When your digestion is under stress you whole body can feel below par. Energy levels, mood and your immunity can all suffer. Giving your digestive system some TLC could give you whole new lease of life.

FODMAPS are the new buzzword on nutritionists’ lips but chances are like us, you’ve not heard of them before. FODMAPS is just an acronym for a whole load of scientific names for a group of carbs which you ferment during digestion. Although some people can cope with this without any problems, others (up to 45% of us) really struggle – that can mean a whole host of really unpleasant symptoms:

Think bloating, swollen “football” tummy, pain, gas and even worse, sudden and unpredictable changes in your bowel habit! These are all symptoms associated with Irritable Bowel Syndrome (IBS), the umbrella term widely used to describe digestive problems. Not all bloating is due to IBS. If you suffer from time to time but don’t think you have IBS it’s worth trying a low FODMAP diet for 2-3 weeks. If things improve, keep going for the full 8 weeks.

IBS is notoriously difficult to treat and a lot of people suffer in silence for years. FODMAPs are a real breakthrough, giving up to 70% of sufferers real, lasting relief and control over their symptoms. Unlike most IBS “miracle cures” FODMAPs are based on science. The approach has been developed in clinical trials and hospitals across the globe and its gathering support of doctors, gastroenterologists and dietitians.

How does it work?

The idea is simple – you need to remove FODMAPSs from your diet as completely as possible for about 8 weeks. This gives your digestive system and chance to rest and recover.

Then you gradually reintroduce FODMAPs to see if they still cause you problems. Some people can include all the FODMAP again with no further problems, other have to continue to avoid some of the FODMAPs but very few people need to avoid them all permanently.

Word of warning! This is not a weight loss diet!

It’s a diet to help your digestive system. You shouldn’t follow the eating plan for more than 8 weeks and if you are concerned about following the diet for any reason consult your GP.

The low FODMAP Plan

We don’t promise this is an easy plan to follow, the best way to stick to a low FODMAP eating plan is to prepare as much of your food as possible from scratch and eat out as little as possible.

The only good news we can promise is that it is only for 8 weeks and if you have been suffering there’s a really good chance this will help- so it has to be worth a try, right?

The first thing you need to know is what foods contain FODMAPs – these are all the foods you need to try to avoid for the next 8 weeks.

High FODMAP foods: AVOID

  • All foods containing wheat, rye – e.g. bread, flour, pasta, some cereals, biscuits, cakes and pastries
  • Foods containing high levels of lactose (milk / sugar) – e.g. cow’s, sheep’s and goat’s milk, processed cheese, cottage cheese, any low fats cheese and ricotta cheese, most yoghurts, ice creams and custards
  • Pulses – all peas, beans and lentils
  • Foods containing artificial sweeteners called polyols – sugar free mints, chewing gum, and sugar free sweets and sugar free chocolate
  • Most (but not all) fruits which have pips or stones – apples, pears, apricots, peaches, plums and nectarines. You need to avoid blackberries, cherries, grapefruit, pomegranate and lychees too
  • As well as pulses, you need to avoid these vegetables – asparagus, avocado, beetroot, celery, garlic, onion, leeks and mushrooms. You’ll also need to leave out brassicas like broccoli, cauliflower, sprouts and green cabbage. And, there’s no sweet potato, squash and sweetcorn either.
  • Lastly – no dried coconut, pistachios, cashew nuts or honey

So, what can I eat?

  • Get friendly with the Free from isle in your supermarket – there’s plenty of choice for wheat free breads, pizza bases, pasta, biscuits, cakes, crackers and cereals. As long as they are wheat free you can go ahead. Some spelt bread is also wheat free so check these out at health stores
  • You’ll also find plenty of Soya alternatives to dairy foods – milks, yoghurts and custards are especially good. Go for Soya if possible as these have added calcium so you don’t miss out
  • Hard cheeses like cheddar or parmesan are fine – you can also have feta, mozzarella, brie, camembert and goat’s cheese. Butter is okay too
  • There are also lactose free dairy products around and these are all okay too. And, yes you can have chocolate but stick to dark chocolate
  • There’s no other way to guide you around fruits and veggies other than to list them. It’s really helpful to keep the list of okay fruit and veggies with you when you’re shopping

Fruits

Banana, blueberry, cantaloupe melon, clementine, cranberries, grapes, honeydew, kiwi, lemon, lime, orange, papaya, passion fruit, raspberry, rhubarb and strawberry

Veggies

Aubergine, bamboo shoots, beansprouts, cabbage (white) ,carrot, chard, chilli, courgette, chives, cucumber, endive, ginger, lettuce, olives, pak choy, parsnip, peppers, potato, radish, rocket, seaweed, spinach, spring onion (green only), swede, tomato and turnip

Try to make sure you still have your 5 a day.

