Diet is always crucial to your health. Deficiencies or excesses of particular components can lead to serious consequences. Therefore, you should take care of your diet, even if you are perfectly healthy. What about for people with various ailments? Diet is often one of the primary methods of treatment. Today we will look at the low-FODMAP diet, which is used in the course of IBS and SIBO. If these abbreviations are foreign to you, I strongly recommend reading on and you will learn everything!

Low-FODMAP diet. What does it mean and what does it consist of?

What does FODMAP stand for?

Before we get into the diet, it's worth deciphering what FODMAP even means. As is usually the case, the acronym is derived from the English name. However, this time it also fits almost perfectly into the Polish translation. Let's get down to it letter by letter:

FODMAP therefore stands for fermentable oligo-, di-, monosaccharides and polyols. They all belong to the group of sugars. Consequently, a low FODMAP diet will involve limiting them. Just how to go about it? First, you need to know what products they are in.

Categorisation and occurrence of sugars

Even if you know the breakdown of sugars, not all of them ferment easily. So it's worth taking a look to clear up any doubts:

• Monosaccharides (simple sugars) - are, for example, glucose and fructose. They are found in fruits and vegetables in different proportions. Glucose does not cause problems and even helps digest fructose. Meanwhile, too high a concentration of fructose in some fruits can cause digestion problems.
• Disaccharides (disaccharides) - are made up of two molecules of simple sugars. The most common of these are sucrose, maltose and lactose. Sucrose is the so-called table sugar and is well digested. Maltose is rarely found in food, and lactose is included in milk and milk products. It is with its digestion that most problems sometimes occur.
• Oligosaccharides - are made up of 2 or more molecules of simple sugars. So disaccharides are also included in this group. An example of an oligosaccharide made up of 3 molecules is raffinose and gentianose. On the other hand, stachyose consists of four. They are not digested by the human body, but have prebiotic properties. In moderation, therefore, they are healthy, but one should not overdo it.
• Polyols - are otherwise known as sugar alcohols. They also impart a sweet taste and are used to make sweeteners. These include xylitol, sorbitol and mannitol. They are mostly metabolized by bacteria only in the large intestine. This can cause bloating, gas, loose stools and diarrhea.

Assumptions of low-FODMAP diet

The main premise of the low-FODMAP diet is very simple - limit products containing large amounts of fermentable sugars. However, in practice this can cause many problems. The list of products containing the sugars in question is very extensive. By eliminating them all from your diet, you run the risk of developing deficiencies. Therefore, you need to act individually and in stages.

1. Elimination phase - excluding all high-FODMAP products from your diet for 2-6 weeks. After this time, at least some of the gastrointestinal complaints should disappear.
2. Reintroduction phase - gradually incorporate some of the products into the diet. Add one product at a time, starting with small doses. After a few days of testing, it will be possible to determine whether it can return to the diet permanently.
3. Personalization phase - creating your own list of intolerable products. This is simply an extension of the reintroduction phase with the inclusion of more and more products in the diet.

The low FODMAP diet should last from 6 to 8 weeks, and in some cases a maximum of 12 weeks. Above all, phase 1 cannot be followed longer, as it leads to B vitamin deficiencies. After staying on a restrictive diet for a long time, it's a good idea to visit your doctor and get basic blood tests for deficiencies. You may find that supplementation of some vitamins and minerals is necessary as well. That's why it's so important to include as much variety in your diet as possible.

List of FODMAP products

You will find a list of products broken down according to their FODMAP content below. From it you will learn what to eat and drink on such a diet, and what to avoid. I have marked products rich in FODMAPs as not recommended, and those with low FODMAP content as safe. Remember, however, that the unrecommended products should be eliminated only in the first phase of the diet (2-6 weeks), and then slowly test them. It may also be the case that some products with moderate FODMAP content acutely in your case will exacerbate concerns more strongly than some of the generally non-recommended ones.

Troublesome FODMAP products

I think it's worthwhile to address some concerns on this occasion. My clients often ask about specific products that are problematic for them.

• Bread - the most common cereal products (wheat, rye) contain a lot of insoluble dietary fiber, which feeds the bacteria in the large intestine. In people with IBS, this causes an increase in symptoms. Baking bread on sourdough and spelt flour reduces FODMAP content. Gluten-free bread is also well tolerated.
• Ketchup - this is one of the most common questions for a reason. Up to 13 g per day is considered a safe dose. However, it all depends on the brand, as the composition can vary greatly. Pay attention to the fructose content, but sugar-free ketchups can be the most dangerous. They may contain sweeteners - including xylitol sorbitol, etc.
• Kefir - is a natural probiotic that is worth having in your diet. Unfortunately, standard kefir is rich in lactose, but versions without this sugar are increasingly appearing in stores. Lactose-free kefir is a safe product in the low-FODMAP diet.
• Tofu - this is a very interesting issue, as it is made from soybeans, which are not allowed on the low-FODMAP diet. However, the process of making tofu causes the FODMAP content to drop to tolerable levels. Therefore, it can be included in the diet without any problem.

When to use the L-FODMAP diet?

FODMAP sugars should not cause any severe symptoms in healthy people. They exhibit prebiotic effects, so they promote the development of normal intestinal microflora. The products in which they are contained are most often beneficial to health. So who is the low-FODMAP diet designed for? 

Such a diet was developed for people struggling with Irritable Bowel Syndrome (IBS). Why exactly in this case are they harmful? They cause an increase in osmotic pressure. This leads to an increase in the volume of food in the intestines. They are poorly digested and ferment only in the large intestine, causing a lot of gas.

They also provide food for the bacteria that inhabit your intestines. Under normal circumstances, this is very beneficial. However, it becomes a problem if you suffer from Small Intestinal Bacterial Overgrowth Syndrome (SIBO). In this case, they also feed bacteria that have proliferated where they shouldn't.

It's worth knowing that FODMAP intolerance can affect both adults and children. If your child frequently reports abdominal pains, start watching them closely. Flatulence, gas or recurring diarrhea may indicate poor tolerance of fermentable sugars.