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FODMAP’S™

Sufferers of IBS are all too familiar with the symptoms of wind, pain, bloating and either diarrhoea or constipation (or fluctuations between the two for some sufferers). Trialling a low FODMAP’s diet (fermentable oligosaccharides, di-saccharides, mono-saccharides and polyols) is a great step to determine dietary involvement in your symptoms and to begin piecing together the puzzle of what food components may be acting as triggers for your symptoms, and also what amounts of those foods are required to initiate the onset of your symptoms.

A dietary approach to determine sensitivity to a group of carbohydrates found commonly amongst dietary choices:

• Fructose – Primarily found in fruits and honey, fructose is absorbed with glucose, also found commonly in the diet. Foods with an imbalance of fructose to glucose may result in poor tolerance in some individuals. Excess intake of any fruit should be minimised as a ‘build-up’ of fructose may result in the onset of unpleasant symptoms.

• Lactose – The sugar found in dairy products such as milk and yoghurt. There is a significant amount of individual variation for tolerance of lactose, with foods such as yoghurt, hard cheeses and small amounts of milk in beverages generally tolerated with greater success.

• Fructans – Wheat, rye and some vegetables are the key sources of fructans within the diet. Common foods that these are found in include breads and cereals, pasta, bakery goods such as biscuits, pastries and cakes as well as common vegetables such as onion and garlic.

• Galactans – Not always consumed in significant amounts, with key sources including legumes, lentils and cabbage.

• Polyols – Generally used to add sweetness to foods, these are commonly found in lollies and chewing gums and come with the warning that excess consumption may have a laxative effect. Polyols are also found in certain fruits, including apples, apricots, cherries, nectarines, pears, peaches and plums.

Diagnosing FODMAP sensitivity

FODMAP sensitivity can be diagnosed using one of the two methods listed below.

Method 1 – A low FODMAP diet for 2-4 weeks followed by food challenges.

This method is recommended, as it will assist in determining your individual FODMAP tolerance level.

Method 2 – Hydrogen breath test. While this test is used to diagnose FODMAP sensitivity, it is expensive ($525 in NSW) as it currently needs to be posted from Victoria.

The low FODMAP Dietary approach

| |Things to avoid during the initial phase of the low FODMAP’s diet |Suitable low FODMAP alternative |

|Fruit |Apples |Banana |

| |Blackberries |Blueberry |

| |Figs |Cumquats |

| |Guava |Durian |

| |Longon |Grapefruit |

| |Lychee |Grape |

| |Mango |Honeydew melon |

| |Nashi |Jackfruit |

| |Papaya |Kiwi fruit |

| |Pear |Lemon |

| |Persimmon |Lime |

| |Quince |Mandarin |

| |Stone fruit eg apricots, cherries, nectarines, peaches and |Orange |

| |plums/prunes |Passionfruit |

| |Watermelon |Pawpaw |

| |Apple and pear juice ( or large intakes of other fruit juices) |Pineapple |

| |Tinned fruit in natural juice |Raspberry |

| |Dried fruit, dried fruit bars etc |Rockmelon |

| | |Rhubarb |

| | |Strawberry |

| | |Tangelo |

| | | |

| | |Eat all fruit one at a time only |

|Vegetables |Artichoke |Bamboo shoots |

| |Asparagus |Bok choy |

| |Avocado |Carrot |

| |Beetroot |Celery |

| |Broccoli |Capsicum |

| |Brussel sprouts |Choko |

| |Cabbage |Corn |

| |Cauliflower |Choy sum |

| |Fennel |Eggplant |

| |Garlic |Green beans |

| |Leek |Lettuce |

| |Mushrooms |Chives |

| |Okra |Parsnip |

| |Onion (the green part of spring onions is ok) |Pumpkin |

| |Radicchio |Silverbeet |

| |Snow peas |Spring onion (green part only) |

| |Sugar snap peas |Tomato |

| |Shallots | |

| |Witlof | |

| |Things to avoid during the initial phase of the low FODMAP’s diet |Suitable low FODMAP alternative |

|Legumes and Lentils |Beans (baked beans, borlotti, 4 bean mixes, butter beans etc.) |None |

| |Chickpeas | |

| |Lentils | |

| |Dried bean and lentil mixes | |

|Breads and Cereals |Wheat/rye when eating in large amounts. Varieties of |All gluten free breads and cereals |

