So, your doctor handed you a sheet of paper about the low FODMAP diet. Or you’ve spent hours reading about it online, only to feel overwhelmed and confused.
Don’t feel bad. I’m a dietitian and I felt the same way when I started on the diet! Over the last 4 years, after doing lots of research and pursuing additional education with FODMAP-trained dietitians, I've learned a few things that I wish I'd known when I started out. I've done my best to distill some of the most important "getting started" tips into this blog post, and I sincerely hope they'll save you some hassle.
The hard part about this diet is that it is not exactly intuitive and it restricts foods that are considered healthy. I ate a healthy vegetarian diet for over 20 years, but I often felt miserable with IBS symptoms. It seemed there was no rhyme or reason to my flare ups, and I often couldn't attribute my symptoms to specific foods. But when I tried the low FODMAP diet, it really changed my life and was so worth the effort I put into it! If you are sick of feeling sick and ready to make some big changes, read on for my top 10 tips for starting low FODMAP.
Consider working with a FODMAP knowledgeable registered dietitian. Not every dietitian is knowledgeable about FODMAPs because most of us did not learn about this diet in school so we have had to seek out additional training in it.
*Side note, many insurances do not cover for IBS, but it’s worth checking with yours to find out. If they do cover it, they may have a list of approved dietitians for you to look into.
Here are some lists of FODMAP trained dietitians as a starting place:
You can also ask your GI doctor for a referral, as they may have a dietitian they work with. If you can't find a dietitian locally, note that many offer remote counseling now (including me). The benefit of working with a dietitian is that they have already narrowed down the reliable information about the diet and can save you hours of time trying to figure that out yourself.
They will also help you modify your usual diet to be low FODMAP and ensure you are getting all of your nutritional needs met. It's especially important that you eat a varied, balanced diet because the strictest phase of the diet is rather limited.
How do you find reliable information and recipes on this diet you ask? If you have a smart phone, I highly recommend you invest in the Monash University low FODMAP app. Yes, I know we think all apps should be free or cheap, and though this app is about $7.99, you will use it time and again. That's easily the cost of 2 lattes! Think of it as an investment in your health. I’m still using mine years after purchasing it.
Also, proceeds from the app go back into research into this diet, which is much needed. Monash University has the widest database of tested foods out there, and they are adding new data and new foods all the time.
FODMAP Friendly also makes an app that is less expensive, though their database of foods is less comprehensive than Monash. You should also be aware that, likely due to testing differences and differences in food production around the world, there are some discrepancies between these two apps regarding FODMAP content of certain foods.
Plan out your meals and snacks and make a grocery list for the week so you set yourself up for success. You are more likely to make a poor food choice if you don't have anything on hand to eat. Look for recipes that make sense for your lifestyle.
If you are someone who doesn't like to cook or doesn't have a lot of time to cook, then don't pick complicated recipes that take a lot of time to make. In that case, stick with simple recipes with minimal prep involved. I encourage you to try new foods, and focus on what you can eat vs what you cannot eat!
Find and make note of the best sources of Low FODMAP information on the web. Some of my favorites websites for up-to-date information and recipes are:
Alana Scott’s Website, A Little Bit Yummy, which is filled with recipes and helpful articles, all reviewed by registered dietitians (including me :)
Alana has also recently launched a (very affordable) dinner meal planning service, which can be modified for various allergens, like gluten, dairy and nuts. It also includes shopping lists and great tips.
These are some FODMAP dietitian's blogs that are great for recipes and useful tips on the diet:
In the US:
In addition to their awesome blogs, these dietitians provide remote counseling:
Be ready to spend extra time in the store carefully checking labels. Try to avoid buying many pre-packaged items and focus on fresh produce, whole grains, and proteins.
Label reading can feel overwhelming at first, but it is a skill worth practicing, and it does get easier and faster the more you do it. Click here for a great label reading guide.
If you must have pre-made foods, (I understand, we all get tired and don’t feel like cooking every darn thing from scratch for every meal), look at FODY foods in the US for low FODMAP bars, BBQ sauce, salsa, and pasta sauces.
* Full disclosure: FODY purchased my former company Nicer Foods, but I do not work for them and do not receive any financial incentive from them for referring customers.
A few low FODMAP food companies that have recently launched:
True Self Foods has yummy snack bars.
Casa de Sante has a variety of products including spices, granola, and Ayurvedic digestive drinks.
FODMAPPED For You now sells soups and simmer sauces in the United States via Amazon. This is Sue Shepherd's company, an RD who was part of the research team that developed the Low FODMAP diet!
All of these products are certified low FODMAP, so you can trust that they are safe to eat during the elimination phase of the diet.
If you are on Facebook, consider joining a low FODMAP support group. I am part of several groups that share and exchange support, ideas, tips, and recipes and it has been so helpful to me personally. There's nothing like getting support from people who know exactly what you are going through.
Did you know that this diet isn't meant to be followed for life? Experts say to stay on it for 2-6 weeks, or until you achieve good symptomatic control. Many people are tempted to stay on it forever because they often feel better on it than they have in years! But this is not recommended due to the unknown and possibly harmful effects on beneficial gut bacteria long term.
Take it one day, one meal at a time. Try not to stress about it. Stress often makes our IBS symptoms worse. If you screw up and eat something high in FODMAPs, that is ok. You don’t have to start the diet all over again from day one. Just start over with your next meal and try to stick with it as closely as possible to give the diet a fair chance to work. Be patient and compassionate with yourself.
After the 2-6 week time period, as long as your symptoms are under good control, you can start the re-introduction phase, where you will systematically re-introduce each group of FODMAPs to see which ones you tolerate and in what quantities. It's rare that someone doesn't tolerate all groups of FODMAPs. It's more likely that you'll be able to add back in some high FODMAPs foods in limited quantities. There is no one perfect way to re-introduce and different healthcare providers may recommend different ways.
The re-introduction phase is an important time to work with a dietitian if at all possible, as she/he can help guide you through the process, which can be a bit tricky and confusing.
If you need to do re-introduction on your own, the best resource I've seen on this topic is the book "Re-challenging and Reintroducing FODMAPS: A self-help guide to the entire reintroduction phase of the low FODMAP diet" by Registered Dietitian Lee Martin.
And lastly, before starting the low FODMAP diet, please be sure to consult your doctor to verify a definite diagnosis of IBS before undergoing this diet, as IBS can mimic more serious illnesses.
All the best to you on your low FODMAP journey!