The Difficulties of Implementing the Low Fodmap Diet

Wouldn’t you love it if the doctor said, “Go gluten-free and your IBS issues will be solved” or “Go lactose-free and your IBS symptoms will disappear”?

But no!

We get a low Fodmap diet which has guidelines that are as grey as waste water. Fodmaps are in almost all foods, so we can’t eliminate them all like we could dairy or wheat, or we would die of malnutrition.  The Monash University research centre has very kindly split foods into high Fodmap and low Fodmap with a fine line between the two, but that is just the beginning of the complexity which is the low Fodmap diet.

What are the difficulties inherent in using a list of Good Foods and Bad Foods?

• You choose food randomly from the list and fill your plate with them. A slab of meat, 3 potatoes and a large mixed salad. Oh dear, the resulting pain and bloating is so debilitating! This diet is crap – it doesn’t work. I ate only low Fodmap foods. Ah, but does your list have permitted amounts beside each food? If not, chuck the list and start again.
• So, let’s say your list has the permitted amounts on it, but they are averages for the average person, and who among us is average? Someone will be, I guess, but not all of us. My greatest trigger is fructose and, if I ate the permitted amounts of fruit, I would be in constant pain. I have to halve the amounts. Your reaction point will be different to anyone else’s, and there may not even be a trigger point for one or more of the Fodmap groups. I have not yet had a client who malabsorbed all the Fodmap groups.
• You look at the Good Foods list and decide to have 1 carrot, ½ cup of zucchini, 1 tomato and 1 cup of lettuce for your lunch. What a lovely healthy meal! You pat yourself on the back and proceed to eat it. Oops! Why has your stomach bloated to the size of a party balloon? Why do you have the urge to get to the toilet pronto? You just created a high Fodmap mashup, that’s why. Fodmaps add together just like 2+3=5. Also, while we are talking about a healthy meal. That was not healthy. You had no protein or carbohydrate. Your energy levels would flag very quickly and you would be reaching for the forbidden high Fodmap cakes.
• With the Good Foods list in hand, you graze your way through the day, having a carrot here, a few rice crackers there, a piece of chicken half an hour later and you get bloated. What the heck are you doing wrong? You are following the list. But what you are doing is you are not allowing the first lot of food to be digested before having the next. You are not leaving enough time for the cleansing wave to adequately divert unwanted waste from the small intestine. Stop snacking!
• On the other hand, you have a bad relationship with food after so many years of pain and you only eat a few larger meals a day to minimize the discomfort. Funny how you still feel bad most of the time, isn’t it, even though you are following that famous Good Foods list! That’s because your digestion has finished, and you are now accumulating gas in your intestines. And what does gas mean for those of us with IBS? It means bloating, trapped wind and pain. Eat 5 small meals a day.
• Even though somehow you have happened upon all the above and got everything right, you still have symptoms. Then, let’s check out the list, shall we? Is it accurate? You would expect so, but actually there is a high probability that you have found one of the many inaccurate lists out there in internet land. Why are there so many false and conflicting lists? Here are a few reasons:

• Much of what you find on the internet is just plain wrong on any subject.
• Research into the low Fodmap diet is ongoing and many lists on the net are now outdated. For example, we used to think rice milk was okay and almond milk wasn’t. The latest research has shown exactly the opposite. The only way to get this right is to stay on top of the research.
• We are all different and our final expanded diets will all vary and not suit anyone else. But many people these days are starting up blogs to document their progress with the low Fodmap diet and basing it on their own discoveries for their own digestive systems. That is not going to help any of us. Even now, there are very few websites that I go to for anything to do with the low Fodmap diet. It’s a scary world out there for the uninitiated.

• Okay, one last one. You are one of the tiny percent who get all the above right by themselves but you still have good days and bad days. What on earth is going on? Life is going on – that’s what. Lack of sleep, lack of exercise, stress, busyness and a general feeling of being overwhelmed. Many of my clients come to me in a state of desperation, not just because they can’t begin to imagine tackling such a complicated diet but because their lives are so busy that they don’t have time to do it by themselves. And therein lies part of the problem. That lack of time – the crazy lifestyle they have created for themselves over the years in an effort to get ahead, to have things for themselves and their families, to have a certain status - is killing their gut. Even if they have the diet right, they will have symptoms – it’s that simple.

There are even more moving parts to the story of sorting your IBS like non-Fodmap triggers and the accumulation factor, but for now that is enough to be getting your mind around.

This is a jolly tricky diet. But who ever told us the answer would be simple? Scientists know very little about IBS and the mechanism that causes it, which means they are far from a cure. So, we should be grateful that there is any help for us at all. And let me reassure you, if you get all the elements right, THIS IS A MIRACLE DIET.