ANSWER
What is FODMAP?
FODMAP is a family of poorly absorbed, short-chain carbohydrates such as Oligosaccharides, Polyols, Free Fructose and Lactose (Barrett et al., 2010). These short-chain carbohydrates are poorly absorbed in the small intestine, highly osmotic and rapidly fermented by gut bacteria which can lead to increased gas, distention, bloating, cramping and diarrhea. These are all the symptoms of Irritable Bowel Syndrome (IBS) (Marcason, 2012).
FODMAP Components
1. Oligosaccharides
– Consists of fructans (fructo-oligosaccharides or FOS) and galacto-oligosaccharides (GOS) which are unable to be digested as human do not have the necessary enzymes to break them down.
– Thus, they are not absorbed in the small intestine which may cause problems for patients with IBS.
– Examples for Oligosaccharides in common foods includes artichokes, asparagus, beets, brussels sprouts, broccoli, cabbage, fennel, garlic, leeks, okra, onions, peas, shallots, wheat, rye, barley, legumes, lentils, chickpeas, apples, peaches, persimmon, watermelon and pistachios.
2. Polyols
– Polyols are a form of sugar alcohol in which absorption across the intestinal barrier is slow.
– Examples for Polyols in these common foods includes apples, apricots, cherries, pears, nectarines, peaches, plums, prunes, watermelon, avocado, cauliflower, mushrooms, snow peas, and the artificial sweeteners sorbitol, mannitol, maltitol and xylitol.
3. Free Fructose
– A simple sugar and that requires no digestion.
– When the amount of fructose exceeds glucose, an alternative absorption method is required however it is impaired in some individuals which leads to fructose malabsorption.
– Examples of fructose in common foods includes apples, cherries, mangoes, pears, watermelon, asparagus, artichokes, sugar snap peas, honey, and high fructose corn syrup.
4. Lactose
– A disaccharide that will not be absorbed if undigested by lactase; an enzyme that splits milk sugar lactose into glucose and galactose
– Examples of common foods with Lactose includes milk, yogurt, ice cream, custard, and soft cheeses
Source: Marcason, 2012.
Low-FODMAP
Low FODMAP diet is a nutritionally balanced diet for those with irritable bowel syndrome (IBS) as it is low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs). This type of diet is based on restricting dietary intake of short chain carbohydrates that are slowly absorbed or indigestible and not absorbed during passage through the small intestine (Halmos et al., 2014).
Irritable bowel syndrome (IBS) is a common medical condition characterized by chronic, recurrent, abdominal pain and discomfort, and altered bowel habits that occur in the absence of other organic gastrointestinal (GI) disease (Defrees & Bailey, 2017).
The principle of the low FODMAP diet is that the patients avoid all foods with high FODMAP content in normal serving sizes and replaces them with those low in FODMAPs, with long-term restriction limited to what is required to control symptoms This is important as FODMAPs are found in multiple food groups and ensures patients consume foods from all of the 5 core food groups, which are dairy, meat and meat alternatives, fruit, vegetables and legumes, and grains and cereals (Iacovou et al., 2015).
References
Defrees, D. N. & Bailey, J. (2017). Irritable Bowel Syndrome: Epidemiology, Pathophysiology, Diagnosis, and Treatment. Elservier, 44(4), 655-671.
Iacovou M., Tan V., Muir J. G. and Gibson P. R (2015). The low FODMAP diet and its application in East and Southeast Asia. Journal of Neurogastroenterology and Motility, 21(4), 459-470.
Halmos E. P., Power V. A., Shepherd S. J., Gibson P. R., Muir J.G. (2014). A diet low in FODMAPS reduces symptoms of irritable bowel syndrome. Clinical – Alimentary Tract, Gastroenterology, 146(1), 67–75. https://doi.org/10.1053/j.gastro.2013.09.046
Marcason, W. (2012). What Is the FODMAP Diet? Journal of the Academy of Nutrition and Dietetics, 112(10), 1696. https://doi.org/10.1016/j.jand.2012.08.005
Barrett J. S., Gearry R. B., Muir J. G., Irving P. M., Rose R., Rosella O., Haines M. L., Shepherd S. J. & Gibson P. R. (2010). Dietary poorly absorbed, short-chain carbohydrates increase delivery of water and fermentable substrates to the proximal colon. Alimentary Pharmacology & Therapeutics, 31(8), 874–882. https://doi.org/10.1111/j.1365-2036.2010.04237.x
