In our society, and especially since the pandemic, the incidence of digestive problems has been steadily increasing . It now seems rare not to know someone with a digestive condition or intolerance, and it's becoming more and more common to see gluten-free or dairy-free options when we eat out.
Although indigestion and other related symptoms are becoming increasingly common, we shouldn't normalize them. We must address the root cause and treat it, because if left untreated, the situation can become much more complicated and lead to far worse conditions that further limit our quality of life. And this is where the FODMAP diet comes in.
FODMAP is the acronym coined by Monash University (Australia) to describe foods rich in different types of highly fermentable fiber: fructooligosaccharides, galactooligosaccharides, lactose, fructose, and polyols. This group of carbohydrates is not fully digested and in some cases can trigger symptoms such as gas, bloating, abdominal pain, diarrhea, or constipation. Reducing the FODMAP content in our diet will improve these symptoms (1).
The low FODMAP diet is applied in pathologies such as irritable bowel syndrome (1), Crohn's disease and ulcerative colitis (2) or any digestive discomfort (3), which may be derived from intolerances or bacterial overgrowth, the increasingly well known SIBO.
However, these highly fermentable fibers are found in fruits, vegetables, grains, legumes, etc., making this a limited diet in both variety and quantity. A healthy diet should be as varied as possible, with plenty of fruits and vegetables.
For this reason, the low FODMAP diet consists of three phases (4):
- FIRST PHASE: more restrictive, we exclude foods with high FODMAP content for a maximum of 6-8 weeks. We avoid foods such as garlic, onions, asparagus… among others that are likely to cause discomfort.
- SECOND PHASE: Once the symptoms are under control, we reintroduce foods to test tolerance. We test fructose tolerance with honey, sorbitol tolerance with avocado…
- THIRD PHASE: symptom control and maintenance of a healthy microbiota.
If done correctly, this diet works; the improvement in digestion is very noticeable, and with it, the person's quality of life. But it's important to do it right. It's a fairly strict diet and should only be followed for a limited time, which is why it's crucial to consult a professional.
This is a therapeutic diet that shouldn't be followed for extended periods, as the carbohydrates it excludes are food for our gut bacteria. Maintaining a low-FODMAP diet for too long will damage our precious gut microbiota (5). If you're unsure how important this is, check out this article on the website where I explain it in detail. Don't miss it!
The FODMAP diet will help with your digestion, but only if you use it for a limited time and follow it correctly. For this, it's vital to have a registered dietitian or nutritionist who can explain how to do it, what to eat, what to avoid, and how to reintroduce foods that didn't bother you before and that you're eager to enjoy again.
I hope you found this article useful and interesting.
And don't forget that the FODMAP diet is a temporary tool, not a lifelong diet.
***
Coral Martín is a dietitian and psychologist. Every Tuesday she offers nutritional counseling at Salud Mediterránea Manuel Becerra: C/Ortega y Gasset 77.
Click here for more information and pricing for this service.
Bibliographic references:
1. Altobelli, E., Del Negro, V., Angeletti, PM, & Latella, G. (2017). Low-FODMAP Diet Improves Irritable Bowel Syndrome Symptoms: A Meta-Analysis. Nutrients, 9(9), E940.
2. Zhan, Y., Zhan, Y.-A., & Dai, S.-X. (2018). Is a low FODMAP diet beneficial for patients with inflammatory bowel disease? A meta-analysis and systematic review. Clinical Nutrition (Edinburgh, Scotland), 37(1), 123-129.
3. Marsh, A., Eslick, E.M., & Eslick, G.D. (2016). Does a diet low in FODMAPs reduce symptoms associated with functional gastrointestinal disorders? A comprehensive systematic review and meta-analysis. European Journal of Nutrition, 55(3), 897-906.
4. https://www.monashfodmap.com/blog/3-phases-low-fodmap-diet/
5. Catassi, G., Lionetti, E., Gatti, S., & Catassi, C. (2017). The Low FODMAP Diet: Many Question Marks for a Catchy Acronym. Nutrients, 9(3), E292.