Low-FODMAP Diet

Last Updated: September 28 2022

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).

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What are FODMAPs?

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.

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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.

Which are low-FODMAP foods and which are high?

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

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Dietary FODMAP content can be confusing, so click here to read more about the most common sources and their low-FODMAP replacement options.

What is a low-FODMAP diet?

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.

Who is a good candidate for a low-FODMAP diet?

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.

Are there any risks associated with a low-FODMAP diet?

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.

What else is Low-FODMAP Diet known as?
Note that Low-FODMAP Diet is also known as:
  • Low-FODMAP
Examine Database: Low-FODMAP Diet
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References
1.^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)
2.^Emma Altobelli, Valerio Del Negro, Paolo Matteo Angeletti, Giovanni LatellaLow-FODMAP Diet Improves Irritable Bowel Syndrome Symptoms: A Meta-AnalysisNutrients.(2017 Aug 26)
3.^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)
5.^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)
6.^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)
7.^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)
8.^Jacqueline S BarrettHow to institute the low-FODMAP dietJ Gastroenterol Hepatol.(2017 Mar)
9.^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)
10.^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)
11.^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)
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13.^Mari C W Myhrstad, Hege Tunsjø, Colin Charnock, Vibeke H Telle-HansenDietary Fiber, Gut Microbiota, and Metabolic Regulation-Current Status in Human Randomized TrialsNutrients.(2020 Mar 23)
14.^Jane Varney, Jacqueline Barrett, Kate Scarlata, Patsy Catsos, Peter R Gibson, Jane G MuirFODMAPs: food composition, defining cutoff values and international applicationJ Gastroenterol Hepatol.(2017 Mar)
15.^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)
17.^Karla A Bascuñán, Luca Elli, Nicoletta Pellegrini, Alice Scricciolo, Vincenza Lombardo, Luisa Doneda, Maurizio Vecchi, Cecilia Scarpa, Magdalena Araya, Leda RoncoroniImpact of FODMAP Content Restrictions on the Quality of Diet for Patients with Celiac Disease on a Gluten-Free DietNutrients.(2019 Sep 14)
18.^Marina Iacovou, Simon S Craig, Greg W Yelland, Jacqueline S Barrett, Peter R Gibson, Jane G MuirRandomised clinical trial: reducing the intake of dietary FODMAPs of breastfeeding mothers is associated with a greater improvement of the symptoms of infantile colic than for a typical dietAliment Pharmacol Ther.(2018 Nov)
20.^Péter Varjú, Nelli Farkas, Péter Hegyi, András Garami, Imre Szabó, Anita Illés, Margit Solymár, Áron Vincze, Márta Balaskó, Gabriella Pár, Judit Bajor, Ákos Szűcs, Orsolya Huszár, Dániel Pécsi, József CzimmerLow fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet improves symptoms in adults suffering from irritable bowel syndrome (IBS) compared to standard IBS diet: A meta-analysis of clinical studiesPLoS One.(2017 Aug 14)
21.^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)
23.^Steven O Stapel, R Asero, B K Ballmer-Weber, E F Knol, S Strobel, S Vieths, J Kleine-Tebbe, EAACI Task ForceTesting for IgG4 against foods is not recommended as a diagnostic tool: EAACI Task Force ReportAllergy.(2008 Jul)
24.^S Allan BockAAAAI support of the EAACI Position Paper on IgG4J Allergy Clin Immunol.(2010 Jun)
25.^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)
26.^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)
27.^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)
28.^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)
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30.^D Schumann, J Langhorst, G Dobos, H CramerRandomised clinical trial: yoga vs a low-FODMAP diet in patients with irritable bowel syndromeAliment Pharmacol Ther.(2018 Jan)