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garlic and onion are high fodmap foods

IBS diet: Does the low FODMAP diet work for IBS?

10 Aug 2021 • 4 min read

Food is one common trigger for digestive conditions such as irritable bowel syndrome (IBS).

Avoiding high FODMAP foods is the cornerstone of some of the most common IBS diets.

But is it really worth cutting out those fermentable carbohydrates and following a low-FODMAP diet?

Let’s do some digging and find out!

What are FODMAPS?

FODMAPs are a collection of carbohydrates that contribute to IBS symptoms like gas, bloating and stomach pains.

To spell this out:1

Fermentable

Oligosaccharides

Disaccharides

Monosaccharides

Polyols

Summary

  • FODMAP is an anagram for carbohydrates that could cause/worsen IBS symptoms

Why choose a FODMAP diet for IBS?

Some (but not all) carbohydrates are poorly absorbed in the small intestine. As a result, they move further through the gut and ferment in the large intestine.

In people with IBS, this can trigger symptoms such as bloating, constipation, wind, diarrhoea, stomach pain and flatulence.

The guiding theory of a low FODMAP IBS diet is to replace high FODMAP foods that are poorly digested with low FODMAP foods that easily break down in the stomach.

This decreases the fermentation of sugars in the large intestine. Consequently, this can reduce bloating, constipation and other IBS symptoms.

However, IBS sufferers aren’t all sensitive to the same high FODMAP foods. To help reduce IBS symptoms, a dietitian may recommend you eliminate high FODMAP foods for a short period.

They are then gradually reintroduced in phases to identify which exact foods you are most sensitive to. It can also show which are better tolerated.

Summary

  • It has been proven that some carbohydrates (FODMAPs) can trigger IBS
  • The FODMAP diet can help you distinguish which cause your symptoms and which are ‘safe’

How do you start a low-FODMAP diet?

A low-FODMAP diet is not quite as simple as cutting out all high-FODMAP foods and focusing on low-FODMAP foods. It usually involves the following three stages:

  1. Restriction

This stage usually lasts a few weeks and requires strict avoidance of high-FODMAP foods.

Once you find adequate relief of IBS symptoms then you can move onto the next stage.

  1. Re-introducing foods

This next step requires reintroducing high-FODMAP foods to see which type and amount of high-FODMAP foods are affecting you the most.

It is recommended that you reintroduce foods one at a time – and it is recommended that you use a dietician to help guide you through this process.

  1. Making it work for you

This stage allows you to know which FODMAP foods you need to restrict, and which ones are actually fine to consume.

For example, you may be fine eating a piece of wheat bread every day but may want to avoid cauliflower all the time.

As you can see, a low FODMAP diet is a significant dietary intervention. And unless you have diagnosed IBS and have exhausted all other IBS diet options, it can do more harm than good.

If you don’t want to be so strict…

The lists of high- and low-FODMAP foods below show how complex and restricted a low FODMAP diet can be.

Just to reiterate, a low FODMAP diet isn’t for everyone. But that’s not to say you can’t take inspiration from some of the theory.

For example, keeping a food diary to track the severity of your symptoms against what you’ve consumed.

Most of us can’t remember exactly what we eat on a day-to-day basis. This is why it can be helpful to write it down.

This visibility allows you to recognise patterns between your diet and IBS symptoms. With this knowledge you could then reduce or eliminate a food for a short period to see if it has an impact on symptoms.

This is a simple but effective way to, see how an individual food may be causing your digestions problems.

How to start a food diary for IBS

  1. Write down everything you eat daily, the time you ate it, and the severity and time of your IBS symptoms on the same day.
  2. If you recognise a pattern where eating a certain food seems to regularly coincide with a rise in your digestion problems, consider eliminating this from your diet for a few weeks.
  3. During this elimination period, continue to keep a food diary and track your symptoms.
  4. After this period, gradually reintroduce the food and record any changes in your symptoms.
  5. Repeat with other foods if necessary.

It’s always recommended that any changes to diet are done in consultation with your GP or a dietitian.

