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Ask the Diet Doctor: The Low-FODMAP Diet

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Q: I've been dealing with digestive distress. Is there any way to help alleviate some of my symptoms?

A: You may have heard about a newcomer to the diet scene—and we’re not talking about one that helps you lose weight. The low-FODMAP diet is an up-and-coming approach to treating digestive issues, and could be a good option for you to try in order to get relief, ideally under the supervision of a nutrition professional experienced in this area.

Low-FODMAP diets are becoming increasingly more popular in the treatment of IBS. Personally, I have used it or variations of it over the past several years with clients having unexplained digestive problems. It may be a little tricky and restrictive at first like most diets, but once you get the hang of it you shouldn’t have any problems. Like I always tell clients, if following this diet help eliminate chronic digestive issues then the inconvenience is a small price to pay.

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FODMAP is an acronym for poorly digested and fermentable sugars: Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. A low-FODMAP diet is one that is low in these sugars/carbohydrates. The idea behind this dietary approach is that when these carbohydrates remain undigested, it can lead to an overfeeding of certain bacteria in your digestive tract, which causes increased bloating. The undigested sugars can also cause perturbations in water balance in your digestive tract, which adds further discomfort and bloating. A low-FODMAP diet aims to reduce these carbohydrates and restore balance to your digestive tract.

So what do you eat on this diet? Here are the major foods to avoid that are high in FODMAPs, and what to reach for instead:

Oligiosaccharides 
Avoid: Onions, wheat, leeks, nectarines, barley, rye, lentils, pistachios, kidney beans, chickpeas, broccoli
Eat Instead: Quinoa, corn, potato, buckwheat, eggplant, pumpkin, bok choy, cucumbers, endive, tomato, zucchini, gluten-free products

Lactose (Disaccharide)
Avoid: Milk, cottage cheese, ice cream, yogurt
Eat Instead: Feta, swiss cheese, cheddar cheese, lactose-free dairy products, soy/almond milk alternatives (ensure inulin is not added ingredient)

Fructose (Monosaccharide)
Avoid: High-fructose foods like apples, mangos, honey, asparagus, pears
Eat Instead: Banana, blueberries, kiwi, raspberry, strawberry

Polyols
Avoid: Avocado, mushrooms, cauliflower, prunes, peach, cherries, blackberries, sugar alcohols (xylitol, sorbitol)
Eat Instead: Almonds, pine nuts, honey dew, raspberries, stevia

Some of these carbohydrates/sugars, like lactose and fructose, are poorly digested by some people, while others cannot be digested by humans at all, like the galacto-oligosaccharides present in legumes. In either case, if you are sensitive to high-FODMAP foods, the presence of these types of carbohydrates can cause digestive issues.

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However, many of these foods should not be universally excluded, as they can be good for you if you’re not sensitive to them. Fermentable oligosaccharides, for example, are prebiotic fibers that can foster healthy growth of beneficial bacteria, and lactose is found in dairy products and contains protein and other key essential nutrients. On a low-FODMAP diet you aren’t eliminating these different types of carbohydrates completely—just reducing them.

If you want to adopt a low FODMAP diet, talk to your doctor first. You should commit to the diet for at least four weeks before you determine if it’s beneficial for your digestive system. Keep notes and a journal along the way to document changes in your digestive discomfort.

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