Fodmap diet , what is it, what food does it congestion

Introduction and short summary to FODMAP diet

1. FODMAP DIET

2. What is FODMAP? FODMAPs are actually components found in many of the foods that we eat – in fruits, vegetables, grains, nuts, legumes, dairy, as well as in a number of other processed foods.

3. What is it’s significance? The significance of these FODMAPs is that for those who struggle with Irritable Bowel Syndrome (IBS) they can trigger mild to severe symptoms including abdominal pain, bloating, distention, gas, diarrhea and constipation

4. Impact on IBS. The Low FODMAP Diet is a diet protocol designed to help those with IBS identify which FODMAPs are causing gastrointestinal symptoms. Evidence shows that the Low FODMAP Diet is effective in improving symptoms in 70% of people with IBS. As well, a systematic review and meta-analysis found that the Low FODMAP Diet is able to reduce symptom severity and improved quality of life of those with IBS.

5. What does the Acronym FODMAP stand for? FODMAP is actually an acronym that stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. To make it easy to talk about these components as a group, they are collectively referred to as FODMAPs. It sort of makes it easier, doesn’t it? Some of those names are quite a mouthful.

6. Why does FODMAPs cause symptoms in IBS? FODMAPs are small, poorly absorbed carbohydrates which either attract water to the small intestine and/or are fermented by the bacteria living in the large intestine. These actions of FODMAPs within the digestive tract are what cause symptoms for many people with IBS.

7. Should everyone avoid FODMAPs? The answer to this is ‘no’. FODMAPs do not cause symptoms in everyone and you do not need to avoid them if they don’t cause you grief. You don’t really even need to avoid them if they cause tolerable symptoms, like a bit of gas or mild bloating. It’s when they cause significant enough symptoms to negatively affect your daily life that the Low FODMAP Diet may be something to be considered.

8. Are FODMAPs harmful ? What’s important to keep in mind is that FODMAPs don’t cause any damage to your gut. There is no physical damage happening to your intestines, unlike what happens to someone with celiac disease when they consume gluten (gluten physically damages the small intestine). The reaction to eating FODMAPs for people with IBS may be unpleasant, or even painful but their consumption does not cause any damage to the body.

9. Now let’s talk about specific groups in FODMAPs

10. Fermentable Oligosaccharides There are two main groups of oligosaccharides in the Low FODMAP Diet, fructans and galacto-oligosaccharides (or GOS, for short). Fructans are found in a number of foods including wheat, barley, rye, onion, garlic, grapefruit, nectarines, and watermelon. Galacto-oligosaccharide are found in legumes (like kidney beans, black beans and soybeans), bitter melons, peas, cashews, and pistachios. Fructans and GOS are not able to be absorbed as our body does not contain the enzymes needed to break them down. This means that both fructans and GOS will pass on through to the large intestine where they are fermented by bacteria to produce gas. This is true for both those with and without IBS. In sensitive individuals (i.e. those with IBS) the production of gas will cause bloating, distention and altered bowel habits (diarrhea or constipation).

11. Fermentable Oligosaccharides One thing to note is that both fructans and GOS are important for our digestive health as they act as prebiotics, or food, for the beneficial bacteria within our gut. So while they do cause symptoms in some people with IBS, at least some intake of foods with these FODMAPs is important for a healthy gut environment.

12. Disaccharides The ‘D’ in FODMAP stands for disaccharide, which in this case refers to lactose. Lactose is a carbohydrate made up of two sugar units (glucose and galactose) and is found in dairy products, including milk, yogurt, ice cream, sour cream and condensed milk.
Lactose is digested by the lactase enzyme in the small intestine, however, many people are lacking this enzyme and are unable to tolerate much in the way of dairy products. Lactose intolerance is not, however, specific to IBS. It is equally common in those with and without IBS.

13. Monosaccharides Fructose, and more specifically excess fructose, has been implicated in causing symptoms in those with IBS. Let me explain further. If the fructose concentration of a food is equal or lesser than the concentration of glucose, it is generally well tolerated. However, if fructose is present in a greater concentration than glucose, it can cause digestive trouble. This is why we specify that excess fructose, and not just fructose itself is something to avoid on the low FODMAP diet.

14. Why fructose causes problems When fructose exceeds glucose in the small intestine, absorption switches to a slower, less efficient method. With a bunch of fructose hanging around waiting to get absorbed, it attracts water into the small intestine and because absorption is slow and inefficient, a portion of fructose will travel to the colon to get fermented by bacteria. These actions once again cause abdominal pain, bloating, distention, gas, and altered bowel habits (often times diarrhea). Fructose is found in fruit (and some vegetables). Fruits and veggies with excess fructose include apples, cherries, figs, mangos, pears, asparagus, sugar snap peas, and Jerusalem artichokes. Sweeteners such as honey and high fructose corn syrup are also sources of excess fructose.

15. Polyols Polyols, also known as sugar alcohols, make up the last FODMAP subgroup. The polyols that cause many of our digestive woes are sorbitol and mannitol. Similar to excess fructose, the absorption of sorbitol and mannitol is a slow and inefficient process. If present too long in the small intestine they will draw water into its lumen, while any of the polyols not absorbed will be fermented in the colon causing symptoms in those with IBS.
Sorbitol is found in sweet corn, avocados, apples, blackberries, pears, lychee and stone fruit (apricots, peaches and plums). Mannitol is found in cauliflower, mushrooms and snow peas. In addition to sorbitol and mannitol, there are other polyols that are added to foods as sugar-free sweeteners including maltitol, xylitol, and isomalt. These are often found in sugar-free candy and chewing gum and should also be avoided on the low FODMAP diet.

16. Thank you for reading/listening Presented by BHARATH VINOD(72-B) AND VYAS AAMLAN PRAKASH(72-A)