Summary

  • There are several stages to a formal FODMAP diet, all of which help you to determine which foods are a problem for you
  • It is recommended that you consult a trained dietician for help with this
  • Keeping a food diary can also help you find out which foods you may need to avoid

What are FODMAPs foods?

FODMAPs can be found in varying amounts in a wide variety of foods.

Some foods contain just the one, e.g. only fermentable carbs, whereas others can contain several different types.

High-FODMAP foods

In many cases, high FODMAP foods are to blame for IBS symptoms. So, it makes sense to cut them out, right?

But whilst there’s growing evidence to show restricting these foods can drastically improve IBS symptoms, it takes serious commitment.

Here is a comprehensive list of high FODMAP foods which you should avoid/reduce if you want to follow this diet (especially in the first reduction stage).2

  • High-FODMAP vegetables/legumes

  1. Garlic (including garlic salt, garlic powder) – should be avoided entirely if possible
  2. Onions (including onion powder) – should be avoided entirely possible
  3. Artichoke
  4. Asparagus
  5. Bakes beans
  6. Beetroot
  7. Broad beans
  8. Butter beans
  9. Cassava
  10. Cauliflower
  11. Celery
  12. Falafel
  13. Pickled / fermented vegetables, e.g. sauerkraut
  14. Kidney beans
  15. Mangetout
  16. Mung beans
  17. Mushrooms Peas
  18. Kidney beans
  19. Cabbage
  20. Soybeans
  21. Spring onions
  • High-FODMAP fruit

  1. Apples
  2. Apricots
  3. Avocado
  4. Bananas (ripe)
  5. Blackberries
  6. Blackcurrants
  7. Cherries
  8. Currants
  9. Dates
  10. Figs
  11. Goji berries
  12. Grapefruit (over 80g)
  13. Guava (unripe)
  14. Lychee
  15. Mango
  16. Nectarines
  17. Peaches
  18. Pears
  19. Pineapple
  20. Plums
  21. Pomegranate
  22. Prunes
  23. Raisins (over 1 tbsp)
  24. Sultanas
  25. Tined fruit in pear / apple juice
  26. Watermelon
  • High-FODMAP meat

  1. Chorizo
  2. Sausages
  • High-FODMAP cereals, grains and nuts

  1. Wheat (and products containing it, e.g. biscuits, bread, noodles)
  2. Almond flour/meal
  3. Amaranth flour
  4. Barley
  5. Bread
  6. Carob flour / powder
  7. Cashews
  8. Chestnut flour
  9. Couscous
  10. Einkorn flour
  11. Freekeh
  12. Gnocchi
  13. Granola
  14. Muesli
  15. Pistachios
  16. Rye
  17. Semolina
  18. Spelt flour
  • High-FODMAP sweeteners, condiments, spreads, etc.

  1. Agave nectar
  2. Fructose
  3. Gravy (if it contains onion)
  4. High fructose corn syrup
  5. Hummus
  6. Honey
  7. Jam
  8. Molasses
  9. Pesto
  10. Stock cubes
  11. Vegetable pickle
  12. Most sugar-free sweets
  13. Sweeteners (inulin, isomalt, lactitol, maltitol, mannitol, sorbitol, xylitol)
  14. Tzatziki dip
  • High-FODMAP drinks

  1. Beer (more than one bottle)
  2. Apple and raspberry cordial (50-100% real juice)
  3. Orange cordial (20-50% red juice)
  4. Fruit / herbal tea with apple
  5. Apple, pear or mango fruit juice
  6. Orange juice (if over 100ml)
  7. Fruit juices (any in high quantities)
  8. Kombucha
  9. Meal replacement shakes containing milk
  10. Rum
  11. Fizzy drinks with high fructose corn syrup
  12. Soy milk
  13. Sports drinks
  14. Tea (if strong or with added soy milk)
  15. Wine (more than 1 glass)
  16. Whey protein (unless lactose free)
  • High-FODMAP dairy foods

  1. Buttermilk
  2. Ricotta cheese
  3. Cream
  4. Custard
  5. Gelato
  6. Ice cream
  7. Kefir
  8. Cow’s milk
  9. Goat’s milk
  10. Evaporated milk
  11. Sheep’s milk
  12. Sour cream
  13. Yoghurt

Summary

  • As you can see, there are a lot of foods to be aware of if you want to go low-FODMAP

Low FODMAP foods

It’s not all doom and gloom though, there are also lots of foods that are perfectly fine to eat while following a low-FODMAP diet.

