by Scheinberg D

Low FODMAP Diet

(Low fermentable, oligo-, di-, mono-saccharides and polyols diet; Diet, Low fermentable, oligo-, di-, mono-saccharides and polyols)

What is a Low FODMAP Diet?

FODMAPS are different types of carbohydrates found in foods. The letters stand for:
  • F—fermentable
  • O—oligosaccharides—fructans (wheat, garlic, or onion)
  • D—disaccharide—lactose (dairy)
  • M—monosaccharide—fructose (certain fruits, high fructose corn syrup)
  • a—and
  • P—polyols, alcohol-based sweeteners (sorbitol, mannitol), or fruits with pits (avocado, cherry, plums)
In a low FODMAP diet, certain types of foods that contain these carbohydrates are avoided.

Why Follow a Low FODMAP Diet?

For some people, some FODMAPs attract water into the intestine during digestion. Some may be slowly or incompletely digested or may be fermented by bacteria in the intestines. These steps can cause bloating, constipation, gas, diarrhea, or cramping. For people with irritable bowel syndrome (IBS) or other function gastrointestinal problems, these symptoms can be severe enough to interfere with normal activities or work.
A low FODMAP diet may reduce these symptoms.

Low FODMAP Diet Basics

Low FODMAP diet is done in 2 phases. During the first 2-8 weeks all high FODMAP foods may be restricted. If there were no improvements in symptoms then FODMAP foods may not be the culprit. If there was an improvement in symptoms in the first phase, some FODMAPs will be systematically reintroduced during phase 2. This will help determine which FODMAPs may be causing symptoms and which are safe to continue. This time period may require frequent dietary changes.

Eating Guide for a Low FODMAP Diet

This guide is based on dietary alternatives to reduce gastrointestinal distress. The list is not complete, but has examples of what key ingredients to look for.
Food Category Low FODMAP foods High FODMAP foods to avoid
Grains
  • Oats, potato, quinoa, or rice-based grains, popcorn
  • Grains (including breads, pasta, cereals, etc.) made with wheat, barley, rye if it is the main ingredient; gluten-free or spelt grains made with foods that need to be limited; chicory root, inulin
Vegetables
  • Eggplant, peppers, kale, lettuce, zucchini, squash, tomatoes, potatoes, cucumbers, cabbage, carrots, sprouts
  • Artichokes, mushrooms, cauliflower, asparagus, broccoli
Fruits
  • Strawberries, blueberries, raspberries, melons, kiwi, lemon, lime, oranges, pineapple, grapes
  • Blackberries, canned fruits, dates, pitted fruits (like avocado, peach, plum, mango), watermelon, prunes
Milk
  • Low lactose or lactose-free dairy, including cheese, cream cheese, soft cheeses, Greek yogurt, sherbet, whipped cream
  • All high lactose dairy, including buttermilk, custard, ice cream, cottage cheese, ricotta, sour cream
Protein from egg, meat, poultry, or fish
  • Beef, chicken, eggs, fish, lamb, pork, lunch meats, shellfish
  • Proteins that contain high fructose corn syrup
Nuts, legumes, and non-dairy alternatives
  • Milk made with almonds, coconut, rice,; nuts (walnuts, macadamias, peanuts, pecans)
  • Cashews, beans, black-eyed peas, bulgur, lentil, soy milk (made from soybeans), pistachios
Jams, relishes, seasonings
  • Foods made without high fructose corn syrup, mustard, butter, margarine, pickle relish, mayonnaise, olives, pepper, salt, sugar, gluten-free soy sauce, vinegar, salad dressings
  • High fructose corn syrup or other foods that are limited
Sweets
  • Made with foods allowed
  • High fructose corn syrup or other foods that are limited

Suggestions

Making adjustments can be difficult. Consider the following:
  • Eat a variety of foods from each of the food groups every day that don’t cause symptoms.
  • Learn to read food nutrition labels to avoid ingredients that may trigger symptoms.
  • It is important to work with a registered dietitian to get adequate nutrition and to do this elimination diet correctly. If it isn’t done absolutely correctly, you won’t discover what causes your symptoms and what doesn’t.

RESOURCES

American Gastroenterological Association
http://www.gastro.org
National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

CANADIAN RESOURCES

Canadian Association of Gastroenterology
http://www.cag-acg.org
Canadian Digestive Health Foundation
http://www.cdhf.ca

References

Gibson PR, Shepherd SJ. Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach. J Gastroenterol Hepatol. 2010;25(2):252-258.
Low FODMAP diet. Shepherd Works website. Available at: http://shepherdworks.com.au/disease-information/low-fodmap-diet. Accessed September 14 2016.

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