Nutritionists from the University of Maryland Medical System provide regular guest posts to the Picture of Health blog. The latest is from Shanti Lewis.
FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols. Each of these terms refers to a kind of carbohydrate commonly found in the American diet. Limiting foods that contain FODMAPs may help some individuals with functional GI disorders – like irritable bowel syndrome – experience symptom relief. That's because the carbohydrates that are eliminated cause water to be pulled into the intestinal tract, which can lead to diarrhea, constipation, bloating, and gas.
The most common oligosaccharides are fructans and galactans. The most common fructan is wheat; however, other sources of fructan include rye, onions, garlic, and artichokes. Sources of galactan include legumes (beans, soy, chickpeas, and lentils), cabbage, and Brussel sprouts.
The most common disaccharide is lactose. Foods that are high sources of lactose include dairy products, beer and prepared soups/sauces.
Free fructose is the most common monosaccharide. Common sources of free fructose include fruits, high fructose corn syrup, honey and agave nectar.
Polyols can be found in some fruits and vegetables but are often found in artificial sweeteners. Common food sources of polyols are apples, avocados, peaches, cauliflower, mushrooms, and snow peas. Artificial sweeteners such as sorbitol, mannitol, xylitol, and isomalt can be found in gums, toothpastes, and mouthwashes.
Limitations with the FODMAP diet
While there is compelling evidence that some individuals with functional GI disorders experience symptom relief using the FODMAP diet, there are some concerns:
•The diet may be difficult to follow. High FODMAP foods are eliminated for 2-6 weeks and then slowly reintroduced to assess tolerance.
•The diet can pose a financial burden.
•Many studies examining the FODMAP diet are based on clinical observation only.
••Patient education before dieting varies and may not be done by a trained registered dietitian.
•The restriction of FODMAPs long-term has the potential to lead to nutritional inadequacies and changes in gastrointestinal microflora.
Should you consider following the FODMAP diet?
It is important for a physician or health care provider to accurately diagnose an individual with a functional GI disorder first. Then, the best treatment approach utilizes a registered dietitian along with a heath care provider to educate the patient on the potential trigger FODMAP foods in his or her diet, carbohydrate malabsorption, and the need for appropriate portion control when reintroducing high FODMAP foods. There is still a need for additional research to help determine the specific FODMAP content of many foods, along with evidence supporting the universal benefit of eliminating FODMAPs in patients with functional GI disorders.