The FODMAP diet, The Good and the Bad!

Fermentable Oligo-sacchraides Disaccharides Mono-saccharides And Polyols. It’s a bit of a mouthful to say the least. But for people suffering from functional gastrointestinal disorders (FGIDs), understanding and implementing a low-FODMAP diet could drastically alter your life for the better.

Breaking down FODMAP into more easily digestible pieces is the best way to try and understand it:

Fermentable Carbohydrates

The term broadly describes a group of ingredients that are difficult or impossible for some people to digest. Instead of being broken down normally, for some, these foods react with bacteria in the gut and produce excessive amounts of hydrogen; to cause bloating, flatulence, constipation and abdomen pain; and/or fluid being drawn into the intestine; causing diarrhea. For anyone, these symptoms are unwelcome, but for those with an existing FGID such as irritable bowel syndrome (IBS), Crohn’s disease, ulcerative colitis or coeliac disease, FODMAPs act as fuel to the fire, often making everyday activities such as work, family time and social events a living hell.

The Not-so-fab four

Here are some of the fermentable carbohydrates that should be avoided if you wish to follow a low-FODMAP diet:

Oligosaccharides occur naturally and synthetically. Garlic, onions, leeks and legumes (beans and pulses) all contain natural forms of oligosaccharides.

Disaccharides include lactose; the sugar in milk, cream, cheese and dairy products, sucrose; ‘table sugar’ used in cereals, cakes, pastries and biscuits, and maltose; the sugar found in beer, bread, cereals and cooked sweet potato.

Mono-saccharides include fructose, galactose and glucose. Fructose is found in many fruits and their juices including apples, pears, grapefruit and watermelon (although other types of melon are low fructose), while galactose is contained within dairy products and dairy substitute products such as soymilk. Glucose is a product of our own digestion of carbohydrates that is then stored in our system as blood sugar. Certain foods create more glucose than others with molasses, honey, dried fruits, white bread, pasta and rice all being examples of ingredients that are turned into high amounts of glucose very quickly, causing our blood sugar levels to rise (or even spike) at speed.

Polyols - also known as sugar alcohols - (yet they are neither sugar nor alcohol) are low-calorie sweeteners including Erythritol, Hydrogenated Starch Hydrolysates, Isomalt, Lactitol, Maltitol, Mannitol, Sorbitol and Xylitol. They also occur naturally in stoned fruits such as peaches and plums and vegetables such as broccoli and cauliflower.

All news is not good news!

Knowing which foods to avoid (and there are many, many more) is only half the battle. Following a low-FODMAP diet means reducing and restricting an incredibly extensive list of foods and drinks that involves very careful and considerate preparation and education. While removing these foods from your diet can help to alleviate the symptoms of your FGID; slashing entire food groups from your diet can also have a negative impact on your intake of essential vitamin and minerals.

Baby on board : Pregnancy and Post-natal Advice

Pregnant women, or those who have just had a baby must consider their options very carefully if they wish to follow a low-FODMAP diet. There are certain vitamins and minerals that are recommended to maintain the health of both the mother and her new baby, but may be more difficult to achieve through a FGID-friendly eating regime.

 Calcium is vital to ensure the development of your baby’s bones and teeth, plus Vitamin D is calcium’s best friend as it helps to regulate the way calcium is stored and used in the body. This advice, however, can be extremely confusing for women on a low-FODMAP diet as some of the best sources of calcium - such as dairy - are advised against, while alternatives such as fish are not recommended during pregnancy. Similarly, foods that are rich in

Vitamin D, including cheese, fruit juice and cereals are restricted on a low-FODMAP diet but recommended during pregnancy. This poses a very difficult conundrum for women struggling with FGIDs but obviously want a happy and healthy pregnancy. For this reason, it would be advisable to continue to control your FGID symptoms with a low-FODMAP diet but look into alternative ways to get your calcium intake such as fruit (orange, guava), nuts and seeds (always check which are suitable during pregnancy) then bolster this with a good quality vitamin D supplement.

Pregnant women must also be making a conscious effort to make sure that they are getting enough Vitamin B12 (also known as Folate or Folic acid) and Iron to keep their energy levels high, fight fatigue and protect themselves against anemia; which is a condition that effects the proper production of red blood cells. In extreme cases, vitamin B12 deficiency can also cause fertility problems, pregnancy complications and birth defects. All women are recommended to take a folic acid supplement during pregnancy, and this is even more pertinent for women on a low-FODMAP diet where foods that are naturally rich in vitamin B12 such as milk, cheese, yoghurt and fortified cereals are restricted.

Furthermore, new and expectant mums must be very careful that a low-FODMAP diet is not causing them to miss out on vitamin C – which is in a lot of fruit and vegetables that are on the FODMAP ‘no list’ or vitamin A – found in dairy products. (Very high doses of vitamin A are not recommended during pregnancy so always consult a doctor if you think you are getting too little or too much).

Food for Thought

A low-FODMAP diet can be life changing for people suffering from FGIDs but restricting and reducing certain foods for a happier digestive system also means you need to consider very carefully how you get your vitamins and minerals. This is important when you have just yourself to think about but absolutely crucial if you are pregnant, planning to get pregnant or have just a had a baby. Using the above advice as a guide however is a good start for new mums; what it can’t do however is help with those sleepless nights and dirty diapers.