The low FODMAP diet is a revolutionary approach that is being used for the management of Irritable Bowel Syndrome and other functional gut disorders including functional diarrhoea and functional abdominal bloating.
What does FODMAP stand for?
FODMAP is an acronym where F=Fermentable O=Oligosaccharides, D=Disaccharides, M=Mono-saccharides A=And P=Polyols
Collectively FODMAP’s are short-chain carbohydrates which are easily fermented by gut micro-flora and exert an osmotic effect increasing fluid delivery into the large bowel. In susceptible individuals, these effects result in excessive gas production, wind, abdominal pain and often affect stool consistency and frequency of output.
Evidence Based Approach: Dietitian-led
The scientific evidence available to date shows that this new dietary approach has been proven to significantly relieve symptoms in up to 74% of patients when delivered under the guidance of a FODMAP-trained Dietitian. This approach has only been evaluated/researched as a Dietitian-led approach, and Dr. Bill Chey, Gastroenterologist from The University of Michigan reported at Gastrodiet 2015, that Dietitian delivery of this diet is key in terms of it’s success. .
Clinical trials have also found that the Low FODMAP diet is more effective at relieving IBS symptoms than standard dietetic advice following the NICE guidelines. Research also supports the use of the low FODMAP diet in patients whose inflammatory bowel disease is in remission but continue to experience gastrointestinal symptoms.
The success of the dietitian-led approach is well documented by extensive research from Monash University, Melbourne. More recently, Kings College London has been following in their footsteps and they are the central hub of research on FODMAPS in this hemisphere. Their training course for Dietitians has become the gold standard course and Dietitians from all over Europe travel to KCL to complete it. I completed this course in November 2013.
Reference: Staudacher et al (2012) (68% of participants reported improvements in symptoms on low FODMAP diet) and Shepherd et al (2006) (74% of participants reported improvement in symptoms on low FODMAP).
What to Expect on the Low FODMAP diet?
The low FODMAP phase generally lasts for 4-8 weeks and is a form of elimination diet. It is very specific, needs to be followed strictly to optimise results and it is essential that clients get advice from a Dietitian who has a specific training in the low FODMAP approach.
After the low-FODMAP phase, the length of which is very individual and will be determined by your Dietitian, reintroduction of the various FODMAPS can begin. It is very important that this phase is completed so that you are not unnecessarily restricting your diet indefinitely. This phase is done in a very methodical and structured way and needs to be done under the supervision of a FODMAP-trained Dietitian to allow patients determine as accurately as possible what FODMAPS are their trigger foods as well as to determine their individual tolerance levels to the various FODMAPS.
Patient resources are updated regularly by Kings College London are only available for purchase by qualified Dietitians who are members of Irish Nutrition & Dietetic Institute. In addition, I offer patients a brand-specific shopping list for suitable foods available across all supermarkets in Ireland, from which all the food labels have been checked thoroughly by qualified dietitians.
I also provide low-FODMAP adapted recipes and can also tailor the diet to include other modifications which patients may require such as Diabetes, Hyperlipidaemia, Coeliac Disease, IBD, Sports Nutrition and Weight Management.