FODMAP. It seems like an incredibly insensible acronym right? The creators of this diet, hailing from Monash University in Australia, probably mulled over the naming quite a bit, but the foods often responsible for triggering GI symptoms in a whole lot of people…. they don’t fit nicely into an simply named category. FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. Which is just a really science-y way of saying they’re easily fermentable short-chain carbohydrates.
Most people don’t have a problem digesting these compounds, but a high percentage of people who have digestive woes do have difficulty. What actually happens in the gut in a person unable to digest FODMAPs is this: these compounds are not absorbed properly, then they travel down the intestines where they are fermented by bacteria to produce methane and hydrogen gas. This leads to a host of uncomfortable and potentially embarrassing symptoms (a distended belly, abdominal pain, and diarrhea to name a few).
FODMAPs are present in wheat, many fruits/vegetables, garlic, onions, and sugar substitutes. Lactose is a familiar FODMAP which about a third of people globally cannot digest. Lactose intolerance could also be considered an inability to digest this specific FODMAP. Fructose is another common example of a FODMAP, and fructose is found not only in the familiar example making many news headlines, high fructose corn syrup, but also in many fruits. People who do not digest fructose efficiently may have symptoms of fructose intolerance, or the above named GI maladies.
The diet is an elimination diet, meaning that during the first phase of the diet all FODMAPs are eliminated. It is not meant to be a life long diet, it is more of a “learning diet”. If significant benefits are noted during the elimination phase of the diet, foods are added back in one by one to identify which FODMAPs may be personal triggers. The dieter learns even more information as time goes on about how much of what they can eat in order to manage symptoms well.
Clinical research on the low FODMAP diet has been published in many reputable medical journals, including the Journal of Crohn’s and Colitis, Gastroenterology, and the Journal of Human Nutrition and Diet. The research shows that about 75% of patients find significant symptom relief on the diet. I’ve worked with this diet in my private practice for the past 2 years, and I see this reflected in my patients too (the diet being effective about 75% of the time).
If you have difficult to manage or live with digestive symptoms this diet may be for you. Specifically, the diet can be most helpful for those who have been diagnosed with IBS or those who have Crohn’s/ulcerative colitis/celiac disease with ongoing symptoms despite being in remission or undergoing treatment.
Feel free to reach out to me if you have any questions about the low FODMAP diet. I have also developed a presentation I have given to various professional groups (physicians, dietitians, and other health professionals) detailing the research supporting use of the diet in certain patient populations, and basics about implementation.