Pros & Cons
- Physical and emotional relief from digestive woes
- Understanding your food intolerances
- Difficult to tackle
- Limited guiding resources
Do's & Don'ts
Relief for irritable bowel syndrome (IBS) and, in some cases, inflammatory bowel disease (IBD).
Limiting certain types of carbs that may be poorly digested and absorbed has been shown to vastly improve symptoms of IBS such as bloating, gas and abdominal pain.
Lower your FODMAPs and you’ll lower your digestive troubles, goes the thinking behind this diet for IBS that was developed in 2005 by researchers at Monash University in Australia. So, what the heck are FODMAPs? An acronym for fermentable oligosaccharides, disaccharides, monosaccharide and polyols, these are types of carbohydrates that are difficult to digest and become fermented by bacteria, causing bloating and discomfort. By removing potential triggers to digestive distress and then reintroducing them, with the help of a trained dietitian, you’ll pinpoint your food intolerances and adjust your diet accordingly. You’ll feel better and maximize dietary diversity for optimal nutrition.
This diet has not been ranked by U.S. News.
How does the Low FODMAP Diet work?
The program is an intensive treatment, which should only be followed under the supervision of a registered dietitian and is not a substitute for seeking medical attention for digestive disorders. The process of eliminating and reintroducing foods to identify digestive triggers generally takes between two to six weeks, experts say. Most people complete it in four, but those who suffer from constipation may require longer.
First, you’ll cut out a number of foods that are high in FODMAPs such as: wheat, rye, onions and legumes; lactose, which is found in soft cheese, yogurt and milk; fructose, found in high-fructose corn syrup, honey and certain fruits like apples and pears; and artificial sweeteners like sorbitol. Fiber is also limited as it can create digestive distress. You’ll then reintegrate some of these foods with, for example, a cup of milk or a teaspoon of honey, to learn what sets off your gastrointestinal woes. From there, you’ll embark on a gentler diet for your digestive system, limiting only what’s necessary to calm your gut.
While you’re on the program, you’re free to indulge in meat, poultry, fish, eggs and cold cuts; lactose-free dairy, hard cheeses, mozzarella and sherbet; nuts and seeds; wheat-free grains and flours like oats and quinoa; certain fruits such as bananas, berries, oranges and melon; and veggies, including kale, cucumbers and sweet potatoes.
What’s out? Lots of dairy products, such as sour cream, cottage cheese, yogurt, milk from cows, sheep or goats, and even chocolate. You’ll also need to avoid dried fruit, stone fruit like peaches, and other fruits such as apples, cherries, mango and papaya. You’ll eliminate beans and lentils (goodbye hummus and soy); squash, cabbage, mushroom, broccoli, onions and garlic; coffee, tea and juices made from low FODMAP fruits and veggies; and high-fructose corn syrup, agave and artificial sweeteners.
Because this is a limited and specific way of eating, it’s critical to work with a dietitian trained in the low FODMAP diet to help you follow it properly, identify food intolerances and develop a nutritious long-term diet.
Will you lose weight?
Not necessarily – and especially not if you swap out wheat for gluten-free processed foods or opt for unhealthy, FODMAP-free foods like potato chips that pack a lot of calories for little nutritional value. But if you swap processed foods, which are often loaded with FODMAPS, for fruits and vegetables and other whole foods, you may then see your weight drop.
This diet also modifies gut bacteria, which play a role in obesity, according to emerging research. However, it’s unclear how the low FODMAP diet specifically shapes that connection. In any case, this eating pattern may help get rid of that belly bloat that results from food intolerance.
Does it have cardiovascular benefits?
Not necessarily. If you’re working with a dietitian to ensure a nutritious diet, you should be eating plenty of fruits and vegetables along with lean meats and whole grains. Such an eating pattern should ideally be low in fat and high in fiber, which conforms with the medical community’s definition of a heart-healthy diet. However, the sample menu below delivers 44 percent of calories come from fat. It will be up to you to make sure that you follow this program in such a way that keeps your heart health in mind.
Can it prevent or control diabetes?
Prevention: The low FODMAP diet depends entirely on the particular foods an individual finds intolerable and the manner in which the dieter compensates for this elimination. If, for example, you identify wheat as a trigger food and ditch your wheat-filled processed food snacks for healthy whole-grain substitutions, you will likely lose weight and, consequently, lower your risk for diabetes. But if you switch instead to wheat-free processed foods, you won’t lessen your risk – you might even heighten it. diabetes.
Control: The low FODMAP diet can easily match up with the eating plan recommended by the American Diabetes Association, which calls for filling half your plate with non-starchy vegetables like bok choy and spinach, and dividing the rest between starchy foods such as rice or sweet potatoes and protein like fish or lean beef.
Are there health risks?
Because this diet is a complicated trial for IBS treatment, food options are limited. The diet should only be followed under the guidance of a trained dietitian who can help assist you in navigating its challenges. Your dietitian can also help ensure you’re getting enough calories and avoiding nutrient deficiency. However, people with chronic gastrointestinal trouble should seek medical attention.
How well does it conform to accepted dietary guidelines?
