You may or may not have heard of a low FODMAP diet. If you have heard of it, it’s likely that you have a lot of questions about it! I’m often asked if a low FODMAP diet will help with a child’s gut issues, or even other childhood conditions. Many parents are also interested in whether a low FODMAP diet will be beneficial for their own health concerns.
For a healthy person, FODMAPs are part of a healthy, balanced diet. But for someone who is sensitive, it can cause not only digestive symptoms, but also negatively affect their overall wellbeing.
Watch the video or keep reading below to learn about the potential benefits of a low FODMAP diet.
What is a low FODMAP diet?
The low FODMAP diet excludes a specific group of carbohydrates. It excludes fermentable oligosaccharides, disaccharides, monosaccharides and polyols – you can see why we just call it FODMAP! You may also see it referred to as the specific carbohydrate diet, or SCD.
FODMAPs are found in foods that are generally very healthy for the average person. But there are some people that have difficulties with digesting and absorbing these carbohydrates. Although is mainly used for the relief of digestive symptoms, it can be useful for other symptoms that someone with FODMAP sensitivity might experience.
Unlike many other diets, low FODMAPs is often recommended by conventional practitioners such as GPs and gastroenterologists, as well as complementary practitioners such as naturopaths and nutritionists.
However, when it comes to doctors recommending a low FODMAP diet, there is one area that they often overlook – repairing the gut.
There is a lot of research that supports it as a helpful intervention for many gut issues. But it’s important to understand that it is not designed for long-term use. That is why I always recommend working with a practitioner who will guide you in terms of treatment length.
Why do FODMAPs cause symptoms in sensitive people?
When someone is unable to break down and absorb FODMAPs, they are fermented by bacteria in the gut. This can cause symptoms including pain, bloating, discomfort, loose bowels, diarrhoea and occasionally even constipation. But it also has a wider effect on health because it can impair the nutrient absorption in the gut. This can lead to a host of nutrient deficiencies, as well as their side effects.
Unlike a food allergy, FODMAP intolerance is non-immune-meditated – the immune system isn’t producing the main reaction. It is not the food itself that is the problem, but a deficiency of enzymes in the gut. Much like lactose intolerance, there aren’t enough enzymes to break the FODMAPs down.
As with any intolerance, different people can tolerate different amounts of FODMAPs before triggering symptoms. Because it is an intolerance, it also means that you don’t need to cut them out forever! In fact, it is not recommended to follow a low FODMAP diet long-term.
Which foods contain FODMAPs?
FODMAPs are found in a variety of wholefoods – fruit, vegetables, legumes and grains – as well as sugar and sweeteners. Some examples of higher FODMAP foods include:
- Legumes such as chickpeas
- Wheat products
- Dairy products
- Natural sweeteners such as honey and table sugar
- Sugar alcohol-based sweeteners such as mannitol and sorbitol
When to consider a low FODMAP diet
This will depend on the person’s symptoms and overall health picture. But there are a few times that you might want to consider whether a low FODMAP diet is a good idea for your child.
If you have already eliminated common food intolerances such as gluten or dairy, but your child is still experiencing symptoms such as:
- Abdominal discomfort
- Excess wind
- Stomach cramps
- Feeling very full after a small amount of food
– it may be warranted. However, it is best to work with a practitioner, as you don’t want to put them on low FODMAPs if it’s not needed.
Although there is not much research yet, many practitioners also see kids with autism benefiting from a low FODMAP diet. Kids on the spectrum often have gut issues, so low FODMAPs may help if a gluten and casein-free diet has not alleviated these symptoms.
What does a low FODMAP diet look like?
A diet that is low in FODMAPS can be really difficult to follow at first. It cuts out a lot of healthy wholefoods, along with wheat and dairy products. Many parents struggle to adhere to the protocol if done without support from a practitioner.
In my experience, garlic and onion are the hardest high FODMAP foods to eliminate. It can make it difficult to eat out, or eat dinner at a friend’s place.
You will also need to swap many fruit and veg out for alternatives. For example, apples and pears are out, but berries and bananas are fine. Broccoli is gone, but bok choy is a good switch.
The same goes for sweeteners. Honey, sugar and sugar alcohols are out, but maple syrup and rice malt syrup can be good substitutes for baking.
When it comes to following low FODMAPs, your best bet is to purchase the Monash University FODMAP diet app. It’s about $13, but it is priceless when you are new to the protocol. The app breaks down every common food into low, medium or high FODMAPs. It also shows which of the FODMAPs each food contains. This is important to know as you start the reintroduction, as you can monitor which types are tolerated and which are not.
Why you can’t just cut out FODMAPs forever
Eliminating FODMAPs is not a long-term treatment. High FODMAP foods are often an excellent source of prebiotic fibre. This fibre is essential for gut health, particularly for the good bacteria in the gut. If you don’t consume prebiotic-containing foods, it can deplete the good bacteria and allow the bad to overgrow.
There is a link between FODMAP intolerance and intestinal permeability, or leaky gut. It’s not known which comes first. But we do know that leaky gut is mainly caused by an imbalance in gut bacteria. Bad bacteria overgrows and damages the gut lining, making it ‘leaky’. This allows undigested food to enter the bloodstream, which can trigger inflammation and immune responses in the body.
This imbalance, or dysbiosis, can be caused by many common diet and lifestyle factors. But there are also many ways to rebalance the bacteria, which I talk more about in my free gut health ebook.
This is why I believe that building up gut health is just as important as removing FODMAPs in a low-FODMAP protocol. By correcting the imbalance and healing the gut lining, you can build up tolerance to FODMAPs.
All of this is why you want to follow the diet as a short-term intervention, and build up gut health along with it. More often than not, people are only sensitive to a 1-2 of the FODMAPs, and tolerate the others. For example, you might be sensitive to fructose, but be fine with lactose.
How long should I cut out FODMAPs for?
Generally speaking, you should only be following a strict low FODMAP diet for around 6 weeks. Some clients may warrant 12 weeks depending on symptoms relief. After that, you’ll want to reintroduce each FODMAP, one at a time, over a period of several weeks. This is when it’s best to have a practitioner on your team to guide you with how to reintroduce and monitor your symptoms.
After reintroduction, it’s time to find your own balance with FODMAPs. If you continue to build up your gut health, you’ll be better able to tolerate FODMAP-containing foods.
As with any health concern, the most important step is to find the root cause of the intolerance, and address that directly. A strict elimination diet is never the sole answer for your child or yourself.
Building up gut health is an essential part of treating the root cause of FODMAP sensitivity. I talk more about how to do this in my free gut health ebook – you can download it here.