The low FODMAP diet promises relief from the troublesome symptoms of irritable bowel syndrome, but the endless lists of forbidden foods can be overwhelming. Read on for a digestible review of foods to eat and what to avoid during all three phases of this therapeutic diet.<\/p>\n
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You may have landed here from our previous article on the benefits of the low FODMAP diet. If so, you know that FODMAPs (fermentable oligo-, di-, mono-saccharides and polyols) are carbohydrates that can worsen the symptoms of irritable bowel syndrome, <\/b>and that the low FODMAP diet aims to cut trigger carbs and reduce those symptoms. If not, you may want to read that post first to make sure you\u2019re up to speed.<\/p>\n
This post will list and explain which foods to eat and avoid during each phase of the low FODMAP elimination diet.<\/p>\n
First, we\u2019ll discuss the major groups of carbohydrates that are classified as FODMAPs and list some of the foods that are highest in each. These are the foods you should avoid, especially during phase one of the low FODMAP diet.<\/p>\n
During phase one, or elimination, people with<\/b> IBS<\/b><\/a> should choose foods with less than 1 g of total FODMAPs per serving<\/b>, and the lower the better. Scroll down to the \u201cwhat to eat\u201d section for a list of foods that fit the bill [R<\/a>].<\/p>\n Fructose is a simple sugar naturally present in fruits, vegetables, and<\/b> honey<\/b><\/a>. It has probably been a part of the human diet for millions of years, but too much of it may cause health problems in people with irritable bowel syndrome (IBS) [R<\/a>, R<\/a>].<\/p>\n Many processed foods are sweetened with high-fructose corn syrup.<\/b> Check and double check the ingredients list on all processed foods (including things like jams and sauces<\/b>) to make sure that they don\u2019t include this sweetener [R<\/a>, R<\/a>, R<\/a>].<\/p>\n For the purposes of IBS, \u201cexcess fructose\u201d or \u201cfructose in excess of glucose<\/a>\u201d is the measurement to watch for, if possible. Some fructose is bound with glucose to make sucrose, or table sugar; this fructose is generally not considered to be a problem. Only the unbound (excess) fructose is expected to cause problems [R<\/a>].<\/p>\n People with IBS should choose foods with less than 0.15 g of excess fructose per serving.<\/b> There\u2019s more flexibility with fresh fruits and vegetables; up to 0.4 g of excess fructose per serving should be fine [R<\/a>].<\/p>\n Unprocessed foods and ingredients that are high in fructose include [R<\/a>]:<\/p>\n Lactose, sometimes called milk sugar, is found in all milk<\/b>. It is responsible for the symptoms of people with lactose intolerance, and it can also irritate people with IBS. In fact, many people with IBS are also lactose intolerant <\/b>[R<\/a>, R<\/a>, R<\/a>].<\/p>\n Milk and dairy products like yogurt, cheese, and ice cream<\/b> are, of course, highest in lactose. Goat and sheep milk<\/b> are lower in lactose than cow’s milk. However, most people with food sensitivities or IBS will still react to them. To stay on the safe side, avoid all types of milk on a low FODMAP diet [R<\/a>, R<\/a>, R<\/a>, R<\/a>]<\/p>\n Other processed foods that contain lactose include [R<\/a>]:<\/p>\n In summary: anything prepared with milk, butter, or cheese is likely to contain lactose. Many lactose-free products will be specially labeled as such.<\/p>\n One of the most common polyols (the P in FODMAP), sorbitol<\/b><\/a> is a <\/b>\u201csugar alcohol<\/b>,\u201d which just means that it is a sugar molecule with an extra hydrogen atom attached. People with IBS should choose foods with less than 0.2 g of sorbitol per serving [R<\/a>, R<\/a>].<\/p>\n Dried fruits, especially prunes<\/b>, raisins<\/b>, and apricots<\/b>, contain the highest amount of sorbitol per serving. Other foods especially high in sorbitol include [R<\/a>, R<\/a>]:<\/p>\n Look for E420 as well as sorbitol in the ingredients list<\/b>; this is sorbitol\u2019s food additive code [R<\/a>].