Herbs and spices

Two of the hardest ingredients to exclude are garlic and onion so you’ll be glad to know you can use all other herbs and spices to add flavour to your cooking. You may want to try Hing or Asafoetida powder (from Asian supermarkets). This is fine on a low FODMAP diet and gives a good alternative flavour to onion and garlic

Nuts and seeds

Most are fine accept pistachios and cashews

Fats and oils

All are low in FODMAPs so are okay to include

Drinks

Try and avoid caffeinated drinks like tea, coffee and cola as the stimulant effect of caffeine can irritate IBS, so can alcohol so while you are following the low FODMAP diet it’s best if you can lay off the booze

Jams and marmalades

These are fine – but avoid low sugar varieties which contain artificial sweeteners

Meat and Fish

You can eat any meat, fish or poultry providing it is not breaded. Eggs are also perfectly fine and you can have between 4 and 6 eggs per week

Low FODMAP meal ideas

Breakfasts

  • Porridge made with soya or lactose free
  • Cornflakes or rice krispies with free milk
  • Wheat free toast with butter or peanut butter
  • Boiled, scrambled or poached eggs with wheat free toast
  • Smoked salmon and scrambled eggs
  • Cheese, chive and pepper omelette
  • Grilled bacon, egg and tomato

Lunches: Try and plan these ahead and take them with you if you are having lunch at work or on the run

  • Homemade soup with wheat free bread- make sure you leave onion out of any soup recipes
  • Baked potato with cheese, tuna, homemade chilli (no beans)
  • Wheat free crackers with cheese, cherry tomatoes, cucumber and sliced pepper
  • Mixed salad with homemade potato salad and cold meat
  • Rice salad with roasted tomatoes, peppers and courgettes and smoked mackerel
  • Quinoa salad with feta cheese, olives, tomato and cucumber and chopped fresh herbs
  • Sushi or sashimi
  • Sandwiches made with wheat free bread, rolls or pitta

Dinner

  • Fish, steak, chops or chicken with potato, salad or vegetables
  • Risotto (no onion) with salad
  • Caesar salad with grilled chicken or salmon
  • Greek salad (no onion) – lettuce, tomatoes, cucumber, olives and feta with grilled fish and baby new potatoes
  • Quinoa with roasted vegetables and harrisa spiced lamb chops (rub harrisa spice mix into lamb chops before grilling)
  • Quinoa with roasted vegetables and baked goats cheese
  • Wheat free pasta Carbonara made with pancetta, egg and soya cream, lots of black pepper and parmesan
  • Omelette with low FODMAP filling, salad and baked potato
  • Stir free low FODMAP veggies with chicken, rice or wheat free noodles. Make a sauce with sunflower oil, chilli, ginger, lime juice and a little sugar.

Snacks

  • Soya yoghurt
  • Fruit from low FODMAPs list
  • 50g suitable nuts
  • Rice or corn crackers with pate, peanut butter or cheese
  • Wheat free biscuits
  • Wheat free cake
  • Flapjack (made simply with oats, butter and golden syrup)
  • Crisp- ready salted or salt and vinegar only

Other things to do to help take care of your digestives system

The low FODMAP diet is all about giving your digestive system a chance to rest . Relaxing your mind and body has a really positive affect on their digestion too. Try to have a weekly massage, facial or some sort of treatment which is designed to help you relax. At night before you go to sleep, gently massage you tummy from right to left in a circular motion, do this for 5-10 minutes before you go to sleep. It’s unlikely that you’ll be able to avoid stress completely during the low FODMAP phase but try and follow the diet when you think life is going to be relatively calm and relaxed.

Reintroducing FODMAPS

Hopefully you will have noticed a dramatic improvement in your symptoms since you’ve been following the low FODMAP plan. After all the hard work’s over the end is in sight! It’s time to start the reintroduction phase.

There is a set way to do this- You need to introduce a high FODMAP food over three days. If after three days you are symptom free that food can be included in your diet and you can assume it does do not cause you a problem.

If your symptoms return within the three days, you should assume the food does irritate your symptoms and it will need to be avoided long term.

How to introduce a challenge food

  1. Continue with your low FODMAP plan
  2. Food high in fructose or lactose can be introduced in groups. You can assume if one food from the fructose group doesn’t cause a problem, all foods from the same group will be okay. The same goes from the lactose group
  3. Introduce the trial food in isolation e.g. 1 teaspoon of honey – not a honey coated cereal- the cereal will contain a lot of ingredients other than honey and may give you a false result
  4. Fructose group challenge: Honey-try 1 teaspoon of honey on three consecutive days- don’t introduce any other new foods. If after day three you are symptom free you can go on to include any of the following foods: Asparagus, mango, sugar snap peas, apples, pears, peaches and watermelon
  5. Lactose group challenge: Milk: try 100 ml of cow’s, sheep’s or goat’s milk. If after day three you are symptom free you can go ahead and introduce all dairy foods- cheeses, yoghurts, custards etc

The remaining FODMAP foods need to be reintroduced one at a time using the same three day test. Follow this order of foods if you can.

Order of reintroduction: try for 3 days in isolation

Wheat (shredded wheat), onion, garlic, leek, apricot, artichoke, avocado, beans (try butter beans canned in unsalted water- if okay all beans will be okay), beetroot, blackberry, broccoli, Brussels sprout, cabbage, cashews, cauliflower, celery, cherry, fennel, grapefruit, lentils, mushrooms, peas, peaches, pistachio nuts, pomegranate, squash (butternut), sugar free mints or gum, sweetcorn, sweet potato.

If you get symptoms after a food challenge avoid that food completely. You can re-challenge again at a later date if you want to try again. If you know there are days when you have to eat out or when it’s going to be difficult to control your diet take a break from reintroducing and start again when you have a better routine

What about the long term?

Everybody has a tolerance level to FODMAPs. If you eat too many high FODMAP foods in a short space of time you may get symptoms so it’s will be good to be wary of over doing it. The main aim of the low FODMAP diet trial is to give you control over your symptoms. If you make a mistake you will not do your digestive system any harm, it’s just a mistake – now you’ll probably be able to work out what caused the symptoms.

If you are worried that your long term diet is not providing all the nutrients you need, let us know and we can point you in the right direction.

If you would like any advice, or to discuss your health needs, please Nigel Denby at Hormone Health 92 Harley Street Clinic.

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