Following a low FODMAP diet can be time-consuming and difficult. This article aims to provide a comprehensive guide to the low FODMAP diet, including a printable chart for easy reference. The low FODMAP diet is a short-term elimination diet that can potentially offer relief to people suffering from irritable bowel syndrome (IBS).
What is a Low-FODMAP Diet?
FODMAP is an acronym for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. These are short-chain carbohydrates (or sugars) that are poorly absorbed in the digestive tract. Because they aren't properly absorbed, FODMAPs reach the far end of your small intestine rather than being absorbed into your bloodstream, where much of your gut microbiota reside.
- Fermentable: Foods that gut bacteria feed on, converting them to gasses in a chemical process called fermentation.
- Oligosaccharides: Soluble plant fibers known as prebiotics, which feed the beneficial bacteria in your gut. Oligosaccharides include onions, garlic, beans/lentils, and many wheat products.
- Disaccharides: Lactose is the fermentable sugar in this group, found in dairy and breast milk. Lactose intolerance is one of the most common food intolerances worldwide.
- Monosaccharides: Fructose, the sugar in fruit, is the fermentable sugar in this group, but only in certain quantities and proportions, so not all fruits are affected.
- Polyols: Sugar alcohols, commonly used as artificial sweeteners. They are also found naturally in some fruits.
Why are FODMAPs Difficult to Digest?
FODMAPs are sugar molecules that are linked together in chains and are fermentable by the bacteria in your gut. Molecules in chains need to be broken down into single molecules to be absorbed through your small intestine. But FODMAPs can’t be broken down, so they can’t be absorbed there. Your small intestine draws in extra water to help move the FODMAPs through to your large intestine. There, the bacteria living in your colon have a field day fermenting them (eating them). This produces gasses and fatty acids as byproducts inside your gut.
Are FODMAPs Bad for Everyone?
Not at all. In fact, our digestive systems are designed to process some foods that we can’t fully digest ourselves - for example, dietary fiber, which has an important place in digestive health. And feeding the bacteria in our gut is part of our symbiotic arrangement with those bacteria. But some people with sensitive guts experience a level of indigestion from these foods that significantly impacts their quality of life. For these people, the byproducts of fermentation cause chronic symptoms of gas, bloating, abdominal pain, and distension. The extra water drawn by the small intestine may cause diarrhea in excess, or constipation if there isn’t enough.
Who Might Benefit from a Low-FODMAP Diet Plan?
The low-FODMAP diet is often prescribed for limited periods for people diagnosed with irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO). Studies show that a majority of people living with these conditions benefit from the diet. It can also be used as a short-term elimination diet for anyone who has digestive problems and wants to try and isolate the foods that are causing them. An elimination diet removes common problem foods and then adds them back in systematically to observe how your system reacts. The low-FODMAP diet is just one of many elimination diets that you can use to discover food sensitivities.
Read also: Foods for Pre-Diabetes
What Does a Low-FODMAP Diet Consist Of?
The diet has three phases:
- Elimination Phase: Avoid all of the high-FODMAP foods - a list of specific fruits, vegetables, dairy products, and grains. This phase typically lasts for two to six weeks.
- Reintroduction Phase: Systematically add foods back in, one at a time, to identify which FODMAPs trigger symptoms.
- Maintenance Phase: Keep what works for you and leave out what doesn’t. This phase keeps well tolerated foods and FODMAPs are reintroduced to your diet, while poorly tolerated foods and FODMAPs are restricted, but only to a level that provides symptom relief.
It’s not recommended to try this diet without first consulting a dietitian or your healthcare physician. While low-FODMAP diets may help those with preexisting gastrointestinal conditions, not everyone will be a fit for this elimination diet strategy.
Navigating the Low-FODMAP Diet: Food Choices
Identifying safe foods can be challenging for those following a low-FODMAP diet, as different FODMAPs can be found in a wide range of foods. To make following the diet easier, it's helpful to have a comprehensive list of low FODMAP foods that you can have on hand for easy reference. All of the foods recommended are low FODMAP at certain quantities, so please do check the Monash App before consuming to ensure you are within low FODMAP guidelines.
Fruits
When choosing low-FODMAP fruits, it's essential to be mindful of the main FODMAPs present in them, namely sorbitol and excess fructose.
- Fruits high in excess fructose: apples, pears, mangoes, cherries, figs, pears, watermelon, and dried fruit.
- Fruits rich in sorbitol: apples, blackberries, pears, peaches, and plums.
Some fruits are okay to eat in limited amounts but will bother you in larger amounts. Apples, watermelon, and stone fruits are high in FODMAPs, but grapes, strawberries, and pineapples are OK. A ripe banana is high in fructose, but you can have up to a third cut up in your cereal, or you can have a whole one if it’s not quite ripe.
Read also: Printable Food Guide
Vegetables
When selecting low-FODMAP vegetables, it's important to consider the primary FODMAPs found in them: fructans and mannitol.
