What are FODMAPS (and why might you care!)
I’m writing this article, even though it’s not strictly about menopause, because understanding FODMAPs has been so helpful to me and because digestive issues do sometimes get worse during perimenopause and going into menopause. There seems to be a group of us for whom the very sound advice ‘eat more plants’ unleashes a whole world of pain.
FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. What that amounts to is a wide collection of carbohydrates that absorb water and ferment as they go through the gut.
The thing about FODMAPS is that if you don’t have a problem with them, these foods are really good for you. They help feed our beneficial gut bacteria and most people’s guts cope perfectly well with all the water and gas.
But for those of us with IBS that gas and water can be agony. That’s likely to be because we have an extra sensitive gut wall or we’re already having some problems with the system that is supposed to push everything through at an even rate.
Fermentable oligosaccharides are found in wheat flour among many other foods. In fact many people who feel that they are gluten intolerant turn out to have a problem with these soluble fibre molecules that ferment inside us. It’s worth not making that assumption because gluten intolerance is easily tested for.
The great news is that if you do have a problem with fermentable oligosaccharides you may well be ok with sourdough bread.
Other possible culprits include fructose (a monosaccharide, also known as fruit sugar) and lactose (milk sugar, a disaccharide) and sugar alcohols such as sorbitol (which you find in large amounts in sugar free sweets and chewing gum, but also in many fruits). There’s also a similar molecule mannitol which is found in many vegetables.
The thing about FODMAPs is that it’s a very wide group and they’re everywhere! You can’t possibly avoid all of them long term and have a healthy diet — and it’s very unlikely that you’ll react to all of them. The trick is to work out which ones you react to.
You do this by avoiding them all for a few weeks and seeing if the symptoms improve. You then spend many weeks selectively reintroducing them to work out which ones cause you problems.
The low FODMAP diet is not a lifestyle diet, it’s an elimination and reintroduction diet — and it’s really better done with the support of a qualified dietician.
Writer and dietician Megan Rossi suggests trying a low-FODMAP light diet, by just removing polyols — sorbitol and mannitol, which are a common source of irritation. Even that’s not easy. It takes out common foods such as apples, pears, cherries, plums, sweet potato, mushrooms, mange-tout, green peppers, coconut, avocado and many more.
I can tell you how hard it is because I did FODMAP diet with the support of Wythenshawe hospital in Manchester a few years ago. I discovered that polyols were causing me problems. Not eating them is challenging, especially for a vegetarian. No more smashed avocado brunches. No more apple juice smoothies. No more sweet potato chips. Other things I can tolerate in small amounts.
It has also been life-changing. My IBS, which I have struggled with since my early 20s, has settled down which has enabled me to improve my health in other ways.
The best source of information about low FODMAPs is Monash University. They have a website and you can download their apps.
However, it’s important enough to repeat — this is not a long term eating plan, it’s an exclusion and re-introduction plan which needs to be done in partnership with a qualified dietician. But if you have IBS symptoms that aren’t really responding to other strategies it’s worth seeking out that person who can help you.
Originally published at https://www.linkedin.com.
