FODMAPs stands for Fermentable Oligo-saccharides, Disaccharides, Mono-saccharide, And Polyols.

All those O, D, M, P terms sounds confusing, but they refer to certain types of sugar/ carbohydrates groups.

Oligo-saccharides has subcategories of Fructo-oligosaccharides (FOS) found in wheat, rye, onions and garlic, and Galacto-oligosaccharides (GOS) found in legumes/pulses.

Disaccharides is the Lactose found in dairy, like milk, soft cheese, yoghurts.

Mono-saccharide are the Fructose (in excess of glucose) found in honey, apples, high fructose corn syrups etc.

Polyols – Sugar (eg. sorbitol, mannitol) found in some fruit and vegetables and used as artificial sweeteners.

Some people cannot digest some, or all, of these sugars/ carbohydrates in their small intestine, so they end up in the large intestine, where they ferment. This is the process through which gut bacteria degrade undigested carbohydrate to produce gases (hydrogen, methane and carbon dioxide). Source

The gases cause bloating, swollen tummy, pain and cramps, constipation. Diarrhoea occurs when water is drawn into the bowel by these carbohydrates/ sugars. Source

I began a Low FODMAP way of eating in 2015, after being diagnosed with Irritable Bowel Syndrome (IBS). For several years I had suffered gastrointestinal issues and upset, like bloated, swollen tummy, constipation to diarrhoea, generally feeling off. I believe that my poor gut health related to years of taking antibiotics and NSAIDS medications like nurofen, for sinus issues that happened after I moved to Canberra in 2008. I finally saw my GP about the ongoing tummy issues, and only wish I had done it sooner.

Although we were not perfect with our eating (too many treats sneak in), but even when eating fairly well, following elements from a real food/ nourishing traditions type diet, including eating lots of fruit and veges, good quality grassfed meat and broth, having honey instead of sugar, having full fat pasture-raised dairy… I still had the issues.

It turns out some of those fruit and veges, that honey, the lactose in dairy… they were not good for me, as I could not digest them any more. Things that I had been eating for many years, all my life, like watermelon, corn, beetroot, avocado, chickpeas, lentils… why was I not tolerating them? Looking back, I realise my gut health & microbiome had been compromised. Read more about microbiome in this fascinating book, 10% Human by Alanna Collen (there are many others out there too).

The foods I could no longer seem to eat without experiencing side effects within a couple of hours (lasting up to three days) are high in certain types of sugar (carbohydrates), that some people cannot digest in the small intestine, so the foods ferment in the large intestine, and the naughty bacteria/ microbes have a party. They have so much fun feeding off the sugars, they produce gas, which leads to bloating, and upset tummys.

I was diagnosed by my gastroenterologist with Irritable Bowel Syndrome, IBS, which is pretty much saying nothing else serious showed up in my tests or colonoscopy, and the symptoms fit. His dietician recommended trying the Low FODMAP way of eating, and gave me information about Monash University research including the booklet, and told me about their Low FODMAP Diet  app. The app gives you a handy thorough and updated guide to which foods are High or Low in FODMAPs, plus lots of other information.

Even though I had heard of this diet years before, I had been reluctant to try it, because it seemed complicated (even after years of eating gluten free, and making other big changes before) and involved giving up garlic! But I was willing to give it a try, because at that point I was so sick of being bloated and rushing to the toilet! My husband was also keen to try as his gut health had never been great, so we immediately made some changes, and gradually made other changes over a couple of weeks.

The Low FODMAP diet does not mean you have to give up your favourites forever! (Yay) After you have done a full elimination diet, and resolved your gastrointestinal symptoms, you can trial reintroducing some categories of sugars/ carbs carefully, and see how you do with them, one a time. Talk to your dietician, and check out the Monash Uni information.

You may find it is only certain sugar groups that affect you, that you need to reduce or avoid longer term. Or you may find you can heal your gut and tolerate everything again.

If you do have ongoing issues, or find a particular type of sugar/ carb group that you don’t tolerate very well, you may find that if you keep your overall FODMAP intake low over the course of a day/ week, you may be able to have small amounts of those things that are considered high in FODMAPs, like a small amount of guacamole on nachos. But don’t have cheesy bean nachos with guacamole, sour cream, corn salsa and a watermelon margarita in one day!

