LOW FODMAPS DIET AND INTESTINAL HEALTH: WHEN AND WHO TO APPLY TO?

The low FODMAPs diet consists of temporarily restricting foods rich in FODMAPs to control intestinal symptoms until “trigger foods” are identified.

And what foods are rich in FODMAPs?

There are several foods rich in FODMAPs. In the list below I bring some examples:

  • Fruits: apple, pear, peach, mango, watermelon, nectarine, cherry, avocado, dried fruit ;

  • Various dairy products: cow, goat or sheep milk, ice cream, yogurt (even skim), cheese fresh and creamy (ricotta, cottage, cream cheese);

  • Vegetables and legumes: Artichoke, asparagus, beets, broccoli, cabbage, garlic, leeks, okra, onion, cauliflower, peas, chickpeas, beans, lentils;

  • Cereals and pastas: breads, cakes, cookies or cereals containing wheat and rye and cereals with syrup corn.

As there are many foods rich in FODMAPs, the level of restriction is great, making the diet quite complex. The chances of inadequate intake of fibers, micronutrients and bioactive compounds are very high, which can lead to constipation, nutritional deficiency. That is why it is so important to know who to apply for, for how long and how to prescribe.

FODMAP-диета при метеоризме: что можно, а что нельзя есть при газах в животе?

So, for whom to prescribe the Low FODMAPs diet?

In some cases of SIBO ( intestinal bacterial overgrowth syndrome ), patients experience symptoms such as bloating, pain, gas, bloating, and may present complications due to the change in the permeability of the intestinal barrier. SIBO is very prevalent in Irritable Bowel Syndrome, Crohn’s Disease and Celiac Disease, for example, and the evidence shows that patients with SIBO can benefit from a diet low in FODMAPs.

In cases of Irritable Bowel Syndrome, a review article published in World Journal of Gastroenterology, entitled: Diet in irritable bowel syndrome: What to recommend, not what to forbid to patients! (Diet in Irritable Bowel Syndrome: what to recommend and not what to prohibit for patients!), Showed first and second line approaches to treatment:

  • The first line treatment consists of reducing caffeine, pepper and lactose, and increasing fiber soluble (psyllium) and liquid (1.5 – 3 liters);

  • The second line treatment consists of eating a diet low in FODMAPs, that is, restricting mainly monosaccharides (fructose), disaccharides (lactose), oligosaccharides (GOS and FOS) and polyols (xylitol, mannitol, sorbitol) .

When we prescribe a diet with so many restrictions, we have to be careful to inform the patient what he can include in the diet during the low FODMAPs diet, which is why we also have the list of foods low in FODMAPs.

Here are some examples:

  • Fruits: banana, blackberry, carambola, grape, pineapple, melon, kiwi, lemon, lime, orange, tangerine, strawberry, passion fruit.

  • Dairy: lactose-free milk, lactose-free yogurt, soy milk, rice or almond milk, butter.

  • Vegetables and legumes: Bamboo shoots, carrots, celery, corn, eggplant, lettuce, chives, cucumber, pumpkin, zucchini, lettuce, tomato, spinach, potato, sweet potato.

  • Cereals and pastas: gluten-free flours, breads, macaroni and biscuits, products with corn flour or cassava, quinoa, rice, tapioca, rice noodles.

Food maps диета: FODMAP Диета для проблем с кишечником – FODMAP диета: меню на русском – База знаний игры R2 Online

I am also careful to pass the options of the meal plan in the format of meals, so that the patient does not have to follow only a list of foods. The menu must be calculated according to your particular tolerance,  to your food preferences. In addition, it is also necessary to offer options for culinary preparations with the ingredients that the patient can use, with simple and practical recipes that generate more adherence to treatment.

Here is an example of a delicious and super easy bread recipe:

 low banana bread recipe

Ingredients:

– 4 eggs

– 1 teaspoon of vanilla extract (optional)

– 3 very ripe bananas

– 1/2 cup of coconut oil

– 1/2 cup of almond flour

– 1/2 cup of coconut flour

– 1 teaspoon of chemical yeast

– 1 teaspoon of cinnamon

– 1 pinch of salt

Method of preparation:

Preheat the oven to 180ºC. In a bowl mix the dry ingredients (except yeast) with the mashed bananas. In an electric mixer, beat the eggs with the vanilla and coconut oil. Then add the dry ingredients and beat until a homogeneous mixture is obtained. Place the dough in a greased form and bake for approximately 45 minutes at 180ºC.

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