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Is healthy food causing your digestion problems?

Mmmm, lunch! Being health-conscious, you grab a bowl of lentil soup with whole wheat toast. You slather it with fat-free apple butter. Later in the day, you treat yourself to a little frozen yogurt with your family.
You’ve picked up these habits after years of trying. But if you’re eating really well and still suffering from uncomfortable (or even really painful and embarrassing) digestion, you’re not alone.

One in five Americans suffers from gastrointestinal problems. Feeling bloated, gassy, crampy, constipated, or running to the bathroom in a panic is, sadly, happening to about 20% of Americans.
Years ago, this was my story too. With my super-healthy vegetarian diet, I felt like I never enjoyed a day of comfortable digestion!
If you’re one of those lucky lads with digestive complaints, keep reading. There is a reason for it, and there are ways to address it.

Symptoms of gut disorders, such as Irritable Bowel Syndrome (IBS), include gas, bloating, pain, constipation, and/or diarrhea.

They are often persistent, draining, and can take a serious toll on quality of life, triggering anxiety and depression.

People who have intolerances to FODMAPs foods may suffer these symptoms, as well as increased pathogenic bacteria, as a result of certain carbohydrates fermenting.

The low FODMAPs strategy is a dietary approach that is growing in popularity for IBS sufferers. Many of my patients have found relief when I’ve helped them through the FODMAP method. It’s clinically demonstrated to help 75% of patients improve their IBS symptoms.

The low FODMAP diet could be an important component for you in reducing your IBS symptoms. You can listen to my recent podcast with Dietitian Patsy Catsos on this topic here.

What are FODMAPs?

FODMAPs are short-chain carbohydrates with the following characteristics:

  • Rapidly fermentable (causing gas and bloating)
  • Incompletely absorbed in the small intestine
  • Act as bacteria’s fast food in the large intestine
  • Osmotically active (pulling water into the gut)

The term FODMAPs is an acronym that stands for the following:

Fermentable carbohydrates are fermented by bacteria, and this serves as a food source for our healthy bacteria. These can include prebiotic foods, such as onion, garlic, and banana.

O is for Oligosaccharides – Oligosaccharides are short-chain carbohydrates. This term represents both fructans (chains of fructose with a glucose molecule at the end) and galactans (chains of galactose with a fructose molecule).

  • Fructans– The majority of people eat fructans as wheat, onion, garlic and many other vegetables.
  • Galactans – Primarily, beans and lentils

Plate of sprouted beansBeans are high in oligosaccharides

D is for Disaccharides – This represents pairs of sugar molecules. Dairy is a good example.

M is for Monosaccharides – This is a single sugar molecule.

A is for AND

P is for Polyols – Polyols include sugar alcohols like xylitol, sorbitol, or mannitol. (Your clue is to look for ingredients with -ol to indicate a sugar alcohol.) The charming effects is usually diarrhea, constipation or gas. Large amounts of polyols rarely occur in nature, and we don’t naturally digest them very well. The do occur in several fruits and mushrooms. Where people get into a lot of trouble is when eating sugar-free or diabetic sweets.

banana creme pie

Bananas and dairy contain FODMAPs

Where FODMAPs are found

FODMAPs are found combined in many, many foods (see Stanford’s list here). These include common fruits, vegetables, mushrooms grains, dairy, honey, coffee-replacements and some grains.
There is nothing inherently wrong with these nourishing, wholesome foods. Where sensitive people can get into trouble is when they eat a lot of FODMAPs, and the total load is too much.

mushrooms

Mushrooms contain Polyols

The purpose of a low FODMAPs diet

The purpose of the diet is to determine which food group is impacting your symptoms the most. The goal of elimination is to minimize symptoms while eating the most varied and healthy diet as possible.

The low FODMAP diet is a discovery process designed to help the person with IBS determine their personal trigger foods. I’ve had clients tell me they put themselves on a FODMAPs diet, but that it didn’t work for them. Upon deeper investigation, I discovered that they really just tried to restrict some of the FODMAPs food, but didn’t learn anything about which specific group impacted them the most.

