Is a Low FODMAP Diet Worth the Effort?

If you've ever experienced digestive issues like IBS, you may have been recommended to follow the low FODMAP diet. This therapeutic diet has helped many people decrease digestive symptoms like gas and bloating, however it requires a bit of effort and planning. Here's what to know if you're considering trying it.

What is the low FODMAP diet?

It's an elimination style diet that excludes foods containing high amounts of easily fermentable carbohydrates. FODMAP stands for fermentable, oligo-, di-, mono-sacharides and polyols -- 4 types of easily fermented carbohydrates. In particular, fructose, lactose, fructans, galacto-oligosaccharides, and polyols/ sugar alcohols are avoided. If these sugars aren’t properly digested in the small intestine they will be fermented by the bacteria in the colon, causing unpleasant symptoms such as bloating and diarrhea. For this reason, a low-FODMAP diet is often recommended as a treatment for irritable bowel syndrome (IBS).

The low FODMAP diet consists of 3 phases: restriction (during which a strict low-FODMAP diet is followed), reintroduction (during which specific foods are introduced back into the diet one at a time in order to identify which foods cause symptoms), and personalization (the phase in which you customize your diet to only excludes foods that cause digestive discomfort).

What are the claimed benefits?

A Low-FODMAP diet has been praised for its ability to ease and even eliminate common symptoms of IBS such as bloat and diarrhea.

What does the science say?

Double blind randomized controlled trials exploring the efficacy of Low-FODMAP diets for management of IBS symptoms found that 50%-86% of patients have a clinically meaningful response to the low FODMAP diet. This suggests that the diet is, in fact, an effective treatment for IBS. Because of its effectiveness it has also been shown to improve anxiety related to IBS and other quality of life measures of those with IBS.

There is, however, a good bit of criticism regarding the diet. Many researchers have criticized the diet for the following reasons:

• It is incredibly restrictive and challenging to navigate

• There are insufficient dietitians trained in the low-FODMAP diet to effectively support all patients

• Because the low-FODMAP diet restricts fermentable carbohydrates it may cause significant and possibly unfavorable changes to the gut microbiome (the bacteria residing in the colon). This is important to note since we know that the microbiome plays an important role in digestion, immune function, and stress management.

• The long-term effects of a low-FODMAP diet on the microbiome are unknown as most studies have focused on the elimination phase as opposed to the reintroduction or personalization phase

• Because the diet is so restrictive, following the diet for an extended period of time puts one at greater risk for developing nutrient deficiencies and disordered eating behaviors

The Apeiron Life perspective

The low-FODMAP diet could be of benefit for those suffering from IBS, but it is important to work with a dietitian or your Client Advocate to help you navigate both the elimination and reintroduction phase.

Failure to completely eliminate all potential triggers may limit the diet’s effectiveness. Additionally, keeping the diet overly restricted for an extended period of time may have negative consequences. For example, it may lead to unfavorable changes in the gut microbiome, prevent you from obtaining valuable nutrients, and decrease your quality of life as it relates to the ability to enjoy food and participate in food-related social events.

Will It benefit you?

Perhaps. If you have a diagnosis of IBS and/or experience consistent bloating or diarrhea, then the low-FODMAP diet may be of benefit. There are many other possible reasons as to why you might be experiencing these symptoms though, aside from the fermentation of carbohydrates. Before testing out the Low-FODMAP diet we recommend speaking with a nutritionally-informed doctor to gain more insight into the potential cause of your symptoms.

If you do not have IBS, persistent bloating, or chronic diarrhea, the diet is unlikely to be of benefit to you. In fact, it is likely to do more harm than good since it limits fiber, excludes many healthy foods, and increases the risk of developing disordered eating behaviors.

Still curious to try it? If you do, here’s what to keep an eye on:

Ask yourself the following questions:

• Why am I interested in trying this diet?

• What am I trying to achieve?

• Do I have a diagnosis, indicating that this diet might be of benefit?

• Is following this diet realistic for me?

• Am I willing and able to methodically move through all three stages of the diet?

• Do I have the necessary support to help me navigate this diet?

Before attempting to make any big dietary changes, it’s important to have a clear understanding of WHY you want to make the change and HOW you will make it. Working with your Client Advocate can help you gain clarity over both of these questions, as well as help you navigate some of the challenges that might arise from attempting to follow such a strict elimination diet.

More reading

• Low-FODMAP Diet Guide - Stanford University Digestive Health Center

• Efficacy of the low FODMAP diet for treating irritable bowel syndrome: The Evidence to date