We were SO lucky to have Jaci Barrett and CK Yao, two of Monash Uni’s low FODMAP diet experts and researchers on a worldwide twitter FODMAP chat last night. For those of you that stay clear away from twitter or simply didn’t have time to follow along (or it was too late to join in…it started at 11 PM UK time), here is a little recap.
First, I have to say, the chat was well attended and it is clear the interest in the low FODMAP diet is increasing. I really loved seeing a global presence on twitter last night for this chat on FODMAPs. How cool is that?
Here are some of the questions and answers that we discussed:
Where can we get the most up to date FODMAP food info? The Monash Uni low FODMAP diet app was the overwhelming response. And be sure you select the Monash University app which has the latest and most accurate info! The app will be updated in a few months. Another great place to look for new info on FODMAPs is the Monash site found here! Recent tea updates can be found here. And know that by purchasing this app you are supporting more FODMAP research….which helps all of us!!
If a person only experiences minimal improvements on the low FODMAP diet what should be trialled next? There were a few ideas suggested including:
- Evaluate for small intestinal overgrowth (SIBO) but the researchers cautioned that current testing methods are not very accurate.
- Make sure the low FODMAP diet is being followed accurately.
- Consider food chemical sensitivity–salicylates, amines
- Get evaluated for pelvic floor dysfunction.
- Be sure fiber intake is adequate
- Gut directed hypnotherapy
Fiber intake can be reduced for some on the low FODMAP diet. What are some good low FODMAP fiber sources? Low FODMAP fruits and veggies were recommended. Oat bran, rice bran, linseeds (flaxseeds), chia seeds, buckwheat, quinoa were also mentioned as top fiber without FODMAP food sources. Linseeds (flaxseeds) have been difficult to test due to their gelling nature–so limit to tolerance since we don’t have an exact cut off limit.
Any thoughts on the use of digestive enzymes, fructosin, beano for those with IBS? These have not been thoroughly tested in those with IBS. Here is a paper on fructosin for those interested in learning more. There are more studies forthcoming in this area.
Malto-oligosaccharides are being added to yogurt in the US. Are these fibers FODMAPs? This added fiber supplement should be adequately broken down by human digestive enzymes therefore is not a FODMAP.
What about probiotic use? When should they be added to the diet—before, during or after low FODMAP trial? Bifidobacteria infantis 35624 & bifidobacteria animalis have the best efficacy for IBS. Bifidobacteria animalis may increase stool frequency so perhaps not best option for diarrhea-predom IBS. There is no evidence for use of probiotics pre or post low FODMAP diet. Likely probiotic benefits are individual and more research is needed in this area for IBS patients.
Does cooking alter FODMAP content? Veggies that are cooked in water will lose some of the fructans and GOS into the water but cooking produce in water also leads to less nutrients in the food. Canned legumes have less FODMAPs as some of the FODMAPs leach into the liquid and then are drained off and removed. Sourdough processing can reduce FODMAPs (fructans) in breads to varying degrees depending on processing time etc Trial of spelt or oat sourdough bread might be well tolerated! In the US, Westbrae canned lentils without any onion/garlic may be worth a trial.
Do different varieties of wheat have different FODMAP content–einkorn, spelt, kamut? According to Jaci Barrett, only spelt has been tested for FODMAP content recently at Monash Uni. So…it will be interesting to learn more about this ancient wheat grains and their FODMAP content at a later date. Sourdough spelt bread tested in Australia is low enough in FODMAPs to be allowed on elimination phase of the diet.
Should the low FODMAP diet be followed for life? Any risks? Should family members be following along w/ the low FODMAP diet. The short answer: NO. The low FODMAP diet reduces beneficial gut bacteria and this may lead to unwanted health risks down the line. Try to limit use of the diet for 4-6 weeks and work with a dietitian to re-introduce/re-challenge FODMAPs to determine what foods you can add back and which may need to be reduced due to triggering symptoms.
We’ll try to connect with the Monash researchers again….maybe later in the year for more updates. The low FODMAP diet is evolving right before our eyes….and changes with food analysis will be forthcoming!