Are homemade coconut milk and almond milk low in Fermentable Oligo-, Di-, Mono-saccharides, and Polyols (FODMAPs) for a patient with Irritable Bowel Syndrome (IBS)?

Homemade Coconut Milk and Almond Milk FODMAP Status

Homemade coconut milk is low FODMAP and can be used freely during all phases of the low FODMAP diet, while homemade almond milk is also low FODMAP when consumed in appropriate portions (typically up to 250ml per serving). 1

Coconut Milk for IBS Patients

• Coconut milk is recommended as a safe dairy milk alternative when preparing foods and beverages for IBS patients following a low FODMAP diet 1
• It contains no significant fermentable oligosaccharides, disaccharides, monosaccharides, or polyols that would trigger gastrointestinal symptoms 1
• Coconut milk can be used during the restriction phase without concern for FODMAP content 1

Almond Milk Considerations

• Almond milk is generally low FODMAP when homemade or commercially prepared in diluted form, as the FODMAP content is significantly reduced compared to whole almonds 1
• Whole almonds contain galacto-oligosaccharides (GOS) as their primary FODMAP and are unsuitable during the elimination phase 2
• However, when almonds are diluted to make milk (typically 1 part almonds to 3-4 parts water), the FODMAP concentration per serving becomes low enough to be tolerated 2
• Unsalted varieties are generally better tolerated than salted versions 2

Practical Implementation

When implementing the low FODMAP diet as second-line therapy after first-line dietary advice has failed:

• Use coconut milk or almond milk as dairy substitutes during the 4-6 week restriction phase 3, 1
• These plant-based milks avoid the lactose content found in regular dairy milk, which increases small intestinal water volume and colonic gas production in those with visceral hypersensitivity 1
• Both options allow patients to maintain adequate fluid intake (at least 8 cups daily) as recommended in general IBS dietary advice 4

Important Caveats

• The low FODMAP diet should be supervised by a registered dietitian with gastrointestinal expertise, as the diet can be complex and requires proper guidance through all three phases (restriction, reintroduction, personalization) 3, 2
• The restriction phase should not exceed 4-6 weeks to avoid potential nutritional inadequacies and negative impacts on the gut microbiome, particularly reduction in beneficial bifidobacteria 3, 2
• Approximately 70% of IBS patients respond to the low FODMAP diet, with network meta-analyses showing it superior to other dietary interventions for reducing abdominal pain, bloating, and improving bowel habits 3, 5