What Is a Low-FODMAP Diet? How to Use It to Help Bloating, Pain, and IBS

Though no one likes to talk about it, roughly 60 to 70 million Americans suffer from digestive problems and while doctors have trouble diagnosing exactly what's causing the issue, there is one way to ease symptoms and relieve pain.

Called a "low-FODMAP diet," this is a way of eliminating foods that may be the likely culprit, to see if symptoms clear up as the result of this diet change. FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols.

Digestive problems can be linked to food intolerances or allergies that may be near-impossible to detect by blood work or an allergy "scratch" test. That's why more medical professionals are suggesting anyone with issues try the low-FODMAP diet as a natural way to alleviate symptoms, before adding back in food groups one by one, to figure out which food group is the worst offender. Following a low-FODMAP diet has been effective in "up to 86 percent of patients with IBS find improvement in overall gastrointestinal symptoms as well as individual symptoms such as abdominal pain, bloating, constipation, diarrhea, abdominal distention, and flatulence following the diet," according to a study.

The low-FODMAP diet has been used by medical professionals in recent years to help patients suffering from gastrointestinal disorders, such as Irritable Bowel Syndrome (IBS), which is a catch-all phrase for anything that causes gastro distress, or Celiac Disease, which is an allergy to gluten, the protein that is found in wheat products.

FODMAPs are naturally occurring sugar molecules in the fruits, vegetables, and legumes that the body has trouble digesting.

In order to not eliminate everything all at once (and have few plant-based foods to choose from), doctors suggest eliminating one FODMAP food group at a time, such as not eating fruit one day and then cutting out dairy the next, until your body tells you what it is that has been causing the bloat and gastric distress. Here is the list of FODMAP foods to eliminate:

Eating a diet high in FODMAP foods, such as sugar, starch, and fiber, can lead to gas, bloat, and stomach pain or diarrhea. This is because the small intestine (which lies below the stomach and above the large intestine) has trouble breaking down these types of foods,  leading the body to try even harder, and increasing the amount of fluid it secretes in an effort to break down the sugar and fiber. The combination of gas in your stomach and excess digestive fluid leads people to experience bloat and pain and results in "poor digestion."

The goal of a low-FODMAP diet is to eliminate foods one by one until you find the trigger food (or foods) causing your pain. Those suffering from nonstop stomach pain relating to food sensitives or allergies should reach out to a doctor since there could be serious causes not related to diet, and doctors recommend not doing a low-FODMAP diet for longer than six weeks. Here is how to do it, according to Monash University, a top university in Australia.

Once you pinpoint the aggravating foods, you should be able to get back to a less restrictive diet, which is important since many of these FODMAP foods are full of healthy nutrients and should not be avoided for long if they don't cause gastro distress.

A low-FODMAP diet means cutting back on fiber-rich foods but that doesn't mean you can't eat any fruits or vegetables. Plant-based foods that classify as low-FODMAP include soy, dairy-free milk alternatives, grains, nuts, seeds, and certain legumes. The goal is to find foods that are easy to digest and don't harm your gut or identify methods that allow you to eat whole food without suffering.

"Eating cooked food seems to be easier to digest," even those foods that cause issues for some people, according to Dr. Angie Sadeghi, a specialist in gastroenterology based in Newport Beach, California, on a recent webinar hosted by Forks Over Knives on the topic of How to Eat to Beat IBS and Heal Your Gut.

As you eliminate healthy whole foods like legumes or cruciferous vegetables, if you find that they are not the cause of your problems, re-introduce them since the healthy fiber, protein, antioxidants, and nutrients are key to eating a healthy plant-based diet. So try incorporating small amounts of these healthy whole foods back into your diet in small amounts of about 1/4 of a cup daily, according to the Monash University plan.

Fiber foods are essential for a healthy gut and should be slowly increased back into your diet, points out Dr. Sadeghi, who adds that eating a low-FODMAP diet can cause more problems than it cures.

"I am not a fan of low-FODMAP for your health, because the foods you eliminate are good for us. You may be hurting your gut, not helping it," says Dr. Sadeghi. She recommends cutting dairy out of your diet before any other food, which has helped many of her patients manage their symptoms.

One caveat: People use a low-FODMAP diet as a restrictive way of eating or a type of disordered eating, which is why doctors don't recommend it for longer than six weeks.  "As a restrictive diet, the low-FODMAP diet carries risks of nutritional inadequacy and of fostering disordered eating, which has received little attention," according to a study on the controversial nature of the diet. As foods are eliminated, the dieter is deprived of vital nutrients found in whole foods. Low-FODMAP dieting is meant to be a short-term approach that doesn't restrict eating but helps find the food(s) to avoid and ease IBS symptoms or pain.

To follow the low-FODMAP plan you should avoid most legumes but you can have small amounts of butter beans, chickpeas, lentils, and lima beans since these are not 1/4 of a cup daily.

It is possible to try a low-FODMAP diet while plant-based. As always, be sure to consult your doctor or health professional before embarking on a new diet.

For more health content, visit The Beet's Health & Nutrition articles. 

Protein: 21 grams in ⅓ cup (1 ounce) Seitan isn’t as popular as other proteins, but it should be! Made from wheat gluten, its texture resembles ground meat. It’s often used in pre-made veggie burgers or meatless nuggets. Seitan has a savory taste, like mushrooms or chicken, so it works well in dishes that call for an umami flavor. With a hearty texture, seitan can be the star of practically any vegan main dish. Add it to stir-fries, sandwiches, burritos, burgers, or stews. Like tofu, seitan will take on the flavor of any marinade or sauce.

