Reducing FODMAPs

Judy Seybold, MS, RDN, LD, CLC
Chief Nutrition Officer

What is FODMAP? FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are types of carbohydrates (sugars) found in food that draw water into the intestine. Foods high in FODMAP can be poorly absorbed in your digestive tract and are rapidly fermented in the gut. Avoiding these foods may reduce symptoms such as pain, gas, and diarrhea associated with irritable bowel syndrome (IBS). Some FODMAPs may be high in fiber and this diet can limit fiber intake, so make sure to include alternative fiber sources.

Foods high in FODMAPs that may need to be temporarily restricted include:

Fructose: mango, watermelon, agave, high fructose corn syrup, honey
Lactose: milk, ice cream, yogurt, soft cheeses
Fructans: wheat, onions, garlic, artichokes
Galactans: legumes (beans, peas, etc.), broccoli, brussels sprouts, soy-based products
Polyols: stone fruits (apricots, cherries, nectarines, peaches, etc.), apples, pears, cauliflower, mushroom, sugar alcohols

Sifter can help you find foods for a low-FODMAP diet
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Getting Started

Following a FODMAP diet involves 3 stages. Following each stage will help you determine which FODMAPs may cause symptoms for you. This is typically very individualized: what one person can tolerate may cause symptoms in another. By removing the most common symptom-causing foods and then reintroducing them one at a time, it is relatively easy to identify foods that cause problems for you in your diet. The great news is that following a low FODMAP diet isn’t a lifetime change. It is about monitoring your tolerance to FODMAP-rich foods and finding a diet that suits you and your symptoms.

Stage 1 - Low FODMAP:
Start out using foods low in FODMAP and avoiding high FODMAP foods as much as possible. The low FODMAP stage should last about 2-6 weeks. Swap high FODMAP foods for low FODMAP alternatives.

Stage 2 – Reintroduction:
This stage gradually reintroduces FODMAP-containing foods slowly so that it is easier to identify the foods that cause your GI symptoms. Over the next 8 -12 weeks, reintroduce one high FODMAP food at a time. Increase serving size each day for 3 days and monitor tolerance before adding the next new food. Keeping a food and symptom diary during this time will help you to identify any FODMAP foods that cause symptoms and you need to continue to avoid.

Stage 3 – Maintenance:
This is the personalization stage of the FODMAP diet. By the time you complete the Reintroduction stage, you will better understand what FODMAPs you can and cannot tolerate. It’s a balance between tolerated high FODMAP foods and the avoidance of others. Remember that a low FODMAP eating plan is not a no-FODMAP eating plan. Work with a registered dietitian to help you work through the different stages and to ensure that your diet is nutritionally adequate.

High FODMAP Foods:

Cereal/grain products: wheat, rye, barley
Dairy and alternatives: cow’s milk, ice cream, soy milk, yogurt
Fruit: apples, cherries, dried fruit, nectarines, watermelon
Nuts: cashews, pistachios
Protein: most legumes, some marinated meats, poultry, seafood
Sweets: high fructose corn syrup, honey
Vegetables: artichoke, asparagus, cauliflower, leek, mushrooms, onion

Low FODMAP Foods:

Cereal/grain products: corn flakes, oats, rice, gluten-free bread
Dairy and alternatives: almond milk, feta cheese, hard cheese, lactose-free milk
Fruit: cantaloupe, grapes, orange, strawberries
Nuts: macadamia nuts, peanuts, pumpkin seeds, walnuts
Protein: eggs, plain meat, poultry, seafood
Sweets: dark chocolate, maple syrup, table sugar
Vegetables: eggplant, green beans, bell pepper, cucumber, tomato, zucchini

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Tips for Starting a FODMAP Diet

New research is showing that enhancing the growth of good bacteria and changing the diversity of your gut microbiome may improve IBS. Gut bacteria thrive on many of the FODMAP foods that are high in fiber. People who do tolerate FODMAPs should understand that they can be beneficial to the gut.

Over-restriction can cause deficiencies, so it is important to make sure you start reintroducing foods after 2-6 weeks in the Low FODMAP Stage. Eliminating dairy foods, plant-based proteins, fruits, and vegetables can lead to deficiencies in vitamins A, C and D, fiber, and minerals such as calcium. This diet can also put vegetarians or vegans at risk for protein deficiency, so take care to include low-FODMAP protein sources in your diet if you do not eat animal products.

Prior to starting any new diet, consult a medical professional to rule out celiac disease and food allergies or intolerances, especially if you’re experiencing stomach pain or intestinal problems. Consult a registered dietitian if you are considering a low-FODMAP diet for a complete list of FODMAP-containing foods and individualized guidance on how to follow the diet. FODMAP eating plans are highly personalized and can help manage symptoms, but do not cure the underlying disease. Look for the FODMAP attribute to help shortcut your food selections. This attribute identifies foods that are low in FODMAP.

Additional Resources

IBS Diets: FODMAP Food List
The Low FODMAP Diet Approach
Discover the Monash University Low FODMAP Diet™ and manage your IBS symptoms
Stanford Healthcare: Our Approach to the Low FODMAP Diet