Mapping the FODMAP!
Food intolerances are on the rise and the highly recommended high-fiber foods great for pre-diabetics and general weight loss may not be the answer for all the health conditions. Ten to 15 percent of the adult population in the United States suffers from irritable bowel syndrome (IBS). IBS is a chronic functional bowel disorder affecting the large intestine characterized by abdominal pain, intestinal gas and bloating after eating certain foods. Only a fraction of IBS patients consult healthcare professionals. There are tailored dietary, behavioral and pharmacologic treatments available for patients. However, the goal of treatment depends on the type and degree of the symptoms.
Bloating, abdominal and intestinal pain, diarrhea, constipation may respond well to dietary modifications. The low FODMAP diet was first developed by researchers at Monash University, in Melbourne, Australia. In 2005, a study published on the FODMAP diet in the Journal of Alimentary Pharmacology and Therapeutics set the stage for this diet to be frontline therapy for IBS patients. FODMAP are short chain carbohydrates and the acronym stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. FODMAP foods (sugar molecules) are not absorbed well in the small intestine and rapidly fermented by gut bacteria at the base of large intestine, in people suffering from IBS. The byproduct of rapid fermentation process, where there is an absorption of water and release of carbon dioxide, hydrogen and methane gas, is the primary cause of the gastrointestinal symptoms.
High FODMAP foods are eliminated for 3-8 weeks and then gradually included into a low FODMAP diet. Slow introduction of foods helps to identify the food that causes GI symptoms. People with IBS, arthritis, SIBO (small intestinal bacterial overgrowth, eczema, migraine can use this diet as part of the treatment).
Common foods high in FODMAP
Fructose: Honey, apples, mango, pears, watermelon, asparagus, artichokes, fruit juices, dried
fruit, high fructose corn syrup, molasses
Lactose: Milk, softer cheeses like mascarpone, cottage, ricotta, yogurt, ice cream
Fructans: Asparagus, Brussels sprouts, garlic, onion, cabbage, broccoli, rye, wheat
Polyols: Apples, prunes, figs, apricots, nectarines, cauliflower, mushrooms, sweet potato,
snow peas, peaches, cherries and avocados, Sorbitol, Mannitol, Xylitol or Maltitol
Galactans: Chickpeas, legumes, lentils, pistachio nuts, cashews.
Low FODMAP foods
Fruits: Bananas, all berries except for blackberries, clementines, grapefruit, kiwi, papaya, lemon, lime, tangelo, honeydew, grapes
Vegetables: potatoes, zucchini, tomatoes, ginger, bell pepper, cucumber, spinach, carrot, eggplant, green beans, scallions, yellow squash, leeks, lettuce, olives
Grains: Rice, gluten-free oats, corn, millet, quinoa, amaranth, tapioca, sorghum
Meat and seafood.
Fats: oils, nuts and seeds (no pistachios or cashews).
Sweeteners: Splenda, maple syrup, aspartame
Drinks: Green tea, tea, coffee with non-dairy milk, water and fresh fruit juice
Protein: Tofu, hard cheeses like cheddar, Swiss, parmesan
A vegetarian low FODMAP meal plan looks like this:
Breakfast: gluten-free oats dosa with tomato chutney
Snack: Strawberries and blueberries
Lunch: Quinoa stir fry with tofu, bell peppers, spinach, carrots and almonds,
Snack: 1 glass carrot and orange juice with ginger
Dinner: 2 Jowar roti with potato, eggplant and tomato curry, rice
Amount of FODMAP can be reduced in lentils and beans by soaking them and changing water frequently. While cooking, changing water reduces the amount of FODMAP. Half cup washed canned lentils, ¼ cup canned chickpeas, 2/3rd cup sprouted mung beans are low FODMAP food. Soaking and sprouting may reduce the FODMAP content since soaking helps in leaching out the oligosaccharides and sprouting activates the enzyme to breakdown the oligosaccharide.
Benefits of low FODMAP diet include reduced digestive symptoms like decrease in flatulence, constipation and diarrhea, increased quality of life by increased energy levels for individuals. According to the research studies, 75 percent of the IBS patients benefit from low FODMAP diet. Comparison of symptom response following advice for a diet low in FODMAP versus standard dietary advice, a study published in Journal of human nutrition showed evidence that 76 percent of the IBS patients reported satisfaction with low FODMAP diet. There are apps like fast FODMAP and Monash app to help you navigate through high, medium and low FODMAP foods.
Recipe of the month:
Quinoa palak dal
½ cup red quinoa
¼ cup cooked spinach
4 cups water
½ inch ginger
1 tbsp green part of green onions
1 tbsp olive oil
¼ tsp cumin seeds
¼ tsp dhana jeera
½ tsp garam masala
¼ tsp turmeric powder
¼ tsp red chilli powder
Salt to taste
Wash and soak quinoa for 5-6 hours, discard water, add fresh water, half turmeric and half salt, bring it to boil. Simmer on low heat for 20 minutes. Blend the quinoa to give rich texture. Heat the oil and add cumin, clove, chives and palak, chopped ginger, sauté for few minutes and add chopped tomatoes and rest of the masalas. Add pureed quinoa to the sautéed mix, simmer for about 5 minutes and garnish with cilantro.
To Our Health!!!
Bhavi Nirav is a Registered Dietitian/M.S., R.D., L.D., certified yoga practitioner, and can be reached at firstname.lastname@example.org.