- Vegetables particularly rich in fructans: artichokes, garlic, leeks, onions, and spring onions.
- Vegetables particularly rich in mannitol: mushrooms and celery.
Grains and Cereals
When it comes to grains and cereals, the primary FODMAPs to watch out for are fructans. Grain and cereal foods particularly rich in fructans include wholemeal bread, rye bread, muesli containing wheat, wheat pasta, and rye crispbread.
Since gluten-free grains are lower in fermentable sugars than grains that have gluten, some people who think they are sensitive to gluten may actually be sensitive to the oligosaccharides residing in wheat products.
Legumes and Pulses
For vegetarian and vegan options, the main FODMAP to watch out for is GOS, present in legumes and pulses. Legumes and pulses particularly high in GOS include red kidney beans, split peas, falafels, and baked beans.
Dairy Foods and Alternatives
Dairy products can be tricky in a low-FODMAP diet due to the presence of lactose, a FODMAP commonly found in items like soft cheeses, milk, and yoghurt. Dairy foods that are high in lactose include soft cheeses, milk, and yoghurt. There are also many dairy foods that are naturally low in lactose, for example butter and cheese. For this reason, dairy foods are definitely not excluded from a low FODMAP diet.
Read also: Shopping List for ADHD Diet
When opting for milk alternatives, remember that they don't naturally contain calcium. Many plant-based milk alternatives are also low in FODMAPs, e.g. soy milk (made from soy protein), almond milk, and rice milk. However, milk alternatives do not naturally contain calcium, so remind patients to choose calcium fortified varieties (containing >120mg calcium per 100ml). Lactose-free milk and yogurt, rice milk, almond milk, coconut milk, butter, and ice cream substitutes like gelatin and sorbet are good options.
Protein
Protein-rich foods like meats, poultry, and fish are naturally FODMAP-free, making them excellent choices for a low-FODMAP diet. Low FODMAP choices include plain cooked meats, poultry, seafood, eggs, while high FODMAP options include marinated meats, processed meats (e.g. sausage / salami) and meats served with gravy/sauces that may include high FODMAP ingredients.
Nuts and Seeds
Most seeds are considered low FODMAP, making them a suitable addition to your diet. However, certain nuts may contain GOS and fructans, which are FODMAPs that can trigger digestive symptoms. High FODMAP nuts include cashews and pistachios, while low FODMAP nuts include macadamias and peanuts.
Herbs and Spices
Herbs and spices can add flavor and variety to your low-FODMAP meals without triggering digestive symptoms. Most herbs and spices are naturally low in FODMAPs, making them a great way to enhance your dishes. Whilst some exceptions exist, such as garlic and onion-based spices, the small amounts typically used in cooking generally make them well-tolerated.
Sugars and Sweeteners
The main FODMAPs present in sugar sweetened foods and beverages are fructose and sugar polyols (e.g. sorbitol, xylitol, erythrytol). It is a good idea to read the food labels to identify high FODMAP sugars, especially on artificially sweetened drinks and confectionery. High FODMAP sugars include honey, high fructose corn syrup and sugar-free confectionery. Low FODMAP options include dark chocolate, table sugar, maple syrup and rice malt syrup. Mints/ gums, sweeteners ending with "ol" like sorbitol, mannitol , xylitol are to be avoided.
Condiments and Sauces
Some dips, condiments, sauces, and marinades contain garlic and onion. Ask for them separately or on the side if you are unsure of their FODMAP content. High FODMAP options include garlic / onion based marinades and sauces, vegetarian mince. Low FODMAP options include barbeque sauce, mayonnaise, soy sauce, chutney, cranberry juice.
Implementing the Low-FODMAP Diet: A Step-by-Step Approach
The low-FODMAP diet involves three key steps:
Step 1: Restriction. This involves restricting all FODMAPs from your diet for a period of 2-6 weeks. This step is designed to discover whether your IBS symptoms are sensitive to FODMAPs. Not everyone with IBS will improve on a low FODMAP diet. For example, if you normally eat wheat-based toast with honey for breakfast, you could swap to sourdough spelt toast with jam. The Food Guide of the Monash FODMAP App is very useful in this step of the diet. Use the simple traffic light system to identify high (red) and moderate (amber) FODMAP foods that you will swap for low (green) FODMAP alternatives. Follow the Step 1 diet for 2-6 weeks. If your symptoms improved after 2-6 weeks on the Step 1 diet, it is time to move onto the Step 2 diet. If they did not improve, it might be that your IBS symptoms are not sensitive to FODMAPs and you need to consider other therapies, such as stress reduction, gut directed hypnotherapy, over-the-counter medications such as laxatives, fibre supplements, or prescription medications.
