How the low-FODMAP diet transformed my health
by Rose Clark
If five years ago someone had said I wouldn鈥檛 eat a scrap of onion or garlic or my daily Granny Smith, I鈥檇 have told them exactly where to stick that apple. But after years of pregnancy-belly, stomach pains and military-like plans for toilet emergencies, I was diagnosed with IBS (Irritable Bowel Syndrome) and put on the low-FODMAP diet, which alleviates symptoms in of sufferers.
We don鈥檛 know why some people get IBS. About of people in the UK experience it in any year, and it鈥檚 more common in women and people . Contributing factors include infections, stress and genetics, so it鈥檚 unsurprising that treatments vary 鈥 and it鈥檚 usually a lifelong condition. But it鈥檚 not all doom and gloom.
Could a diet that involves cutting out staples such as bread, milk and lots of fruits and vegetables work for me?
What is the low-FODMAP diet?
Numerous studies show certain foods exacerbate symptoms in of IBS sufferers. The low-FODMAP diet cuts out foods containing short-chain carbohydrates for four to eight weeks. These are poorly absorbed by the small intestine, so ferment quickly. That can lead to excess water and gas, resulting in IBS symptoms.
FODMAP stands for the types of sugars 鈥 Fermentable Oligosaccharides, Dissacharides, Monosaccharides And Polyols. They are found in foods as wide-ranging as pasta, apples and chickpeas.
The list of is daunting. How could I make a sauce without onion or garlic? What would I eat for breakfast without lactose or gluten?
But within a few weeks of going on the diet, my stomach had deflated and I was virtually pain-free for the first time in years.
So what can you eat?
鈥淔ocus on all of the foods you can eat rather than the foods you can鈥檛鈥, says dietitian Chloe Hall.
There are plenty of low-FODMAP foods 鈥 meat, fish, eggs, rice and lots of fruit and veg, as well as an ever-growing selection of lactose-free and gluten-free alternatives.
鈥淐hives are a great way to add onion flavour鈥 and almost all spices are low-FODMAP. A sprinkling of low-FODMAP nuts or a squeeze of citrus can add flavour. Miso and anchovies can add the best umami punch鈥, says low-FODMAP blogger and author .
There is a way to make almost anything FODMAP-friendly. My favourite hacks include finely chopped celery and garlic-infused oil (garlic isn't soluble in oil) as a base for sauces, curries and soups. I make 鈥榟ummus鈥 using spiced-roast squash and plenty of tahini instead of chickpeas and garlic. Homemade muesli and granola is cheaper and nicer than shop-bought too.
I鈥檝e got used to the looks of waiters when I list my dietary requirements, and (mostly) feel less awkward answering a dinner invitation with a thesis of what鈥檚 off the menu!
Reintroducing FODMAPs
Once the elimination process is over, if symptoms have improved, patients reintroduce food groups one at a time to see which foods they鈥檙e sensitive to and to what extent they trigger symptoms. The third stage is living on a personalised version of the diet, hopefully symptom-free.
I found the reintroduction process tricky. Despite initially thinking I鈥檇 be desperate to tuck into dal, apple pie and garlic bread again, I was reluctant to eat anything that might make me feel unwell. Having a dietitian鈥檚 advice and trialling one food at a time in small doses over a number of days was key. If your symptoms return, you must wait until they鈥檝e gone before trying another food.
Over time, I鈥檝e been able to reintroduce loads of ingredients. I doubt I鈥檒l ever be able to eat a French onion soup, but I can eat lactose in all its delicious forms, as well as leeks, asparagus, peas, artichokes, cauliflower and mushrooms. I鈥檓 a vegetarian, but still get enough protein (thank you tofu, eggs, quinoa, nuts and milk). It鈥檚 important to keep trying to reintroduce foods, as your tolerance can change over time.
鈥淭he ultimate goal is to eat and live as freely as possible 鈥 the more FODMAPs you can return to your diet without triggering symptoms, the healthier your gut is likely to be鈥, says Emma Hatcher.
Before you start the diet
It鈥檚 crucial to be diagnosed with IBS by a doctor, and to consult a dietitian, before cutting out FODMAPs. I was referred to a dietitian by my GP. There are also private dietitians with specialist gastrointestinal knowledge.
There鈥檚 little research on the long-term impacts of being FODMAP-free. Some FODMAPs are prebiotic, so the more you eat, the more good gut bacteria can grow. Studies have linked having a healthy composition of gut microbes to a strong , the body鈥檚 and many other aspects of health.
鈥淚t is essential that people do not follow the diet long term and reintroduce FODMAP-containing foods in a structured manner to improve their microbiome鈥, says Professor Kevin Whelan, Head of Department of Nutritional Sciences at King鈥檚 College London. He also suggests people consider a probiotic supplement, especially one containing the bacteria bifidobacteria, which has been shown to go down on the diet.
The low-FODMAP diet isn鈥檛 the only way to treat IBS symptoms. The exercise, relaxation, homemade healthy meals and trying probiotics. They also suggest not skipping meals, avoiding spicy, fatty and processed foods and limiting the amount of caffeine, alcohol and fizzy drinks you consume.
But if you鈥檝e been diagnosed with IBS and decide to try the FODMAP diet, these recipes will help you to eat well.
Life goes on after garlic, believe me.
Originally published July 2019
