccharides, but you can avoid them if you choose:

• Breads that don’t contain wheat, barley or rye.
• Corn.
• Oats.
• Quinoa.
• Rice.
• Sourdough spelt bread.

Low-FODMAP sweeteners

Steer clear of artificial sweeteners commonly found in sugarless gum, mints and products labeled “sugar-free.” Satisfy your sweet tooth in moderation with these low-FODMAP options:

• Dark chocolate (without high fructose corn syrup).
• Maple syrup.
• Rice malt syrup.
• Table sugar.

Does the low-FODMAP diet work?

Studies show that the low-FODMAP diet can reduce or eliminate digestive problems in many people with IBS. But if it doesn’t work for you, don’t be discouraged.

“Not everyone will get amazing results from the plan, even if they follow it perfectly,” says Dr. Cresci. “If your symptoms don’t get better when you eliminate FODMAPs, then they probably aren’t a trigger for you. This information is useful because we can look at other possible IBS triggers, such as stress.”

IBS symptoms can be sneaky, but the low-FODMAP diet can uncover hidden triggers. “There’s no cure for IBS, but diet usually plays a big role,” says Dr. Cresci. “If you avoid the FODMAPs you can’t tolerate, you might start feeling a lot better.”