Fodmap Diät

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The low FODMAP diet

Dr. Adrian Weingart

The low FODMAP diet

In this article, we would like to bring you closer to a topic that is closely related to a syndrome that we have written about before - irritable bowel syndrome. There is news, and good news at that!
Probably very few want to talk about it, but in Germany alone millions of people are affected by the so-called irritable bowel syndrome, or IBS for short. This manifests itself in a wide variety of symptoms, some of which severely limit everyday life. That shouldn't be the case, thought two Australian scientists. Peter Gibson and Susan Shepherd developed a nutritional strategy designed to reduce these symptoms. It's called the low-FODMAP diet. In the following text you will learn everything you need to know about it!

First of all, what are FODMAPs?

It should be said beforehand that this is a diet specifically for those who have been diagnosed with irritable bowel syndrome. Such a diet is not intended to lose weight and is only done temporarily.
The word is formed from the initial letters of the English translation of “Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols ”, is an acronym. Who now thinks: So many foreign technical terms in one word! What do you mean with that? - Don't worry, we'll first break down what they mean:
  • Fermentation
    A process that is mainly used with fresh vegetables. This is placed in brine and then stored airtight. During storage, the bacteria that live on the surface of vegetables multiply and convert the fruit's sugars and starches into lactic acid. This process causes the pH to drop, creating an acidic environment. Putrefactive bacteria have no chance of surviving here. The positive effect of fermentation is the formation of vitamin B12, which otherwise only occurs in animal foods. On the other hand, a lot of histamine is also formed, a substance that can cause an allergic reaction in some people in high doses.
  • Monosaccharides
    They are also called "simple sugars" and are a group of organic chemical compounds. Monosaccharides are the products of the oxidation of polyhydric alcohols. The monosaccharide is the building block of all carbohydrates and can combine to form multi-chain sugars such as disaccharides, oligosaccharides, or polysaccharides. Fructose is the main representative of the monosaccharides, which is counted among the FODMAPS.
  • oligosaccharides (Greek. oligos = little)
    = carbohydrates that are made up of several (3 - 10) identical or different monosaccharides and are connected to one another by glycosidic bonds. The FODMAPs of these "multiple sugars" include galacto-oligosaccharides (GOS), fructans, inulin and fructo-oligosaccharides (FOS).
  • Disaccharides
    = carbohydrate molecule formed from two monosaccharides. Milk sugar, i.e. lactose, are disaccharides and belong to the FODMAPs.
  • polyols
    This refers to sweet-tasting, alcoholic compounds that are also known under the name sugar substitutes. Good to know: The following sugar alcohols are permitted in the EU: erythritol, isomalt, mannitol, maltitol, lactitol, sorbitol and xylitol. All of these polyols are also FODMAPs.

Why are FODMAPs so poorly tolerated by some people?

Now that we know what is meant by the term FODMAP, the question that remains is what all these different products have in common that makes them so difficult to digest for certain people. FODMAPs are structured in such a way that the small intestine can hardly or not at all use them. Therefore, they move further into the large intestine. The intestinal bacteria there break them down relatively quickly into short-chain fatty acids such as acetate, butyrate and propionate. This fermentation then produces gases such as hydrogen, methane or carbon dioxide, which bloat the intestines and can cause abdominal pain, flatulence, cramps or colic. FODMAPs also have the property of having an osmotic effect. This means that they bind a lot of water and draw it into the intestinal lumen - a condition that can make the symptoms even worse. Loose stools and diarrhea are such a “classic” sign of the response of FODMAPs in the gut.

What counts as FODMAPs?

FODMAPs include a wide range of foods, so it's worth studying them closely. If you want to avoid them, it's best to write down a comprehensive list of do's and don'ts. We have listed some of them here, but please do get more information from your consulting specialist, for example, as the list is not complete. Special carbohydrate compounds include:

  1. Fructose, found in fruits such as apples, pears, mango, plum, apricots, cherries, and watermelon, as well as honey and corn syrup; The following applies here: the riper the fruit, the higher its FODMAP content.
  2. Lactose: is found in milk and all dairy products.
  3. Galactans in beans and various types of cabbage.
  4. Fructans in wheat, rye, barley and onions. Especially fructans from wheat products make up a large part of regular FODMAP consumption. This includes, for example, baked goods, couscous or pasta. Bread in particular causes complaints for many IBS sufferers, because wheat is often even worse tolerated than products made from spelled, einkorn or emmer.
  5. Other FODMAP-rich products are sugar substitutes such as sorbitol, mannitol or xylitol. FODMAPs also include nuts such as almonds, cashews and pistachios.

How does the low FODMAP diet work?

In the first phase, affected IBS patients initially abstain from all FODMAPs. You can see the whole thing as a restart for the intestinal flora. First of all, the intestine can recover from all the stress that these products have triggered in it. This relatively strict period shouldn't last more than four to six weeks (sometimes up to eight weeks), because while a break can be seen as something positive, it's also important to note that it does Microbiome important nutrients are removed. It is analyzed to what extent the symptoms have improved. If this is the case, individual products are successively included in the person's diet again in the second phase. Great attention is paid to the tolerance of the individual products. It is worthwhile as a patient to keep a food and symptom diary in order to keep track of the foods that have already been tested and their effects. In the long term, the third phase aims to achieve a balanced, low-FODMAP diet in which the symptoms of IBS are minimal or non-existent and the right amount of nutrients is still consumed. What this diet looks like in concrete terms is of course always individual.

Does the low-FODMAPS diet work?

About ten years ago, as mentioned above, the clinically proven low-FODMAP diet was developed by Australian researchers Susan Shepherd and Peter Gibson. In 2010, the two conducted a clinical study with IBS patients who tested the same diet. The scientists found that consistent adherence to the IBS symptoms could be greatly reduced. Later large-scale clinical studies were also able to prove this. The diet is now recognized worldwide and is prescribed across the board as a therapeutic approach against irritable bowel syndrome.

Should I try a low-FODMAPS diet too?

It is important to know that a low-FODMAP diet is not necessary for people with healthy intestinal flora. Because FODMAPs are not bad in themselves, on the contrary: many FODMAPs have strong positive health effects on digestion and the intestines. A FODMAP diet primarily affects people suffering from irritable bowel syndrome, as well as all those who have a fructose or lactose intolerance, an intolerance to wheat or suffer from celiac disease. If you have already been diagnosed with IBS, it is definitely worth testing this nutritional strategy. You should be aware that this diet involves a certain amount of extra time and also involves the brief complete abstinence of some foods that may be an integral part of your diet.

Everything important summarized again:

  • FODMAPs are different carbohydrate groups that can sometimes cause severe symptoms for people with irritable bowel syndrome.
  • They are of little or no use to the small intestine of those affected. They then break down in the colon to produce gases and liquid, which can lead to all kinds of IBS symptoms.
  • A low-FODMAP diet should be discussed in advance with an experienced professional who, ideally, will also accompany the process.
  • a no-FODMAP diet is not a permanent change in diet that you live by, but should only last a short phase (approx. 4-8 weeks) in the process.
  • The goal of the low-FODMAP diet is a low-FODMAP diet that is nevertheless balanced and causes as few symptoms as possible for the person concerned.


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