Researchers from Australia have come up with a novel approach for IBS treatment, that of having patients follow a low FODMAP diet as a way to reduce IBS symptoms. They have coined the term FODMAPs to describe a collection of short-chain carbohydrates found in many common foods. FODMAPs stands for Fermentable Oligo-, Di- and Mono-saccharides, and Polyols.
The FODMAP theory holds that consuming foods high in FODMAPs results in increased volume of liquid and gas in the small and large intestine, resulting in distention and symptoms such as abdominal pain and gas and bloating. The theory proposes that following a low FODMAP diet should result in a decrease in digestive symptoms. The theory further holds that there is a cumulative effect of these foods on symptoms. In other words, eating foods with varying FODMAP values at the same time will add up, resulting in symptoms that you might not experience if you ate the food in isolation. This might explain the mixed results of studies that have evaluated the effects of fructose and lactose, two types of carbohydrates, on IBS. Ongoing research is being conducted as to the accuracy of the FODMAP theory and the effectiveness of the diet for IBS.
Below you will find lists of common high and low FODMAP foods. These examples are given for informational purposes only. If you are interested in following a low FODMAP diet, it is essential to work individually with a licensed nutritionist (See: Finding a FODMAP Dietician). There are risks to devising your own diet. It is tempting to pick and choose certain items based on your personal preference which could result in continued symptoms due to a lack of strict compliance to a sanctioned low FODMAP diet. Working with a trained nutritionist will also help to ensure that you receive adequate and balanced nutrition including a healthy intake of dietary fiber.
Other things to consider before starting a low FODMAP diet: research into its effectiveness for IBS is at a very preliminary stage and it is unknown at this point if following such a diet would be safe for your health over the long term. As with any new treatment or dietary approach, it is always best to discuss the issue with your own personal physician.
Common High FODMAP Foods
Fruits:
- Apples
- Apricots
- Cherries
- Mango
- Pears
- Nectarines
- Peaches
- Pears
- Plums and prunes
- Watermelon
- High concentration of fructose from canned fruit, dried fruit or fruit juice
Grains
Level of FODMAPs is increased when these foods are eaten in large amounts:
- Rye
- Wheat
Lactose-Containing Foods
- Custard
- Ice cream
- Margarine
- Milk (cow, goat, sheep)
- Soft cheese, including cottage cheese and ricotta
- Yogurt
Legumes
- Baked beans
- Chickpeas
- Lentils
- Kidney beans
Sweeteners
- Fructose
- High fructose corn syrup
- Isomalt
- Maltitol
- Mannitol
- Sorbitol
- Xylitol
Vegetables
- Artichokes
- Asparagus
- Avocado
- Beets
- Broccoli
- Brussel sprouts
- Cabbage
- Cauliflower
- Garlic (with large consumption)
- Fennel
- Leeks
- Mushrooms
- Okra
- Onions
- Peas
- Radiccio lettuce
- Scallions (white parts)
- Shallots
- Sugar snap peas
- Snow peas
Common Low FODMAP Foods
Fruits
- Banana
- Blueberry
- Grapefruit
- Grapes
- Honeydew melon
- Kiwi
- Lemon
- Lime
- Mandarine oranges
- Orange
- Raspberry
- Strawberry
Sweeteners
- Artificial sweeteners that do not end in -ol
- Glucose
- Maple syrup
- Sugar (sucrose)
Lactose Alternatives
- Butter
- Hard cheese, brie and camembert
- Lactose-free products, such as lactose-free ice cream and yogurt
- Gelato
- Rice milk
- Sorbet
Vegetables
- Bok choy
- Carrots
- Celery
- Corn
- Eggplant
- Green beans
- Lettuce
- Parsnip
- Scallions (green parts only)
- Tomato
Grains
- Gluten-free products
- Spelt products
For a printable chart of low FODMAPs foods, click here.
Sources:
Barrett, J. & Gibson, P. "Clinical Ramifications of Malabsorption of Fructose and Other Short-Chain Carbohydrates" Practical Gastroenterology 2007 XXXI:51-65
Gibson, P. & Shepherd, S. "Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach" Journal of Gastroenterology and Hepatology 2010 25:252-258.
"Low FODMAP Diet" Shepherd Works Web Site. Accessed September 27, 2010.
