Monday, January 28, 2013

A FOOD Map for FODMAP

Until about a year ago I was unaware of the FODMAP diet.  I started seeing mentions of it in my Twitter stream, especially by my Australian dietitian friends,  and gave it a cursory look.  http://www.ncbi.nlm.nih.gov/pubmed/20136989 . The FODMAP(Fermentable Oligo-Di-Monosaccharides and Polyols) diet was developed at Monash University in Australia.   In a nutshell, the FODMAP diet aims to restrict or limit "...rapidly fermentable short-chain carbohydrates" to reduce gastrointestinal symptoms often classified as IBS but that include gas, bloating, cramping and diarrhea as these FODMAP's create issues with your digestive system. 
1. The first step is usually to determine by breath testing if you are "triggered" by fructose or lactose.  These types of tests can be ordered by your physician and done at a lab.
2. If these tests are positive, a referral to a dietitian experienced in the FODMAP diet will help guide you through identification of any other trigger carbohydrates.  Go to . www.eatright.org for a dietitian in your area or ask you physician for a referral.
3. The next step is to go on an 6-8  week low-FODMAP diet by eliminating all of the high FODMAP items: http://stanfordhospital.org/digestivehealth/nutrition/DH-Low-FODMAP-Diet-Handout.pdf http://www.health.arizona.edu/health_topics/nutrition/handouts/FODMAPs%20diet.pdf

4. Next, working with your dietitian,  you would gradually  and individually introduce the high FODMAP foods back into your diet based on category to see what you can tolerate and at what threshold. 

The categories of HIGH FODMAP's are:
Lactose - milk, yogurt, ricotta and cottage cheese
Fructose - certain fruits(see links above with lists  for low/high), honey, high fructose corn syrup (HFCS) and agave syrup
Fructans - primarily wheat but also garlic and onions and certain vegetables (see links with lists)
Galactans - beans and lentils
Polyols - found added to sugar-free items as "sugar-alcohols) - maltitol, mannitol, sorbitol,.xylitol; also found naturally in some fruits  like apricots and vegetables like artichokes

5. Once you  have identified your "trigger" carbohydrates and how much you can consume without GI distress;  you and your dietitian should be able to map out a healthy and practical eating plan. 

Some additional resources:
 http://www.ibsfree.net/ - website editied by dietitian Patsy Catsos
http://www.katescarlata.com/ - Kate Scarlata, dietitian and author of "The Complete Idiot's Guide to Eating Well with IBS"

2 comments:

nahidworld said...

thanks for this post.it is a very nice and helpful post.
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Ingles Dietitian said...

you are welcome!