Walter Reed National Military Medical Center
By Bob Goldberg, Registered Dietitian/Certified Diabetes Care and Education Specialist
If you have Irritable Bowel Syndrome (IBS), there is a good chance that your health-care provider has encouraged you to try something called a low FODMAP diet in order to help control symptoms, such as cramping, bloating, gas, abdominal pain and diarrhea and/or constipation.
FODMAP is an acronym that stands for “Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols.” When consumed in excessive amounts (and sometimes, even in small or moderate amounts), these nutrients have a tendency to cause and/or aggravate gastrointestinal symptoms because they are easily fermented in the gut and also draw more fluid into the intestine. This additional fluid and increased gas production can result in the symptoms listed above.
Eating a low FODMAP diet, roughly 75 percent of people struggling with IBS can help decrease these symptoms to varying degrees. Foods high in FODMAPs include items such as garlic, onion, cauliflower, apricots, avocado, apples, wheat bran, multigrain bread, wheat pasta, baked beans, cashews, cow’s milk and yogurt, to name a few. When a food is high in FODMAPs, it does not necessarily mean that individuals must avoid them altogether, but they might need to cut back on the portion size of that particular item.
The low FODMAP diet was originally developed by a research team at Monash University in Melbourne, Australia. They recommend a low FODMAP be executed in a three-step process. First, a strict low FODMAP diet is recommended. Next is a FODMAP Reintroduction Diet, which focuses on continuation of the low FODMAP diet but introducing “Food Challenges” (using foods high in only 1 FODMAP group), used to determine which FODMAPs are tolerated, and discovering the individual FODMAP sensitivities. The final step is the FODMAP Personalization Diet, which focuses on including well tolerated FODMAPs and restricting poorly tolerated FODMAPs, but only to the level which helps to provide relief of gastrointestinal symptoms. The ultimate goal is to establish an eating plan that is minimally restrictive and personalized for each patient.
If you need assistance with a low FODMAP diet by a registered dietitian, call the Outpatient Nutrition Clinic at Walter Reed National Military Medical Center at 301-295-4065 to make an appointment.
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