Protein: 16 grams in 3 ounces If you like a protein with a bit of bite, add tempeh to your list. Made from fermented soybeans, tempeh has a slightly nutty flavor and is pressed into a block. Most varieties include some sort of grains, such as barley or millet. Not only is tempeh a plant-based source of protein, but the fermentation process also creates good-for-your-gut probiotics. You can cut tempeh right off the block and use it as the base for a sandwich or pan-fry it with some sauce. Or, crumble, heat, and make it the star of your next taco night.

Protein: 13 grams in ½ cup cooked Lentils come in multiple varieties--red, yellow, green, brown, black. Regardless of the type lentils are small but mighty nutritional powerhouses. They pack a good amount of protein as well as iron, folate, and fiber. When cooked, brown lentils retain their texture and can be the base for a grain bowl or make a hearty substitute for ground meat in meatballs, lasagna, tacos or Bolognese. Red lentils are a bit softer and make a nice add-in for a hearty soup, chili, or stew.

Protein: 10 grams in 3 tablespoons Hemp seeds are a tender and nutty seed, derived from the hemp plant. They contain good amounts of omega-3s, iron, folate, magnesium, phosphorus, and manganese. They are also a solid source of both soluble and insoluble fiber, which helps to keep your digestive tract healthy and humming. Because they pack a double whammy of protein and healthy fats, hemp seeds can help satisfy hunger, preventing those embarrassing stomach growls as you slog your way to your lunch break. Add them to your morning smoothie or sprinkle them on top of yogurt, oatmeal, or even a salad.

Protein: 9 grams in 3 ounces (⅕ of a block) Made from coagulated soybeans, tofu is the most popular plant-based protein. Soy is one of the only meatless "complete" proteins, meaning that it contains all of the essential amino acids that the body can’t make but needs for muscle and immune function. With 15% of your daily calcium needs, tofu is also a good replacement for dairy.

Protein: 9 grams of protein in ½ cup This sushi appetizer is a nutrient powerhouse, so eat it anytime. Edamame is really just another name for soybeans in their pods. Let’s list off some stats--a small ½-cup serving of edamame has 9 grams of protein, 15% of your daily vitamin C, 10% of your daily iron and 16% of your daily fiber. Keep a bag of edamame in your freezer to serve as a fun-to-eat side dish or opt for the shelled variety to toss into salads or a grain bowl.

Protein: 8 grams per cup (cooked) Quinoa is an ancient grain and since it's gluten-free a great choice for anyone avoiding gluten. Add it to your burger recipe to create filling texture, or instead of meat in your taco or burrito. Quinoa is among the healthiest foods on the planet, delivering phytonutrients that have anti-inflammatory qualities, so keep it in your pantry for any meal that needs a filling grain. Just remember to soak it and rinse before cooking to get rid of any bitter taste.

Protein: 7 grams in ½ cup (canned) Eating beans on the regular might as well be a prerequisite for a plant-based diet. Not only are canned black beans inexpensive, but they also contribute 10% of your daily iron and 25% of your daily fiber to your diet. For less than $1 a can, beans can be the star of tacos, quesadillas, salads, soups, burgers, or dips.

Protein: 6 grams in ⅔ cup (cooked) Chances are you’ve never cooked amaranth. But you should, since this tiny, gluten- free grain is packed with almost 30% of your daily fiber and 20% of your daily iron. Cook it like a traditional grain to yield a soft, porridge-like texture. Many people add amaranth to other a hot breakfast cereal mixture, like oats and quinoa. It also pops like popcorn. Toss it in a pot with some oil and wait for it to pop up into a nutritious snack.

Protein: 5 grams in ⅔ cup If peas were one of your most hated veggies as a kid, it’s time to give them another chance. These green beans are a great low-calorie protein to keep in your freezer. Sure, they don’t always taste great when steamed or microwaved (who wants to eat mushy, overcooked peas?), but they do blend well into a yummy puree that can be slathered on toast. To amp up the flavor, add some lemon juice or mint to your mix before you blend.

Pinto beans have 78.7 milligrams in one cup so add these to any salad, dip or burrito.

Molasses has 82 milligrams in 2 tablespoons. Use it in baking instead of sugar. Look for Blackstrap molasses, and keep in mind that these have been used in recipes for 100s of years, especially in the South. Molasses is also believed to help relieve stress and anxiety.

Tempeh has 96 milligrams of calcium in 100 grams when cooked. You can make chicken substitute from it.

Tofu has about 104mg in one ounce when prepared pan-fried. Throw it in your stir fry, or order it at your next Chinese meal with veggies. It's the perfect non-meat protein. (Note look for the calcium quotient on the Nutrition Facts on the label.)

Bok choy has 158 milligrams of calcium in one cup. Add it to your soup, stir fry or salad.

Soybeans have 175 milligrams of calcium per cup. Sprinkle them on a salad.

Kale has 177 milligrams in one cup. The heroic green makes a great salad, goes in smoothies and delivers a healthy dose of fiber as well.

Turnip greens have 197 milligrams in one cup. Add them to your favorite soup or smoothie.

Collard greens have 268 milligrams of calcium in one cup. Substitute it for string beans.

Alternate milks like almond, soy or rice milk have 300-500 milligrams of calcium in 8 ounces so use any of these on your cereal or in your morning smoothie.