Here are some of the most common ‘safe’ foods and the quantities you should limit certain foods to.

  • Low-FODMAP vegetables/legumes

  1. Alfalfa
  2. Bamboo shoots
  3. Beansprouts
  4. Beetroot
  5. Black beans (45g)
  6. Bok choy / pak choi
  7. Broccoli (35g)
  8. Brussels sprouts (2 sprouts)
  9. Butternut squash (35g)
  10. Cabbage (70g)
  11. Callaloo
  12. Carrots
  13. Celeriac
  14. Celery (less than 5cm of stalk)
  15. Chicory leaves
  16. Chickpeas (42g)
  17. Chili – if tolerable
  18. Chives
  19. Collard greens
  20. Corn (1/2 cob)
  21. Courgette (65g)
  22. Cucumber
  23. Aubergine (80g)
  24. Fennel
  25. Green beans
  26. Green pepper (75g)
  27. Ginger
  28. Kale
  29. Lentils (in small amounts)
  30. Lettuce
  31. Marrow
  32. Okra
  33. Olives
  34. Parsnip
  35. Snow peas (5 pods)
  36. Pickled gherkins
  37. Large pickled onions
  38. Potato
  39. Pumpkin
  40. Radish
  41. Red peppers
  42. Spring onions (the green part)
  43. Seaweed
  44. Chard
  45. Baby spinach
  46. Squash
  47. Sun-dried tomatoes (4 pieces)
  48. Swede
  49. Swiss chard
  50. Sweet potato (65g)
  51. Tomato (1 small / 1/4 a can)
  52. Turnip (1/2 a turnip)
  53. Water chestnuts
  54. Zucchini
  • Low-FODMAP fruit

  1. Ackee
  2. Unripe bananas (1 medium)
  3. Blueberries (45g)
  4. Cantaloupe melon (120g)
  5. Cranberry (1tbsp)
  6. Clementine
  7. Coconut cream (75g)
  8. Coconut flesh (50g)
  9. Dragon fruit
  10. Lingonberries
  11. Grapes
  12. Guava
  13. Honeydew / Galia melons (80g)
  14. Kiwifruit (2 small)
  15. Lemon (including juice)
  16. Lime (including juice
  17. Mandarin
  18. Orange
  19. Passion fruit
  20. Papaya
  21. Pineapple
  22. Plantain
  23. Prickly pear
  24. Raspberry (30 berries)
  25. Rhubarb
  26. Strawberry
  27. Tamarind
  • Low-FODMAP meat/meat substitutes

  1. Beef
  2. Chicken
  3. Chorizo
  4. Foie gras
  5. Kangaroo
  6. Lamb
  7. Pork
  8. Prosciutto
  9. Quorn
  10. Turkey
  11. Cold cuts, e.g. ham, turkey breast
  12. Processed meat (check ingredients)
  • Low-FODMAP fish/seafood

  1. Canned tuna
  2. Fresh cod
  3. Fresh haddock
  4. Fresh plaice
  5. Fresh Salmon
  6. Fresh Trout
  7. Fresh Tuna
  8. Plain crab
  9. Plain lobster
  10. Plain mussels
  11. Plain oysters
  12. Plain prawns
  13. Plain shrimp
  • Low-FODMAP cereals, grains and nuts

