What the heck is that diet, FODMAPS?

FODMAPS is a diet that originated in Australia in the early 2000s, and has steadily gained popularity lately. The New York Times recently wrote an interesting article on it. Because it shows promise for specific people, and I want this blog to highlight current developments in nutrition, consider this FODMAPS 101. I sat down with fellow pediatric dietitian, Kaitlyn Stefanski, RD CNSC CDN, who works closely with FODMAPS patients at the local children's hospital, for some frequently asked questions.

SO what does FODMAPS actually stand for?

The term FODMAPS (besides a fun word for kids to say) is an acronym which stands for "Fermentable, Oligo-, Di-, Monosaccharides, and Polyols." In simpler terms, these are a group of short chain carbohydrates (sugars) that are poorly absorbed in the small intestine, passing through to the large intestine for absorption where they are fermented by bacteria and can cause gas and bloating.

Come again? 

Translated these short chain carbohydrates are recognized in many foods we love:

  • "Oligo" saccharides: Called fructans and galactans (refer to a type of fiber found in some vegetables, fruits and wheat)
  • "Di" saccharides : refers to lactose (milk, cheese, ice cream, yogurt)
  • "Mono" saccarides : refers to fructose (many fruits, sweeteners, honey)
  • "Polyols": refers to sugar alcohols added to sugar free products but they are also found naturally in stone fruits.

Are you having flashbacks of your high school biology class yet?


FODMAPS is not for everyone. Who would benefit from following this way of eating? 

Did you know that the second most common cause for school absence in children is from Irritable Bowel Syndrome (IBS)? IBS refers to a constellation of symptoms and can include abdominal pain, gas and bloating, constipation, and/ or diarrhea. If your child is suffering from tummy troubles, they are not alone. It’s estimated that 1 in 5 children may experience digestive distress on a regular basis! It is important to note that garden variety tummy aches can be different from IBS. Make sure to have you child evaluated by his/her pediatrician if you suspect IBS. Research has shown that the FODMAP diet can be very effective for people with IBS. One study showed symptom improvement in 75% of participants. Before considering this diet for your child, they need to be evaluated by their pediatrician and given a diagnosis of Irritable Bowel Syndrome. This diet must be supervised by a doctor and dietitian.

 

FODMAP friendly fare. Photo Credit: Petite Nutrition

FODMAP friendly fare. Photo Credit: Petite Nutrition

When following a low FODMAP diet which foods CAN you eat?

Source: Petite Nutrition

Source: Petite Nutrition

What foods do you have to avoid?

Source: Petite Nutrition

Source: Petite Nutrition

Is table sugar okay?

Yes. Table sugar is made of sucrose and is absorbed fairly well in the small intestine. That being said too much sugar is not good for anyone, children should consume no more then 3-4 teaspoons of sugar daily.

Does the FODMAP diet have to be followed very strictly?

Experts recommend following the diet strictly for 4-6 weeks before reintroducing small amounts of high FODMAPS foods. Many people react to FODMAPS differently. It’s important to re-introduce these foods in a systematic way to pinpoint what foods are tolerated and in what amounts. This is best done under the guidance of a dietitian. The re-introduction period will ensure your child has the most variety in their diet without experiencing painful GI symptoms.

Do FODMAPS cause gas, bloating and pain in everyone? Should we all stop eating these foods?

No! For most people (non-IBS sufferers) foods high in FODMAPS will cause little to no discomfort. The carbohydrates are still absorbed in the large intestine- however the majority of people do not feel the same digestive distress from these foods. With the exception of high fructose sweeteners and sugar alcohols many foods high in FODMAPS are very nutritious (hello avocados and Brussels sprouts!)

What if I think my child would benefit from this diet?

It is critical to work with your pediatrician. This is a way of eating that eliminates very healthy foods which can result in nutritional deficiencies if not supervised by a doctor and dietitian. The only reason to embark on this journey is to relieve symptoms in a child diagnosed with IBS. If your pediatrician wants your child to try FODMAPS, be sure to work with a registered dietitian familiar with FODMAPS to help you design a nutritionally complete diet. 

What do FODMAP Friendly Meals look like?

Quinoa Breakfast Bowls (makes 1-2 servings)

Ingredients: 
1/3 cup uncooked quinoa
2/3 cup almond milk
2 tsp brown sugar
FODMAP friendly fruit for topping (strawberries, bananas, blueberries, raspberries)

Directions: In sauce pan mix quinoa and almond milk and bring to a boil for ~5 minutes. Reduce heat to a simmer, cover and cook an additional 15-20 minutes until fluffs with a fork. Serve in bowls topped with berries and additional milk if you prefer.

Grilled cheese Lunch:
Grilled Cheddar Cheese sandwich on gluten free bread (UDI’s is a good brand) with sliced tomato
Side of tortilla chips and cucumbers with balsamic vinegar and olive oil to dip

Pesto pasta with chicken and tomatoes Dinner:

Brown rice pasta tossed with Petite Nutrition pesto diced grilled chicken and cherry tomatoes.

Photo Credit: Petite Nutrition

Photo Credit: Petite Nutrition

Sources: "Successful Low-FODMap living," Todays Dietitian, Volume 14

Advances in Nutrition, the Low FODMap diet for treatment of irritable bowel syndrome, Gastroenterology and Hepatology, July 2014.

www.kidshealth.org,  IBS - What is it?