Low-FODMAP Diet
Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) are poorly absorbed dietary carbohydrates associated with gastrointestinal symptoms due to their fermentability and influence on intestinal fluid retention. A low-FODMAP diet temporarily reduces and then systematically reintroduces FODMAPs and has shown efficacy for reducing general symptoms of irritable bowel syndrome (IBS).
Low-FODMAP Diet is most often used for
Last Updated:September 28, 2022
FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are poorly absorbed, highly fermentable carbohydrates that can contribute to gas, bloating, and diarrhea due to their fermentability and attraction of water in the intestinal tract.
Click here to read more about specific FODMAPs and how they function in the intestines.
If you’re wondering about the differences between FODMAPs, fiber, and prebiotics, you’re not alone! Click here for a quick breakdown.
Many foods contain moderate to high concentrations of FODMAPs, with serving sizes dictating the overall FODMAP load. The way a food is prepared can also modify the FODMAP content. Meats and oils are almost always low-FODMAP foods. Fruits, vegetables, nuts, beans, grains, and many protein bars contain different types and amounts of FODMAPs, but some FODMAP categories are predominant in certain foods. Fructans are the main FODMAP found in wheat products, for example.
FODMAPs
Dietary FODMAP content can be confusing, so click here to read more about the most common sources and their low-FODMAP replacement options.
The low-FODMAP diet is thought to improve GI symptoms by reducing the content of FODMAPs in the intestines, resulting in lower intestinal water content and diminished gas production from microbial fermentation. It also modifies the gut microbiome, but the clinical significance of these changes is unknown. [1][2] Though it can be implemented in a variety of ways, the diet generally consists of an initial restriction phase, during which low-FODMAP foods replace those that are moderate or high, followed by a systematic reintroduction process to assess tolerance for each of the FODMAP groups. Dietary FODMAP sources are gradually elevated and diversified based on individual tolerance.
If you want to learn more about how to safely implement a low-FODMAP diet, click here.
The low-FODMAP diet has been shown to improve quality of life as well as general IBS symptoms, including abdominal pain, bloating, diarrhea, and flatulence (though it is likely more effective for individuals with diarrhea-predominant IBS). [2][3] A short-term low-FODMAP diet may also reduce acute GI distress (commonly cramping and diarrhea) associated with intense endurance exercise. [4] Low-FODMAP formulas may also improve nutritional status in patients receiving enteral nutrition. [5] Additionally, in people with celiac disease, low-FODMAP, gluten-free diets are also associated with greater improvements in GI symptom scores compared with a gluten-free diet only.[6]
For reasons that are still unclear, people respond differently to a low-FODMAP diet, and some don’t see any improvements at all. Emerging research suggests that the fermentation capacity of a person’s microbiome might be one factor that explains—or could even predict—how well they’ll respond to a low-FODMAP diet. [7]
Click here to read more about the benefits of a low-FODMAP diet and how it compares to traditional dietary guidance for IBS.
Long-term adherence to a low-FODMAP diet isn’t recommended, because it could be nutritionally inadequate and also appears to modify the microbiome in potentially unfavorable ways. [8][9] The low-FODMAP diet may pose a risk to people with inflammatory bowel disease (IBD), because they are already at risk of malnutrition.[10] The restrictive aspects of the low-FODMAP diet could also exacerbate an eating disorder. [11]
Click here to learn about the potential risks and limitations of a low-FODMAP diet.
- Low-FODMAP
- ^J S Barrett, R B Gearry, J G Muir, P M Irving, R Rose, O Rosella, M L Haines, S J Shepherd, P R GibsonDietary poorly absorbed, short-chain carbohydrates increase delivery of water and fermentable substrates to the proximal colonAliment Pharmacol Ther.(2010 Apr)
- ^Emma Altobelli, Valerio Del Negro, Paolo Matteo Angeletti, Giovanni LatellaLow-FODMAP Diet Improves Irritable Bowel Syndrome Symptoms: A Meta-AnalysisNutrients.(2017 Aug 26)