  1. Wheat free bread
  2. Gluten-free bread
  3. Corn bread
  4. Rice bread
  5. Spelt sourdough bread
  6. Potato flour bread
  7. Wheat- / Gluten-free pasta
  8. Wheat bread (1 slice)
  9. Almonds (10 almonds)
  10. Cream crackers (4 crackers)
  11. Oatcakes (4 cakes)
  12. Shortbread biscuit (1 biscuit)
  13. Brazil nuts
  14. Bulgur (44g cooked serving)
  15. Buckwheat
  16. Brown / wholegrain rice)
  17. Chestnuts
  18. Plain potato crisps
  19. Cornflour / maize
  20. Cornflakes (14g)
  21. Gluten-free cornflakes
  22. Corn tortillas (3 tortillas)
  23. Crackers
  24. Flaxseed / linseed (1tbsp)
  25. Hazelnuts (10 hazelnuts)
  26. Macadamia nuts
  27. Millet
  28. Mixed nuts
  29. Oats
  30. Peanuts
  31. Pecans (10 halves)
  32. Pine nuts
  33. Polenta
  34. Popcorn
  35. Porridge / oat-based cereals
  36. Potato flour
  37. Pretzels
  38. Quinoa
  39. Pasta (100g cooked)
  40. Rice
  41. Rice cakes
  42. Rice flour
  43. Chia seeds
  44. Hemp seeds
  45. Poppy seeds
  46. Pumpkin seeds
  47. Sesame seeds
  48. Sunflower seeds
  49. Tortilla chips
  50. Walnuts
  • Low-FODMAP sweeteners, condiments, spreads, etc.

  1. Aspartame
  2. Acesulfame K
  3. Almond butter
  4. Barbeque sauce
  5. Capers in vinegar
  6. Dark chocolate (5 squares)
  7. Milk chocolate (4 squares)
  8. White chocoalte (3 squares)
  9. Chutney (1tbsp)
  10. Dijon mustard
  11. Fish sauce
  12. Golden syrup (1tsp)
  13. Glucose
  14. Glycerol
  15. Strawberry jam
  16. Raspberry jam (2tbsp)
  17. Maple syrup
  18. Marmalade
  19. Marmite
  20. Mayonnaise (no garlic / onion ingredients)
  21. Miso paste
  22. Mustard
  23. Oyster sauce
  24. Pesto sauce (less than 1 tbsp)
  25. Peanut butter
  26. Rice malt syrup
  27. Saccharine
  28. Shrimp paste
  29. Soy sauce
  30. Sriracha hot chili sauce (1 tsp)
  31. Stevia
  32. Sweet and sour sauce
  33. Sucralose
  34. Sugar
  35. Tahini pate
  36. Tomato sauce / ketchup (2 sachets)
  37. Vegemite
  38. Apple cider vinegar (2 tbsp)
  39. Balsamic vinegar (2 tbsp)
  40. Rice wine vinegar
  41. Wasabi
  42. Worcestershire sauce (the onion and garlic content is acceptably low, making it low-FODMAP)
  • Low-FODMAP drinks

  1. Beer (1 drink)
  2. Vodka (limited intake advised)
  3. Gin (limited intake advised)
  4. Whiskey (limited intake advised)
  5. Wine (1 drink)
  6. Coffee (without milk or up to 250ml lactose free milk)
  7. Coconut milk (125ml)
  8. Coconut water (100ml)
  9. Drinking chocolate powder
  10. Fruit juice (low-FOSMAP fruits only, 125ml)
  11. Lemonade (low quantities)
  12. Egg protein powder
  13. Rice protein powder
  14. Whey protein isolate powder
  15. Soya milk made with soy protein
  16. Sugar free soft drinks (low quantities)
  17. Black tea
  18. Chia tea
  19. Fruit and herbal tea (no apple added)
  20. Green tea
  21. Peppermint tea
  22. White tea
  23. Water
  • Low-FODMAP dairy foods, eggs and alternatives

  1. Butter
  2. Brie
  3. Camembert
  4. Cheddar
  5. Cottage cheese (2 tbsp)
  6. Cream cheese (2 tbsp)
  7. Feta
  8. Goat
  9. Halloumi (40g)
  10. Monterey Jack
  11. Mozzarella
  12. Paneer (2 tbsp)
  13. Parmesan
  14. Ricotta (2 tbsp)
  15. Swiss cheese
  16. Eggs
  17. Margarine
  18. Almond milk
  19. Hemp milks (125ml)
  20. Lactose-free milk)
  21. Macadamia milk
  22. Oar milk (30ml)
  23. Rice milk
  24. Sorbet
  25. Soy protein (avoid soy beans)
  26.  Tempeh
  27. Tofu (drained and firm varieties)
  28. Whipped cream
  29. Coconut yoghurt
  30. Greek yoghurt (23g)
  31. Lactose-free yoghurt
  32. Goat’s yoghurt
  • Low-FODMAP herbs, spices and cooking ingredients