<\/p>\n Mannitol is another polyol (sugar alcohol), very similar to sorbitol<\/b>. In the average healthy adult, 20 g of mannitol is likely to act as a laxative and cause digestive distress. In people with IBS, much smaller amounts can be troublesome [R<\/a>, R<\/a>, R<\/a>].<\/p>\n This sugar is scarce in natural sources. Although mushrooms and cauliflower<\/b> are relatively high in it, large quantities of mannitol are industrially produced. It is added as an artificial sweetener to diabetic food, gum, and candy [R<\/a>, R<\/a>].<\/p>\n Fructans are polysaccharides (sugar chains) made up of many fructose molecules with one glucose molecule<\/b> at the end of the chain. When there are between 2 and 9 fructose units, the whole fructan is called oligofructose<\/b>; when there are more than 10 units, the whole fructan is called inulin<\/b><\/a> [R<\/a>, R<\/a>].<\/p>\n According to one study, some people who believe that they are gluten intolerant may actually be intolerant of fructans [R<\/a>].<\/p>\n Some of the foods that are highest in fructans include [R<\/a>]:<\/p>\n Note that chicory root<\/b><\/a> inulin has been beneficial for some people with IBS<\/b>. This is one reason why it\u2019s important to reintroduce and test FODMAPs one at a time in phase 2: some of them may actually help [R<\/a>]!<\/p>\n The galacto-oligosaccharides (GOS) are made up of galactose and other sugar molecules linked together in a chain<\/b>. The two most common in foods are stachyose <\/b>(two galactose molecules with a fructose and a glucose molecule at one end) and raffinose <\/b>(one galactose, one fructose, and one glucose) [R<\/a>, R<\/a>, R<\/a>].<\/p>\n GOS are typically found in legumes, including [R<\/a>, R<\/a>, R<\/a>]:<\/p>\n Elimination diets are intimidating: there are always giant lists of foods that you\u2019re not allowed to eat, and it looks like everything is on them. Two pieces of good news: first, you only need to cut all<\/i> FODMAPs out in phase one. Second, we\u2019ve got a list right here of foods that you can<\/i> eat, all the way through every phase of the diet.<\/p>\n This is the toughest part of the diet, because for this phase, you need to cut out as many FODMAPs as possible for up to six<\/b> weeks<\/b>. If the low FODMAP diet is right for you, your symptoms should start improving around week 3 or 4 at the latest [R<\/a>, R<\/a>].<\/p>\n These foods are considered safe to eat during the elimination phase of the low FODMAP diet<\/b>. They can form the backbone of your diet during the elimination phase. Choose a variety of foods from all groups and work with a licensed nutritionist to avoid possible nutritional deficiencies<\/b> [R<\/a>, R<\/a>, R<\/a>].<\/p>\n Unlike most berries, blackberries and cherries are high in FODMAPs and should be avoided [R<\/a>].<\/p>\n Because all fruit contains fructose, some nutritionists recommend eating a maximum of one serving of fruit per meal<\/b>. Work with your doctor or nutritionist to determine the appropriate limit for you [R<\/a>].<\/p>\n These foods are right on or just under the cutoff point<\/b> for the low FODMAP diet. Depending on the advice of your doctor or nutritionist, you may be able to eat some of these foods during the elimination phase, but not often or many at a time [R<\/a>, R<\/a>].<\/p>\n Some cheeses may likewise be safe to eat about an ounce at a time<\/b>. To name a few, Swiss cheese, cheddar cheese, brie, blue cheese, mozzarella, camembert, parmesan, and feta generally have a low enough lactose content to be safe in small quantities [R<\/a>].<\/p>\n During phase 1, take note of which symptoms disappear, if any, and which persist. If there\u2019s no improvement after six weeks, stop here<\/b>: the low FODMAP diet likely won\u2019t do anything for you<\/b>. Talk to your doctor about alternative strategies [R<\/a>].<\/p>\n During the reintroduction phase, each subtype of FODMAP should be tested one by one<\/b>. Overall, your diet should be identical to phase 1 except for whichever carbohydrate you are challenging [R<\/a>].