How to Start the Low FODMAP Diet?

How to Start the Low FODMAP Diet?

It all seems a bit confusing right?  Learning about FODMAPs, what they stand for, what they potentially do to our digestive system, which foods you can have, need to limit or completely avoid.  There’s also conflicting information from Australia, the U.K. and the U.S.  At the end of the day, it’s your body and you need to take control and carefully monitor what works and what does not work for you.  

Have patience because decoding the intricacies of your digestive system might take some time. The exact cause of irritable bowel syndrome (IBS) is still unknown, and there is no medical cure for Celiac Disease, Crohn’s Disease or Ulcerative Colitis.  However, if you have any of these issues you may be able to benefit from the Low FODMAP diet.  It’s a natural approach to easing symptoms and during the process, you will also learn more about your body and how to treat physical and mental symptoms.  

Here are some basic tips to get you started with Low Fodmap Diet

PREPARE PHYSICALLY

1. Once you begin, keep a Food & Symptom Diary.  Write down everything you eat and drink.  Make note if you are eating fast, watching TV, using the computer, or playing with your phone at the same time. Make note of any exercise and any stressful situations you have each day.  You’ll want to keep your food diary going for the entire length of the Low Fodmap Diet (through the Elimination Phase and Rechallenge Phase).  The food diary will help you to keep an accurate account and get you closer to knowing your “triggers.”

2. Eliminate all high-FODMAPs for two to six weeks – fructans, GOS, lactose, excess fructose and polyols.  According to Dr. Sue Shepherd, if you know you can completely absorb fructose or lactose “you need not restrict your intake.”

3. Know your portions –

  • a) Do not eat more than one serving of fruit per meal or sitting (1 serving = 1 C or one whole piece of medium-sized fruit, or two small fruits as in the case of kiwis).
  • b) Avoid eating these wheat products in large quantities -wheat, rye, barley (breads, cereals, pasta and cookies).  You can still enjoy small amounts of pieces of cookies in low fodmap ice cream or breadcrumb coatings.  Take a look at my low-FODMAP Grocery List for low-FODMAP foods and their appropriate servings.  For example, 1 slice of white wheat bread is low-FODMAP Wheat, while 1 1/2 slices become moderate in FODMAPs.  You want to stick with low-FODMAP servings.
  • c) Soft cheeses are allowed but only up to 2 ounces.  Look for hard or aged cheeses (again, on my grocery list or on the FODMAP Friendly and Monash FODMAP apps).
  • d) If you have fructose malabsorption you do not need to avoid fructose completely, just as long as there is more glucose than fructose, you can then eat moderate amounts.  If you have IBS, foods can be considered a problem if they contain more than 0.2 grams fructose in excess of glucose per serving –some fruits have the most amount of excess fructose over other foods.
  • e) Use low fructose sweeteners, but in moderation like: maple syrup, molasses (1 teaspoon or less), rice syrup, brown sugar.
  • f) Watch out for anything listed as “sugar-free” or having sugar alcohols (these ingredients often end in “ol”).  These Polyols can trigger symptoms for people with digestive disorders if they contain more than 0.5 grams total polyols per serving.

Check out our Low Fodmap Grocery List for more foods and portions

4. Timing is everything so get testing done as soon as possible.  I had to wait weeks for mine to be scheduled.  So as you’ve begun to avoid all FODMAPs, consider seeing a gastroenterologist and ask for blood and breath tests.  Hydrogen breath tests can help you to determine if you are fructose and/or lactose intolerant (malabsorption), have small intestinal bacterial overgrowth syndrome (SIBO) or a case of rapid passage of food through the small intestine.  Blood tests can help you determine if you need to avoid gluten.  These types of tests though have not all been extremely efficient, so in some cases, by keeping an ongoing Food & Symptom Diary you might get a better sense of food and stress triggers.  If you are used to getting your Vitamin D from milk products, you may want to introduce Vitamin D2 and D3 vitamins into your diet.  Consult with your doctor to ensure you are not or do not become Vitamin D deficient.

5. Whenever possible, put together FODMAP-friendly snacks so you will always have something on hand to enjoy. Vegetables, fruit, wheat-free bread and crackers (gluten-free for Celiac and Hashimoto’s disease), rice cakes, nuts (no pistachios or cashews), decaf green tea.  Stay hydrated!  Check out this post for 45 Low-FODMAP Snack Ideas.

6. Read food labels – make sure to always read a food label to see if the food is Low in FODMAPs.  Ingredients are listed in order of quantity, so the first couple of ingredients will make up most of the food product.  If a food product contains high FODMAPS, but they are in small amounts and listed towards the end of the list of ingredients, it may not cause symptoms or be of concern.  You also want to read gluten-free labels.  Just because something is gluten-free does not mean it’s free of FODMAPs.  Some of the most common high-FODMAP ingredients you may find on food labels are onions, onion powder, garlic, garlic powder, honey, agave, high fructose corn syrup (HFCS), inulin, chicory root, chicory root fiber, apple juice, pear juice and more.

7. Exercise – I have found that exercise always helps me with IBS symptoms (except running, that can sometimes make it worse).   Even if you do not have a regular workout routine, try to at least walk every day for 15 to 30 minutes.  You might get rid of a lot of gas and cramps that way.  If you have a medical condition, please speak with your physician before starting any new exercise regimen.

PREPARE MENTALLY

  1. There will be times when you might be unprepared and haven’t brought lunch to work or had snacks on hand while running errands.  There simply may be times when you cannot find suitable low-FODMAP foods.  You are not going to starve, so take those opportunities to drink more water or decaf green tea until you are able to find nutritious low-FODMAP food again.  If you were unprepared, take note if it brought on any anxiety.  Remind yourself to have a plan of action to be prepared next time.
  2. Learn how to meditate.  Sit in a quiet place without distractions for at least ten minutes and close your eyes.  With long slow breaths, breathe in and out and think about all the reasons you are so grateful to be taking care of your body.  Visualize your body as light as a feather; your tummy no longer distended, your clothes fitting the way they should.  See yourself smiling and waking up feeling energized.  See yourself feeling better with no cramping, abdominal pain, bloating gas, diarrhea and/or constipation.  No feelings of sadness or frustrations.  Only lightness, only positivity.  Only normal bowel activity 🙂
  3. People are going to be nosy.  If you are in a social setting and your friends or family are sharing an appetizer you cannot have, or you need to ask the server to negate some ingredients, just simply say with enthusiasm “I don’t want {insert FODMAP food here} today, I’d rather have something else” or “that looks really good, enjoy!  I’m having the xxxx instead.”  If you feel comfortable talking about the diet go ahead!  Just remember, anyone who is going to make a big deal out of the diet will only make it worse for you so you may consider sharing fewer details with them.  Before starting the diet, find someone close to you that will support you no matter what.  For the supporters, share your Low-FODMAP Grocery List so they can learn more in the process!  Who knows, maybe they’ll surprise you with something low-FODMAP.

Once your symptoms have improved during the Elimination Phase which can take two to six weeks (depending on how fast or slow your digestion system adjusts to a reduction in FODMAPs) , you can start by re-introducing one FODMAP sub-group at a time, one food at a time, in a smaller to larger portion size.

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