Dieting is an ancient practice that people have been doing for millennia. They’ve been regulating what they eat or drink for numerous reasons. It may be to reduce, maintain or gain weight; for religious reasons or medical purposes.
Dieting gained popularity at the beginning of the 20th century and since then, it has become even more popular. There are currently hundreds of diets around the world, each with its own purpose, beliefs, rules and restrictions. It seems like a new diet is being invented every other day. Some are supported by science while others aren’t. Regardless of their scientific validity, many people decide to follow popular diets without assessing their potential risks.
In today’s post, we will be looking at a diet that has gained popularity since its development in the early 2000s. We’ll be discussing the low FODMAP diet and find out what the diet is used for, who it is for, its risks and some misconceptions related to it.
What are FODMAPs?
FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols. It refers to a group of foods containing certain types of short-chain carbohydrates and sugar alcohols. FODMAPs are proven to cause symptoms of extreme gas, bloating, abdominal cramps, diarrhoea and constipation in people with digestive issues such as IBS. Some of these foods can trigger these symptoms in certain people with IBS.
The term FODMAP was devised by researchers at Monash University in Australia. They hypothesized that such types of carbohydrates and sugar alcohols aggravate the symptoms of IBS.
Consuming excess FODMAP foods forces water to the gastrointestinal tract. The foods are poorly digested and when it enters the large intestine along with the liquid, bacteria present there quickly start fermenting it. This reaction produces gas and causes flatulence. An increase in fluid and gas then causes bloating and affects the time it takes to digest food. IBS is a chronic condition so people suffering from it experience the aforementioned symptoms often. Between 1 and 10 people in most countries are affected by IBS. It affects their lifestyle, costs and quality of life as it is difficult to manage.
FODMAP carbohydrates are a part of any normal diet and most people can consume them without any problems. Research suggests that the amount of FODMAPs consumed daily ranges between 15 grams to 30 grams per day. They are actually rich in necessary nutrients, so they prove to benefit those who include them in their diets. It is only in people with digestive issues that the symptoms get triggered.
What is a Low FODMAP Diet?
To get relief from the discomforts of IBS, many adopt a low FODMAP diet for a few weeks, after consulting their dietitians or healthcare providers.
The diet is split into three phases and a dietitian guides you through all phases. The first phase is perhaps the most difficult because of the number of foods that one must limit. It cuts down on all FODMAPs in a person’s diet for 4-6 weeks to decrease symptoms of IBS. The dietitian points out the foods that are and aren’t permitted to eat while ensuring that all vital nutrients are still being consumed.
After the first phase, high FODMAP foods are reintroduced to the diet one by one. Again, under the guidance of a dietician, as they can help find out exactly which foods cause the problem. By the end of the low FODMAP diet, the person on the diet is reintroduced to as many high FODMAP foods as possible that agree with their gut.
This step helps identify the foods causing most digestive issues. According to the severity, the dietitian will advise whether to completely omit those foods or to simply reduce their intake. If the food triggering symptoms contains vital nutrients, the dietitian will make sure to suggest alternatives to include them in the diet. The final step would be to maintain a normal diet, taking caution only when they encounter foods that cause problems.
Some people with IBS can tolerate certain high FODMAP foods but they can’t tolerate others. The case may be different for another person with IBS. Everyone’s body functions differently, hence foods that trigger IBS symptoms also vary from one person to the other.
Some FODMAP Foods
Some FODMAP foods found in everyday meals are:
- Dairy products such as cow’s milk, yoghurt, ice cream, cottage cheese, etc.
- Fruits such as apples, pears, peaches, cherries, mangoes, pears, watermelon, apricots, blackberries, nectarines, plums, etc.
- Vegetables such as artichokes, asparagus, broccoli, beetroot, garlic, onions, cauliflower, mushrooms, etc.
- Grains such as wheat and rye.
- Legumes such as lentils, red kidney beans, baked beans, chickpeas, soy or soy products, etc.
- Sweeteners such as honey, agave nectar, high fructose corn syrup, sorbitol, mannitol, xylitol, maltitol, isomalt, etc.
FODMAPs are everywhere, so it may seem like people following this diet do not eat anything, but that is certainly not the case. Here is a list of some foods that can be consumed on a low FODMAP diet:
- Dairy – Lactose-free kinds of milk, butter, hard cheeses, etc.
- Fruits- bananas, blueberries, kiwi, lemon, lime, oranges, strawberries, etc.
- Vegetables – Bean sprouts, capsicum, carrot, eggplant, tomato, spinach, zucchini, ginger, potato, lettuce, etc.
- Grains- Oats, rice, quinoa, corn flour, millet, chia seeds, gluten-free pasta, etc.
Additionally, nuts, seeds and proteins are permitted as well.
How Effective is the Low FODMAP Diet?
The efficacy of the low FODMAP diet on IBS symptoms has been proven many times since the concept was theorized in the early 2000s.
A study published in 2016 in the peer-reviewed medical journal, Clinical and Experimental Gastroenterology states that 86% of people with IBS who tried this diet displayed reduced symptoms.
In 2017, a study in the Gastroenterology & Hepatology journal concluded that the low FODMAP diet had sufficient evidence to prove that it was efficient in managing IBS symptoms in adults.
There is, however, evidence lacking to support the long-term effects of the diet. Moreover, the diet provides patients relief as long as they are able to identify the problem and maintain their diet accordingly. It doesn’t completely cure IBS nor does it treat the root cause of the problem.
