People who suffer from irritable bowel syndrome often suffer from indigestion after each meal. The so-called low FODMAP diet should be able to provide relief. What's up with this diet? What should people be aware of? And does the diet actually help? Below we explain what FODMAP is and how it can help with an irritable bowel.
What does FODMAP mean?
FODMAP stands for Fermentierbare Oligosaccharide, Disaccharide, Monosaccharides and (in English and) Polyole.
These substances are short-chain sugars and sugar alcohols, such as milk and fructose. They are part of many different foods: from baked goods to dairy products to fruits and vegetables.
Fermentable means that these substances trigger fermentation processes during digestion. This is not a problem for healthy people. Irritable bowel patients, on the other hand, have a very sensitive digestive tract. With them, these fermentation processes can cause discomfort such as flatulence, diarrhea and convulsions.
What is the low FODMAP diet?
Foods that contain FODMAPs are not fundamentally unhealthy. On the contrary, carbohydrates and sugar alcohols are also present in many healthy foods.
The fact that they still cause indigestion in irritable bowel syndrome can be explained by the sensitivity of the intestine. Healthy people, therefore, generally do not need to pay attention to the FODMAP value of food, but for people with chronic digestive problems, it can be important.
The low-FODMAP diet (or simply FODMAP diet) is not a method to lose weight, but one special diet for irritable bowel patients. Foods are classified based on their FODMAP value and those with a high value are avoided as far as possible.
Why FODMAPs cause intestinal discomfort
As part of the normal digestive process, the ingested food is broken down into its components in the stomach and intestine.
When the contained FODMAPs enter the colon, they initiate fermentation processes there. This produces gases that can irritate a sensitive intestine. In addition, the FODMAPs in the intestine attract water. This can lead to diarrhea.
The increased gas and water content inflates the intestine and also stretches the intestinal wall. That makes them more permeable. For example, irritable bowel syndrome can lead to leaky gut syndrome ("leaky gut syndrome"). In the process, substances enter the body through the intestinal wall, which in fact have no place there. This is associated, inter alia, with inflammatory reactions.
Where are FODMAPs included?
FODMAPs are found in a variety of foods, including:
- certain types of fruit (for example, apples, mangoes, peaches, watermelons)
- certain vegetables (for example artichokes, asparagus and onions)
- certain cereals (including wheat and rye)
- lactose-containing dairy products
- Sugar substitutes such as xylitol, sorbitol and maltitol
- Glucose-fructose syrup and other additives in processed foods
In the FODMAP diet, therefore, the supply of the above-mentioned foods is first paused and then taken up again in small doses step by step.
coffee in itself is FODMAP-poor - so you do not have to do without coffee at breakfast. However, it should be drunk black, as milk and creamer as well as many sweeteners contain FODMAPs - conventional sugar is often tolerated in small amounts. However, one should keep in mind that coffee irritates the digestive tract without any FODMAPs.
How does the FODMAP diet work?
This irritable bowel diet is divided into three phases:
- For four to six weeks will be during the restriction phase all FODMAP rigorously deleted from the menu.
- In the Reexpositionsphase every one to two weeks a FODMAP-containing food is tested. If it is tolerated, it can be integrated back into the diet. If the symptoms worsen, it is still possible to re-test the food at a later date.
- Once all the foods have been tested and the most compatible among them has been re-integrated into the nutritional plan, it follows Maintenance phase.
From then on, those affected will know which foods are suitable for them and which ones are not and can use this list to compile their meals. However, the tolerance (tolerance) to the individual FODMAPs changes over time, so it may be necessary to adjust the diet from time to time.
FODMAP: What to eat?
The fact is that the complete abandonment of FODMAPs severely limits the diet. Especially in the first few weeks, when only foods from the low FODMAP list can be consumed, this form of nutrition can be a challenge.
A FODMAP table can help in putting together the nutrition plan. Care should be taken to consume as many different "allowed" foods as possible to bring as much variety as possible into the diet and thus to ensure the absorption of the necessary nutrients.
On the List of low FODMAP foods stand for example:
- lean meat and fish
- Eggplant, tomato, fennel, zucchini and cucumber
- Lettuce and Ruccola
- Grapes, kiwi, pineapple and honeydew melon
- Rice, potatoes, quinoa and polenta
- soy milk
- green tea and mint tea
Challenges of the low FODMAP diet
Processed foods and ready meals almost always contain FODMAPs. It is therefore necessary to prepare most of the meals yourself. The FODMAP-poor diet is often accompanied by additional costs. Restaurant visits or dinner invitations with family and friends are made more difficult.
However, those who make their own experiences with the FODMAP diet and find a benefit for themselves soon learn to deal with such difficulties. It can also help a FODMAP app.
Where can I find Low FODMAP recipes?
There are many free low FODMAP recipes on the internet. In addition, corresponding cookbooks are available.
Adapting traditional recipes to the low FODMAP rules is often difficult. But there are instructions on how to prepare familiar dishes FODMAP-poor or -free, for example, vegetable dishes such as ratatouille and even pies.
Bread can also be consumed as long as it is a low FODMAP recipe.
How fast does FODMAP work?
Like any dietary change, the FODMAP Diet does not work immediately or after a few days. Therefore, the first phase takes four to six weeks to give the body time to adjust to the changes.
Within this time, the symptoms should improve. If this is not the case, it is not worthwhile to continue the diet.
Differences in effect: When does FODMAP work?
Scientific research suggests that this form of nutrition can alleviate the symptoms of irritable bowel syndrome.
The effect of the diet, however, depends on the type of patient. Affected individuals are divided into three groups according to the Institute of Microecology:
- FODMAP type 1 tolerates FODMAPs well and therefore can not benefit from the dietary change in the rule.
- FODMAP type 2 tolerates only certain FODMAP-containing foods or small amounts thereof. Here it is worthwhile to try out the diet.
- FODMAP type 3 has only a very low FODMAP tolerance and should therefore refrain as far as possible from corresponding foods.
FODMAP: When to expect improvement in the long term
Not all irritable bowel patients who benefit from the FODMAP diet will completely lose their symptoms. Eventually "only" an improvement of the symptoms will be achieved.
In order for this positive effect to last, sufferers must also be prepared to eat in line with the low-FODMAP diet over the long term and to regularly check the tolerability of individual foods.
However, the restriction is not always as strong as in the first phase, since later on FODMAP-rich foods may be consumed, which did not lead to a resurgence of symptoms during the second phase.
How does the FODMAP diet work?
How exactly the low-FODMAP diet works has not been researched yet. It is believed that it has a huge impact on the intestinal microbiome.
Under the intestinal microbiome, too intestinal flora called, one understands bacteria, which colonize the intestine of each humans. These can be both beneficial bacteria and harmful ones.
How the intestinal flora is composed depends on many different factors. The individual diet has a particularly strong influence. Also, possible diseases such as irritable bowel syndrome are related to the intestinal flora.
Side effects: Who is the FODMAP diet suitable for?
The long-term effects of the low-FODMAP diet are not yet apparent, as there are no scientific studies on the lasting effects of this relatively new diet. In addition, there is a risk of one-sided nutrition, if patients eat for a long time only from FODMAP-poor foods. This in turn can lead to a shortage of important nutrients.
For these reasons, the diet is really only suitable for people suffering from irritable bowel syndrome. For other people it offers no health benefits. The fact that at least some irritable bowel sufferers could benefit from it, the results of various scientific studies indicate. Also concomitant symptoms such as tiredness and depression could be alleviated.
Since this is a major dietary change that may cause severe effects on the organism, the FODMAP diet should only be administered under the supervision of a physician or qualified nutritionist.