IBS is a common condition observed by gastroenterologists and primary care physicians. Although IBS doesn’t affect life expectancy, its chronic and episodic nature greatly impacts quality of life and daily activities.
Lower abdominal pain, distension, flatulence, alternating bowel habits, and bloating are the most common symptoms of IBS, varying in severity among individuals and even within the same person over time.
The cause of IBS remains unclear, but it’s likely multifactorial. Many individuals with IBS associate symptom onset with food intake but struggle to identify specific trigger foods.
The Low FODMAP Diet, developed by researchers at the Australian Monash University, addresses this challenge by identifying trigger foods, subsequently improving IBS symptoms.
What are FODMAPs?
FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. These are groups of short-chain carbohydrates found naturally in many foods. Some of them are also added to processed foods.
FODMAPs are not absorbed in the small intestine and continue their journey to the large intestine, where gut bacteria use them as a food source, producing gas.
Additionally, FODMAPs draw water into the bowel via osmosis, causing increased gas and water in the intestines, leading to symptoms like bloating, distension, excess gas, diarrhea, and/or constipation.
Each of the FODMAP groups include a long list of foods. While eliminating all high-FODMAP foods may offer significant symptom relief, it is not advisable for the long-term due to low compliance and the risk of nutritional deficiencies.
The Monash University Low FODMAP Diet takes a slightly different approach. As individuals adopt its principles, many find that certain types of FODMAPs are clear triggers for their symptoms, while others are well tolerated.
In addition, they also find that they are able to tolerate a small serving of foods containing a particular FODMAP, and that only the higher serving causes their symptoms.
Simply put, the Monash University Low FODMAP Diet is a dietary management plan that helps create a long-term eating regimen by balancing effective symptom control with a diverse range of foods. It is implemented in 3 phases:
Phase 1 – Low FODMAP diet (typically 2-6 weeks)
The main goal is to identify FODMAP-sensitive individuals and induce symptom relief by swapping high and moderate FODMAP foods for low FODMAP alternatives.
Phase 2 – FODMAP reintroduction (typically 6-8 weeks)
The aim is to identify sensitivities to individual FODMAP subgroups (excess fructose, lactose, GOS, fructans, mannitol and/or sorbitol). While the background diet remains low in FODMAPs, foods containing moderate then high amounts of only 1 FODMAP subgroup at a time are introduced. People with IBS can easily determine which FODMAPs are tolerated and which types need to be avoided or consumed in small servings only.
Note: This phase is followed only when a person experiences a noticeable symptom improvement in Phase 1.
Phase 3 – FODMAP personalization (long-term diet)
The goal is to establish a personalized FODMAP diet based on the findings of the second (challenge) phase. People with IBS can establish an eating regimen, which includes well tolerated foods and FODMAPs, and only restricts poorly tolerated FODMAPs to a level that provides adequate symptom control.
Note: It is recommended to repeat the challenges with poorly tolerated FODMAP subgroups every 6 – 12 months as FODMAP tolerance and IBS symptoms may change over time.
Following the low FODMAP diet can be incredibly helpful in identifying the foods that trigger your symptoms. With patience, perseverance, and the right guidance, relief from your IBS symptoms is achievable.
Now, here’s a glimpse of the meals you can enjoy on the Low FODMAP Diet.
Peanut Butter & Berry Baked Breakfast Toast
Ingredients (9 servings):
- 12 slices Gluten-Free Bread (chopped)
- 2 cups Strawberries (stems removed, chopped)
- 2 cups Unsweetened Almond Milk
- 8 Eggs
- 2 tbsps Maple Syrup
- 1 tsp Vanilla Extract
- 1 tsp Ground Ginger
- 1 tsp Cinnamon
- 1/4 cup All-Natural Peanut Butter
Directions:
- Preheat the oven to 350ºF (175ºC) and grease a baking dish with oil or butter.
- Arrange the bread and strawberries in an even layer in the baking dish.
- In a mixing bowl, whisk together the almond milk, eggs, maple syrup, vanilla, ginger, and cinnamon. Pour the mixture over the bread and strawberries. Gently press down the bread to ensure all pieces are drenched.
- Add dollops of peanut butter. Bake for 45 minutes, or until browned and cooked through. If the top is browned before the cooking time is reached, place a sheet of foil or lid on top to prevent burning. Let cool a bit before serving. Enjoy!
Notes:
- Leftovers: Refrigerate in an airtight container for up to three days.
- Serving Size: A 9- by 13-inch baking dish was used to make six servings.
- Nut-Free: Use oat milk instead of almond milk. Use pumpkin seed butter, tahini, or lactose-free cream cheese instead of peanut butter. You can also omit the peanut butter completely.
- More Flavor: Add nutmeg or your choice of additional spices. Top with flaky sea salt.
- Additional Toppings: Serve with maple syrup or coconut whipped cream.
One Pan Maple Mustard Chicken Thighs
Ingredients (4 servings):
- 1 lb Chicken Thighs with Skin
- 2 Sweet Potato (sliced into wedges)
- Sea Salt & Black Pepper (to taste)
- 1/3 cup Maple Syrup
- 3 tbsps Dijon Mustard
- 2 tbsps Extra Virgin Olive Oil
- 2 tsps Apple Cider Vinegar
- 1/2 tsp Cinnamon
- 2 tbsps Rosemary (optional, chopped)
Directions:
- Preheat the oven to 425ºF (218ºC) and line a baking sheet with foil.
- Place the chicken and sweet potato wedges on the baking sheet and sprinkle with sea salt and black pepper.
- In a small bowl, whisk together the maple syrup, Dijon mustard, extra virgin olive oil, apple cider vinegar and cinnamon. Pour over the chicken and potatoes. Toss to coat.
- Place the baking sheet in the oven and bake for 30 minutes, flipping the sweet potato halfway through. Broil for an additional 1 to 2 minutes to make it crispy at the end. Remove from the oven.
- Divide the chicken and sweet potato wedges between plates and garnish with rosemary. Enjoy!
Notes:
- No Rosemary: Use another fresh herb such as parsley or thyme instead.
- No Extra Virgin Olive Oil: Use avocado oil instead.
- Leftovers: Refrigerate in an airtight container for up to 3 days.
Are you interested in learning more about the benefits of the Low FODMAP Diet? Contact our clinic and book a complimentary Discovery Session.
Marianna Duba, M.Sc., RNCP
Sage Naturopathic Clinic