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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 end up feeling like a complete and total failure as a result. A lot of these people end up coming to me for help to figure out a different strategy to manage their gut issue.

WHAT IS LOW FODMAP?

For those of you who don’t already know, FODMAP stands for Fermentable Oligodisaccharides Disaccharides Monosaccharides and Polyols. Each word in the acronym represents a specific category of carbohydrate that is undigestible and gets fermented in your gut.

For example, galacto-oligosaccharide (GOS) is an Oligosaccharide found naturally in beans and root vegetables. Since GOS cannot be broken down fully by your gut, the foods in this category are eliminated in the Low FODMAP diet plan.

However, GOS also happens to be a beneficial prebiotic which helps promote the growth of beneficial bacteria in the gut.

Maybe you can already see where I’m already going with this…

WHAT’S THE PROBLEM WITH LOW FODMAP?

First off, have you noticed how Low FODMAP food lists 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.

People end up getting sooo 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 supporting the use of Low FODMAP.

HOWEVER, there are several issues I’d like to highlight with the use of Low FODMAP diets:

  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. People assume they’re sensitive to all FODMAPs. Instead of trying to figure out which category of FODMAP may be a potential trigger. They end up unnecessarily cutting out major categories of foods, even though they don’t need to.
  3. The Low FODMAP diet is used as a blanket solution for everyone suffering from IBS and does not take into account the intricacies of each individual person’s underlying gut issues.
  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. Our ancient ancestors ate a lot more fermentable carbohydrates (aka FODMAPs) 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 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 and other digestive disorders.

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

In other words, we depend on our gut microbes to digest a great variety of complex carbohydrates (including FODMAPs) 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, our ability to properly digest foods gets compromised. Some nutrients pass into our lower gut specifically for microbes to complete the breakdown process, so if those microbes are missing or imbalanced then we have an issue with foods not getting broken down properly.

Additionally, if pathogenic bacteria (aka the bad bugs in our gut) are allowed to proliferate due to having low levels of beneficial bacteria, the 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’re basically shutting down the food supply for the microbes in our gut. When we shut down this food supply we can see a reduction in symptoms since we’re no longer adding fuel to the fire.

However, there is a problem with this approach. As 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.

Overtime, your gut issues will begin to worsen. The reason you worsen is because you’ve basically removed the very food that your beneficial bacteria love to feed upon. While you’ve starved your good bacteria, you’ve allowed for more pathogenic bacteria (the bad bugs) 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.

It also makes more sense to temporarily remove food sensitivities that are causing a gut immune reactions at the same time, as up to 80% of our immune system resides in our gut.

This provides concrete information (instead of just guessing and shooting in the dark) as to what foods your gut is actually reacting to. With this approach, we can provide temporary relief while we work on underlying gut imbalances causing your intolerance to certain foods.

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 very 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 Digestive Reset Program get started with your complimentary initial consult here!


Sarah Neumann Haske, MS, RDN is a Digestive Health Dietitian and owner of Neumann Nutrition & Wellness, LLC. Her practice helps women heal their gut 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 live a radiant care-free life. If you’re interested in finding direction and accountability while discovering freedom from your digestive issues, then schedule your free call with Sarah now.

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