Fat. The government recommends that between 20 to 35 percent of daily calories come from fat. A sample daily menu provides 44 percent.
Protein. It’s within the acceptable range for protein consumption – 15 percent, compared with the 10 to 35 percent the government recommends.
Carbohydrates. The government advises that between 45 and 65 percent of daily calories come from carbs. A sample daily menu on this program meets that goal with 46 percent.
Salt. The majority of Americans consume too much salt. The recommended daily maximum is 2,300 milligrams, but if you’re 51 or older, African-American, or have hypertension, diabetes or chronic kidney disease, the limit is 1,500 mg. A sample daily menu on the low FODMAP diet provided1,693 mg.
Other key nutrients. The 2010 Dietary Guidelines call these “nutrients of concern” because many Americans get too little of one or more of them:
- Fiber. Getting the recommended daily amount of 22 to 34 grams for adults helps you feel full and promotes good digestion. You may have to seek out extra fiber on this diet to make up for eliminating wheat. A sample daily menu meets the requirement, with 24 grams.
- Potassium. A sufficient amount of this important nutrient, according to the 2010 Dietary Guidelines, counters salt’s ability to raise blood pressure, decreases bone loss and reduces the risk of developing kidney stones. It’s not that easy to get the recommended daily 4,700 mg. from food. (Bananas are high in potassium, yet you’d have to eat 11 a day.) The majority of Americans take in far too little. A sample daily menu comes up short at 3,456 mg.
- Calcium. It’s essential not only to build and maintain bones but to make blood vessels and muscles function properly. Many Americans don’t get enough. Women and anyone older than 50 should try especially hard to meet the government’s recommendation of 1,000 to 1,300 mg. A sample daily menu provides 607.5 mg.
- Vitamin B-12. Adults should shoot for 2.4 micrograms of this nutrient, which is critical for proper cell metabolism. Fish like salmon and trout, along with eggs and yogurt, are good sources. A sample daily menu provides 1.5 mcg.
- Vitamin D. Adults who don’t get enough sunlight need to meet the government’s 15 microgram recommendation with food or a supplement to lower the risk of bone fractures. Just 3 ounces of sockeye salmon, which packs almost 20 micrograms of vitamin D, will satisfy the requirement. A sample daily menu provides only 1.5 mcg.
Supplement recommended? N/A
How easy is it to follow?
It's not easy, but the program is temporary. You’ll spend between two and six weeks working with a dietitian trained in this program to ensure you’re meeting your nutrition requirements while detecting and managing your food sensitivities.
Recipes are becoming easier to find as news spreads about the effectiveness of this diet for IBS relief.
Recipes. Visit websites and books of by low FODMAP experts, like Monash University, which pioneered the program and offers a booklet and app for low FODMAP eating on its website. Other resources include websites and books by Kate Scarlata, a Massachusetts-based dietitian who specializes in IBS, diabetes, celiac disease and the low FODMAP diet. You can also turn to ibsfree.net, edited by Patsy Catsos, a Portland, Maine-based dietitian and author of “IBS – Free at Last!”
Eating out. It’s not hard – once you know what to do. You can always opt for Asian restaurants and order a dish of rice with protein and low FODMAP veggies, or get an oatmeal breakfast at McDonald’s. Make sure to ask for sauces on the side, and dress salads with a simple mix of oil and vinegar.
Alcohol. Avoid beer, rum and sweet wine. A small amount of dry wine should be OK, as should vodka, gin and whiskey. As always, exercise caution with alcohol: If you’re going to drink, use moderation, and stick with USDA guidelines that limit women to one drink per day and men to two drinks per day.
Timesavers. None, unless you hire somebody to plan your meals, shop for them and prepare them.
Nutrition experts emphasize the importance of satiety, the satisfied feeling that you've had enough. You'll want to fill up on protein and fiber with grains, fruits and veggies that are approved on the low FODMAP diet.
You’re making everything, so if something doesn’t taste good, you know who to blame.
How much does it cost?
It’s moderately pricey, considering that you should hire a dietitian to work with you. Typically, you’ll meet with a dietitian three or four times; prices vary by region, clocking in anywhere from $150 to $350 or more per hour. However, many insurance plans cover 100 percent of the cost.
Does the diet allow for restrictions and preferences?
It’s possible to customize the low FODMAP diet to fit your needs. Pick a preference for more information.
Yes, with a few minor tweaks you can easily replace any animal products with vegetarian- or vegan-friendly options.
The low FODMAP diet currently excludes wheat, which contains gluten, but not all gluten products. People who can’t tolerate gluten can easily tailor this diet to choose gluten-free ingredients.
Doable, but it's up to you to check the nutrition information on recipes and keep track of your sodium intake.
Yes, you can make sure your diet is kosher.
Yes, but it’s up to you to ensure your food conforms.
What is the role of exercise?
The low FODMAP diet is only an eating pattern, but that doesn’t mean you shouldn’t exercise. Being physically active lowers your risk of heart disease and diabetes, helps keep weight off and increases your energy level. Most experts suggest getting at least 30 minutes of moderate-intensity exercise – like brisk walking – most or all days of the week.
Last updated by Rachel Pomerance Berl | January 03, 2014