FODMAPs in Food | Friend or Foe?

WRITTEN BY MILICA STOJSAVLJEVICK AND DR. SWATHI

Have you felt bloated or uncomfortable after eating certain foods? These foods could be high in FODMAPs and could be the reason behind why your stomach is feeling this way! Read on to see why this happens and what foods you should start incorporating into your daily diet.

What does “FODMAP” stand for and what are they (1)?

Fermentable
Oligosaccharides (breads/cereals)
Disaccharides (lactose)
Monosccharides (fructose)
And
Polyols (sorbitol, mannitol)

They are a collection of short-chain carbohydrates that are not able to be absorbed by the gut. Since they are not absorbed, they follow the path of digestion and make their way to the large intestine, where the bacteria there use the FODMAPs for energy to survive. They rapidly ferment the FODMAPs and produce gas. Both the gas in the large intestine and water in the small intestine cause the intestines to expand, which sends a signal to the brain leading to abdominal pain.

What foods are considered high FODMAP (1)?

Vegetables: Artichoke, asparagus, cauliflower, garlic, green peas, mushrooms, onion, sugar snap peas
Fruits: Apples, apple juice, cherries, dried fruit, mango, nectarines, peaches, pears, plums, watermelon
Dairy: Cow's milk, ice cream, soy milk, sweetened condensed milk, yogurt
Protein: Most legumes/pulses, some marinated meats/poultry/seafood, some processed meats
Breads: Wheat/rye/barley-based breads, breakfast cereals, biscuits, and snack products
Sugars and sweeteners: High fructose corn syrup, honey, sugar substitutes
Nuts and seeds: Cashews, pistachios

What foods are considered low FODMAP (1)?

Vegetables: Aubergine/eggplant, beans (green), bok choy, capsicum (bell pepper), carrot, cucumber, lettuce, potato, tomato, zucchini
Fruits: Cantaloupe, grapes, kiwi fruit (green), mandarin, orange, pineapple, strawberries
Dairy: Almond milk, brie/camembert cheese, feta cheese, hard cheeses, lactose-free milk, soy milk, oat milk
Protein: Eggs, firm tofu, some plain cooked meats/poultry/seafood, tempeh
Breads: Cornflakes, oats, quinoa flakes, quinoa/rice/corn pasta, rice cakes, sourdough or spelt bread, wheat/rye/barley-free breads
Sugars and sweeteners: Dark chocolate, maple syrup, rice malt syrup
Nuts and seeds: Macadamias, peanuts, pumpkin seeds/pepitas, walnuts

Some of you might be thinking, what about the other stuff? Like the processed stuff?! Well, FodyFoods is a brand that makes food especially for people that have difficulty eating high-FODMAP foods. They have snacks, sauces, marinades, dressings, condiments, salsas, oil and spices. This allows you to still enjoy some of your favorite foods without having to give them up completely! There are also other snacks and such that are not marketed as low-FODMAP but follow the rules above and tend to not cause as many issues. So, if you got this far and thought there is NO way I could eat low-FODMAP, although slightly difficult, it is very possible! 

Irritable Bowel Syndrome and FODMAPs

Irritable bowel syndrome (IBS) is just that, a syndrome that may not present with any damage to the gut lining, but can be accompanied by a lot of unpleasant symptoms when high-FODMAP foods are consumed (2). A few of these symptoms could include constipation (less than three stools per week), diarrhea (more than three stools a day), pain in the abdominal area, bloating, and/or gas (2). FODMAPS exacerbate these symptoms, which is why a low-FODMAP diet is one way to limit discomfort. 

What else can we do to prevent these undesirable symptoms?

Enter: Supplements.

Guar gum: This is another soluble fiber, but it also helps replace good bacteria in the GI tract and reduce abdominal pain (3)
Peppermint oil: This essential oil rich in terpenes eases abdominal pain caused by inflammation (3)
Probiotics/prebiotics: Probiotics replenish the good bacteria in the GI tract, while prebiotics feed these good bacteria. (Caution: some people can experience bloating from different prebiotics) (3). If you want to know why good bacteria is important, go check out our article on alcohol’s effect on the gut where we talk about the gut microbiome!
Aloe vera: A natural laxative which can help alleviate constipation and soothe pain (3)
FODMATE: This is a digestive enzyme formulated specifically for digesting FODMAPs when ingested. Low-FODMAP diets can be difficult to follow so this is something that can help in a pinch.

References:

1. Fodmaps and Irritable Bowel Syndrome. Monash University. https://www.monashfodmap.com/about-fodmap-and-ibs/ Accessed August 5, 2021.
2. Irritable bowel syndrome. National Institute of Health. https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/definition-facts Updated November 2017. Accessed August 5, 2021. 
3. Cooper J. Supplements that may help IBS. WebMD. https://www.webmd.com/ibs/supplements-help-ibs#2-6 Accessed August 8, 2021.

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This article was edited by Dr. Swathi and was written by Element Apothec Scientific Communications Intern, Milica Stojsavljevic. She is a Doctor of Pharmacy (PharmD) student at Concordia University Wisconsin School of Pharmacy in Mequon, Wisconsin.