Maybe you're one of these people: You eat healthily and try everything to get your intestinal problems under control, but the symptoms just don't seem to get better. Fruits, vegetables and whole grains are considered healthy foods, but in some people they cause digestive problems such as gas, bloating, diarrhea or constipation. How can that be? Some of these foods contain so-called FODMAPs and these are particularly noticeable in people with irritable bowel syndrome. The deceptive thing: FODMAPs include foods that you would actually think would do something good for your health: asparagus, cauliflower, beetroot, onions, apples, bananas, avocado, spelt, buttermilk, honey. So why do healthy foods cause discomfort?
What are FODMAPs and why can they cause digestive problems?
FODMAPs are certain short-chain carbohydrates and sugar alcohols that are naturally present in many foods. FODMAPs are generally not harmful, but are part of the daily diet of health-conscious people. However, Barrett (2017) assumes that the intestines of many people with irritable bowel syndrome are sensitive to FODMAPs. (3) Incidentally, irritable bowel syndrome manifests itself differently in each person: for one person it can lead to severe diarrhea, for another it can lead to stubborn constipation or a mixture of both.
What does the word FODMAP mean?
F – Fermentable
O – Oligosaccharides
D – DisaccharidesM – monosaccharides
A – and (and)
P – Polyols.
FODMAPs is the abbreviation for fermentable oligo-, di- and monosaccharides and polyols (Mehtab et al., 2019). These can lead to digestive problems such as diarrhea, flatulence and abdominal pain. (4)
LOW-FODMAP diet – relief from irritable bowel syndrome
According to Bellini et al. (2020), a low-FODMAP diet (LFD) is a possible form of therapy to relieve symptoms typical of irritable bowel syndrome, such as diarrhea, abdominal pain and flatulence. (1) In some countries, the low-FODMAP diet has already established itself as a regular form of therapy because it delivers promising results for irritable bowel syndrome (IBS). Studies have shown that symptoms can be improved with a low-FODMAP diet in up to 70% of irritable bowel syndrome patients (Camilleri et al., 2014). (2)
It is best to change your diet together with an experienced therapist
Since a low-FODMAP diet severely restricts food choices and has an enormous impact on the intestinal flora, it should only be followed under the guidance of a nutritionist (Bellini et al., 2020). (5) Studies show that the diversity of bacterial cultures in the intestine tends to decrease as a result of a low-FODMAP diet, but species diversity is essential and crucial for a healthy intestinal microbiome (Staudacher et al., 2020). (6)
How does the low FODMAP diet work? The two phases
The low FODMAP diet consists of two phases; one Restriction phase (also elimination phase) and a gradual one Re-exposure FODMAP-rich foods. Not everyone can achieve freedom from symptoms, but the low-FODMAP diet is The currently best available treatment method for irritable bowel syndrome .
In the first phase of the low-FODMAP diet, foods high in FODMAPs are completely avoided for six to eight weeks. If it appears during this time that the symptoms improve significantly or normalize, a long-term diet without these substances may make sense. In the second phase of the diet, various FODMAP-rich foods are tested for their individual tolerance (Dugum et al., 2016). (7)
Low-FODMAPs include fish, kale, lactose-free whipped cream and lemons.
Successes of the low-FODMAP diet in cancer therapy
But considerable success can be achieved not only in the course of irritable bowel syndrome; this diet has also proven to be extremely promising in cancer therapy.
Patients with radiation-induced enteropathy after cancer treatment show similar symptoms to patients with irritable bowel syndrome. Already in 2017, Larsen et al. investigated whether there could be a positive effect of LFD on symptoms and health-related quality of life in patients with radiation-related intestinal disease. In an open, non-controlled pilot study, the FODMAP intake of 11 patients with radiation-related RD symptoms was successfully reduced within four weeks and those symptoms significantly improved. (8th)
Further research is necessary
Although a low-FODMAP diet is increasingly being proposed for the treatment of irritable bowel syndrome, controlled long-term studies are still lacking. Potential limitations and concerns regarding LFD include nutritional adequacy, cost, and difficulty of teaching and maintaining this diet. Most of these limitations can be resolved by involving a qualified nutritionist who can clearly explain the different phases of LFD and ensure nutritional adequacy and compliance. (9)
This article is intended for informational purposes only and should not be construed as medical information or instructions. The recipes are intended for inspiration and are not intended as therapeutic measures. If you have any health problems, we recommend that you contact a doctor or other expert immediately.