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Inflammatory Bowel Disease Resource

FODMAP Diet

laura lomax

 Blueberries are an acceptable option on the FODMAP diet, but limit to 20 berries.

Blueberries are an acceptable option on the FODMAP diet, but limit to 20 berries.

FODMAP’s

FODMAP’s are a collection of short chain carbohydrates and sugar alcohols found in foods naturally or as food additives. While most carbohydrates can be broken down and absorbed, certain carbohydrates such as FODMAP’s are not as easily digested.  FODMAP’s can be poorly absorbed in the small intestine and travel to the large intestine.  In the large intestine the FODMAP’s are rapidly fermented by bacteria, and FODMAP’s are also osmotic (they attract water into the large bowel) with both of these processes can result in symptoms such as abdominal pain, bloating, gas, and changes in bowel habits.

FODMAP diets are popular for use in inflammatory bowel disease, irritable bowl syndrome, and other digestive disorders.  When implementing the FODMAP diet plan there are several steps including elimination, monitoring symptoms, and reintroduction of foods (amount, type, and frequency). As with any elimination diet it is important to work with a dietitian to ensure you continue to meet your nutrition needs  are being met as well as to help identify the foods contributing to symptoms.  Several nutrients of concern on the FODMAP diet include calcium and fiber.  

FODMAP stands for:

Fermentable- stands for fermented or broken down by bacteria which can cause gas and other GI symptoms.

Oligosaccharides – Oligosaccharides are carbohydrates. Oligo meaning few and saccharide meaning sugar they are carbohydrates with a few (~ 3-10) simple sugars that join to form a chain.

Disaccharides- Carbohydrates formed by 2 monosaccharides. The common disaccharide to avoid on FODMAP is lactose.

Monosaccharides: Simple  or single sugars. Here the monosaccharide of concern is fructose, specifically foods with excessive fructose. Examples include high fructose corn syrup, honey, agave, mango, and watermelon.

And

Polyols – Common polyols include sorbitol and mannitol. Polyols are present naturally in fruits (such as cherries, pears, stone fruits) and is also added to foods with sugar alcohols (commonly in “sugar free” products).

While most carbohydrates can be broken down and absorbed, certain carbohydrates such as FODMAP’s are not as easily digested.  FODMAP’s can be poorly absorbed in the small intestine and travel to the large intestine.  In the large intestine the FODMAP’s are rapidly fermented by bacteria, and FODMAP’s are also osmotic (they attract water into the large bowel) with both of these processes can result in symptoms such as abdominal pain, bloating, gas, and changes in bowel habits.

FODMAP’s include:

FRUCTOSE: a naturally occurring sugar. Can be found as a fructose, sucrose (fructose + glucose), or a fructan (polymer of fructose present in fruit, vegetables, grains). Free fructose is absorbed by a transporter, GLUT 5 that is present in the small intestine. When glucose is present with fructose it is absorbed better via a GLUT 2 transporter. Failure to completely absorb free fructose leads to delivery to the colon where the colon bacteria ferment the free fructose to hydrogen, carbon dioxide and short chain fatty acids.

LACTOSE: is made up of glucose + galactose and is found in milk and dairy products. To digest lactose containing products you need lactose which is an enzyme. Lactase will break the sugar into single sugars for the body to absorb. Lactase production in our body can be decreased for a variety of reasons include: decreases as we age, gastrointestinal infection, IBD. If you do not have enough lactase enzyme the lactose is not digested normally and it passes to the large intestine where it is fermented by bacteria.

FRUCTANS: are fructose polymers and are the naturally occurring storage carbohydrates of a variety of vegetables, including onions and garlic, fruits and cereals. They also occur in inulin and fructo-oligosaccharides (FOS) as they are added to a variety of foods for their prebiotic effect.  The small intestine does not produce enzymes that can break the fructose-fructose bonds therefore some people have difficulty digesting fructans.

GALACTO-OLIGOSACCHARIDES: are chains of galactose molecules and are often malabsorbed in the small intestine.  Food sources include lentils, chickpeas, and kidney beans. Similar to fructans the galactose galactose bonds are difficult to digest and can lead to fermentation by the bacteria of the large bowel. 

10 FODMAP Friendly Snacks:

When choosing snacks or food choices on the FODMAP diet portion size is key. While there are foods to avoid on FODMAP it is also important to  be mindful of portion size,  as some foods are acceptable in small portions, but not well tolerated in large portions. 

Boiled egg and 10 almonds

Banana with 1 tbsp. peanut butter

1 ounce cheddar cheese + Rice crackers

½ cup oatmeal (prepared w/ soymilk) with ¼ cup blueberries and 1 tsp chia seeds

Rice cake with peanut butter

Lactose free yogurt ( be sure to check label for no high FODMAP ingredients)

Tuna pouch + baby carrots

1 ounce walnuts + 1 cup coffee with almond milk

Sliced Cucumbers + 1 ounce cheddar cheese

½ cup strawberries + 1 cup almond milk

For more info on a low FODMAP diet check out www.monashfodmap.com. They also have a great FODMAP friendly app.