The phases of a FODMAPs diet (super simplified)

Phase 1: Eliminate or reduce all FODMAPs. You’ll need to follow a specific meal plan in order to achieve this and maintain sanity.

Phase 2: Systematically re-challenge each FODMAP by GROUP, not by food item.

Phase 3: After you’ve learned about which group impacts you the most, you can develop a maintenance plan. You’ll need to ensure you’re able to eat the widest variety of food possible and support your nutrition needs.

Work with an expert

Work with a qualified Registered Dietitian (RD) who understands FODMAPs. This RD can help you design a meal plan, interpret your symptoms, rule out other serious conditions, and ensure that you’re getting enough nutrition.

As Kate Scarlata, RD & IBS experts says,

The low FODMAP diet is an evidenced based elimination diet shown to manage symptoms in 75% of those with IBS. The majority of the studies on the low FODMAP diet utilized a Registered Dietitian (RD) to help implement the diet.  Work with an RD knowledgeable in the low FODMAP diet to be sure you are following it correctly.  The diet has many nuances making it a challenging diet to implement on your own.

You may wish to get yourself a book to help you.

 Resources I recommend:

Who might benefit from reducing FODMAPs?

Tired business person with headache in work

Again, remember that the medical conditions listed can become very serious. Ensure you have a physician overseeing your case.

  • Someone with IBS with gas, bloating, diarrhea, constipation.
  • Someone who has already ruled out Celiac Disease (see why that’s important here)
  • Someone whose IBS hasn’t responded to standard therapies;
  • Someone with Small Intestinal Bacterial Overgrowth (SIBO)
  • Someone already eating a lot of FODMAPs foods and is also having symptoms
  • Is willing and able to adhere to dietary restrictions (may be difficult for someone not in control of food purchasing)
  • Is not pregnant or dealing with an eating disorder

Have you tried the low FODMAP approach to IBS treatment? Share your story in the comments below!

References:

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  • Lilia Lee

    Thanks Frances. This is an informative article on a subject I didn’t understand. You’ve helped me get a better grasp of it.

  • Gabriella Graham

    Now I know what is FODMAPs. Thanks for the great article, Frances. Keep writing.

  • Lori Manns

    Wow! This post was so informative. I learned a lot. Thanks for sharing the characteristics of FODMAPS so clearly.

  • Dorothy Pang, Fertility Coach & Acupuncturist

    Frances, I had not heard of this before, but having treated a LOT of digestive complaints with acupuncture, this does show up quite often in clinical practice! I’m so happy to have another resource for my patients!

  • Healthy me

    Hi Frances,

    Thank you for the information you shared about stomach problems. Whenever I have stomach problems, that would really caused by indigestion. I have been using herbal supplements like Mimonis Digestic to avoid indigestion. Good thing is that, it is very effective for and I didn’t worry because it is purely organic. I think this might help to other people that will visit here.

    • Frances Arnold

      Hi HealthyMe,

      I’m glad you found something that could help you. It’s good to get to the root cause of the digestive issues for the best chance at recovery. Some folks do need digestive enzymes. I’m not familiar with the brand you mention. My thought is that I always read the ingredients label to understand what is inside. Best wishes!

  • Gastroenterologist

    Take diet advice with dietitian and gastroenterologist near you because veg or non veg diet is risky in special health condition.

    • Frances Arnold

      Hi Gastroenterologist,

      You’re right that we need to adjust our diets based on specific health conditions. And a dietitian would be an important part of the medical therapy team to support healing with food and nutrients. I’ve found gastroenterologists sometimes completely skip over the food conversation with patients. Patients have told me that their gastro told them food has nothing to do with their IBS, inflammatory bowel, ulcerative colitis, or what-have-you. That’s a real challenge because it can leave a patient feeling confused, as though medications are the only option. Your thoughts?

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