These individuals may be responding to FODMAPS. These are carbohydrates, actually a type of sugar found in foods. FODMAPS are osmotic which means they pull water into the intestinal tract which leads to bloating and diarrhea. They may or may not be digested or absorbed well and they may be fermented by bacteria in the gut leading to gas and bloating. The response to FODMAPS is very individual and it requires some effort to determine individual triggers.
What are FODMAPS? FODMAPS = fermentable, oligo-di-monosaccharides and polyols. OK, now that you have swallowed that mouthful, let's break it down. FODMAPS are short chain sugar molecules that are poorly absorbed in the intestine.
- Fructose - found in high amounts in some fruits (watermelon, pineapple, oranges, honeydew melon, peaches, starfruit, mango, apples and pears), honey, and high fructose corn syrup
- Lactose - milk sugar found in most dairy products (all types of milk, ice cream, custard, yogurt and soft cheese such as ricotta and cottage cheese)
- Fructans - these are also known as inulin and are found in wheat, onions, garlic, zucchini, mango, persimmon and watermelon
- Galactans - found in beans, baked beans, green beans, lentils, cabbage and Brussels sprouts
- Polyols - found in low calorie sweeteners such as sorbitol, mannitol, isomalt and xylitol, and in some fruits such as apples, pears, apricots, cherries, nectarines, peaches and plums
A low FODMAPS diet may help to resolve symptoms that have not been resolved by simply eliminating foods containing gluten. To try this approach, you need to avoid all FODMAPS food for at least 6 weeks. This is not easy because so many foods are restricted. It would be wise to do this elimination diet with the help of a registered dietitian or gastroenterologist. Those who are sensitive to FODMAPS usually see resolution of symptoms in 1 to 2 weeks.
The next step is to slowly reintroduce FODMAPS one category at a time to see if symptoms reappear. Many hesitate doing this step once they are feeling better. But, it is important because not everyone responds to every FODMAP. In many cases a person simply needs to limit, rather than eliminate foods. Symptoms are often due to a dose response. In many cases a person can eat a reasonable portion (1/2 cup) of a food but eating more may trigger symptoms. Though it may appear complicated once triggers are found, it is easy to avoid them.
Following a low FODMAPS diet, once individual triggers are determined, is quite safe. There are many gluten-free options currently on the market and many alternative choices for foods that must be avoided.
Important to the success of implementing a low FODMAPS diet is the education you receive from a dietitian or doctor. It takes considerable time to examine a person's diet and identify potential triggers. It is also important that you understand and can identify alternative foods that are allowed. Compliance with the diet and its ultimate success will be spotty without a qualified health care provider for support.
For more information on FODMAPS go to the National Center for Celiac Awareness at www.celiaccentral.org.
For more information on finding a registered dietitian go to the Academy of Nutrition and Dietetics at www.eatright.org.
© NRH Nutrition Consultants, Inc.
Jo-Ann Heslin, MA, RD, CDN is a registered dietitian and the author of the nutrition counter series for Pocket Books with sales of more than 8.5 million books.
The Diabetes Counter, 5th Ed., 2014
The Fat and Cholesterol Counter, 2014
The Most Complete Food Counter, 3rd ed., 2013
The Calorie Counter, 6th Ed., 2013
The Complete Food Counter, 4th ed., 2012
The Protein Counter, 3rd Ed., 2011
The Ultimate Carbohydrate Counter, 3rd Ed., 2010
The Healthy Wholefoods Counter, 2008
Your Complete Food Counter App: http://itunes.apple.com/us/app/your-complete-food-counter/id444558777?mt=8
For more information on Jo-Ann and her books, go to: www.TheNutritionExperts.com.
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