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Low FODMAP diet – friend or foe?

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You may have heard the term low FODMAP diet. FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols. Most people are okay with FODMAP foods; however, these foods can be problematic for people with digestive issues, mainly those with irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO). FODMAP foods can draw extra fluid into the bowel, causing diarrhoea, gas, cramping and bloating for people with gut issues. Therefore, restricting FODMAP foods can relieve gastrointestinal symptoms for these people. Studies have found that it reduces symptoms in 86% of IBS and SIBO sufferers.


The idea of the FODMAP diet is to restrict fermentable carbohydrates enough to provide the individual with some relief and then to re-introduce those groups of foods to check what the person can tolerate. Only then can an individualised diet be created that the patient can use to decrease symptoms and eat FODMAP foods to a tolerable quantity. However, if the person has underlying symptoms, there must be a reason for this. Commonly, for those with IBS and SIBO, it is dysbiosis, an imbalance of good and bad bacteria. Therefore, using the low FODMAP diet should accompany correcting the underlying gut issue. 


I would not often recommend that a client try this challenging, restricting diet. It cuts out many food groups and many sources of fibre. Men should have 30g and women 25g of fibre daily for health, including lowering bowel cancer risk. The FODMAP diet also restricts fructooligosaccharides (FOS) and galactooligosaccharides (GOS), which fuel beneficial colonic bacteria, can improve the microbiome and benefit individuals with leaky gut. Hence, using the FODMAP diet should only be short-term.


I use the low FODMAP diet as a last resort for people who really need it. Sometimes, people are only intolerant to one type of food, for example, lactose. Those who are lactose intolerant would have relief on a low FODMAP diet because the diet restricts eating disaccharides that include lactose. However, with a proper case history, it is often easy to ascertain that someone has lactose intolerance and that using the FODMAP diet is unnecessary in these individuals. Lactose intolerance can also be tested with a breath test, bypassing strict dietary measures.


So you may want to think twice if someone recommends using the low FODMAP diet and doesn’t suggest the re-introduction of food and correction of underlying imbalances. Sometimes, you may do more harm than good to your gut microbiome. As always, make sure to seek advice from a qualified medical professional

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