- ^Anne-Sophie van Lanen, Angelika de Bree, Arno GreylingEfficacy of a low-FODMAP diet in adult irritable bowel syndrome: a systematic review and meta-analysisEur J Nutr.(2021 Sep)
- ^Stephanie K Gaskell, Bonnie Taylor, Jane Muir, Ricardo J S CostaImpact of 24-h high and low fermentable oligo-, di-, monosaccharide, and polyol diets on markers of exercise-induced gastrointestinal syndrome in response to exertional heat stressAppl Physiol Nutr Metab.(2020 Jun)
- ^So Ra Yoon, Jong Hwa Lee, Jae Hyang Lee, Ga Yoon Na, Kyun-Hee Lee, Yoon-Bok Lee, Gu-Hun Jung, Oh Yoen KimLow-FODMAP formula improves diarrhea and nutritional status in hospitalized patients receiving enteral nutrition: a randomized, multicenter, double-blind clinical trialNutr J.(2015 Nov 3)
- ^Leda Roncoroni, Karla A Bascuñán, Luisa Doneda, Alice Scricciolo, Vincenza Lombardo, Federica Branchi, Francesca Ferretti, Bernardo Dell'Osso, Valeria Montanari, Maria Teresa Bardella, Luca ElliA Low FODMAP Gluten-Free Diet Improves Functional Gastrointestinal Disorders and Overall Mental Health of Celiac Disease Patients: A Randomized Controlled TrialNutrients.(2018 Aug 4)
- ^Sean M P Bennet, Lena Böhn, Stine Störsrud, Therese Liljebo, Lena Collin, Perjohan Lindfors, Hans Törnblom, Lena Öhman, Magnus SimrénMultivariate modelling of faecal bacterial profiles of patients with IBS predicts responsiveness to a diet low in FODMAPsGut.(2018 May)
- ^Jacqueline S BarrettHow to institute the low-FODMAP dietJ Gastroenterol Hepatol.(2017 Mar)
- ^Ruth M Harvie, Alexandra W Chisholm, Jordan E Bisanz, Jeremy P Burton, Peter Herbison, Kim Schultz, Michael SchultzLong-term irritable bowel syndrome symptom control with reintroduction of selected FODMAPsWorld J Gastroenterol.(2017 Jul 7)
- ^Maria G Grammatikopoulou, Dimitrios G Goulis, Konstantinos Gkiouras, Meletios P Nigdelis, Stefanos T Papageorgiou, Theodora Papamitsou, Alastair Forbes, Dimitrios P BogdanosLow FODMAP Diet for Functional Gastrointestinal Symptoms in Quiescent Inflammatory Bowel Disease: A Systematic Review of Randomized Controlled TrialsNutrients.(2020 Nov 27)
- ^Helen Burton Murray, Ryan Flanagan, Bryana Banashefski, Casey J Silvernale, Braden Kuo, Kyle StallerFrequency of Eating Disorder Pathology Among Patients With Chronic Constipation and Contribution of Gastrointestinal-Specific AnxietyClin Gastroenterol Hepatol.(2020 Oct)
- Breath Methane - Derrick K Ong, Shaylyn B Mitchell, Jacqueline S Barrett, Sue J Shepherd, Peter M Irving, Jessica R Biesiekierski, Stuart Smith, Peter R Gibson, Jane G MuirManipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndromeJ Gastroenterol Hepatol.(2010 Aug)
- Alpha-Diversity - Heidi Maria Staudacher, Miranda C E Lomer, Freda M Farquharson, Petra Louis, Francesca Fava, Elena Franciosi, Matthias Scholz, Kieran M Tuohy, James O Lindsay, Peter M Irving, Kevin WhelanA Diet Low in FODMAPs Reduces Symptoms in Patients With Irritable Bowel Syndrome and A Probiotic Restores Bifidobacterium Species: A Randomized Controlled TrialGastroenterology.(2017 Oct)
- Alpha-Diversity - Ruth M Harvie, Alexandra W Chisholm, Jordan E Bisanz, Jeremy P Burton, Peter Herbison, Kim Schultz, Michael SchultzLong-term irritable bowel syndrome symptom control with reintroduction of selected FODMAPsWorld J Gastroenterol.(2017 Jul 7)
- Alpha-Diversity - Yawen Zhang, Lijun Feng, Xin Wang, Mark Fox, Liang Luo, Lijun Du, Binrui Chen, Xiaoli Chen, Huiqin He, Shuwen Zhu, Zhefang Hu, Shujie Chen, Yanqin Long, Yubin Zhu, Li Xu, Yanyong Deng, Benjamin Misselwitz, Brian M Lang, Bahtiyar Yilmaz, John J Kim, Chung Owyang, Ning DaiLow fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet compared with traditional dietary advice for diarrhea-predominant irritable bowel syndrome: a parallel-group, randomized controlled trial with analysis of clinical and microbiological factors associated with patient outcomesAm J Clin Nutr.(2021 Jun 1)
- Quality of Life - Natalia Pedersen, Nynne Nyboe Andersen, Zsuzsanna Végh, Lisbeth Jensen, Dorit Vedel Ankersen, Maria Felding, Mette Hestetun Simonsen, Johan Burisch, Pia MunkholmEhealth: low FODMAP diet vs Lactobacillus rhamnosus GG in irritable bowel syndromeWorld J Gastroenterol.(2014 Nov 21)
- Quality of Life - Mohammad Javad Zahedi, Vahideh Behrouz, Maryam AzimiLow fermentable oligo-di-mono-saccharides and polyols diet versus general dietary advice in patients with diarrhea-predominant irritable bowel syndrome: A randomized controlled trialJ Gastroenterol Hepatol.(2018 Jun)
