April is Irritable Bowel Syndrome (IBS) Awareness Month, so we sat down with Registered Dietitian Beth Candela to answer your top 10 questions about the disorder, FODMAPS and more. We’re proud to be able to say that we offer healthy and low-FODMAP compliant cooking oils to individuals suffering from IBS. Find Beth’s IBS-friendly recipes (pictured throughout this post) here made with Colavita Monash FODMAP Certified Roasted Garlic Extra Virgin Olive Oil.
What are FODMAPs and why does following a low FODMAP diet help those suffering from IBS or IBD?
FODMAPs is an acronym for Fermentable Oligo-, Di-, and Mono- -saccharides and Polyols (sugar alcohols). The list includes fructose, lactose, fructans, galactans and polyols which are a group of fermentable carbohydrates. These carbohydrates are listed as FODMAPs because they are commonly not digested or absorbed well – and as a result, can cause bloating, cramping, diarrhea, constipation or both diarrhea and constipation. These symptoms are often a common occurrence amongst people diagnosed with IBS and Inflammatory Bowel Disease (IBD).
IBS and IBD are two different conditions that can share similar symptoms, such as diarrhea, abdominal pain, gas and bloating. IBS is a collection of symptoms that can come and go, while IBD envelopes more chronic conditions presented as Crohn’s disease or Ulcerative colitis, the two of which are auto-immune diseases.
A low-FODMAP diets is promoted to help combat poor absorption and digestion. Since food containing the FODMAPs isn’t getting absorbed in the small intestine, certain bacteria in our lower digestive tract start to feed on them. Feeding bacteria can result in an overgrowth of bacteria in the large and small intestine, leading to small intestinal bacterial overgrowth (SIBO) and leaky gut syndrome. Fortunately, research has shown that low-FODMAP diets can reduce the certain colonic bacterial species, thus reducing symptoms.
It is important to note that people diagnosed with IBS or IBD can respond differently to a low-FODMAP diet. This is based on several varying factors that should be discussed with your physician. Overall, a low-FODMAP diet is a viable option when experiencing IBS-like symptoms in people who have been diagnosed with IBS or IBD but should be carefully supervised to mitigate additional complications.
The low FODMAP diet can be overwhelming and confusing. Is there a simplistic way to introduce those recently diagnosed to this diet?
As a Registered Dietitian, I personally introduce people to a chart that lists the foods which have the highest FODMAP content. I also explain that FODMAPs are both dose and frequency related. This means that symptoms can be caused by how much you eat and how often.
Based on this review, clients start to understand that some FODMAPs are better tolerated when consumed in very small amounts. I also explain that certain FODMAPs are better tolerated when cooked. For example, you may better tolerate cooked onion vs raw; or cooked garlic vs raw; or apple sauce vs whole apples.
Typically, a Low FODMAP Diet involves 3 Phases:
Phase 1: Restriction/Elimination: Phase 1 involves the strict avoidance of high-FODMAP foods. Once someone experiences less IBS symptoms, we proceed to Phase 2, usually between three to eight weeks.
Phase 2: Reintroduction: This phase involves a reintroduction to the high-FODMAP foods in small portions. This gets tricky because at this time, clients must also monitor the amount of FODMAPs they can tolerate. In this phase, clients are directed to test specific foods one by one for three days each.
Phase 3: Personalization: Once we determine the “gut triggers,” clients can start adjusting the amount of FODMAP foods that are tolerated based on their Phase 2 results.
Do you have to follow a low FODMAP diet for the rest of your life?
No. It is in fact not recommended that a low-FODMAP diet be followed for more than two months because people risk becoming deficient in specific nutrients such as fiber, vitamins and minerals - especially the mineral calcium and vitamins A, C and D. The low FODMAP diet is low in fiber which isn’t good long term. A fiber-rich diet helps in the prevention of diabetes, heart disease and weight management.
How does olive oil fit into a low FODMAP diet? How does it compare to other oils?
As with all oils, olive oil is a fat and does not contain FODMAPs. With this said, not all oil products are created equally.
Olive oil is healthy monounsaturated fat full of antioxidants and polyphenols associated with reducing inflammation, and does not contain FODMAPs. Time after time, research promotes olive oil as a healthy oil. In fact, olive oil consumption has been shown to be beneficial for human health and particularly for the prevention of cardiovascular diseases, breast cancer, and type 2 diabetes (4). One study even showed that the “exclusive culinary use of olive oil, as opposed to either non-exclusive or no culinary use of olive oil, beneficially impacts successful aging, particularly among individuals aged over 70 years of age.” (5)
What are three pieces of advice you recommend to those starting a low FODMAP diet?
First, I recommend starting with a food chart that lists the High FODMAP foods. Also, educating oneself on how FODMAPs are both frequency and dose related.
Second, consuming high FODMAP foods in small amounts or cooked rather than raw, are good ways to determine which works best. I recommend learning how to read food labels as well to be able to properly choose which pre-packaged goods are least likely to cause any IBS-related discomfort.
Lastly, I advise anyone starting a low FODMAP diet to remember that is hard to follow because it’s an elimination diet. Working with an expert who performs MRT Food Sensitivity Testing will make it easier and pinpoint exactly what you can eat. This allows you to develop meal plans making without weeks of trial and error.
Be on the look out for part two next week!