However, a low FODMAP education can’t stop with the elimination diet. Patients must be instructed on how to reintroduce FODMAPs as tolerated. A low FODMAP diet should only be as restrictive as symptoms require.
Perhaps you’re wondering the same?
Many high FODMAP foods are fruits, vegetables, beans, legumes, and nuts. In other words, they’re plants, and the key to a healthy dietary pattern is eating a variety of wholesome foods, mostly plants. Why deprive yourself of these valuable nutrients if you don’t have to?
Some of these nutritious plants are prebiotic fibers, meaning they serve as food for your beneficial microbes in your intestines. A healthy gut microbial balance is key to good health. A low FODMAP diet has been shown to reduce the abundance of beneficial bacteria, although its long-term effect on the gut microbiota is unknown.
Low FODMAP diets tend to be low in fiber. Switching from whole wheat bread to rice cakes, eliminating favorite vegetables without replacing them with low FODMAP vegetables, and snacking on potato chips instead of dried fruit are a few examples of how people cut back on fiber when they cut down on FODMAPs. Reintroducing favorite high FODMAP vegetables, fruits, and other plant foods adds both flavor and fiber.
All restricted diets pose a risk for nutritional deficiencies. While people following a well-balanced and varied low FODMAP diet can meet their nutritional needs, those with other dietary restrictions may not. For example, vegans and vegetarians have limited protein options since many plant proteins and dairy products are high in FODMAPs. Adding back beans, legumes, or dairy (for vegetarians) will make it easier for these folks to meet their protein requirements.
Dining at restaurants or friends’ houses can be especially challenging on a low FODMAP diet, even with the best intentions. High FODMAP foods, like onion and garlic, sneak their way into most recipes. Knowing your tolerance to these foods, and others, gives you more control and confidence eating meals prepared outside your home.
You might be surprised by your ability to tolerate higher FODMAP foods, but you won't know until you try.
For more detailed instructions on the FODMAP challenge phase, I recommend you consult with a knowledgeable dietitian and/or check out Patsy Catsos' new book The IBS Elimination Diet and Cookbook.