- Quality of Life - Bridgette Wilson, Megan Rossi, Tokuwa Kanno, Gareth C Parkes, Simon Anderson, A James Mason, Peter M Irving, Miranda C Lomer, Kevin Whelanβ-Galactooligosaccharide in Conjunction With Low FODMAP Diet Improves Irritable Bowel Syndrome Symptoms but Reduces Fecal BifidobacteriaAm J Gastroenterol.(2020 Jun)
- Quality of Life - Shanti Eswaran, William D Chey, Kenya Jackson, Sivaram Pillai, Samuel W Chey, Theresa Han-MarkeyA Diet Low in Fermentable Oligo-, Di-, and Monosaccharides and Polyols Improves Quality of Life and Reduces Activity Impairment in Patients With Irritable Bowel Syndrome and DiarrheaClin Gastroenterol Hepatol.(2017 Dec)
- Abdominal Pain - Emma P Halmos, Victoria A Power, Susan J Shepherd, Peter R Gibson, Jane G MuirA diet low in FODMAPs reduces symptoms of irritable bowel syndromeGastroenterology.(2014 Jan)
- Abdominal Pain - Shanti L Eswaran, William D Chey, Theresa Han-Markey, Sarah Ball, Kenya JacksonA Randomized Controlled Trial Comparing the Low FODMAP Diet vs. Modified NICE Guidelines in US Adults with IBS-DAm J Gastroenterol.(2016 Dec)
- Combined Anxiety & Depression - Lena Böhn, Stine Störsrud, Therese Liljebo, Lena Collin, Perjohan Lindfors, Hans Törnblom, Magnus SimrénDiet low in FODMAPs reduces symptoms of irritable bowel syndrome as well as traditional dietary advice: a randomized controlled trialGastroenterology.(2015 Nov)
- Diarrhea Symptoms - Dana M Lis, Trent Stellingwerff, Cecilia M Kitic, James W Fell, Kiran D K AhujaLow FODMAP: A Preliminary Strategy to Reduce Gastrointestinal Distress in AthletesMed Sci Sports Exerc.(2018 Jan)
- Fibromyalgia Symptoms - Ana Paula Marum, Cátia Moreira, Fernando Saraiva, Pablo Tomas-Carus, Catarina Sousa-GuerreiroA low fermentable oligo-di-mono saccharides and polyols (FODMAP) diet reduced pain and improved daily life in fibromyalgia patientsScand J Pain.(2016 Oct)
- Fecal Microbial Load - Tim J Sloan, Jonna Jalanka, Giles A D Major, Shanthi Krishnasamy, Sue Pritchard, Salah Abdelrazig, Katri Korpela, Gulzar Singh, Claire Mulvenna, Caroline L Hoad, Luca Marciani, David A Barrett, Miranda C E Lomer, Willem M de Vos, Penny A Gowland, Robin C SpillerA low FODMAP diet is associated with changes in the microbiota and reduction in breath hydrogen but not colonic volume in healthy subjectsPLoS One.(2018 Jul 26)
- Fecal Microbial Load - Emma P Halmos, Claus T Christophersen, Anthony R Bird, Susan J Shepherd, Peter R Gibson, Jane G MuirDiets that differ in their FODMAP content alter the colonic luminal microenvironmentGut.(2015 Jan)
- Irritable Bowel Syndrome Symptoms - Melanie Wiffin, Lee Smith, Jose Antonio, James Johnstone, Liam Beasley, Justin RobertsEffect of a short-term low fermentable oligiosaccharide, disaccharide, monosaccharide and polyol (FODMAP) diet on exercise-related gastrointestinal symptomsJ Int Soc Sports Nutr.(2019 Jan 15)
- Irritable Bowel Syndrome Symptoms - Selina R Cox, James O Lindsay, Sébastien Fromentin, Andrew J Stagg, Neil E McCarthy, Nathalie Galleron, Samar B Ibraim, Hugo Roume, Florence Levenez, Nicolas Pons, Nicolas Maziers, Miranda C Lomer, S Dusko Ehrlich, Peter M Irving, Kevin WhelanEffects of Low FODMAP Diet on Symptoms, Fecal Microbiome, and Markers of Inflammation in Patients With Quiescent Inflammatory Bowel Disease in a Randomized TrialGastroenterology.(2020 Jan)
- Quality of Life - Giorgia Bodini, Claudia Zanella, Mattia Crespi, Sara Lo Pumo, Maria Giulia Demarzo, Edoardo Savarino, Vincenzo Savarino, Edoardo G GianniniA randomized, 6-wk trial of a low FODMAP diet in patients with inflammatory bowel diseaseNutrition.(Nov-Dec 2019)
- Intestinal Fatty Acid Binding Protein - Stephanie K Gaskell, Bonnie Taylor, Jane Muir, Ricardo J S CostaImpact of 24-h high and low fermentable oligo-, di-, monosaccharide, and polyol diets on markers of exercise-induced gastrointestinal syndrome in response to exertional heat stressAppl Physiol Nutr Metab.(2020 Jun)
- Quality of Life - Leda Roncoroni, Karla A Bascuñán, Luisa Doneda, Alice Scricciolo, Vincenza Lombardo, Federica Branchi, Francesca Ferretti, Bernardo Dell'Osso, Valeria Montanari, Maria Teresa Bardella, Luca ElliA Low FODMAP Gluten-Free Diet Improves Functional Gastrointestinal Disorders and Overall Mental Health of Celiac Disease Patients: A Randomized Controlled TrialNutrients.(2018 Aug 4)