<\/p>\n In clinical settings, nutritionists recommend challenging each carb once a day for 3 days<\/b>, and then returning to the low FODMAP baseline for another 2-3 days [R<\/a>].<\/p>\n Alternately, you can take a cue from research settings: challenge each carb once a day for a full week<\/b>, and then go back to the low FODMAP diet for another week afterward. Take note of whether symptoms returned during the challenge week, and whether they went away again the next week. This method will take considerably longer than the three-day method, but you may get clearer results [R<\/a>].<\/p>\n Only challenge one<\/i> carbohydrate at a time. If you reintroduce multiple carbs at once, you won\u2019t know which one is triggering your symptoms<\/b>. Later, during phase 3, you\u2019ll reintroduce multiple FODMAP foods and learn whether any of them may be interacting [R<\/a>].<\/p>\n Ideally, your doctor or nutritionist will guide you through this second phase. The instructions below should not be used to replace anything that a medical professional recommends.<\/b><\/p>\n Nutritionists recommend challenging fructose with either honey or mango. Eat 1 tsp of honey OR half a mango<\/b> once a day for three days and take note of any symptoms [R<\/a>].<\/p>\n Lactose is richest in dairy products, so it makes sense to challenge with dairy. Drink half a cup of milk OR eat 200 g of yogurt<\/b> (regular, not Greek) per day for three days and take note of any symptoms [R<\/a>].<\/p>\n It\u2019s important to challenge sorbitol using foods that are low in fructose. You can use small amounts of foods that are sweetened with sorbitol, or you can use apricots or avocados. Eat \u2153 to \u00bd an avocado OR 1 small apricot<\/b> per day for 3 days and take note of any symptoms [R<\/a>].<\/p>\n Mannitol is significantly less common than fructose and sorbitol, but some vegetables have enough to be significant. Eat half a cup of mushrooms OR half a cup of cauliflower<\/b> per day for 3 days and take note of any symptoms [R<\/a>].<\/p>\n Fructans can be more troubling than the simple sugars and polyols for some people with IBS. Using a challenge of either a slice of whole wheat bread OR a cup of pasta<\/b>, nutritionists recommend challenging for one day, resting for one day, and challenging for one day. Take note of any symptoms you experience on challenge days or on the day in between [R<\/a>].<\/p>\n Because there are so many types of fructans, nutritionists recommend treating onion and garlic fructans as a separate challenge with the same schedule. Eat one ring of onion OR up to half a clove of garlic<\/b>; these foods are very rich in fructans [R<\/a>].<\/p>\n As with fructans, nutritionists recommend challenging, resting, and challenging again to test galacto-oligosaccharides (GOS). Eat half a cup of (freshly cooked, not canned) lentils OR 2 tbsp of chickpeas<\/b> once per challenge day and take note of any symptoms [R<\/a>].<\/p>\n Fructose and sorbitol can be especially bothersome in combination, which is why some people with IBS have such trouble eating apples and pears. Eat half an apple OR half a pear<\/b> once per day for three days and take note of any symptoms [R<\/a>].<\/p>\n Once you\u2019ve gone through all of the challenge phases, it\u2019s time to personalize your diet. Here, you reintroduce the FODMAPs that don\u2019t cause symptoms, or that cause manageable symptoms, to your taste and comfort<\/b> [R<\/a>, R<\/a>].<\/p>\n Gradually increase your intake of FODMAPs that were manageable during phase 2. Try to do most of your experimentation on weekends, or other times when you\u2019re at home for a few days, to minimize stress<\/a> [R<\/a>, R<\/a>].<\/p>\n Phase 3 is all about your comfort level and optimal health. One advantage of reintroducing certain FODMAPs is that you avoid potential<\/b> nutrient deficiencies<\/b><\/a>; another is that it makes your long-term diet easier to follow<\/b> when you\u2019re allowed to eat more foods. On the other hand, only you know which symptoms are tolerable and which are not<\/b>; work with a medical professional who can help you design your diet accordingly [R<\/a>, R<\/a>].