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Why the low FODMAP diet isn’t the answer to solving your digestive issues.

If you suffer from IBS (irritable bowel syndrome) then you’ve no doubt heard of the “low FODMAP diet.”

Maybe your own doctor provided you a one page handout describing this mysterious diet. Or maybe you’ve seen articles claiming the diet cures the majority of IBS sufferers.

Sadly, I’ve seen dozens of clients who’ve implemented the low FODMAP diet to no avail– and feel like a complete and total failure as a result (that’s why a lot of them end up coming to me for help!).

WHAT’S THE PROBLEM WITH LOW FODMAP?

First off, low FODMAP food lists will vary from one resource to another. There’s seems to be a never ending stream of conflicting information as to what is or what isn’t a low FODMAP food.

I think people get too tied up in the details of this and miss the overarching picture of their gut health.

Yes, there’s a lot of research out there on low FODMAP.

BUT the problem is:

  1. Many people jump to conclusions assuming EVERYONE who suffers from IBS should be placed on low FODMAP for an indefinite period of time.
  2. Many people assume they’re sensitive to ALL FODMAPs instead of trying to figure out which category of FODMAP may be a potential trigger.
  3. Low FODMAP is used as a blanket solution for everyone suffering from IBS and does not take into account the intricacies of each individual person’s health scenario.
  4. The Low FODMAP diet is still a band-aid approach to your gut issue and doesn’t solve the underlying problems as to why you don’t tolerate these fermentable carbohydrates in the first place.

The research behind low FODMAP only provides a small piece of the complex puzzle to your gut health.

LOOKING AT OUR ANCESTORS

FODMAPs are ubiquitous in a broad range of plant foods and have been part of the human diet for millions of years. Actually, our ancient ancestors ate a lot more fermentable carbohydrates than most modern humans do.

To give you context, some ancient people have eaten as much as 135 grams of inulin-type fructans everyday. Contemporary African hunter-gatherers, such as the Hadza, are also known to consume large amounts of fermentable carbohydrates (aka FODMAPs) as well.

You might be asking “so what do our ancient ancestors have to do with our modern day gut issues?”

The answer: everything.

There’s no reason to think that humans have suddenly lost our ability to digest fermentable carbohydrates (aka FODMAPs). There has to be something else that’s going on here.

GETTING TO THE ROOT OF YOUR GUT ISSUE

An imbalance in your gut microbes (aka Gut Dysbiosis) is a key feature in the pathophysiology of many gut issues, including IBS.

Given this information, it shouldn’t come as a surprise that people with IBS have trouble digesting fermentable carbs.

We depend on our gut microbes to digest a great variety of complex carbohydrates that are found in the plants we eat.

By ourselves (with the assistance of our digestive enzymes), we’re only capable of digesting simple sugars & starches. The rest is up to our gut bacteria!

If the microbes in our lower gut are diminished or imbalanced, digestion is compromised. Some nutrients pass into our lower gut specifically for microbes to complete the breakdown process, so if those are missing or imbalanced then we have an issue with foods not getting broken down properly.

Additionally, if pathogenic bacteria are allowed to proliferate (due to having low levels of beneficial bacteria), symptoms of food intolerance like bloating, loose stools, and gas may continue to manifest.

SO WHAT DOES THIS ALL MEAN?

Given all of this information you may start to see why people with IBS see temporary relief from a Low FODMAP diet.

When a person with IBS reduces the intake of fermentable carbs, they are basically shutting down the food supply for microbiota residing in the intestine, which can reduce symptoms since they’re no longer adding fuel to the fire in their gut.

However, one study notes, “further alteration of microbiota through FODMAPs restriction diet might predispose the patient to additional pathological dysbiosis.”

This, in and of itself, is a problem.

You might be able to keep your symptoms at bay, however the underlying problem with your gut imbalances continue to rage on, and, in fact, may continue to worsen with this diet when followed long-term.

The reason you worsen is because you’ve basically removed the very food that your beneficial bacteria love to feed upon. You’ve starved your good bacteria and allow for more pathogenic bacteria to take hold in your gut.

THE TAKEAWAY

Instead of removing all of those fermentable carbohydrates from your diet, it makes more sense to address the underlying microbial imbalances that are leading to those food intolerances in the first place. I usually also have clients temporarily remove food sensitivities that are causing a gut immune reactions at the same time to provide temporary relief while we work on underlying gut imbalances.

Shifting the balance of the gut microbes is a very effective strategy that can lead to improved tolerance to foods over time.

The low-FODMAP diet might be useful temporarily in some cases, however it shouldn’t be relied on as a permanent solution.

A diet that restricts the fuel that feeds our our healthy gut microbes is a novel experiment and is likely to continue to make us sick and fragile.

Our modern lifestyle of processed foods, antibiotics, toxins, and other microbe disruptors has changed the microbial balance in our gut. We’re suddenly having problems digesting nutrients that have been a part of the human diet for millenia as a result.

The solution is not to continue to restrict and whittle away our list of “safe foods” to just a handful. The solution is to repair our gut imbalances and address lifestyle factors that are contributing to these gut issues in the first place.

If you’re a woman looking to jump start your digestive health journey, then I’ve got you covered! To learn more about my 12 week IBS Rehab Program, get started here!

Sarah Neumann Haske, MS, RDN is a Women’s Health Functional Dietitian and owner of Neumann Nutrition & Wellness, LLC. Her practice helps women heal their gut, regulate their hormones and balance their thyroid using a root-cause approach to their health. As a result of her program her clients are able to come off medications, feel more energized, and be more confident in their bodies again. If you’re interested in being a partner in your own health journey and finding the direction and accountability you need to reach your health goals, then schedule your complimentary call with Sarah now.

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References:

https://www.ncbi.nlm.nih.gov/pubmed/21139123

https://www.sciencedirect.com/science/article/pii/S0047248414000815

https://www.nature.com/articles/ncomms4654

https://www.ncbi.nlm.nih.gov/pubmed/27231695

https://www.ncbi.nlm.nih.gov/pubmed/26900286

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4202342/

https://www.ncbi.nlm.nih.gov/pubmed/23580243

https://www.ncbi.nlm.nih.gov/pubmed/27863247

https://www.ncbi.nlm.nih.gov/pubmed/25156449

https://www.ncbi.nlm.nih.gov/pubmed/26900286

https://www.mdpi.com/2072-6643/11/2/373/htm