What is a low FODMAP (Fermentable Oligo-, Di-, Mono-saccharides, and Polyols) diet?

From the Guidelines

A low FODMAP diet is recommended as a second-line diet for patients with irritable bowel syndrome (IBS) who do not respond to traditional dietary advice, as it has been shown to reduce the risk of remaining symptomatic compared to control interventions 1. When implementing a low FODMAP diet, it is essential to work with a specialist dietitian to avoid nutritional deficiencies and overly restrictive eating habits. The diet involves eliminating high FODMAP foods for 2-6 weeks, then systematically reintroducing them to identify personal triggers.

Key points to consider:

• Foods to avoid initially include wheat, rye, onions, garlic, certain fruits (apples, pears, watermelon), some vegetables (cauliflower, mushrooms), legumes, and dairy products containing lactose 1.
• Safe foods include rice, quinoa, potatoes, carrots, cucumbers, oranges, grapes, lactose-free dairy, and most meats.
• The low FODMAP diet works by restricting certain carbohydrates that can trigger digestive symptoms in people with IBS, as FODMAPs are poorly absorbed in the small intestine and fermented by gut bacteria, causing gas, bloating, and altered bowel habits in sensitive individuals 1.
• It is crucial to screen out patients at high risk for restrictive eating habits prior to recommending a low FODMAP diet, and to closely monitor them to avoid nutritional deficiencies 1.
• The effect of FODMAP reintroduction to tolerance on IBS symptoms is unclear, and further research is needed to determine the long-term efficacy of an adapted low FODMAP diet 1.

From the Research

Low FODMAP Diet Overview

• The low FODMAP diet is a dietary approach used to manage symptoms of irritable bowel syndrome (IBS) and other gastrointestinal disorders 2, 3, 4, 5, 6
• The diet involves restricting foods high in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) for a period of time, followed by reintroduction and personalization of the diet based on individual tolerance 2, 4, 6

Phases of the Low FODMAP Diet

• The low FODMAP diet typically consists of three phases:
  • Restriction: eliminating high FODMAP foods for 2-6 weeks 2, 6
  • Reintroduction: gradually reintroducing high FODMAP foods to assess tolerance 2, 4, 6
  • Personalization: customizing the diet based on individual tolerance and symptom response 2, 4, 6

Efficacy of the Low FODMAP Diet

• Studies have shown that the low FODMAP diet can be effective in reducing symptoms of IBS, including abdominal pain, bloating, and changes in bowel habits 3, 4, 5
• The diet has also been shown to improve quality of life and overall well-being in patients with IBS 3, 4

Considerations and Limitations

• The low FODMAP diet can be complex and may require the guidance of a healthcare professional or registered dietitian to ensure adequate nutrition and compliance 2, 4, 5
• Potential limitations of the diet include nutritional inadequacy, cost, and difficulty in maintaining the diet long-term 5
• Further research is needed to fully understand the effects of the low FODMAP diet on gut health and to identify predictors of response to the diet 4, 5