History of the low FODMAP diet
The term was first found in the hypothesis paper published in 2005 by Dr Peter Gibson and Dr Sue Shepherd. By 2006, a team of researchers at Monash University, Melbourne, Australia, developed the first low FODMAP diet to improve the symptoms of digestive disorders.
Since then, the low FODMAP diet has developed further to evolve into the version followed today. In 2012, the Monash University FODMAP diet app was launched as a database of FODMAP tested foods. It essentially tells the user which food is low, moderate or high FODMAP. It also provides updated information about FODMAPs and even recipe ideas.
The low FODMAP diet has since gained popularity because it is supported by scientific evidence, it is a recommendation as a therapy for IBS in many domestic and international guidelines and, because many suffering from IBS have adopted the diet and find it helpful.
Risks associated with the low FODMAP diet
Many diets around the world require eliminating or restricting the consumption of certain foods. Before following a diet, it is always a good idea to assess whether eliminating the food is really necessary and, whether the diet will cause any nutrition deficiency, thus risking health.
The low FODMAP diet is undoubtedly an intense, restrictive and difficult diet to follow. Adopting this diet without the guidance or consultation of a healthcare professional or dietitian can end up doing more harm than good.
Importance of Consulting a Healthcare Professional
Only a professional would be able to advise how to maintain proper levels of vital nutrients while on a restrictive diet, based on your body type and condition. Additionally, it is not common knowledge to know how to reintroduce high FODMAP foods in the safest way possible after limiting or avoiding them for a significant amount of time.
Secondly, many cannot grasp the entire information. For example, the second phase of the diet, the gradual reintroduction of high FODMAP foods, is a highly important part of the diet. Many people get so habituated to restricting high FODMAP foods for several weeks that they often forget to start phase 2. Without professional guidance, many could face this issue.
Other people skip or delay phase 2, deliberately believing they’ll see better results. Carrying on this diet for a longer period of time could deprive the body of essential nutrients required for the body to function, such as iron, calcium, fibre, etc. Additionally, there could be a reduction or alteration of useful bacteria in the gut. This could harm the intestinal microbiome, possibly causing intolerance of more foods or even eating disorders in those susceptible to it, in the long term.
In some other cases, many complete the second phase but they do not maintain the diet afterwards. Hence, they experience the same symptoms that they perhaps used to. Seeing no results, they lose faith in the diet.
Jumping on the Trend
In many cases, people self–diagnose themselves and start following popular diet regimes. Even if it does end up working for some people, they wouldn’t really know what their symptoms are for. Many diseases or ailments have similar symptoms, but the real issue could be something else. In this case, for example, the person may not know if they have IBS or lactose intolerance.
Lastly, as the diet picks up pace, more and more people believe that just anyone can start following it. Jumping on the trend, people make their own versions of the diet, or spread misinformation, deviating from the original scientifically supported diet. This once again poses similar risks.
Numerous medical sources repeatedly recommend people to not follow the low FODMAP diet or any other diet unnecessarily.
Misconceptions surrounding the low FODMAP diet
The developers of the low FODMAP diet fear that the diet could just become another one of those fad diets. With an increase in its fame, social media influencers and celebrities are endorsing the diet, but to achieve goals that haven’t been supported by scientific evidence.
The diet is meant to help reduce the symptoms of digestive issues such as IBS. However, popular figures claim that it can help with weight loss or that it can help build muscle.
Another misconception was that the diet can cause acne. One social media user would determine whether or not foods were low FODMAP by feeding their pet rabbit. They believed that if the rabbit eats it, the food is low FODMAP.
There is currently no scientific evidence that supports any of these claims or beliefs.
Steps taken to combat misconceptions
To fight misconceptions, false claims and false information. The developers of the low FODMAP diet are using the revenue from the FODMAP app to create a team. This team is responsible for spreading accurate and reliable information to combat all the false information on the internet.
Not Another Fad Diet
While it is important that the knowledge of scientifically proven diets such as the low FODMAP diet reaches the mass, the more fame it receives, the further it will be from the truth. It can be compared to a game of Chinese whispers or telephone, where the original message that is passed on almost always never stays the same by the time it reaches the last person in line.
Thanks to the efforts of the low FODMAP diet developers and the public’s willingness to be more aware, people acknowledge that it was developed to alleviate the symptoms of digestive problems like irritable bowel syndrome.
For more information about the low FODMAP diet, visit https://www.monashfodmap.com/
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References
Bellini, M., Tonarelli, S., Nagy, A., Pancetti, A., Costa, F., Ricchiuti, A., de Bortoli, N., Mosca, M., Marchi, S. and Rossi, A., 2020. Low FODMAP Diet: Evidence, Doubts, and Hopes. Nutrients, 12(1), p.148.
Gibson, P., 2017. History of the low FODMAP diet. Journal of Gastroenterology and Hepatology, 32, pp.5-7.
Hill, P., Muir, J. and Gibson, P., 2017. Controversies and Recent Developments of the Low-FODMAP Diet. Gastroenterol Hepatol (N Y), 13(1), pp.36-45.
Quek, S., Loo, E., Demutska, A., Chua, C., Kew, G., Wong, S., Lau, H., Low, E., Loh, T., Lung, O., Hung, E., Rahman, M., Ghoshal, U., Wong, S., Cheung, C., Syam, A., Tan, N., Xiao, Y., Liu, J., Lu, F., Chen, C., Lee, Y., Maralit, R., Kim, Y., Oshima, T., Miwa, H., Pang, J. and Siah, K., 2021. Impact of the coronavirus disease 2019 pandemic on irritable bowel syndrome. Journal of Gastroenterology and Hepatology, 36(8), pp.2187-2197.