Step 2: Reintroduction. This is about identifying which FODMAPs you tolerate, and which trigger your IBS symptoms. Understanding this will help you to follow a less restrictive, more nutritionally balanced diet for the long term that only restricts foods that trigger your IBS symptoms. In Step 2, you continue your low FODMAP diet (as per step 1). However, you will complete a series of ‘FODMAP challenges’ to identify which FODMAPs you tolerate and which trigger symptoms. FODMAP ‘challenges’ involve eating a food rich in only 1 FODMAP group daily for 3 days and monitoring symptoms. The diary section of the Monash FODMAP App is very useful in this step, as it lists foods that you can use for each FODMAP challenge. These foods are recommended because they contain large amounts of one FODMAP type. For instance, milk is high in lactose, but does not contain any other FODMAPs. Very common foods (such as apple, pear, certain legumes and wheat products) that are high in two FODMAP types are also included as optional challenges in the diary (see below). After each 3-day challenge, record how well you tolerated the FODMAP(s). You can do this using a paper diary, or the Diary in the Monash FODMAP App. The in-app Diary allows you to record challenge foods eaten, IBS symptom type and severity, bowel habit and stress levels.
Step 3: Personalization. Step 3, the aim is to relax dietary restrictions as much as possible, expand the variety of foods included in your diet and establish a ‘personalized FODMAP diet’ for the long-term. In this step well tolerated foods and FODMAPs are reintroduced to your diet, while poorly tolerated foods and FODMAPs are restricted, but only to a level that provides symptom relief. We recommend that you repeat challenges of poorly tolerated foods and FODMAPs over time to see whether your tolerance changes.
Printable Low-FODMAP Shopping List
To help make your next grocery trip a breeze, a printable low-FODMAP shopping list can be a valuable tool. A downloadable low FODMAP diet chart PDF that contains the most common foods in a handy printable format. The chart can be printed and be attached to your fridge or hung on the wall in your kitchen as a quick reference or reminder of what foods are low in FODMAPs and high in FODMAPs. The main high FODMAP foods to avoid are garlic and onions. These foods can be found hidden in many foods that you would not expect so be sure to read through the ingredients list. If you would like a more comprehensive list of foods suitable for the diet then head over to the FODMAP food list page. The food list page has a comprehensive list of foods that are both suitable and not suitable to be consumed on the diet.
Please note that everyone's IBS and gut health is different. If you have an intolerance or sensitivity to certain foods, please remove these from your shopping list. We always recommend keeping a Food Diary to keep track of symptoms, so you can refer back and analyse. A great accompaniment to this print out is a low FODMAP food diary and symptom tracker that can be downloaded and printed or you can buy a low FODMAP food diary from Amazon specially created by this site. This book has room to store nearly 4 months worth of daily food tracking to help pin point which foods are specifically causing problems for you whilst doing the low FODMAP diet.
Additional Tips for Success
- Consult a Dietitian: A FODMAP diet should be followed under the guidance of a dietitian who has specialty skills in managing IBS and using a FODMAP diet.
- Read Labels Carefully: Be vigilant about reading food labels to identify hidden sources of FODMAPs like garlic and onion.
- Use the Monash University FODMAP Diet App: This app uses a simple traffic light system to rate foods as low, moderate, or high in FODMAPs. The Monash FODMAP team has laboratory tested the FODMAP content of hundreds of local and international foods. Some of this information is published in the scientific literature, and all of the information is publicly available via the Monash University FODMAP Diet App.
- Be Mindful of Quantities: All of the foods recommended are low FODMAP at certain quantities, so please do check the Monash App before consuming to ensure you are within low FODMAP guidelines. If no amount is given then you should still eat that food in conservative amounts, otherwise high quantities can stack (known as FODMAP “stacking”) and lead to a high FODMAP load. Monash university are constantly testing new foods, and adding foods to their app as the data comes in.
- Consider Bay's Kitchen: Bay's Kitchen offers award-winning, IBS-friendly and low FODMAP certified foods that are free from common allergens like dairy and gluten. Simplify your cooking with Bay's Kitchen's easy stir-in sauces, dresses and condiments, perfect for busy individuals seeking nutritious and tasty meals in no time. With traditional condiments, sauces, and stocks often containing high-FODMAP ingredients like garlic and onions, Bay's Kitchen aims to fill the gap in the market.
- Explore Simple Swaps: Creating well-balanced, low-FODMAP meals doesn't have to be challenging. Start by exploring some simple swaps that can help you transition to a FODMAP-friendly lifestyle with ease. For more low-FODMAP meal inspiration, visit our recipes page for a wide selection of delicious and nutritious options.
Potential Benefits of a Low-FODMAP Diet
For those with IBS, SIBO, and other GI issues, low-FODMAP diets may provide relief from symptoms of gastrointestinal distress, which may help you feel more in control of your body and how you feel on a day-to-day basis. One of the biggest benefits of participating in a low-FODMAP diet is the possibility of relief from symptoms related to gastrointestinal issues that some may experience. Some of these symptoms, such as diarrhea or cramping, can be debilitating, so having relief may provide a world of difference. The most common symptoms that can improve with a low-FODMAP diet are bloating and abdominal pain, but issues related to fatigue and bowel movements may improve as well.