<\/p>\n The low FODMAP diet includes three phases: elimination, reintroduction, and personalization. During the first phase, FODMAPs should be drastically reduced or nearly eliminated in the diet to ensure that these carbohydrates are responsible for the symptoms of IBS.<\/p>\n During the second phase, subgroups of FODMAPs (fructose, lactose, sorbitol, mannitol, fructans, and galacto-oligosaccharides) should be introduced one by one to see if they trigger IBS symptoms. If they don\u2019t, they can be added back into the diet, slowly, during phase 3.<\/p>\n The low FODMAP diet can be intimidating because of the long lists of disallowed foods during phase 1. However, you can make delicious, nutritious meals using only the low FODMAP foods listed in this post. Plus, it\u2019s not forever: reintroducing safe FODMAPs is just as important as eliminating bothersome ones.<\/p>\n<\/div><\/div>\n","protected":false},"excerpt":{"rendered":" The low FODMAP diet promises relief from the troublesome symptoms of irritable bowel syndrome, but the endless lists of forbidden foods can be overwhelming. Read on for a digestible review of foods to eat and what to avoid during all three phases of this therapeutic diet.<\/p>\n","protected":false},"author":14656,"featured_media":72012,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[5],"tags":[],"yst_prominent_words":[802,21320,21319,21310,21308,807,21317,21316,837,21309,21307,21321,21315,8344,1125,511,515,21318,21313,518],"_links":{"self":[{"href":"https:\/\/selfhacked.com\/wp-json\/wp\/v2\/posts\/72002"}],"collection":[{"href":"https:\/\/selfhacked.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/selfhacked.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/selfhacked.com\/wp-json\/wp\/v2\/users\/14656"}],"replies":[{"embeddable":true,"href":"https:\/\/selfhacked.com\/wp-json\/wp\/v2\/comments?post=72002"}],"version-history":[{"count":16,"href":"https:\/\/selfhacked.com\/wp-json\/wp\/v2\/posts\/72002\/revisions"}],"predecessor-version":[{"id":148269,"href":"https:\/\/selfhacked.com\/wp-json\/wp\/v2\/posts\/72002\/revisions\/148269"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/selfhacked.com\/wp-json\/wp\/v2\/media\/72012"}],"wp:attachment":[{"href":"https:\/\/selfhacked.com\/wp-json\/wp\/v2\/media?parent=72002"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/selfhacked.com\/wp-json\/wp\/v2\/categories?post=72002"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/selfhacked.com\/wp-json\/wp\/v2\/tags?post=72002"},{"taxonomy":"yst_prominent_words","embeddable":true,"href":"https:\/\/selfhacked.com\/wp-json\/wp\/v2\/yst_prominent_words?post=72002"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}Fructose<\/b><\/span><\/h3>\n
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Lactose<\/b><\/span><\/h3>\n
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Sorbitol<\/b><\/span><\/h3>\n
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Mannitol<\/b><\/span><\/h3>\n
Fructans<\/b><\/span><\/h3>\n
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Galacto-Oligosaccharides<\/b><\/span><\/h3>\n
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What to Eat on the Low FODMAP Diet<\/b><\/span><\/h2>\n
Phase 1: Elimination<\/b><\/span><\/h3>\n
Very Low FODMAP<\/b><\/h4>\n
Animal Products & Dairy Alternatives<\/b><\/h5>\n
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Grains<\/b><\/h5>\n
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Vegetables & Greens<\/b><\/h5>\n
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Fruits<\/b><\/h5>\n
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Other<\/b><\/h5>\n
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Low FODMAP<\/b><\/h4>\n
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Phase 2: Reintroduction<\/b><\/span><\/h3>\n
Fructose<\/b><\/h4>\n
Lactose<\/b><\/h4>\n
Sorbitol<\/b><\/h4>\n
Mannitol<\/b><\/h4>\n
Fructans<\/b><\/h4>\n
Galacto-Oligosaccharides<\/b><\/h4>\n
Fructose & Sorbitol Combination<\/b><\/h4>\n
Phase 3: Personalization<\/b><\/span><\/h3>\n
Takeaway<\/span><\/h3>\n