  1. Most herbs and spices (avoid chili, garlic, onion)
  2. Avocado oil
  3. Canola oil
  4. Coconut oil
  5. Olive oil
  6. Peanut oil
  7. Rice bran oil
  8. Sesame oil
  9. Soybean oil
  10. Sunflower oil
  11. Vegetable oil
  12. Acai powder
  13. Baking powder
  14. Baking soda
  15. Cacao powder
  16. Cocoa powder
  17. Gelatine
  18. Ghee (1tbsp)
  19. Icing sugar
  20. Lard
  21. Mango powder (1tsp)
  22. Nutritional yeast
  23. Salt
  24. Soybean oil

Summary

  • Thankfully, there are a lot of ‘safe’ low-FODMAP foods around, which may be worth implementing into your diet to see if you experience a difference

Before you consider a low FODMAP IBS diet

Following a low FODMAP IBS diet is not a decision to take lightly. Only attempt it if:

  • Your IBS is formally diagnosed by your GP
  • You’ve tried other less restrictive diet strategies already (e.g. increasing your fibre intake and probiotics)
  • You’re recommended this diet by a FODMAP trained dietitian. Don’t attempt it alone – you need ongoing professional nutrition advice and support to implement this diet plan effectively

This final point is particularly important.

If this is a diet change you would like to initiate, careful implementation is crucial.

A FODMAP trained dietitian can assess if it’s appropriate for your IBS symptoms and also ensure what you’re eating continues to be nutritionally sufficient.

This is not an allergy diet

Eliminating high FODMAP foods isn’t a long-term solution.

This is where IBS diets can differ from allergy diets.

It’s important to recognise, IBS is not caused by a food allergy. It has nothing to do with your immune system.

Whereas diets for food allergies and intolerances often involve permanent exclusion of an allergen, this is not usually required in IBS diets.

For example, after the initial elimination period in a FODMAP diet, most IBS sufferers can start to tolerate small to moderate quantities of high FODMAP foods.

Consider that food may not be causing your IBS

Remember, diet is only one cause of IBS. If lifestyle factors, such as stress, are the trigger of your IBS symptoms, making behavioural changes could be more valuable.

In addition, if you suffer with food anxiety of any form, or have other underlying health conditions, it’s particularly important to seek medical guidance before pursuing an IBS diet.

Summary

  • A low-FODMAP diet is a big commitment and shouldn’t be taken lightly
  • Increasing your fibre and probiotics could help your IBS before going for a FODMAP diet
  • Eliminating FODMAP foods isn’t a long-term solution, as different people can tolerate different types/amounts of FODMAP foods
  • Keep in mind that food may not be causing your IBS, as it can also be linked to stress, food anxiety and other underlying health conditions

The final say

  • FODMAPS are different groups of carbohydrates which may affect/worsen IBS symptoms
  • A low-FODMAP diet is sometimes recommended to help determine which FODMAP foods affect you
  • FODMAP diets can be very restrictive and should not be viewed as a long-term solution
  • If you have been diagnosed with IBS and want to try a FODMAP diet, it is recommended that you consult a registered dietician to help
The advice in this article is for information only and should not replace medical care. Please check with your GP or healthcare professional before trying any supplements, treatments or remedies. Food supplements must not be used as a substitute for a varied and balanced diet and a healthy lifestyle.

Last updated: 10 August 2021

donia-hilal

Donia Hilal

Author

Nutritionist

Joined Holland & Barrett: January 2018

Bsc in Nutrition, Registered Associate Nutritionist and Certification in Pre and Post Natal Nutrition

Donia started her career as a freelance nutritionist, later she joined Nestle as their Market Nutritionist to help support their healthier product range, before joining the team at Holland & Barrett in January 2018.

Donia has over 6 years experience as a Nutritionist and also works with clients on a one to one basis to support their goals which include weight loss, prenatal and postnatal nutrition and children’s health.

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