IBS (for those of who you clicked on this article out of sheer curiosity…hello and welcome) stands for irritable bowel syndrome and is pretty common, affecting between 10-15% of adults in the U.S. and sigh, twice as many American women than men. If you think you have IBS, your symptoms may include abdominal pain, bloating, diarrhea or constipation (or a mix of both) plus other not-so-fun things.
There is no cure for IBS (which, yep, sucks), but certain tactics can reduce your symptoms—and that includes your diet. John Damianos, M.D., an internal medicine physician focusing on gastroenterology at Yale New Haven Hospital, often recommends a low FODMAP diet. “The low FODMAP diet is one of the best studied diets in IBS, and what’s been shown in the research is that the low FODMAP diet consistently improves global symptoms of IBS and specific symptoms, including abdominal pain and bloating,” he says. “Patients do report an improved quality of life when they’re on the low FODMAP diet.”
But for you skincare queens, think of it like adding retinol to your nightly regimen: Best practice is to embark on a low FODMAP diet in phases, and instead of your beloved dermatologist, you’ll be under the supervision of a registered dietitian.
What’s a low FODMAP diet?
FODMAP stands for (ready for this?) Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols, which are fermentable short-chain carbohydrates, or, in other words, carbs that ferment in your gut. “The idea with a low FODMAP diet is that patients with IBS do not absorb the components of the FODMAP very well, so the food goes down to the large colon where bacteria digests it and produces gas and causes discomfort,” says Eva Shelton, M.D., a physician at Harvard/Brigham and Women’s Hospital and member of the medical team at Mochi Health. “These changes in digestion also affect the fluid balance in the gut, which can cause constipation and diarrhea, depending on the shift of the balance.” The thinking behind a low FODMAP diet is that if you avoid these FODMAP foods, your gut will be happier.
What foods should I avoid on a low FODMAP diet?
You should avoid foods that are high in FODMAPs, but it gets a little tricky from there. For example, some fruits, like apples, are high in FODMAPs, whereas others, like bananas and blueberries, are not. Consider the list below an overview, but not comprehensive (gotta go to your doctor or RD for that). And note: This isn’t a list of foods you can’t eat, but rather, it’s groups of foods that you can experiment with limiting in your diet. One person may find that simply cutting out onions and garlic does wonders, while another may see improvement by avoiding lactose or certain vegetables. Your doctor or registered dietitian may also advise you on which groups to try cutting first (such as lactose, or gluten) based on your history. Most of these foods provide nutrients, so they offer beaucoup benefits if you can tolerate them.
What foods should I eat on a low FODMAP diet?
If a low FODMAP diet sounds restrictive, it is. And if a low FODMAP diet sounds confusing, it is. “A huge pitfall that a lot of people—even doctors—sometimes do is they’ll print off a list of low FODMAP foods and high FODMAP foods from the internet and say, ‘follow this,’ and that is not appropriate by any means,” says Dr. Damianos. “The low FODMAP diet is a highly restrictive diet, and it should actually be done in three phases, the final of which are reintroduction and personalization of the diet, so this should only be done under close collaboration with a gastrointestinal-trained registered dietitian.”
For patients who don’t have the access or resources to collab with a registered dietitian, Dr. Damianos recommends the Monash University FODMAP Diet app ($8 for Apple and Android).
Download the app
Dr. Shelton adds that it can be useful for patients to keep a food diary to identify food triggers and remove certain foods from their diet, 1-2 items at the time, to see if that helps improve their symptoms. “The idea is to identify food triggers and avoid them in order to minimize IBS symptoms,” she says.
Are there any drawbacks to a low FODMAP diet?
Yes. Because a low FODMAP diet is very restrictive and difficult to sustain, “it’s not meant to be a long-term solution,” says Jenna Volpe, a registered dietitian based in Round Rock, Texas. The goal is to use it to discover what foods are triggering your IBS, and which foods don’t seem to cause flare-ups. Certain groups should use extra caution when considering a low FODMAP diet and speak to their doctor about different courses of treatment entirely.
Who should avoid the FODMAP diet?
If you’ve ever struggled with disordered eating, this may not be the approach for you. “Restrictive diets including low FODMAP can be very dangerous for people who are prone to disordered eating, as these types of diets often trigger these people to spiral into a full-blown eating disorder,” says Volpe.
And if you’re pregnant or trying to be, welp: “People who are pregnant have higher nutritional demands, so restrictive diets can be dangerous and potentially lead to intrauterine growth restriction,” says Dr. Damianos. “This is why any dietary intervention, whether low FODMAP or something else, should be done in conjunction with a registered dietician to ensure that both the patient and the fetus are getting adequate nutrition.”
Bottom line: A low FODMAP diet is all about trial and error and figuring out what foods will and won’t cause a flare-up. Sure, it’s complicated. But! The good news is: You can do this. Grab an empty journal, start that food diary, make that appointment with a doctor, and you’ll be well on your way to sweet, sweet relief.
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