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The Low FODMAP Diet: The Good, The Bad, And The Ugly.

May 7, 2020

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Let me clear the air on one thing before we start talking about the low FODMAP diet.

The low FODMAP diet is not your only solution to eliminating gas, bloating, diarrhea and constipation, and overall inflammation in the gut. In fact, it’s not the strategy I recommend you follow at all. Why? Because the low FODMAP diet is quite restricting, it eliminates some of the world’s healthiest foods, and it can actually create unfavourable changes in the microbiome in the long run (1). In other words, if you follow the low FODMAP diet for an extended period of time, you may see decreased numbers of beneficial bacteria in your gut, including lactobacillus, which, we know are incredibly health promoting bacteria species. This has been supported by numerous clinical research studies.

The fact that you cannot digest high FODMAP foods sends the signal that your colon and the trillions of microbes that inhabit it, are out of balance, and there’s a reason why you’re unable to consume certain amounts of these foods.

The real solution to getting around this problem lies in your ability to:

  1. Reduce stress (and as a result, strengthen digestion)
  2. Increase absorption and the breakdown of high FODMAP foods (again, digestion needs work)
  3. Address stomach acid levels (because stomach acid is needed for breaking down foods such as FODMAPs).
  4. Reduce inflammatory foods in the diet
  5. Start with small amounts of FODMAP rich foods and work your way up
  6. Utilize supplements, probiotics, and other food therapeutics to repair the damage done to the gut
  7. Partake in a short term commitment to receive a long term gain

But before you can even try to manage your consumption of high FODMAP foods, let’s look a little more closely at what they even are:

First, the O in FODMAPs stands for “oligosaccharides”. Oligosaccharides are made of multiple chains of monosaccharides (mono = 1). The D stands for disaccharides, which are made of two monosaccharides, and the M stands for monosaccharides. Despite all of this jargon, just know that these are all chains of carbohydrates that must be broken down into their components in order to be absorbed in the small intestine.

The last type of compound in FODMAPs is P, or polyols. These compounds, also called sugar alcohols include sorbitol, mannitol, and xylitol, which are added to foods, mints, and chewing gum because they taste sweet. But sorbitol, mannitol, and xylitol are not absorbed into the bloodstream and, like undigested oligosaccharides, disaccharides, and monosaccharides, they pass from the small intestine to the colon before being eliminated. In addition to lactose, I truly believe that we don’t need to be consuming these in excess, as they are not whole foods, and were only added to food starting in the 1960s.

You might think that a low FODMAP diet is the answer for someone who has symptoms like bloating, gas, etc, but that’s not necessarily the case, as all of the high FODMAP foods, with the exception of lactose (a disaccharide), are incredibly health promoting and are directly associated with positive changes in the gut microbiome. This is probably due to the fact that these foods are high in a variety of types of fibre, and directly feed the bacteria in your gut that create short chain fatty acids (the fuel for the cells that line and protect your gut lining and help reduce your risk of intestinal permeability).

And when we consider that a poorly composed microbiome (imbalance of bacteria) is part of the problem for those who have IBS, it truly doesn’t make sense to cut them out, especially in the long term.

Getting to the root

For the most part, humans can produce enzymes needed to break down FODMAP foods into their individual subunits. Most people can handle modest amounts of grains and beans fairly well, but those who have GI disturbances and are living with a condition like IBS may not be so lucky. Why? The science is pointing toward disturbances in the colon and your gut microbiome, as well as faulty digestion. 

Here’s why you most likely cannot break down, digest, and absorb high FODMAP foods:

Part 1: Faulty Digestion: These chains of carbohydrates need enzymes to be broken down, and usually faulty digestion equates to inadequate enzyme numbers as well as low stomach acid and thus, the inability to further break them apart (stomach acid is necessary for proper digestion). As a result, we see partially broken down carbohydrates enter the large intestine where the bacteria ferment them (hence the F for fermentable in FODMAP) and produce gas.

Part 2: Dysbiosis in the Microbiome: It’s hard to say what an “ideal”? microbiome looks like, but we do know that the greatest predictor of a healthy microbiome is the diversity of plants you eat, and that symptoms such as bloating, gas, diarrhea, and constipation are a sign that the microbiome is experiencing some level of dysbiosis (or imbalance). This typically occurs due to a number of reasons, but can include a history of antibiotic use, high consumption of processed foods and animal foods, and a high stress lifestyle.

It’s a vicious cycle, because animal products are broken down by microbes that are efficient at processing bile acids (because bile is needed to digest animal foods) during the final leg of their digestion in the colon. We know, for a fact, that these species of bacteria are also associated with increased incidences of inflammatory bowel conditions like IBD and IBS (2).

So when we eat these foods in excess, not only are we crowding out more health promoting species of bacteria (like any ecosystem, what you feed, will flourish), but we’re also making it harder on ourselves, because the species that break down fibre start to die off. And here begins the cycle, of the inability to break down fibre rich foods, then, eating more animal foods because they “feel”? better, and continuing to feed these pathogenic bacteria and starve the bacteria that are efficient at breaking down FODMAPs and other carbohydrates. And as I’m sure you can guess, any attempt at eating fibre rich foods moving forward goes sideways and we start to associate plant foods with unfavourable symptoms, discomfort, pain, and sickness.

What’s your exit strategy?

So as I’m sure you can probably guess, eliminating high FODMAP foods for 2-3 months, and then reintroducing them without an exit strategy will usually not fix the problem. In fact, if you continue to eat the same way (ample animal products and other inflammatory foods) minus high FODMAP foods, during the duration of the diet, it may only make your symptoms worse. Moreover, we know that following this diet can reduce microbial diversity (1), and diversity of bacterial species in the microbiome is the only chance we have at truly repairing the gut.

As it so happens, many of the foods that are a firm “no”? when following a low FODMAP diet, are also the foods that happen to be the best at improving microbial diversity, strengthening the microbiome, and promoting the health of the mucosal lining of the colon. Without these foods, we’re only heading toward the path of continued dysbiosis.

So if the low FODMAP diet isn’t for me, then what can I do?

Well, for starters, you can book in for a free 15 minute discovery call with me to uncover a sound strategy that will take you from gas, bloating, diarrhea, and constipation to balance, energy, vibrancy, and feeling like your’e yourself again. If you’re finally ready to feel at peace with your body, and start listening to it, rather than fighting with it, this is your time. This is your path, and you are in the right place.

Book your free call here, and I look forward to chatting with you and getting you back on track soon!

References:

(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6062106/

(2) https://www.ncbi.nlm.nih.gov/pubmed/28388917

(3) https://www.healio.com/gastroenterology/irritable-bowel-syndrome/news/online/%7B865c905a-80be-4e2e-a98c-b667454086ab%7D/gut-microbiome-profiles-predict-response-to-low-fodmap-diet-in-ibs

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