GARLIC AND ONION

• I substitute garlic and onion with Cobram Estate infused oils (available through many supermarkets, or direct from the website. There may also be other brands). They are also very convenient to use, no peeling, chopping or tears!
• Cobram Estate Garlic Infused Olive Oil – 1 teaspoon equals about two garlic cloves
• Cobram Estate Roast Onion Infused OIive Oil – 2 teaspoons equals about one medium onion
• You can fry garlic and onion slices in oil, then remove the pieces and continue making your meal using the flavoured oil. The sugars from garlic and onion will not leach into oil, however, they will leach in to water.
• You can use the green part of spring onions/ scallions, or leeks too (not the white bulb).
• Try adding other seasonings, like ginger, lemongrass, bay leaves (whatever suits the dish) to add oomph!

DAIRY

• Lactose free milk (which simply has the lactase enzyme added to it) – there are a couple of brands available in Australian supermarkets fresh or long life dairy sections, including Pauls Zymil and Liddells, or you may be lucky and can source Barambah Organics lactose free milk
• You can also buy Lactose Free cheese, yoghurt, ice cream, cream cheese, custard and sour cream, UHT milk and UHT cream – the Liddells range may be available in your local supermarket, or the Pauls Zymil range (though it isn’t as extensive)
• Hard/ aged cheeses are low in lactose, but the fresh cheeses (cream cheese, ricotta) are moderate in lactose
• Lacteeze tabs are tiny chewable tabs that contain an enzyme to help digest lactose (buy them over the counter at the chemist)
• You may be able to tolerate goats milk, almond milk (although almonds are high FODMAPs, apparently almond milk is not) and some canned coconut milk (make sure it doesn’t contain inulin) 

FRUIT AND VEGES, NUTS

• I used the guide on the Monash Uni Low FODMAP Diet app to buy fruit and veges, and find suitable options, so I am never missing out on my intake of lots and lots of veges (zucchini, green beans, carrot, kale, capsicum, swede, potatoes, Asian greens, lettuce, cucumber, tomatoes, sprouts, Jap pumpkin, some sweet potato, some broccoli) and some fruit (citrus, grapes, pineapples, bananas, honeydew melon, berries)
• I use macadamias, pecan and walnuts, as well as sunflower seeds and pepitas, in small amounts

SEASONING MIXES AND FLAVOURINGS/ MEAL BASES

• Make your own seasoning mixes from scratch, such as Low FODMAP Nacho Seasoning
• Make your meals using safe sauces and herbs/ spices, instead of buying bottles of ready made sauces, like quick and simple Sticky Chicken, or meal prep in advance, making sauces and keep in containers in the fridge (or freezer) until needed
• Make your own Low FODMAP curry pastes

Eating out whilst following a Low FODMAP diet can be tricky. We don’t eat out that often, but when I do, I avoid dishes with high or obvious FODMAPs.

A few great resources:

How to Eat Out on a Low FODMAP Diet by A Little Bit Yummy

Eating Out on a Low FODMAP Diet by FODMAP Challenge

Eating out on a Low FODMAP Diet by Monash University

Avoiding high FODMAP foods is one thing that helps, but I think it is also important to boost your ability to digest by improving gut health. There is a lot of information available, including many good books to find researched and new details about the effects of our microbiome on our health, and ways to boost the diversity in our gut ecosystems.

I am not a dietician, nutritionist or alternative food specialist, so I cannot advise you the best way forward for your own health. This is just what I am doing.

I have been trying to boost my good microbes and heal my gut, with

• increase vege intake, with low FODMAP veges, herbs and fruit, organic where possible, which feed the good bacteria and increase the diversity
• probiotics (I use GutPro3) and by making lactofermented foods, like carrot kraut, kimchi and dill pickles, plus have occasional kombucha
• consuming bone broth that I make using organic grassfed beef bones, or organic free range chicken carcasses (I drink it, make it into soup, gravy or in place of stock in risottos etc)
• gelatine (I use it in gummies or desserts) and collagen hydrolysate (a non-gelling protein, in smoothies, desserts etc) – I have just recently swapped to this brand
• reducing refined sugar and processed foods in general
• avoiding antibiotics, where possible, and antibiotic products (like handwash, lozenges)
• avoiding nurofen, naproxyen and other NSAIDs

Monash University Low FODMAP Diet

Kate Scarlata