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. Part one of this series covered the basics of IBS and FODMAPs, and this one goes into more depth about what to expect when following a low-FODMAP diet.
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.Is relief immediate upon switching to a low FODMAP diet?
It depends. I’ve seen some clients have immediate success following a low-FODMAP diet, but some won’t get any relief because their food sensitivities aren’t related to FODMAPs/carbohydrates. Instead it may have to do with proteins in foods that create an inflammatory response.Is it okay for those who don’t have IBS or any sort of stomach discomfort to follow this diet?
A Low FODMAP diet can be adhered to by one’s entire family over a period of two to three months with a few easy modifications. Such modifications should specifically address potential mineral deficiencies. For example, children, teens and adults all need calcium. Calcium needs can be met by using lactose-free foods or by taking digestive enzymes prior to dairy consumption. Calcium can also be enhanced by incorporating non-dairy foods that are high in calcium.
There is also a potential for vitamin and fiber deficiencies when one stays on a low FODMAP diet for a prolonged length of time. For this reason, I encourage following a balanced diet full of protein, starchy foods, fruits and vegetables to avoid fiber and vitamin A, C and D deficiencies. I also warn clients that a diet low in fiber can reduce the diversity of gut flora which can weaken the immune system and cause inflammation. In light of the recent COVID-19 pandemic, building your gut flora and boosting the immune system is important.
The diet to be followed during a flare would depend on the type of IBS or if that person has IBD.
Of course, bone broth would help hydrate and keep blood pressure up (with electrolytes such as sodium) in those having diarrhea. Staying hydrated is also recommended for those clients suffering with constipation. Crackers could help stabilize blood sugar, but they can also make matters worse for those who suffer from IBS-C. Likewise, eating whole wheat crackers can make matters worse for those with IBS-D.
Keep in mind, the Monash Low FODMAP diet is a bland diet. So, technically, if someone is in a flare and it is solely related to consumption of foods that are high FODMAP, then going back to a bland, low-FODMAP diet can help. During any flare, I highly recommend eating small, balanced meals, every three to four hours to minimize becoming dehydrated and nutrient deficient.Does a low FODMAP cure IBS? Or does it make it more manageable?
A low-FODMAP diet can be used as an initial and economical way to address certain discomfort resulting from IBS. Unfortunately, it is not a cure. When a low-FODMAP diet is not followed consistently, one may suffer symptoms associated with IBS. This can be especially true if a client has other complications going on that are related to obesity, enzyme deficiencies, stress (including over exercising), medications, supplements, or poor nutrient timing.
If a client does not show improvement, then I recommend running other tests to rule out celiac disease, IBS, and other food sensitivities and gut issues. I also analyze their health history to review other potential factors contributing to symptoms such as weight, sleep, stress, etc.
The low-FODMAP diet should include very simple meals. To minimize nutritional deficiencies, each meal should be balanced. Balanced low-FODMAP meals will include a protein, a starch, fruits and/or vegetables as follows:
When balancing meals, divide your plate into 3 sections, making half your plate fruit and/or vegetables. One quarter of your plate should include a starch and the remaining quarter should include a protein. Most people will eat fruit in the morning or as a midday snack. I encourage making half your plate non-starchy vegetables at both lunch and dinner. Vegetables are full of antioxidants, phytonutrients and fiber that help drive down inflammation while strengthening your immune system. Shoot for at least two colors of vegetables at both lunch and dinner.
The recipes that have been provided are simple, balanced meals composed of low-FODMAP foods. I added kale, spinach, tahini – and even an option for feta cheese – to ensure foods high in calcium were used. The flavor of each dish has been enhanced using the Colavita Roasted Garlic Extra Virgin Olive Oil to avoid high-FODMAP aromatics such as onion and garlic.
The recipes have also been designed to enable a working parent or caregiver to quickly assemble with minimal clean up. There is even an option for the frittata to be prepared and poured into a muffin tin lined with cupcake liner so that families can grab breakfast and go during the week!
It’s hard when you feel poorly, perceive certain foods to trigger your symptoms and still feel awful when restricting those foods. The high-FODMAP food lists have been developed to be a very comprehensible guide. Unfortunately, restricting certain foods can become confusing, especially if you don’t keep a food log or when you are still not seeing results. Other factors, such as lifestyle habits, pre-existing conditions, food sensitivities, medicines and supplements may also play a role in exacerbating gastrointestinal distress, which is why as a Registered Dietitian, I have the philosophy that the health of our gut and our bodies goes beyond nutrition.