| |bread/pasta/noodle |Arrowroot |

| |Gluten-free (GF) varieties are fine |Amaranth |

| |Cous cous |Barley |

| |Cracked wheat |Buckwheat |

| |Regular grainy crackers (GF options are fine) |Buckwheat noodles |

| |Biscuits, cakes, pastries etc |Corn flour, Corn thins, polenta, corn pasta |

| |Wheat flour and anything else made with wheat flour |Millet |

| |Rye bread, Pumpernickel |Oats |

| |Semolina |Pearl barley |

| | |Plain muesli |

| | |Psyllium husk |

| | |Potato flour |

| | |Quinoa |

| | |Rice, rice noodles, Rice bubbles, Rice |

| | |cakes/crackers, rice flour, rice pasta |

| | |Soy noodles |

| | |Tapioca |

| | |Taco shells |

| | |Wheat free rye breads & biscuits |

|Dairy |Milk (cow, goat and sheep- full and low fat) |Lactose free milk Liddells, Zymil), rice milk,|

| |yoghurt/custard/ice-cream/cream |soy milk |

| |Evaporated and condensed milk varieties |hard cheese and brie/camembert/feta/mozzarella|

| |Soft cheese/fresh cheese – cottage cheese, ricotta, cream cheese |lactose free yoghurt |

| |LeRice, fruche (and other dairy desserts) |ice cream substitutes (gelato/sorbet), soy ice|

| | |cream (check fruit) |

| | |butter |

|Fluids |Fruit juices (and any other drink with fruit juice included) |Water |

| |More than 1 glass of wine |Diet cordial and soft drink |

| |Significant amounts of soft-drink/cordial (remove altogether to be|Coffee, tea |

| |ultra conservative) |Cordial |

| |Lucozade |Glucose |

| |Soy milk – flavoured |Hot chocolate |

| |So Good |Milo |

| |Sport Drinks (check labels) |Ribenna |

| | |Organic - Soy milk |

| | |Soda Water |

| | |Soft drinks |

|Meats and alternatives|Wheat-based crumbs or coatings |Chicken |

| |Dairy/garlic fillings eg chicken kiev |Fish, tinned fish, seafood |

| |sausages |Fresh Meat |

| | |Tofu |

|Miscellaneous |Coconut milk/cream |Eggs |

| |Condiments – pickles, chutneys, salsa, relish, sweet and sour |Nuts |

| |sauce |Seeds |

| |Dairy-based mayonnaise |Maple syrup/golden syrup |

| |Honey |Sweeteners: any except polyols eg: sugar, |

| |Instant sauces/meal options containing hidden onion and garlic |glucose and artificial sweeteners not ending |

| |Licorice |in ‘ol’ |

| |Sweeteners: sorbitol (420), mannitol (421), xylitol (967), isomalt|Fibre supplements: |

| |(953) fructose and high fructose corn syrup |Metamucil/psyllium/benefibre |

Sample Meal and Snack Guide

Breakfast:

Homemade muesli – traditional rolled oats + puffed rice + puffed + mixed nuts/seeds + fruit eg raspberries served with lactose free/soy milk or yoghurt (or both) OR

Gluten-free toast + poached/boiled/scrambled eggs served with grilled tomato OR

Gluten free cereal (check ingredients to ensure any included fruits are not from the ‘avoid’ list) served with lactose-free or soy milk + fruits not found on ‘avoid’ list

Lunch:

Gluten free sandwich/wrap + lean meat + spinach leaves, grated carrot, and cucumber (or try sandwich fillings on top of Corn Thins) OR

A salad made with spinach leaves, tinned tuna, fetta, capsicum, carrot and cucumber OR

leftover dinner options OR

Soup made with capsicum, carrot, celery, eggplant, parsnip, potato, pumpkin, sweet potato (use onion and garlic free stock cubes eg Massel 7)

Dinner:

Aim to include carbohydrate + protein + salad/veg

eg

rice + stir fried lean meat and pumpkin, bok choy, carrot, capsicum OR

gluten free chicken, vegetable (pumpkin, parsnip, carrot, celery, capsicum) soup with gluten free noodles OR

baked salmon/trout with mashed sweet potato + bok choy

Make good use of allowed vegetables – eg bok choy, carrot, celery, eggplant, parsnip, potato, pumpkin spinach, squash, sweet potato, zucchini

Snacks:

Allowed fruit eg banana, blueberries, grapes, honeydew melon, kiwi fruit, oranges, passionfruit, pineapple, raspberries, rockmelon, strawberries OR

Corn thins + sliced tomato/sliced cheese/Vegemite

Nut and seed mix

Low-lactose yoghurt

Resources and Suggested reading

.au

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Book: Low FODMAP diet, food shopping guide, by Dr Sue Shepherd

Book: Irresistibles for the Irritable, by Dr Sue Shepherd

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