What is the low FODMAP diet?
The low FODMAP diet is a dietary approach developed by Monash University to improve the symptoms of people suffering from irritable bowel syndrome (IBS). The diet limits foods that have been shown to aggravate the gut and cause IBS symptoms including intestinal bloating, gas and pain. These gut-aggravating foods are a high in a group of sugars called FODMAPs. Following the low FODMAP diet has been shown to improve the symptoms of 3 in 4 individuals suffering from IBS symptoms. However when combining a low FODMAP and vegan diet together, it can become very difficult to follow.
What are FODMAPS?
FODMAP is an acronym describing a group of short-chain carbohydrates (or sugars) which are found both in food and food additives. FODMAPs are quickly fermented by healthy bacteria that reside within your intestines. When these are fermented, they pull more water into your gut, which cause gas (hydrogen and methane) to be produced. This can also cause bloating and distention and impact the way muscles in your gut contract. As a result, you can experience symptoms of wind, abdominal bloating, diarrhoea and constipation.
What does FODMAP stand for?
F - Fermentable
Process through which gut bacteria ferment undigested carbohydrate to produce gases
O - Oligosaccharides
Fructans & GOS - found in foods such as wheat, shallots, barley, inulin, rye, onions, garlic and legumes/pulses (chickpeas, lentils, kidney beans).
D - Disaccharides
Lactose - found in dairy products like milk, soft cheeses and yogurts.
M - Monosacchardines
Fructose - found in honey, apples, high fructose corn syrups, mango, pear and watermelon.
P - Polyols
Sorbitol & Mannitol - Found in apples, apricots, nectarines, pears, plums, prunes, mushrooms, sorbitol (420), mannitol (421), xylitol (967), maltitol (965) and isomalt (953).
How does the diet work?
The low FODMAP diet is recommended to be followed under the supervision of a qualified dietitian who has experience in the specialised area. The diet begins with an "elimination phase" - a two to six week period of high restriction where FODMAP-containing foods are reduced and eliminated in the diet. This is then followed by a "challenge phase", where FODMAPs are gradually reintroduced and challenged whilst the baseline low FODMAP diet is maintained.
Is the low FODMAP diet right for me?
It is important to seek out a definitive diagnosis of Irritable Bowel Syndrome from your GP or gastroenterologist to ensure there are no other underlying medical conditions that could be a potential cause of symptoms. It is important to rule out other functional gut disorders such as Coeliac Disease, Ulcerative Colitis and Chrons Disease. This may require you to have a series of blood and/or stool test. It is essential to undergo this process as if these conditions are not diagnosed and left untreated, there potentially could be serious, long term health consequences.
Should I stay on the low FODMAP diet forever if it is improving my gut symptoms?
No, FODMAPs are actually very important for us. They are a fuel source for our good gut bacteria which in turn produce short-chain fatty acids which have a wealth of health benefits. Recent research has shown that following a strict low FODMAP diet for a long period of time can reduce levels of certain beneficial bacteria in the gut.
The goal of the low FODMAP diet is to improve the health your gut by giving your gut time to rest, then, to reintroduce certain foods back into your diet over a controlled period of time. We only recommend the diet to be followed for 2 - 6 weeks due to it's restrictive nature. It is especially important to complete the diet (elimination and challenge phases) as a vegan, as the diet cuts out a lot of food if you are following both dietary patterns. This may put you at risk for deficiencies of certain nutrients (it also gets very boring).
Can I follow the low FODMAP diet as a vegan?
As FODMAPs are only found in plant-based food (besides lactose), this can make the low FODMAP diet particularly difficult to complete whilst also following vegan diet. Yes it can definitely be done, but be warned that the it will reduce the variety of foods you are eating and you may find yourself getting bored quite easily. This reinforces the importance of completing the reintroduction challenge phase of the diet.
What can I eat as a vegan?
Egg alternatives: flax-egg, chia-egg.
Milk alternative: soy milk (made from soy protein e.g. santarium), macadamia milk, almond milk, rice milk
Fruit: rockmelon, grapes, green banana, strawberries, orange, kiwi fruit, mandarin, pineapple, honeydew melon, passionfruit, raspberries.
Vegetables: eggplant, green beans, bok choy, capsicum, carrot, cucumber, lettuce, potato, tomato, zucchini, kale, spinach, choy sum, lettuce, chinese cabbage, Jap (kent) pumpkin.
Grains: corn flakes, oats, quinoa flakes, quinoa, rice, corn pasta, rice cakes, sourdough spelt bread, wheat/rye/barley free breads, millet, bean thread noodle, polenta, buckwheat pasta, gluten-free pasta (made from rice, potato, corn)
Proteins: firm tofu, tempeh, red kidney beans (up to 1/2 cup), brown lentils (up to 1/2 cup).
Nuts & seeds: sunflower seeds, chia seed, flax seed, pumpkin seed, brazil nuts, macadamia, peanuts, walnuts.
Condiments: dark chocolate, maple syrup, table sugar, rice malt syrup, soy sauce, vinegar, coconut milk, lemon juice, fresh herbs, dried spices.
Drinks: cacao powder hot chocolate, peppermint tea, white or black or green tea, water.
Top mistakes to avoid:
1. Check your soy milks
Milks made from soy beans are high FODMAP whilst those from soy proteins are low FODMAP.
2. Don't start a probiotic at the same time
Probiotics are live microorganisms that can lead to health benefits in the gut. There is some evidence that probiotics can help with IBS symptoms, but this may vary depending on which probiotic preparation is used. We recommend that you try one management strategy at a time; commence the low FODMAP diet first. If you have not achieved good symptom control after two to six weeks, consult with your dietitian. At this review-stage, you can discuss other management strategies and the possibility of introducing probiotics.
3. Be ware of meat-alternatives
Vegan meats made with gluten are low in fodmaps (e.g. seitan) , but not those made from soy!
4. Be careful of canned beans!
In canned legumes (lentils and chickpeas) the water-soluble FODMAPs (GOS) leach out of the legume into the brine mixture. So, if you’re eating a low FODMAP diet, make sure that you discard the brine and wash your legumes before use.
What if nothing works?
Not everyone find that the low FODMAP diet improve their symptoms. If you are one of the one in four individuals with IBS that don't experience any benefit, there are a few other alternative therapies that may be of assistance. This includes probiotics, medication, clinically-trialed herbal preparations (e.g. Iberogast) or gut-directed hypnotherapy.