August 01, 2019 at 04:00PM by CWC
Everyone likes to giggle when someone farts in yoga class or when they hear the word diarrhea, but having your life continuously affected by digestive problems is far from funny. Always being aware of the nearest bathroom, skipping important events in fear of an upset, eating the same foods on rotation because you’re scared to eat anything else…it can be paralyzing and majorly disruptive to a person’s life.
For many, being put on a low-FODMAP diet for IBS or other gut issues can be life-changing—it can provide the framework to pinpoint troublesome foods and allow someone to start eliminating their symptoms. The eating plan focuses on six different types of short-chain carbohydrates—fructose, lactose, fructans, galactans, and polyols —which can cause digestive distress in some. On a low-FODMAP diet, a person eliminates foods with high concentrations of FODMAPs and then slowly phases them back in, one category at a time, to determine which of the groups are causing a person’s digestive issues.
Again, the eating plan is really helpful to people with digestive problems. But gastroenterologists say there is quite a bit of mixed information out there on the eating plan. Here, three gut health experts set the record straight by dispelling the most common myths they hear about the low-FODMAP diet.
Myth 1: Stay far away from everything on the “don’t eat” list.
Anyone who has ever attempted the low-FODMAP diet can tell you that the list of foods you can’t eat is long, especially in the beginning phases of the eating plan. Cauliflower, avocado, watermelon, wheat, hummus… all off-limits. Except they’re not. “A lot of people will find that they can tolerate a little of FODMAP foods and it’s only when they have too much that they start experiencing symptoms,” says integrative medicine doctor and Happy Gut author Vincent Pedre, MD. “You could have a quarter or half an avocado and be completely fine.” The key, he says, is seeing how your body reacts to a food in small amounts, then testing your limits by increasing it in small increments. If you start to feel gassy or bloated, then you know your limit.
Plus, everyone’s experience with the diet is a little bit different. “Depending on the makeup of the gut, there are going to be different tolerances among people following the low-FODMAP diet,” Dr. Pedre says. In other words: your microbiome looks totally different than your mom’s or your best friend’s—even if you’re all following the low-FODMAP diet, your trigger foods could vary.
Myth 2: The low-FODMAP diet helps alleviate all digestive issues.
Sometimes, Dr. Pedre says, the low-FODMAP diet is not the right course of action to take because it could mask the real problem occurring. “Someone might just be intolerant to dairy or gluten, not FODMAP foods, or they could have Small Intestinal Bacterial Overgrowth, which would require a different treatment plan,” he says. Because it can be so complicated to pinpoint what exactly is causing distress, Dr. Pedre says it’s important to work with a doctor and not try the low-FODMAP diet on your own with no guidance—especially since it might not even be necessary.
Myth 3: It’s okay to cut out all low-FODMAP foods long-term.
This is the biggest misconception integrative medicine doctor and gastroenterologist Marvin Singh, MD says he sees. “Sometimes people think this is how they have to eat their whole life. That isn’t the case,” he says. “You may need to eat in this way for a period of time but we hope that things will improve and you can liberalize your diet.”
Melanie Klesse, MS, RD, a registered dietitian who works with low-FODMAP food delivery service Epicured agrees: “The low-FODMAP diet is not a lifelong diet. Instead, going through the phases of the diet—elimination, reintroduction, personalization—is meant to help you figure out what triggers your individual symptoms. The goal is for you to be in control and to have the least restrictive diet possible to maintain a healthy microbiome and a good quality of life.”
Myth 4: Once you decide to end the low-FODMAP diet, you can eat whatever you want.
As with Whole30, once you finish the elimination portion of the low-FODMAP diet, it’s not a good idea to just go back to your old ways of eating. Jacob Skeans, MD, a gastroenterologist at Ohio State University’s Wexner Medical Center, explains it’s important to introduce foods incrementally and individually so you can figure out exactly what’s bringing imbalance to your gut. “[The diet works best when] you remove the foods for six to eight weeks, then gradually reintroduce them,” he says. Another reason for this, he adds, goes back to Dr. Pedre’s point of everyone’s list of trigger foods looking different.
Myth 5: The low-FODMAP diet is about food and that’s it.
Dr. Pedre says he often sees patients who say they’re sticking to the low-FODMAP diet but are still experiencing gut probs. Barring other undiagnosed gut issues, Dr. Pedre says anxiety often can play a role. “Someone could be checking all the boxes externally, but they just need to relax,” he says. “You can’t heal the gut if you’re overly anxious or stressed and constantly in fight-or-flight.” The mind-gut connection is real and your anxiety could be making you sick. “Diet changes are not a cure-all,” Kleese adds. “Although the low-FODMAP diet relieves symptoms in the lion’s share of patients struggling with IBS, lifestyle factors like stress, medications, and hormonal changes can all trigger symptoms as well.”
Myth 6: Low-FODMAP food automatically means suffering through a few months of bland food.
As someone who works directly with chefs curating low-FODMAP meals, Kleese can tell you the low-FODMAP diet does not have to be boring or flavorless. “For any food-lover following a low-FODMAP diet, one of the biggest challenges is avoiding garlic and onions. But there is a work-around,” she says. “Try making—or buying— garlic- or onion-infused oil. The infused oils don’t trigger symptoms because the FODMAPs in garlic and onion are water-soluble, not fat-soluble, so they can’t get into the oil.” Kleese adds that there are also low-FODMAP cookbooks, Facebook groups, brands, and of course meal delivery services like the one she works with that make following the eating plan much easier.
Myth 7: Anyone can safely try the low-FODMAP diet.
“If you may have an eating disorder, are having problems with gaining weight, are pregnant, or have other medical issues that would become complicated by a restrictive diet, then you should consider whether or not this type of diet is the best for you in conjunction with your medical doctor,” Dr. Singh says. It’s important to be totally up-front with your MD or dietitian about your full physical and mental well-being so they can figure out a treatment plan that works best uniquely for you.